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Step III

Step III - Cardio 2

hypertensive EMERGENCY is when BP is + what else > 179/119 + S/S end organ damage
insidious onset HA, h/o long standing HTN, n/v, confusion, restlessness, seizure, coma Hypertensive encephalopathy
BP goal for HTN emergency 100-105 diastolic @ 2-6 hrs (no more than 25% of original)
Rx for tx of HTN emergency IV nitroprusside, nicardipine, clevidipine, labetalol, fenoldopam
What defines HTN URGENCY BP > 179/119 w/o S/S organ damage
Approach to lowering BP in HTN urgency pt lower the blood pressure to <160/100 mm Hg over several hour to days (rapid lowering can lead to cerebral/myocardial ischemia)
Rx tx approach to HTN urgency If already treated outpt can adjust Rx; if never treated start w/ ACEI, CCB, β(-); avoid diuretic
Notable side effects of β(-) Can’t maintain erection, depression, dizzy/light headedness, diarrhea, rash, low sex drive, impotence
Which HTN medication can lower HDL, incr LDL cholesterol and TGs Β(-)
AE Furosemide hypokalemia and hypoeruricemia
AE Lisinopril and pt who should not be taking this rx cough and should be avoided in pregnant patients
AE Hydrochlorothiazide and avoid use in these pts increased levels of uric acid and should be avoided in patients with gout
AE Verapamil arrhythmias and may cause elevations in transaminase levels
What are the major criteria of CHF in Framingham paroxysmal nocturnal dyspnea, neck vein distention, rales, cardiomegaly, acute pulm edema, S3 gallop, incr venous pressure, (+) hepatojugular reflux
Minor criteria for CHF in Framingham is ext edema, night cough, dyspnea on exertion, HSM, pleural effusion, vital capacity reduced by 1/3 normal, tachycardia >=120; weight loss of 4.5 Kg or more during the course of therapy may be considered as a major or minor criterion
What is required in Framingham for dx of CHF 1 major + 2 minor
HTN in female of reproductive age w/ 3 elevated readings on 3 office visits. Prevalent cause of HTN in this type of pt OCP
alcoholic pt w/ edema, dyspnea and distended neck veins, ventricular enlargement. Dx dilated cardiomyopathy from thiamine defx
Impaired diastolic filling is found in what types of cardiomyopathies restrictive and hypertrophic cardiomyopathies
Cardiac amyloidosis is what type of cardiomyopathy restrictive cardiomyopathy
Disorganized hypertrophic myocardial fibers represents what type of cardiomyopathy hypertrophic cardiomyopathy
A left-to-right shunt causes pulmonary hypertension and is found in what ype of cardiac defects atrial and ventricular septal defects
Alcoholism can cause a dilated cardiomyopathy which may lead to congestive heart failure due to systolic dysfunction.
what type of cardiomyopathy is found in alcoholics Dilated
Compare and contrast PIP and Dressler’s syndrome Onset of PIP is 12hrs-10 DAYS post MI; Dressler’s peak onset is 7-11 WEEKS (up to 28wks) post MI. S/S of both are same but Dressler’s includes low grade FEVER, MALAISE, MYALGIA, weakness, arthralgia
sharp, persistent midsternal chest pain which radiates to the shoulders or mid-scapular region of acute onset in post MI pt Post infarct pericardx (PIP)
pericardial friction rubs + PLEURAL friction rubs = Dressler’s
what is the etio of Dressler’s autoimmune
high-pitched decrescendo diastolic murmur at the right sternal border, weakness, severe dyspnea, hypotension, widened pulse pressure +/- angina Aortic regurgx
crescendo-decrescendo systolic murmur Aortic stenosis
Created by: DrINFJ