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NR667 CEA Module Questions and Answers 100%
Correct UPDATED!!!
Cardiovascular anatomy and flow complications
Ø Location
- Central anterior chest
- RV is anteriorly located
- LV is posteriorly located
Ø Flow of blood in the body
- Lungs > pulmonary veins > left atrium > left ventricle > aorta >
body tissues > vena cava > right atrium > right ventricle >
pulmonary arteries > lungs.
Ø Blood flow complications
- Contractility: EF, CAD, LVH, Cardiomyopathy
- Preload: Central fluid volume status
- Afterload: Arterial backpressure on outflow (Chronic
hypertension). (**RAAS system typically manages this).
Hypertension
Ø JNC8
- Defined as 140/90
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- Secondary HTN: Up flow issue going up to kidney, ex: renal
stenosis.
- Age > 60 or < 60 years. (>60 = 150/90).
- DM and CKD: ACE/ARBs (nephro protective).
- Non-black vs. Black: Calcium channel blocker for African
Ascent.
- General starting place: Thiazides/ACE/ARBs.
- ACE/ARBS: “Prils” and “Sartans”
- Beta Blockers: “olol” not on JNC8 guidelines, history of cardiac
disease, reduce HR. Carvedilol is a dual alpha/beta, great for
Heart failure.
- CCB: Dihydropyrines and Non-Dihydropyrines. Dihydropyrines
work more peripherally (amlodipine, etc). Non-Dihydropyrines
work more on heart (Verapamil and diltiazem). Common ASE:
Constipation and peripheral edema.
- Diuretics: Thiazides, Loops. Thiazides are less potent.
Thiazide= Low electrolytes, Higher calcium. Loops- lowers
everything. Potassium-sparing diuretics (Increase potassium,
lowers sodium).
Heart failure
Ø HFrEF (Less than 40%)
Ø HFpEF (Higher than 40%)
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Ø Systolic heart failure: inability for myocardium to effectively
contract.
Ø Diastolic heart failure: inability to myocardium to effectively
relax.
Ø Typical patient: elderly with comorbidities of HTN, DM,
Smoking.
- Class I: Mild symptoms
- Class II-III: Symptoms with exertion (II), ADL's cause symptoms
(III)
- Class IV: Symptoms severe, likely needs hospitalization.
Ø Classic symptoms: SOB, Fatigue, exertional dyspnea,
dependent and pulmonary edema, low activity tolerance,
abdominal bloating, orthopnea.
Ø Causes: ischemic heart disease, valve disease, MI,
cardiomyopathy.
Ø Treatment: ACE/ARB, ARB/ARNI, BB, Diuretics, nitrates plus
hydralazine, Fluid and salt restriction, daily weights.
Lipid management
Ø AVSCD
- Statins
- Hight-intensity statins: Atorvastatin 40-80mg and Rovusatan
20-40mg (Don't require being taken at bedtime). LDL < 190
- Common ASE: Myalgia. Rhabdomyolysis worse case scenario.
- Statins, Ezetimibe in conjunction. PC9-Inhibitors (injectable Q2
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weeks). (Cardiology at consult prior to PC9-Inhibitors).
- Familial homozygous hyperlipidemia= PC9-Inhibitors.
- HDL: "Cleaning agent."
- LDL- "Scrum between glass window in shower"
Valve disease and aneurysms
Ø Aortic stenosis: Narrowing of outflow to aortic root through
aortic valve due to calcification. Symptoms tend to mirror CAD
with addition of syncope/near syncope.
Ø Aortic Regurgitation/Insufficiency: instability for aortic valve
to appropriately close. Commonly due to aortic root dilation or
endocarditis/infection. A direct contraindication for IABP use
(common board exam question).
Ø Mitral stenosis: Narrowing of inflow into LV through the
mitral valve due to calcification.
Ø Mitral regurgitation/Insufficiency: instability for mitral valve
leaflets to close. Commonly due to mitral root dilation from an
MI, CHF, induced LV dilation, papillary muscle rupture,
endocarditis.
Ø Identifying Murmurs (left sternal border, 2nd intercoastal).
- Aortic stenosis: swishing, systole, tends to radiate to neck.
- Mitral stenosis- low-frequency, diastole, tends to radiate to
lateral chest.
- Mitral regurgitation: systole,
- Aortic regurgitation, Diastole
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NR667 CEA Module Questions and Answers 100%
Correct UPDATED!!!
Cardiovascular anatomy and flow complications
Ø Location
- Central anterior chest
- RV is anteriorly located
- LV is posteriorly located
Ø Flow of blood in the body
- Lungs > pulmonary veins > left atrium > left ventricle > aorta >
body tissues > vena cava > right atrium > right ventricle >
pulmonary arteries > lungs.
Ø Blood flow complications
- Contractility: EF, CAD, LVH, Cardiomyopathy
- Preload: Central fluid volume status
- Afterload: Arterial backpressure on outflow (Chronic
hypertension). (**RAAS system typically manages this).
Hypertension
Ø JNC8
- Defined as 140/90
1|Page
,2|Page
- Secondary HTN: Up flow issue going up to kidney, ex: renal
stenosis.
- Age > 60 or < 60 years. (>60 = 150/90).
- DM and CKD: ACE/ARBs (nephro protective).
- Non-black vs. Black: Calcium channel blocker for African
Ascent.
- General starting place: Thiazides/ACE/ARBs.
- ACE/ARBS: “Prils” and “Sartans”
- Beta Blockers: “olol” not on JNC8 guidelines, history of cardiac
disease, reduce HR. Carvedilol is a dual alpha/beta, great for
Heart failure.
- CCB: Dihydropyrines and Non-Dihydropyrines. Dihydropyrines
work more peripherally (amlodipine, etc). Non-Dihydropyrines
work more on heart (Verapamil and diltiazem). Common ASE:
Constipation and peripheral edema.
- Diuretics: Thiazides, Loops. Thiazides are less potent.
Thiazide= Low electrolytes, Higher calcium. Loops- lowers
everything. Potassium-sparing diuretics (Increase potassium,
lowers sodium).
Heart failure
Ø HFrEF (Less than 40%)
Ø HFpEF (Higher than 40%)
2|Page
,3|Page
Ø Systolic heart failure: inability for myocardium to effectively
contract.
Ø Diastolic heart failure: inability to myocardium to effectively
relax.
Ø Typical patient: elderly with comorbidities of HTN, DM,
Smoking.
- Class I: Mild symptoms
- Class II-III: Symptoms with exertion (II), ADL's cause symptoms
(III)
- Class IV: Symptoms severe, likely needs hospitalization.
Ø Classic symptoms: SOB, Fatigue, exertional dyspnea,
dependent and pulmonary edema, low activity tolerance,
abdominal bloating, orthopnea.
Ø Causes: ischemic heart disease, valve disease, MI,
cardiomyopathy.
Ø Treatment: ACE/ARB, ARB/ARNI, BB, Diuretics, nitrates plus
hydralazine, Fluid and salt restriction, daily weights.
Lipid management
Ø AVSCD
- Statins
- Hight-intensity statins: Atorvastatin 40-80mg and Rovusatan
20-40mg (Don't require being taken at bedtime). LDL < 190
- Common ASE: Myalgia. Rhabdomyolysis worse case scenario.
- Statins, Ezetimibe in conjunction. PC9-Inhibitors (injectable Q2
3|Page
, 4|Page
weeks). (Cardiology at consult prior to PC9-Inhibitors).
- Familial homozygous hyperlipidemia= PC9-Inhibitors.
- HDL: "Cleaning agent."
- LDL- "Scrum between glass window in shower"
Valve disease and aneurysms
Ø Aortic stenosis: Narrowing of outflow to aortic root through
aortic valve due to calcification. Symptoms tend to mirror CAD
with addition of syncope/near syncope.
Ø Aortic Regurgitation/Insufficiency: instability for aortic valve
to appropriately close. Commonly due to aortic root dilation or
endocarditis/infection. A direct contraindication for IABP use
(common board exam question).
Ø Mitral stenosis: Narrowing of inflow into LV through the
mitral valve due to calcification.
Ø Mitral regurgitation/Insufficiency: instability for mitral valve
leaflets to close. Commonly due to mitral root dilation from an
MI, CHF, induced LV dilation, papillary muscle rupture,
endocarditis.
Ø Identifying Murmurs (left sternal border, 2nd intercoastal).
- Aortic stenosis: swishing, systole, tends to radiate to neck.
- Mitral stenosis- low-frequency, diastole, tends to radiate to
lateral chest.
- Mitral regurgitation: systole,
- Aortic regurgitation, Diastole
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