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What is the cause of rheumatic heart disease
Cardiac disease secondary to rheumatic fever, resulting from Type A streptococcal infection
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what complicationsare associated with rheumatic fever
- Heart failure
- Arrhythmias
- Infective endocarditis
- Sudden cardiac death
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What time frame should antibiotics be given to avoid rheumatic fever
- Within the first 2-3 weeks
- Caridac damage becomes evident some 30 years later
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What is a temproary imbalance of O2 to the myocardium
Angina pectoris
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What are the signs and symptoms of cardiac tampanod
- Chest pain
- Dysnea
- Orthopnea
- Altered mental status or consciousness
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MI is the most common cause of q
Cardiogenic Shock
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Looking for CASH as manifestations of poor perfusion in Arrhythmias
- C=Chest Pain
- A=altered mental status
- S=shortness of breath
- H=Hypotension
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What is the most common cause of MI
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What is an accumiltion of fluid within the pericardial sac causing compression of the heart
Cardiac Tamponade
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Usually caused by trauma, will have rapid onset of manifistations of symptoms.
Infectious process or malignancy may take longer for fluid accumilation or compression
Cardiac Tamponade
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Most common causitive agent of endocarditis
Gram negative bacteria
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These patients are at high risk for Endocarditis
- Prosthetic heart valve
- Aortic valve disease
- Mitral regurgitation
- Patent ductus arterious
- Ventricular septal defect
- coartation of the aorta
- Marfans syndrome
- Intravenous drug abuse
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Patients who are at intermediate risk for endocarditis
- Mitral valve prolapse
- Pure mitral Stenosis
- Tricuspid valve diease
- pulmonary valve disease
- previous endocarditis
- Calcified aortic stenosis
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Patients at LOW risk for endocarditis
- atrial septal defect
- arteriosclerotic plaque
- Coronar artery disease
- syphilitic aortic disease
- cardiac pacemakers
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What is the most common arrythmia associated with cardiac death
Ventricular Fibrillation
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What medications are used to manage MI
- O2 -2-4 L NC
- Nitroglycerin 1 sublingual dose Q 5 min x3
- Asprin 325 mg po chewed and swallowed
- Morphine 2-5mg slow IV
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What are the symptoms of aortic stenosis
- SAD
- S= Syncope, especially exertional
- A= Anginal chest pain
- D= Dyspnea
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clinical findings of aortic stenosis
- Murmur: creshendo-decrescendo systolic murmur at the right upper sternal border
- murmur may radiate to the neck
- S4 possible
- lateral displacement of PMI
- Weak peripheral pulses with narrowed pulse pressure
- possible signs of congestive hr\eart failure
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Most common cause of Mitral Stenosis
Rheumatic heart disease
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Clinical findings of endocarditis
- New or recent changes in heart murmur
- septic emboli
- Petechiae
- Hemorrhagic
- Anemia
- Splenomegaly
- Clubbing of the digits
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Symptoms of Pericarditis
- Chest Pain
- Increased chest pain with twisting of the thorax
- radiates to scapula
- typically relieved by sitting up and leaning forward
- may be accompanied by fevers, chills, and myalgias if due to an infectious process
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What is the JNC-7 recommendation for pre hypertension
- Lifestyle modifications and other preventive measures
- Weight reduction and treatment
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The most common primary diagnosis in america
Primary Hypertension
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Complications of Hypertension
- Worsening of hypertension
- Myocardial ischemia or infection
- Cerebrovascular accident
- Retinopathy
- Nephropathy
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What medications do you give for anaphylactic shock
- Epinephrin 0.3-0.5 mg IM or SQ q3-5 min
- IM: 0.1mg dilute in 10ml of NSS q3-5 min
- Dyphenhydramine 25-50mg IM
- Albuterol via nebulizer tx
- H2 blockers (ranitidine, cimetidine)
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What
is defined as any abnormality in the cardiac conduction system; results
in a change in pulse rate or rhythm. Basically, anything that is not normal
sinus rhythm?
Arrhythmia
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Heart failure, Arrhythmias (A-fib, Ventricular arrhythmias),
Infective endocarditis, and sudden cardiac death are complications of what?
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. Early treatment of what, aids in prevention of Rheumatic
fever?
- Streptococcal pharyngitis
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. Rheumatic fever develops how many weeks after the initial
throat infection?
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A
patient presents with chest pain, dyspnea, shortness of breath, and an altered
mental status may have what cardiac condition?
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What
is the most important ‘section’ of an EKG in relation to an arrhythmia?
QRS complex
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What
usually results from thrombus formation in a coronary artery, initiated
by ulceration of an atherosclerotic plaque?
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Trauma, Infectious process or malignancy, and Complication
of cardiothoracic surgery are causes of what condition?
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What
are the three components of Cholesterol that make up ‘Total” Cholesterol
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What
component of Total Cholesterol is considered a “negative risk factor”
for Coronary Artery Disease (CAD)?
- High-Density Lipoprotein (HDL)
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What Total Cholesterol level is considered to be “High Risk”
in (mg/dl)
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AV Block (Complete Heart Block)
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Niacin
is also known as what?
- Nicotinic acid
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Nicotinic acid may be considered in the treatment of what
condition, due to its cost (or) its ability to increase HDL levels?
- Heyperlipidemia (High Cholesterol)
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Niacin
has what effect on LDL? Niacin has what effect on HDL?
- Lowers ¯LDL by 20% - Raises HDL by 20-40%
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What medication class is contraindicated in pregnancy and
may cause potentially fatal rhabdomyolysis and renal failure (extremely rare)?
- HMG CoA Reductase Inhibitors AKA: “Statins
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Syncope
with exertion, anginal chest pain, and dyspnea are all symptoms of what?
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What condition is almost always due to rheumatic heart
disease and usually accompanies mitral stenosis?
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.
Janeway lesions and Osler’s nodes are associated with what condition?
- Endocarditis, dermatologic Involvement
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Tender, pea-sized, erythematous nodules usually found in the
puld spaces of the fingers and toes are known as what?
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What symptom favors Pericarditis vice AMI?
Duration of pain for several days
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Sharp, stabbing pain for several days that starts anteriorly
and radiates to the scapula is symptomatic of what condition?
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. Aortic Dissection is a tear in which layer,
through which blood accumulates within the aortic wall.
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What is the primary difference between Hypertensive Urgency
and Emergency?
- Urgency– no end-organ damage yet
- Emergency – some finding of end-organ damage
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Hypertensive encephalopathy, Hypertensive nephropathy, Visual
changes, Neurologic impairment, and Cardiovascular insufficiency are symptoms
of what condition?
- Hypertensive Emergency / Crisis
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encephalopathy: headache, confusion, irritability, and/or
- altered mental status
Hypertensive nephropathy: oliguria or anuria Visual changes: blurred vision, diplopia Neurologic impairment: numbness, tingling, weakness Cardiovascular insufficiency: dyspnea, orthopnea, chest pain
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Antibiotics,
Sulfa-containing agents, and Vaccines are all causative agents in what type of
shock?
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What is “Shock state resulting from abnormal cardiac
function” resulting in reduction in cardiac output and inadequate en-organ
perfusion?
Cardiogenic Shock
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A patient presents with cool, clammy skin with “wet” lung
sounds. What type of shock are they experiencing?
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What
is the most common cause of Cardiogenic Shock?
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