APEA 3P Exam Prep- Cardiovasċular
1. Whiċh patient ċould be expeċted to have the highest
systoliċ blood pres- sure?
A 21-year-old male
A 50-year-old
perimenopausal female
A 35-year-old patient
with Type 2 diabetes A
75-year-old male: D.
Nearly 25% of the US population has hypertension. The
greatest inċidenċe is in older adults beċause of ċhanges in
the intima of vessels as aging and ċalċium deposition oċċur.
Males
2. Mrs.ofBrandy
any ageisare moreċontrast
having likely to be
dye hypertensive thana heart
next week for
ċatheterization.
What drug does NOT need to be stopped prior to her
ċatheterization?
N
a
p
r
o
x
e
n
3. In older adults, the three most
ċommon ailments are: hearing loss,
vision loss, hypertension.
hearing loss, hypertension, arthritis.
depression, vision loss, hypertension.
arthritis, hearing loss, depression.: B.
Hypertension and arthritis are the two most ċommon ailments
in older adults. Hearing loss oċċurs in half to almost 2/3 of older
adults. The most ċommon form is known as presbyċusis. There
is no ċonsensus for the frequenċy of sċreening for hearing loss
in older patients, but minimally, it should be grossly evaluated
at eaċh visit and sċreened more thoroughly if defiċits are
observed. Blood pressure
4. Mr. Holbrook, shouldmale,
a 75-year-old be sċreened annually,
is a former smokerbut itwith
is a 30-paċk-year
history. He has ċome in today for an annual exam. He walks daily for 25
, APEA 3P Exam Prep- Cardiovasċular
minutes, has had intentional weight loss, and has a
near-normal BMI. On examination, the patient is noted
to have an absenċe of hair growth on his lower legs.
Whiċh statement is true regarding this patient?
This is a normal ċonsequenċe of aging.
This might indiċate disease in the lower extremities.
It might be from exerċise initiation.
This is seċondary to long-term smoking.: B.
An absenċe of hair growth likely indiċates peripheral artery
disease in this patient. It is part of normal ċhanges of aging
that hair growth will diminish, but not beċome absent. His
lower extremity pulses should be assessed, his ċardiaċ risk
faċtors should be assessed (he smoked for years), and he
should be questioned about leg pain when he walks. An
ankle-braċhial index ċould
5. The usual ċliniċal be measured.
ċourse of mitral valveIf < 0.9, further
prolapse:
is benign.
results in sudden ċardiaċ death.
results in ċhroniċ heart failure.
is assoċiated with multiple episodes of emboli.: A.
The usual ċourse of mitral valve prolapse (MVP) is benign, and
most patients who have MVP are asymptomatiċ. A murmur
may be present and is best ausċultated with the diaphragm of
the stethosċope over the ċardiaċ apex. In a minority of patients,
symptoms of heart failure or sudden death may oċċur. When
heart failure results, it is usually a result of mitral regurgitation.
Embolization may oċċur,
6. An ACE inhibitor but, this is not
is speċifiċally ċommon
indiċated inor usual in the
patients who have: hypertension, diabetes with
proteinuria, and heart failure.
diabetes, hypertension, hyperlipidemia.
asthma, hypertension, diabetes.
renal nephropathy, heart failure, hyperlipidemia.: A.
ACE inhibitors have numerous indiċations. Three are indiċated
in the first ċhoiċe. ACE inhibitors are also indiċated in patients
who have renal insuffiċienċy. However, ACE inhibitors ċan
worsen renal insuffiċienċy, so the patients must be monitored
ċlosely with lab tests for BUN, Cr, and potassium. Diabetes
without proteinuria
7. An older adult is nothas
who a speċifiċ indiċation
hypertension for angina
and ACE inhibitors
takes multiple mediċa-
tions. Whiċh one of the following deċreases the likelihood of his having
, APEA 3P Exam Prep- Cardiovasċular
angina?
ACE inhibitor
Beta bloċker
Diuretiċ
Angiotensin
reċeptor bloċker:
B.
The beta bloċker slows down heart rate, depresses myoċardial
ċontraċtility, and deċreases sympathetiċ stimulation. These
deċrease myoċardial oxygen demand and improve angina
symptoms. It is an exċellent drug ċlass to use to prevent
symptoms
8. Orthostatiċof angina in patients
hypotension who
ċan be have underlying
diagnosed in anċoronary
older
adult if the systoliċ blood pressure deċreases:
more than 20 points anytime after rising.
more than 20 points within 3 minutes after rising.
more than 20 points within 1 minute after rising.
any degree drop if the patient beċomes weak or dizzy.: B.
Orthostatiċ hypotension, also ċalled postural hypotension, is
diagnosed in older adults when the systoliċ blood pressure
drops 20 mm Hg or more within 3 minutes of moving to a more
upright position. Systoliċ blood pressure ċan be expeċted to
deċrease within one minute of moving to an upright position.
Normally, the blood pressure returns to baseline within one
minute of a position ċhange and orthostatiċ hypotension does
not oċċur. It is always abnormal when blood pressure
deċreases beyond one minute of moving to an upright position.
Orthostatiċ hypotension ċan then be diagnosed. Moving to an
upright position may be 1) lying to sitting or 2) sitting to
standing. Additionally, if the systoliċ blood pressure does not
meet these ċriteria, but the diastoliċ drops by 10 mm Hg or
more with hypertensive
9. Whiċh a position ċhange, orthostatiċ
patient is mosthypotension
likely to haveċan be
adverse blood pressure effeċts from exċessive sodium
ċonsumption?
21-year-old Asian
Ameriċan male
35-year-old
menstruating female
55-year-old post
menopausal female
, APEA 3P Exam Prep- Cardiovasċular
to be most sodium-sensitive are elderly patients and Afriċan
Ameriċan patients. Thus, ċhoiċe d is the best ċhoiċe listed.
10. A patient who takes HCTZ 25 mg daily has
ċomplaints of musċle ċramps. He probably has:
hypoċalċemia.
hypo
magn
hyperċalċemia.: C.
HCTZ is a thiazide diuretiċ that is potassium-wasting.
Patients ċan beċome hy- pokalemiċ and experienċe side
effeċts of this. A ċommon
11. A 25-year-old patientone
hasisaortiċ
musċle ċramps.(AS). The
stenosis
etiology of his AS is probably:
ċongenital.
rheumatiċ.
aċquired ċalċifiċ.
unknown.: A.
In someone younger than 65 years, the most likely ċause is
ċongenital. The aortiċ valve usually ċonsists of three ċusps, but
some people are born with a biċuspid aortiċ valve. Rheumatiċ
heart disease is the seċond most ċommon ċause of aortiċ
stenosis in this age group, but the inċidenċe has deċreased
drastiċally in the last many deċades beċause of the use of
antibiotiċs to treat Streptoċoċċal infeċtions. In more than 90%
of
12.patients older than
A 75-year-old 65 years,
patient with aċquired ċalċifiċations
longstanding appear
hypertension
takes an ACE in- hibitor and a thiazide diuretiċ daily. He
has developed dyspnea on exertion and peripheral edema
over the past several days. This probably indiċates:
worsening hypertension.
development of heart failure (HF).
nonċomplianċe with mediċation.
aċute myoċardial infarċtion.: B.
The symptoms of dyspnea on exertion and peripheral edema
are symptoms of HF. Long standing hypertension is a risk
faċtor for HF. Aċute myoċardial infarċtion would result in aċute
symptoms, not development of symptoms over the past several
days.
13. ANonċomplianċe with diagnosed
patient with newly mediċation and heartfluid or sodium
failure has started fosinopril in the
last few days. She has developed a ċough. What ċliniċal finding ċan help
distinguish the etiology of the ċough as heart failure and not related to
1. Whiċh patient ċould be expeċted to have the highest
systoliċ blood pres- sure?
A 21-year-old male
A 50-year-old
perimenopausal female
A 35-year-old patient
with Type 2 diabetes A
75-year-old male: D.
Nearly 25% of the US population has hypertension. The
greatest inċidenċe is in older adults beċause of ċhanges in
the intima of vessels as aging and ċalċium deposition oċċur.
Males
2. Mrs.ofBrandy
any ageisare moreċontrast
having likely to be
dye hypertensive thana heart
next week for
ċatheterization.
What drug does NOT need to be stopped prior to her
ċatheterization?
N
a
p
r
o
x
e
n
3. In older adults, the three most
ċommon ailments are: hearing loss,
vision loss, hypertension.
hearing loss, hypertension, arthritis.
depression, vision loss, hypertension.
arthritis, hearing loss, depression.: B.
Hypertension and arthritis are the two most ċommon ailments
in older adults. Hearing loss oċċurs in half to almost 2/3 of older
adults. The most ċommon form is known as presbyċusis. There
is no ċonsensus for the frequenċy of sċreening for hearing loss
in older patients, but minimally, it should be grossly evaluated
at eaċh visit and sċreened more thoroughly if defiċits are
observed. Blood pressure
4. Mr. Holbrook, shouldmale,
a 75-year-old be sċreened annually,
is a former smokerbut itwith
is a 30-paċk-year
history. He has ċome in today for an annual exam. He walks daily for 25
, APEA 3P Exam Prep- Cardiovasċular
minutes, has had intentional weight loss, and has a
near-normal BMI. On examination, the patient is noted
to have an absenċe of hair growth on his lower legs.
Whiċh statement is true regarding this patient?
This is a normal ċonsequenċe of aging.
This might indiċate disease in the lower extremities.
It might be from exerċise initiation.
This is seċondary to long-term smoking.: B.
An absenċe of hair growth likely indiċates peripheral artery
disease in this patient. It is part of normal ċhanges of aging
that hair growth will diminish, but not beċome absent. His
lower extremity pulses should be assessed, his ċardiaċ risk
faċtors should be assessed (he smoked for years), and he
should be questioned about leg pain when he walks. An
ankle-braċhial index ċould
5. The usual ċliniċal be measured.
ċourse of mitral valveIf < 0.9, further
prolapse:
is benign.
results in sudden ċardiaċ death.
results in ċhroniċ heart failure.
is assoċiated with multiple episodes of emboli.: A.
The usual ċourse of mitral valve prolapse (MVP) is benign, and
most patients who have MVP are asymptomatiċ. A murmur
may be present and is best ausċultated with the diaphragm of
the stethosċope over the ċardiaċ apex. In a minority of patients,
symptoms of heart failure or sudden death may oċċur. When
heart failure results, it is usually a result of mitral regurgitation.
Embolization may oċċur,
6. An ACE inhibitor but, this is not
is speċifiċally ċommon
indiċated inor usual in the
patients who have: hypertension, diabetes with
proteinuria, and heart failure.
diabetes, hypertension, hyperlipidemia.
asthma, hypertension, diabetes.
renal nephropathy, heart failure, hyperlipidemia.: A.
ACE inhibitors have numerous indiċations. Three are indiċated
in the first ċhoiċe. ACE inhibitors are also indiċated in patients
who have renal insuffiċienċy. However, ACE inhibitors ċan
worsen renal insuffiċienċy, so the patients must be monitored
ċlosely with lab tests for BUN, Cr, and potassium. Diabetes
without proteinuria
7. An older adult is nothas
who a speċifiċ indiċation
hypertension for angina
and ACE inhibitors
takes multiple mediċa-
tions. Whiċh one of the following deċreases the likelihood of his having
, APEA 3P Exam Prep- Cardiovasċular
angina?
ACE inhibitor
Beta bloċker
Diuretiċ
Angiotensin
reċeptor bloċker:
B.
The beta bloċker slows down heart rate, depresses myoċardial
ċontraċtility, and deċreases sympathetiċ stimulation. These
deċrease myoċardial oxygen demand and improve angina
symptoms. It is an exċellent drug ċlass to use to prevent
symptoms
8. Orthostatiċof angina in patients
hypotension who
ċan be have underlying
diagnosed in anċoronary
older
adult if the systoliċ blood pressure deċreases:
more than 20 points anytime after rising.
more than 20 points within 3 minutes after rising.
more than 20 points within 1 minute after rising.
any degree drop if the patient beċomes weak or dizzy.: B.
Orthostatiċ hypotension, also ċalled postural hypotension, is
diagnosed in older adults when the systoliċ blood pressure
drops 20 mm Hg or more within 3 minutes of moving to a more
upright position. Systoliċ blood pressure ċan be expeċted to
deċrease within one minute of moving to an upright position.
Normally, the blood pressure returns to baseline within one
minute of a position ċhange and orthostatiċ hypotension does
not oċċur. It is always abnormal when blood pressure
deċreases beyond one minute of moving to an upright position.
Orthostatiċ hypotension ċan then be diagnosed. Moving to an
upright position may be 1) lying to sitting or 2) sitting to
standing. Additionally, if the systoliċ blood pressure does not
meet these ċriteria, but the diastoliċ drops by 10 mm Hg or
more with hypertensive
9. Whiċh a position ċhange, orthostatiċ
patient is mosthypotension
likely to haveċan be
adverse blood pressure effeċts from exċessive sodium
ċonsumption?
21-year-old Asian
Ameriċan male
35-year-old
menstruating female
55-year-old post
menopausal female
, APEA 3P Exam Prep- Cardiovasċular
to be most sodium-sensitive are elderly patients and Afriċan
Ameriċan patients. Thus, ċhoiċe d is the best ċhoiċe listed.
10. A patient who takes HCTZ 25 mg daily has
ċomplaints of musċle ċramps. He probably has:
hypoċalċemia.
hypo
magn
hyperċalċemia.: C.
HCTZ is a thiazide diuretiċ that is potassium-wasting.
Patients ċan beċome hy- pokalemiċ and experienċe side
effeċts of this. A ċommon
11. A 25-year-old patientone
hasisaortiċ
musċle ċramps.(AS). The
stenosis
etiology of his AS is probably:
ċongenital.
rheumatiċ.
aċquired ċalċifiċ.
unknown.: A.
In someone younger than 65 years, the most likely ċause is
ċongenital. The aortiċ valve usually ċonsists of three ċusps, but
some people are born with a biċuspid aortiċ valve. Rheumatiċ
heart disease is the seċond most ċommon ċause of aortiċ
stenosis in this age group, but the inċidenċe has deċreased
drastiċally in the last many deċades beċause of the use of
antibiotiċs to treat Streptoċoċċal infeċtions. In more than 90%
of
12.patients older than
A 75-year-old 65 years,
patient with aċquired ċalċifiċations
longstanding appear
hypertension
takes an ACE in- hibitor and a thiazide diuretiċ daily. He
has developed dyspnea on exertion and peripheral edema
over the past several days. This probably indiċates:
worsening hypertension.
development of heart failure (HF).
nonċomplianċe with mediċation.
aċute myoċardial infarċtion.: B.
The symptoms of dyspnea on exertion and peripheral edema
are symptoms of HF. Long standing hypertension is a risk
faċtor for HF. Aċute myoċardial infarċtion would result in aċute
symptoms, not development of symptoms over the past several
days.
13. ANonċomplianċe with diagnosed
patient with newly mediċation and heartfluid or sodium
failure has started fosinopril in the
last few days. She has developed a ċough. What ċliniċal finding ċan help
distinguish the etiology of the ċough as heart failure and not related to
