NR 601 Week 2; Ham's Primary Care
Geriatrics
What is atrial fibrillation? - answer An irregular heart rhythm where the atria beats
irregularly.
What are the symptoms of atrial fibrillation? - answer Fatigue, palpitations, shortness of
breath. Geriatric patients can present with frequent falls, delirium, or syncope.
What is the classic case of atrial fibrillation? - answer The patient reports a sudden
onset of heart palpitations described as feeling like "a fish is flopping my chest" or
"drums are pounding in my chest," which is accompanied by feeling weak, dizzy, and
tachycardia. Patients may report dyspnea, chest pain, or feeling like passing out.
What will a physical exam reveal for a patient with atrial fibrillation? - answer Irregular
rhythm, tachycardia, heart failure, or stroke.
What are 4 diagnostic testing categories with examples for new onset of atrial
fibrillation? - answerLabs: CBC, LFT, Electrolytes, Renal function, trops, TSH
Radiography: CXR
Cardiac Studies: ECG, Echo, event monitor, EP studies
Noncardiac Studies: Overnight oximetry, sleep study
What is the main goal of treatment for atrial fibrillation? - answerprevent mobility and
motility; the focus should be on reducing the risk of a stroke and minimizing symptoms
related to heart rate and rhythm.
An anticoagulation strategy is necessary for patients with atrial fibrillation to decrease
the risk of stroke. True or False - answerTrue.
What tool is used to assess a patient's risk for stroke with atrial fibrillation? -
answerCHADS2Vac Score.
What are the 8 risks that are in the CHADS2Vac scoring? - answerC: congestive heart
failure
H: hypertension
A: age >75
D: diabetes
S: stroke or TIA hx
V: vascular disease
A: age 65-74 years old
Sc: sex (female)
, **everything is worth one point, except S, which is 2 points**
What are the main medications for the long-term management of atrial fibrillation? -
answerBeta-Blockers, CCB (diltiazem or verapamil). Less often, the patient may use
amiodarone or digoxin for rate control.
What are the main antiarrhythmics used for atrial fibrillation? - answerAmiodarone,
flecainide, propafenone, sotalol, and dofetilide
What are further treatment plans that can be done for atrial fibrillation after medication
fail? - answerCardioversion and pacemaker and ablation.
What is a normal BP? - answer<120/<80
What is a elevated BP? - answer120-129/<80
What BP is considered stage 1 HTN? - answer130-139/80-89
What BP is considered stage 2 HTN? - answer>140/>90
What is essential hypertension? - answerMost people with high BP have essential HTN.
A rise in BP of unknown cause. This is likely because of an interaction between
environmental and genetic factors and tends to coexist with other cardiovascular risk
factors such as aging, obesity, diabetes, and hyperlipidemia.
What is secondary hypertension? - answerThis is uncommon in older adults.
This is HTN due to a secondary cause.
What is markedly elevated blood pressure? - answerSevere asymptomatic hypertension
is defined as SBP 180 or higher, and a DBP 110 or higher without symptoms of acute
target organs.
How is HTN diagnosed? - answerA diagnosis of HTN should be based on 2 or more BP
readings obtained on 2 or more separate occasions.
What is "white coat hypertension" - answerWhen a patient BP is high in the doctors
office due to anxiety.
What is the most accurate way to monitor a patient BP? - answerUsing an ambulatory
BP monitor or, as a practical alternative, home monitoring with a validated device.
When should pharmacological treatment be initiated for HTN? - answerWhen the SBP
is 150 or higher or when the DBP is 90 or higher.
What is the target BP for a patient with HTN? - answer<150/<90
Geriatrics
What is atrial fibrillation? - answer An irregular heart rhythm where the atria beats
irregularly.
What are the symptoms of atrial fibrillation? - answer Fatigue, palpitations, shortness of
breath. Geriatric patients can present with frequent falls, delirium, or syncope.
What is the classic case of atrial fibrillation? - answer The patient reports a sudden
onset of heart palpitations described as feeling like "a fish is flopping my chest" or
"drums are pounding in my chest," which is accompanied by feeling weak, dizzy, and
tachycardia. Patients may report dyspnea, chest pain, or feeling like passing out.
What will a physical exam reveal for a patient with atrial fibrillation? - answer Irregular
rhythm, tachycardia, heart failure, or stroke.
What are 4 diagnostic testing categories with examples for new onset of atrial
fibrillation? - answerLabs: CBC, LFT, Electrolytes, Renal function, trops, TSH
Radiography: CXR
Cardiac Studies: ECG, Echo, event monitor, EP studies
Noncardiac Studies: Overnight oximetry, sleep study
What is the main goal of treatment for atrial fibrillation? - answerprevent mobility and
motility; the focus should be on reducing the risk of a stroke and minimizing symptoms
related to heart rate and rhythm.
An anticoagulation strategy is necessary for patients with atrial fibrillation to decrease
the risk of stroke. True or False - answerTrue.
What tool is used to assess a patient's risk for stroke with atrial fibrillation? -
answerCHADS2Vac Score.
What are the 8 risks that are in the CHADS2Vac scoring? - answerC: congestive heart
failure
H: hypertension
A: age >75
D: diabetes
S: stroke or TIA hx
V: vascular disease
A: age 65-74 years old
Sc: sex (female)
, **everything is worth one point, except S, which is 2 points**
What are the main medications for the long-term management of atrial fibrillation? -
answerBeta-Blockers, CCB (diltiazem or verapamil). Less often, the patient may use
amiodarone or digoxin for rate control.
What are the main antiarrhythmics used for atrial fibrillation? - answerAmiodarone,
flecainide, propafenone, sotalol, and dofetilide
What are further treatment plans that can be done for atrial fibrillation after medication
fail? - answerCardioversion and pacemaker and ablation.
What is a normal BP? - answer<120/<80
What is a elevated BP? - answer120-129/<80
What BP is considered stage 1 HTN? - answer130-139/80-89
What BP is considered stage 2 HTN? - answer>140/>90
What is essential hypertension? - answerMost people with high BP have essential HTN.
A rise in BP of unknown cause. This is likely because of an interaction between
environmental and genetic factors and tends to coexist with other cardiovascular risk
factors such as aging, obesity, diabetes, and hyperlipidemia.
What is secondary hypertension? - answerThis is uncommon in older adults.
This is HTN due to a secondary cause.
What is markedly elevated blood pressure? - answerSevere asymptomatic hypertension
is defined as SBP 180 or higher, and a DBP 110 or higher without symptoms of acute
target organs.
How is HTN diagnosed? - answerA diagnosis of HTN should be based on 2 or more BP
readings obtained on 2 or more separate occasions.
What is "white coat hypertension" - answerWhen a patient BP is high in the doctors
office due to anxiety.
What is the most accurate way to monitor a patient BP? - answerUsing an ambulatory
BP monitor or, as a practical alternative, home monitoring with a validated device.
When should pharmacological treatment be initiated for HTN? - answerWhen the SBP
is 150 or higher or when the DBP is 90 or higher.
What is the target BP for a patient with HTN? - answer<150/<90
