Study Guide for Final Exam
1. Know the causes of an abdominal aortic aneurysm.
The proposed causes of AAA include atherosclerosis, inflammation, mycotic infection,
inheritable connective tissue disorders (Marfan syndrome, type IV Ehlers-Danlos
syndrome), and trauma. Traditionally, atherosclerosis has been considered the most
common cause of AAA. However, aneurysm formation is associated with atherosclerosis
in only 25% of cases.
2. Why is CT imaging limited in women?
Single-photon emission CT imaging is technically limited in women because breast
tissue and smaller coronary artery size.
3. What is self-management support?
Self-management support is a crucial component of the CCM and effectively
implemented by use of a population approach. The goal of self-management support is
to engage patients in their own care and to empower them to reach their full potential as
self-advocates and partners in care. Before patients can begin self-management, they
must have access to information that is appropriate for how they learn and who they are
—educationally, cognitively, emotionally, culturally, and experientially.
4. Which Medicare part covers inpatient hospital services?
Part A – paid through federal payroll taxes – Covers inpatient hospital services as well as some
post-hospital nursing care & home health care
5. Understand risk factors for abdominal aortic aneurysm.
Risk factors for AAA include atherosclerotic vascular disease, white race, male gender,
advanced age, hypertension, smoking, chronic obstructive pulmonary disease (COPD),
history of hernias, family history of AAA, and presence of other aneurysms. 4,5 Despite
extensive investigation, the link between COPD and AAA remains elusive. Evidence
suggests that the high prevalence of AAA in patients with COPD may be related to
medications (oral steroids) and coexisting diseases rather than to a common pathway of
pathogenesis involving plasma elastase or α1-antitrypsin
6. Study atrial fibrillation and at what age is it more common.
Atrial fibrillation is the most common sustained cardiac rhythm disturbance, more
common in men and increasing in prevalence with age. It is estimated that 2.3 million
Americans have atrial fibrillation, which more commonly occurs after the age of
60years.
, 7. Where could you find supporting data for guidelines for prevention of future heart disease?
The recommendation for asymptomatic women with diabetes, peripheral vascular
disease, and possible kidney disease is for secondary prevention strategies to prevent
future cardiac events.
8. Can ischemic changes on an ECG during or after an ETT correlate to the effected artery or
arteries?
It is helpful to correlate the ischemic leads on exercise electrocardiography to the
underlying coronary anatomy to roughly identify the culprit artery or arteries.
9. What is the goal of self-management?
Self-management support is a crucial component of the CCM and effectively
implemented by use of a population approach. The goal of self-management support is
to engage patients in their own care and to empower them to reach their full potential as
self-advocates and partners in care. For many patients and providers alike, this patient-
centered practice is a new method. In the acute care model, clinicians prescribe and
patients comply. Self-management support in the CCM requires different assumptions,
processes, and skills.
10. Know the symptoms of an abdominal aortic aneurysm.
Thromboembolic phenomena may herald the presence of an AAA. Microembolic
infarcts in the lower extremity of a patient with easily palpable pedal pulses may suggest
either abdominal or popliteal aneurysm. Embolization of mural thrombus from an
abdominal aneurysm may be seen with acute limb ischemia caused by femoral or
popliteal occlusion. The classic diagnostic triad of ruptured AAA is hypotension (42%),
pulsatile abdominal mass (91%), and abdominal pain (58%) or back pain (70%). The
triad is encountered in only 50% of patients with a ruptured AAA. Ruptured AAAs
should be suspected in any patient who comes in with complaints of hypotension and
atypical abdominal or back pain symptoms. In a patient with a history of aneurysm or
pulsatile mass, abdominal pain must be considered to represent a rapidly expanding or
ruptured aneurysm and must be treated accordingly. In the community setting, the
death rate from ruptured AAAs is almost 80%.
11. Know the difference between the principles of fidelity, veracity, self-reflection, and finance.
Justice, fidelity, and veracity are ethical principles that health care providers use to
guide their professional interactions. When health care providers treat all with respect
1. Know the causes of an abdominal aortic aneurysm.
The proposed causes of AAA include atherosclerosis, inflammation, mycotic infection,
inheritable connective tissue disorders (Marfan syndrome, type IV Ehlers-Danlos
syndrome), and trauma. Traditionally, atherosclerosis has been considered the most
common cause of AAA. However, aneurysm formation is associated with atherosclerosis
in only 25% of cases.
2. Why is CT imaging limited in women?
Single-photon emission CT imaging is technically limited in women because breast
tissue and smaller coronary artery size.
3. What is self-management support?
Self-management support is a crucial component of the CCM and effectively
implemented by use of a population approach. The goal of self-management support is
to engage patients in their own care and to empower them to reach their full potential as
self-advocates and partners in care. Before patients can begin self-management, they
must have access to information that is appropriate for how they learn and who they are
—educationally, cognitively, emotionally, culturally, and experientially.
4. Which Medicare part covers inpatient hospital services?
Part A – paid through federal payroll taxes – Covers inpatient hospital services as well as some
post-hospital nursing care & home health care
5. Understand risk factors for abdominal aortic aneurysm.
Risk factors for AAA include atherosclerotic vascular disease, white race, male gender,
advanced age, hypertension, smoking, chronic obstructive pulmonary disease (COPD),
history of hernias, family history of AAA, and presence of other aneurysms. 4,5 Despite
extensive investigation, the link between COPD and AAA remains elusive. Evidence
suggests that the high prevalence of AAA in patients with COPD may be related to
medications (oral steroids) and coexisting diseases rather than to a common pathway of
pathogenesis involving plasma elastase or α1-antitrypsin
6. Study atrial fibrillation and at what age is it more common.
Atrial fibrillation is the most common sustained cardiac rhythm disturbance, more
common in men and increasing in prevalence with age. It is estimated that 2.3 million
Americans have atrial fibrillation, which more commonly occurs after the age of
60years.
, 7. Where could you find supporting data for guidelines for prevention of future heart disease?
The recommendation for asymptomatic women with diabetes, peripheral vascular
disease, and possible kidney disease is for secondary prevention strategies to prevent
future cardiac events.
8. Can ischemic changes on an ECG during or after an ETT correlate to the effected artery or
arteries?
It is helpful to correlate the ischemic leads on exercise electrocardiography to the
underlying coronary anatomy to roughly identify the culprit artery or arteries.
9. What is the goal of self-management?
Self-management support is a crucial component of the CCM and effectively
implemented by use of a population approach. The goal of self-management support is
to engage patients in their own care and to empower them to reach their full potential as
self-advocates and partners in care. For many patients and providers alike, this patient-
centered practice is a new method. In the acute care model, clinicians prescribe and
patients comply. Self-management support in the CCM requires different assumptions,
processes, and skills.
10. Know the symptoms of an abdominal aortic aneurysm.
Thromboembolic phenomena may herald the presence of an AAA. Microembolic
infarcts in the lower extremity of a patient with easily palpable pedal pulses may suggest
either abdominal or popliteal aneurysm. Embolization of mural thrombus from an
abdominal aneurysm may be seen with acute limb ischemia caused by femoral or
popliteal occlusion. The classic diagnostic triad of ruptured AAA is hypotension (42%),
pulsatile abdominal mass (91%), and abdominal pain (58%) or back pain (70%). The
triad is encountered in only 50% of patients with a ruptured AAA. Ruptured AAAs
should be suspected in any patient who comes in with complaints of hypotension and
atypical abdominal or back pain symptoms. In a patient with a history of aneurysm or
pulsatile mass, abdominal pain must be considered to represent a rapidly expanding or
ruptured aneurysm and must be treated accordingly. In the community setting, the
death rate from ruptured AAAs is almost 80%.
11. Know the difference between the principles of fidelity, veracity, self-reflection, and finance.
Justice, fidelity, and veracity are ethical principles that health care providers use to
guide their professional interactions. When health care providers treat all with respect
