Exam (elaborations)
NR667 CEA Study Guide Complete With Correct Solutions
- Course
- Institution
NR667 CEA Study Guide Complete With Correct Solutions
[Show more]
Content preview
NR667 CEA Study Guide Complete With CorrectSolutions
Cardiovascular anatomy and flow complications Right Ans - > Location
- Central anterior chest
- RV is anteriorly located
- LV is posteriorly located
> Flow of blood in the body
- Lungs > pulmonary veins > left atrium > left ventricle > aorta > body tissues
> vena cava > right atrium > right ventricle > pulmonary arteries > lungs.
> Blood flow complications
- Contractility: EF, CAD, LVH, Cardiomyopathy
- Preload: Central fluid volume status
- Afterload: Arterial backpressure on outflow (Chronic hypertension).
(**RAAS system typically manages this).
Metabolic syndrome Right Ans - > Insulin-resistance syndrome and
Syndrome X.
> Higher need for type II DM and CVD
> Includes three of the following traits
- Male waist circumference > 40
- Female waist circumference > 35
- HTN, BP > 130/8-
- Triglycerides > 150
- HDL < 40 males, < 50 females
- Hyperglycemia, Fasting glucose > 100 mg/dl.
Hypertension Right Ans - >JNC8
- Defined as 140/90
- Secondary HTN: Up flow issue going up to kidney, ex: renal stenosis.
- Age > 60 or < 60 years. (>60 = 150/90).
- DM and CKD: ACE/ARBs (nephro protective).
- Non-black vs. Black: Calcium channel blocker for African Ascent.
- General starting place: Thiazides/ACE/ARBs.
- ACE/ARBS: "Prils" and "Sartans"
,- Beta Blockers: "olol" not on JNC8 guidelines, history of cardiac disease,
reduce HR. Carvedilol is a dual alpha/beta, great for Heart failure.
- CCB: Dihydropyrines and Non-Dihydropyrines. Dihydropyrines work more
peripherally (amlodipine, etc). Non-Dihydropyrines work more on heart
(Verapamil and diltiazem). Common ASE: Constipation and peripheral edema.
- Diuretics: Thiazides, Loops. Thiazides are less potent. Thiazide= Low
electrolytes, Higher calcium. Loops- lowers everything. Potassium-sparing
diuretics (Increase potassium, lowers sodium).
Heart failure Right Ans - >HFrEF (Less than 40%)
> HFpEF (Higher than 40%)
> Systolic heart failure: inability for myocardium to effectively contract.
> Diastolic heart failure: inability to myocardium to effectively relax.
> Typical patient: elderly with comorbidities of HTN, DM, Smoking.
- Class I: Mild symptoms
- Class II-III: Symptoms with exertion (II), ADL's cause symptoms (III)
- Class IV: Symptoms severe, likely needs hospitalization.
> Classic symptoms: SOB, Fatigue, exertional dyspnea, dependent and
pulmonary edema, low activity tolerance, abdominal bloating, orthopnea.
> Causes: ischemic heart disease, valve disease, MI, cardiomyopathy.
> Treatment: ACE/ARB, ARB/ARNI, BB, Diuretics, nitrates plus hydralazine,
Fluid and salt restriction, daily weights.
Lipid management Right Ans - >AVSCD
- Statins
- Hight-intensity statins: Atorvastatin 40-80mg and Rovusatan 20-40mg
(Don't require being taken at bedtime). LDL < 190
- Common ASE: Myalgia. Rhabdomyolysis worse case scenario.
- Statins, Ezetimibe in conjunction. PC9-Inhibitors (injectable Q2 weeks).
(Cardiology at consult prior to PC9-Inhibitors).
- Familial homozygous hyperlipidemia= PC9-Inhibitors.
- HDL: "Cleaning agent."
- LDL- "Scrum between glass window in shower"
Valve disease and aneurysms Right Ans - > Aortic stenosis: Narrowing of
outflow to aortic root through aortic valve due to calcification. Symptoms tend
to mirror CAD with addition of syncope/near syncope.
,> Aortic Regurgitation/Insufficiency: instability for aortic valve to
appropriately close. Commonly due to aortic root dilation or
endocarditis/infection. A direct contraindication for IABP use (common board
exam question).
>Mitral stenosis: Narrowing of inflow into LV through the mitral valve due to
calcification.
> Mitral regurgitation/Insufficiency: instability for mitral valve leaflets to
close. Commonly due to mitral root dilation from an MI, CHF, induced LV
dilation, papillary muscle rupture, endocarditis.
> Identifying Murmurs (left sternal border, 2nd intercoastal).
- Aortic stenosis: swishing, systole, tends to radiate to neck.
- Mitral stenosis- low-frequency, diastole, tends to radiate to lateral chest.
- Mitral regurgitation: systole,
- Aortic regurgitation, Diastole
>Aortic layers
- Tunica externa
- Tunica media
- Tunica intima
>Aneurysm
- Stanford A (Ascending before the left subclavian): requires surgery (risk of
dissecting coronary ostia/aortic valve).
- Stanford B (descending after the left subclavian): typically treated with
endovascular grafting if anything at all.
- Presentation: asymptomatic, ruptured: classic triad of acute abdominal pain,
abdominal distention, and hemodynamic instability, pulsable mass on
abdomen, tearing feeling in back.
- Congenital concerns: marfan's syndrome, Ehlers's-Danlos syndrome,
Bicuspid aortic valve commonly found.
- Other causes: atherosclerosis, vasculitis, uncontrolled HTN. Tobacco use.
- Supportive management: avoid heavy lifting, BP control, avoidance of
fluroquinolone antibiotics = weakening vascular tissue.
DVT/PE Management Right Ans - > PE
, - Saddle emboli commonly require surgery. (will see evidence of right heart
strain, S1Q3T3, TR on 2D echo, enlarged RV.
- Subsegmental not typically requiring emergent surgery (commonly treated
with tPA and/or IV anticoagulation through a direct PA catheter. May use
ultrasound-assisted technology (EKOs).
- Provoked vs. Unprovoked.
- Anticoagulation for at least 3 months.
- Unprovoked: at least 3 months, may be lifelong if any reoccurrence.
> DVT
- Virchow's triad: Venous stasis, hypercoagulability, endothelial injury.
- Initial diagnostics: CBC, PT/PTT, PT/INR, US with doppler.
- Treatment: Anticoagulation for provoked and unprovoked.
PAD and pleural effusions Right Ans - > PAD
- Clinical findings: pale, waxy, hairless legs, pain with ambulation that
improves with cessation of ambulation.
- Diagnosed with ABI, confirmatory diagnosis with angiography.
- Treatment: stents or bypass of occluded/near occluded vessels.
- Medications: antiplatelet agents (clopidogrel, cilostazol, aspirin), statins for
lipid management.
- Smoking cessation
- Management of comorbid conditions such as DM.
- Daily ambulation exercise therapy.
>Intermittent Claudication
- Not as severe of blockage
- Requires exercise
- Antiplatelet/aspirin regimen
- Treat underlying causes: smoking, HTN, HLD, DM.
]
>Pericardial Effusion and Tamponade
- Fluid around the heart inside the pericardium
- Normally a small volume (<50 ml) present
- If chronic effusion, may drastically increase without consequence.
- Treatment: address underlying causes: malignancy, hypothyroid,
hypercoagulable state, trauma.
- If acute tamponade (narrowed pulse pressure, tachycardia, JVD, muffled
HTs)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller LeCrae. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $27.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
68562 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 15 years now
Recently viewed by you
Exam (elaborations) ·
CBSPD: Chapter 5 Decon Exam Questions and Answers 2023
Summary ·
Samenvatting Professioneel inkopen, ISBN: 9789001877231
Exam (elaborations) ·
NRS 427V -WEEK 5-COMMUNITY TEACHING PLAN PRESENTATION.
Summary ·
Youth and sexuality korte samenvatting artikelen 1-23
Exam (elaborations) ·
ATI PN Custom Lifespan exam 1 2023 questions with rationale
Summary ·
Uitwerking ziektebeeld hartinfarct volgens rode loper
Exam (elaborations) ·
Chem 219 Exam Questions With 100% Correct Answers 2024
Exam (elaborations) ·
AMCA Review for CMAC question n answers graded A+ 2023
