Adult Primary Care Exam -2 with correct solutions

Adult Primary Care Exam #2 with \| \| \| \| \| \|




correct solutions \|




Best lab test to rule out MI - CORRECT ANSWERS ✔✔Cardiac-
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specific troponin I and T (rise within the first 2-4 hrs after MI and
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remain elevated for 7-10 days)
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What should you do for the patient experiencing ACS? - CORRECT
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ANSWERS ✔✔ASA, nitroglycerin and transfer to ED (preferably at
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a hospital with a cath lab)
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Number one symptom of CAD - CORRECT ANSWERS ✔✔Angina
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Characteristics of metabolic syndrome - CORRECT ANSWERS \| \| \| \| \| \| \|



✔✔1) HTN \|




2) Obesity
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3) Dyslipidemia
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4) DM \|




CV risk factors - CORRECT ANSWERS ✔✔1) HTN
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2) Obesity
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3) Dyslipidemia
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4) DM \|




5) Cigarette smoking
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,6) Physical inactivity
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7) Microalbuminuria
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What manometers are best? - CORRECT ANSWERS ✔✔Mercury
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bulb (if using digital, make sure they are periodically recalibrated)
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What are you listening for when measuring BP? - CORRECT
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ANSWERS ✔✔1st and 5th Korotkoff sound \| \| \| \| \|




What factors can transiently elevate BP? - CORRECT ANSWERS
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✔✔1) Anxiety \|




2) Cold
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3) A full bladder
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4) Exercise, smoking or caffeine within the previous 30 minutes
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Essential HTN risk factors - CORRECT ANSWERS ✔✔1) Age
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(arteries stiffen with age) \| \| \|




2) Gender (male until age 60)
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3) Race (AAs have higher rates than whites)
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4) Obesity (10# wt loss can make a big difference; meds work
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better in conjunction with wt loss)
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5) Family history
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6) Alcohol intake (>2 oz per day)
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7) Cigarette smoking
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,Physiologically what causes primary HTN - CORRECT ANSWERS \| \| \| \| \| \| \| \|



✔✔Increased CO which results in increased peripheral arterial \| \| \| \| \| \| \| \|



resistance


Typical presentation of secondary HTN - CORRECT ANSWERS ✔✔-
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Presentation is usually abrupt and severe \| \| \| \| \|




-Usually < 35 y/o \| \| \|




-Negative family hx \| \|




-Failure to respond to empirical therapy despite compliance
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#1 cause of secondary HTN - CORRECT ANSWERS ✔✔Renal artery
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stenosis


Other causes of secondary HTN - CORRECT ANSWERS
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✔✔Pheochromocytoma, primary hyperaldosteronism, coarctation \| \| \| \|



of the aorta, Cushing's, Renal Parenchymal Disease, alcohol,
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medication


How would you diagnose Cushing's? - CORRECT ANSWERS ✔✔24
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urine to see if cortisol levels are elevated
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Questions to ask about HTN - CORRECT ANSWERS ✔✔1) When
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were they initially diagnosed?
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2) Highest reading ever obtained
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3) Have they been on any other anti-hypertensive meds
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previously? (If yes, why did they stop taking them?) \| \| \| \| \| \| \| \|

, Factors from chest pain article - CORRECT ANSWERS ✔✔1) >55 in
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men; >65 in women\| \| \|




2) Known CAD or cerebrovascular disease
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3) Pain not reproducible by palpation
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4) Pain worse during exercise
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5) Pt assumes pain is cardiogenic
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(For scores of 2-5 order EKG; for scores of 4 and 5 give O2 and
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ASA -- arrange for ED transport)
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What medications should you ask about when concerned about
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HTN? - CORRECT ANSWERS ✔✔1) NSAIDs
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2) OTC cold remedies
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3) Oral contraceptives
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4) Anabolic steroids
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5) MOAIs
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6) Tricyclic antidepressants
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7) Diet pills
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What candy (in excess) can elevate BP? - CORRECT ANSWERS
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✔✔Licorice


What are abnormal fundoscopic findings that are
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possible w/HTN? - CORRECT ANSWERS ✔✔1) Abnormal blood
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vessels
2) Vitreous hemorrhage
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