NCA 623 Comprehensive Exam
Study Guide
What are the effects of hypertension on the eyes? - Answer Hypertensive retinopathy
AV nicking
Flame hemorrhages
Retinal edema
Cotton wool spots
Hard exudates
AHA normal BP - Answer < 120 and < 80
AHA elevated BP - Answer 120-129 and < 80
AHA stage 1 HTN - Answer 130-139 OR 80-89
AHA stage 2 HTN - Answer >/= 140 OR >/=90
What are the effects of hypertension on the kidneys? - Answer Hypertensive
nephropathy
Nephrosclerosis, thickening of the vessel walls
Hyaline arteriosclerosis 2/2 protein deposition
Glomerulosclerosis from fibroblast activation by mesangial cells in response to low O2
What are the effects of hypertension on the cardiovascular system? - Answer
Atherosclerosis
Heart failure
MI
Aortic dissection
LVH
S3 gallop
What are the effects of hypertension on the nervous system? - Answer Vascular
dementia
,Stroke
Hypertensive encephalopathy
What are the clinical findings of endocarditis? - Answer Fever
Murmur
↑ ESR and WBC
Endo stigmata:
- Osler's nodes, painful palpable lesions of the fingers and toes,
- Janeway lesions, non-palp non-tender lesions of the hands and feet,
- Splinter hemorrhages of the nails
- Roth spots: exudative lesions of the retina
Primary symptoms of endocarditis - Answer Fever, night sweats, malaise, weight loss
What Duke Criteria must be met to diagnose endocarditis? - Answer 2 majors OR 1
major and 3 minor
Major: positive blood culture, evidence of endocardial involvement
Minor: predisposing factors, temp > 38, vascular phenomena, immunologic phenomena,
microbiological evidence
What antibiotics are ordered empirically for endocarditis? - Answer Vanc and
ceftriaxone for staph, strep, and enterococci
What antibiotics are ordered as prophylaxis prior to dental work in patients with a risk of
endocarditis? - Answer Clindamycin, azithromycin, or cephalexin
What are the causes of pericarditis? - Answer ***Viral
Autoimmune
Cancer
Trauma
What is the typical presentation of pericarditis? - Answer Pleuritic chest pain made
worse with deep inspiration and relieved by sitting forward
What are the clinical findings of pericarditis? - Answer Friction rub
↑ ESR and CRP
Tachycardia
, What ECG changes are seen in pericarditis? - Answer Diffuse scooping ST elevation
PR depression in the limb leads
What labs are commonly elevated in pericarditis? - Answer CRP and ESR
What is the treatment of pericarditis? - Answer - High dose aspirin or NSAIDS for pain
- Indomethacin, colchicine, or steroids
- Monitor for tamponade
How is post-MI, or Dressler syndrome treated? - Answer Aspirin and colchicine instead
of NSAIDS
Corticosteroids for severe or refractory cases
What drug class reduces mortality rate after a STEMI? - Answer ACE inhibitors
What are the first three interventions for a-fib with RVR? - Answer - Rate control with BB
or CCB
- Rhythm control w amio
- Anticoagulation
What is the most common cause of myocarditis? - Answer URI, COVID
What is the presentation of myocarditis? - Answer Sudden onset HF following an URI
Chest pain
Dyspnea
Tachycardia/Arrythmias
Gallop
Cardiogenic shock
What is required for a definitive diagnosis of myocarditis? - Answer Histological
evidence from biopsy
What is the treatment for myocarditis? - Answer NSAIDS for pain
ACE or ARB for those with EF <40%
What are the inferior leads and what coronary arteries do they reflect? - Answer II, III,
aVF - RCA and rarely the LCx
What are the inferolateral leads and what coronary arteries do they reflect? - Answer II,
III, aVF, V5, V6 - LCx
Study Guide
What are the effects of hypertension on the eyes? - Answer Hypertensive retinopathy
AV nicking
Flame hemorrhages
Retinal edema
Cotton wool spots
Hard exudates
AHA normal BP - Answer < 120 and < 80
AHA elevated BP - Answer 120-129 and < 80
AHA stage 1 HTN - Answer 130-139 OR 80-89
AHA stage 2 HTN - Answer >/= 140 OR >/=90
What are the effects of hypertension on the kidneys? - Answer Hypertensive
nephropathy
Nephrosclerosis, thickening of the vessel walls
Hyaline arteriosclerosis 2/2 protein deposition
Glomerulosclerosis from fibroblast activation by mesangial cells in response to low O2
What are the effects of hypertension on the cardiovascular system? - Answer
Atherosclerosis
Heart failure
MI
Aortic dissection
LVH
S3 gallop
What are the effects of hypertension on the nervous system? - Answer Vascular
dementia
,Stroke
Hypertensive encephalopathy
What are the clinical findings of endocarditis? - Answer Fever
Murmur
↑ ESR and WBC
Endo stigmata:
- Osler's nodes, painful palpable lesions of the fingers and toes,
- Janeway lesions, non-palp non-tender lesions of the hands and feet,
- Splinter hemorrhages of the nails
- Roth spots: exudative lesions of the retina
Primary symptoms of endocarditis - Answer Fever, night sweats, malaise, weight loss
What Duke Criteria must be met to diagnose endocarditis? - Answer 2 majors OR 1
major and 3 minor
Major: positive blood culture, evidence of endocardial involvement
Minor: predisposing factors, temp > 38, vascular phenomena, immunologic phenomena,
microbiological evidence
What antibiotics are ordered empirically for endocarditis? - Answer Vanc and
ceftriaxone for staph, strep, and enterococci
What antibiotics are ordered as prophylaxis prior to dental work in patients with a risk of
endocarditis? - Answer Clindamycin, azithromycin, or cephalexin
What are the causes of pericarditis? - Answer ***Viral
Autoimmune
Cancer
Trauma
What is the typical presentation of pericarditis? - Answer Pleuritic chest pain made
worse with deep inspiration and relieved by sitting forward
What are the clinical findings of pericarditis? - Answer Friction rub
↑ ESR and CRP
Tachycardia
, What ECG changes are seen in pericarditis? - Answer Diffuse scooping ST elevation
PR depression in the limb leads
What labs are commonly elevated in pericarditis? - Answer CRP and ESR
What is the treatment of pericarditis? - Answer - High dose aspirin or NSAIDS for pain
- Indomethacin, colchicine, or steroids
- Monitor for tamponade
How is post-MI, or Dressler syndrome treated? - Answer Aspirin and colchicine instead
of NSAIDS
Corticosteroids for severe or refractory cases
What drug class reduces mortality rate after a STEMI? - Answer ACE inhibitors
What are the first three interventions for a-fib with RVR? - Answer - Rate control with BB
or CCB
- Rhythm control w amio
- Anticoagulation
What is the most common cause of myocarditis? - Answer URI, COVID
What is the presentation of myocarditis? - Answer Sudden onset HF following an URI
Chest pain
Dyspnea
Tachycardia/Arrythmias
Gallop
Cardiogenic shock
What is required for a definitive diagnosis of myocarditis? - Answer Histological
evidence from biopsy
What is the treatment for myocarditis? - Answer NSAIDS for pain
ACE or ARB for those with EF <40%
What are the inferior leads and what coronary arteries do they reflect? - Answer II, III,
aVF - RCA and rarely the LCx
What are the inferolateral leads and what coronary arteries do they reflect? - Answer II,
III, aVF, V5, V6 - LCx
