APEA PREDICTOR REMEDIATION STUDY
SET 100% CORRECT!!
,AFIB/ EKG finding - ANSWER Abnormal atrial depolarization w/ normal ventricular
depolarization
CHAOS IN THE ATRIUM
NO P waves
Types of AFIB - ANSWER Controlled- <100 bpm
Uncontrolled- >100 bpm
Management & Meds ( rate control, rhythm control, anticoags) - ANSWER Rate control:
Metoprolol (BBS) or Diltiazem (CCBs)
rhythm control w/ antiarrhythmics ( Amiodarone)
Anticoags- Warfarin - ASSESS CHADS-VASC score
CHADS-VASC score - ANSWER Stroke risk tool used for AFIB
CHF, HTN, >/= 75 yo, DM, prior stroke/ TIA/Thromboembolism
Amiodarone (MOA, LONG TERM USE CAUSES?) - ANSWER prevents conduction of
unwanted cardiac impulses
Test tip: assess chest x-ray & PFTs prior to initiation
Long term use can lead to hypothyroidism, pulmonary toxicity & optic neuropathy
Warfarin - ANSWER normal:1 goal:2-3,
Tx: if <2 increase dose; antidote: Vitamin K
INR 2-9: hold & drop dose
INR >10 (- BLEEDING): Oral Vit K
INR >10 (+ BLEEDING_): IV vit K
Things to avoid with Wafarin - ANSWER Green leafy vegs, mayo, canola oil, beef liver,
Drug to drug interaction (Warfarin) 8 A'S - ANSWER ABX, antifungal, antidepressants,
alternative (St. Johns wort, Gingko), antiplatelet, and anti-inflammatories, amiodarone,
acetaminophen
HTN (goal) - ANSWER <140/90 in pts <60 and past hx of HTN/DM
<150/90 in pts >60 (more flexibity b/c arteries get stiff)
JNC <130/80; If ACVSD risk >10 initiate HTN meds
, TX HTN (1ST) - ANSWER Lifestyle modifications, herbal ( COQ10)
ACE Inhibitors ( slow down how much AT2 your body makes) - ANSWER "PRIL"
Captopril, Enalapril, Afosiopril
Antihypertensive. Blocks ACE ( angiotension converting enzyme) lungs from converting
angiotensin I to angiotensin II (powerful vasoconstrictor). Decreases BP, Decreased
Aldosterone secretions, Sodium and fluid loss. Heart and renal protective for DM
*Orthostatic Hypotension, cough, angioedema, HYPERKALEMIA RISK
ARB (Angiotensin Receptor Blocker) ( blocks the receptors that use AT2 use to narrow
the blood vessels) - ANSWER -Sartan (losartan
antagonizes action of aldosterone
Heart and renal protective for DM
Hyperkalemia risk, dizziness
THIAZIDE - ANSWER HCTZ or chlorthalidone
Blocks the sodium chloride channel in the distal convoluted tubule of the
kidney( decrease sodium reabsorption and therefore decreases fluid reabsorption)
preferred in osteoporosis & AA pts.
Avoid in pts w/ hypercholestermia, gout and DM; causes increases in uric acid, glucose,
triglycerides, and calcium
Calcium channel blockers - ANSWER agents that inhibit the entry of calcium ions into
heart muscle cells, causing a slowing of the heart rate, a lessening of the demand for
oxygen and nutrients, and a relaxing of the smooth muscle cells of the blood vessels to
cause dilation; used to prevent or treat angina pectoris, some arrhythmias, and
hypertension
Preferred in >65 yo & AA pts
SE: ankle edema, headaches
AVOID IN PTS WITH GERD- WEAKENS GASTRIC SPHINCTER
Idiopathic systolic HTN - ANSWER Caused by stiff arteries; overactive thyroid, DM,
seen in pts >60; bp goal: <150 systolic
TX: CCB
Kawaski (CREAM) - ANSWER Acute febrile illness of unknown cause resulting in
vascular inflammation
leading cause of heart disease in < 5 yo
SET 100% CORRECT!!
,AFIB/ EKG finding - ANSWER Abnormal atrial depolarization w/ normal ventricular
depolarization
CHAOS IN THE ATRIUM
NO P waves
Types of AFIB - ANSWER Controlled- <100 bpm
Uncontrolled- >100 bpm
Management & Meds ( rate control, rhythm control, anticoags) - ANSWER Rate control:
Metoprolol (BBS) or Diltiazem (CCBs)
rhythm control w/ antiarrhythmics ( Amiodarone)
Anticoags- Warfarin - ASSESS CHADS-VASC score
CHADS-VASC score - ANSWER Stroke risk tool used for AFIB
CHF, HTN, >/= 75 yo, DM, prior stroke/ TIA/Thromboembolism
Amiodarone (MOA, LONG TERM USE CAUSES?) - ANSWER prevents conduction of
unwanted cardiac impulses
Test tip: assess chest x-ray & PFTs prior to initiation
Long term use can lead to hypothyroidism, pulmonary toxicity & optic neuropathy
Warfarin - ANSWER normal:1 goal:2-3,
Tx: if <2 increase dose; antidote: Vitamin K
INR 2-9: hold & drop dose
INR >10 (- BLEEDING): Oral Vit K
INR >10 (+ BLEEDING_): IV vit K
Things to avoid with Wafarin - ANSWER Green leafy vegs, mayo, canola oil, beef liver,
Drug to drug interaction (Warfarin) 8 A'S - ANSWER ABX, antifungal, antidepressants,
alternative (St. Johns wort, Gingko), antiplatelet, and anti-inflammatories, amiodarone,
acetaminophen
HTN (goal) - ANSWER <140/90 in pts <60 and past hx of HTN/DM
<150/90 in pts >60 (more flexibity b/c arteries get stiff)
JNC <130/80; If ACVSD risk >10 initiate HTN meds
, TX HTN (1ST) - ANSWER Lifestyle modifications, herbal ( COQ10)
ACE Inhibitors ( slow down how much AT2 your body makes) - ANSWER "PRIL"
Captopril, Enalapril, Afosiopril
Antihypertensive. Blocks ACE ( angiotension converting enzyme) lungs from converting
angiotensin I to angiotensin II (powerful vasoconstrictor). Decreases BP, Decreased
Aldosterone secretions, Sodium and fluid loss. Heart and renal protective for DM
*Orthostatic Hypotension, cough, angioedema, HYPERKALEMIA RISK
ARB (Angiotensin Receptor Blocker) ( blocks the receptors that use AT2 use to narrow
the blood vessels) - ANSWER -Sartan (losartan
antagonizes action of aldosterone
Heart and renal protective for DM
Hyperkalemia risk, dizziness
THIAZIDE - ANSWER HCTZ or chlorthalidone
Blocks the sodium chloride channel in the distal convoluted tubule of the
kidney( decrease sodium reabsorption and therefore decreases fluid reabsorption)
preferred in osteoporosis & AA pts.
Avoid in pts w/ hypercholestermia, gout and DM; causes increases in uric acid, glucose,
triglycerides, and calcium
Calcium channel blockers - ANSWER agents that inhibit the entry of calcium ions into
heart muscle cells, causing a slowing of the heart rate, a lessening of the demand for
oxygen and nutrients, and a relaxing of the smooth muscle cells of the blood vessels to
cause dilation; used to prevent or treat angina pectoris, some arrhythmias, and
hypertension
Preferred in >65 yo & AA pts
SE: ankle edema, headaches
AVOID IN PTS WITH GERD- WEAKENS GASTRIC SPHINCTER
Idiopathic systolic HTN - ANSWER Caused by stiff arteries; overactive thyroid, DM,
seen in pts >60; bp goal: <150 systolic
TX: CCB
Kawaski (CREAM) - ANSWER Acute febrile illness of unknown cause resulting in
vascular inflammation
leading cause of heart disease in < 5 yo
