Adult Primary Care Exam #2 UPDATED ACTUAL QUESTIONS AND CORRECT ANSWERS

Adult Primary Care Exam #2 UPDATED
ACTUAL QUESTIONS AND CORRECT
ANSWERS
Best lab test to rule out MI - Correct answers✔✔Cardiac-specific troponin I and T (rise within
the first 2-4 hrs after MI and remain elevated for 7-10 days)



What should you do for the patient experiencing ACS? - Correct answers✔✔ASA, nitroglycerin
and transfer to ED (preferably at a hospital with a cath lab)



Number one symptom of CAD - Correct answers✔✔Angina



Characteristics of metabolic syndrome - Correct answers✔✔1) HTN

2) Obesity

3) Dyslipidemia

4) DM



CV risk factors - Correct answers✔✔1) HTN

2) Obesity

3) Dyslipidemia

4) DM

5) Cigarette smoking

6) Physical inactivity

7) Microalbuminuria

,What manometers are best? - Correct answers✔✔Mercury bulb (if using digital, make sure they
are periodically recalibrated)



What are you listening for when measuring BP? - Correct answers✔✔1st and 5th Korotkoff
sound



What factors can transiently elevate BP? - Correct answers✔✔1) Anxiety

2) Cold

3) A full bladder

4) Exercise, smoking or caffeine within the previous 30 minutes



Essential HTN risk factors - Correct answers✔✔1) Age (arteries stiffen with age)

2) Gender (male until age 60)

3) Race (AAs have higher rates than whites)

4) Obesity (10# wt loss can make a big difference; meds work better in conjunction with wt loss)

5) Family history

6) Alcohol intake (>2 oz per day)

7) Cigarette smoking



Physiologically what causes primary HTN - Correct answers✔✔Increased CO which results in
increased peripheral arterial resistance



Typical presentation of secondary HTN - Correct answers✔✔-Presentation is usually abrupt and
severe

-Usually < 35 y/o

-Negative family hx

,-Failure to respond to empirical therapy despite compliance



#1 cause of secondary HTN - Correct answers✔✔Renal artery stenosis



Other causes of secondary HTN - Correct answers✔✔Pheochromocytoma, primary
hyperaldosteronism, coarctation of the aorta, Cushing's, Renal Parenchymal Disease, alcohol,
medication



How would you diagnose Cushing's? - Correct answers✔✔24 urine to see if cortisol levels are
elevated



Questions to ask about HTN - Correct answers✔✔1) When were they initially diagnosed?

2) Highest reading ever obtained

3) Have they been on any other anti-hypertensive meds previously? (If yes, why did they stop
taking them?)



Factors from chest pain article - Correct answers✔✔1) >55 in men; >65 in women

2) Known CAD or cerebrovascular disease

3) Pain not reproducible by palpation

4) Pain worse during exercise

5) Pt assumes pain is cardiogenic



(For scores of 2-5 order EKG; for scores of 4 and 5 give O2 and ASA -- arrange for ED
transport)



What medications should you ask about when concerned about HTN? - Correct answers✔✔1)
NSAIDs

, 2) OTC cold remedies

3) Oral contraceptives

4) Anabolic steroids

5) MOAIs

6) Tricyclic antidepressants

7) Diet pills



What candy (in excess) can elevate BP? - Correct answers✔✔Licorice



What are abnormal fundoscopic findings that are possible w/HTN? - Correct answers✔✔1)
Abnormal blood vessels

2) Vitreous hemorrhage

3) Flame hemorrhage

4) Cotton wool sports

5) Hard exudates



Why would you draw a CBC w/HTN? - Correct answers✔✔HTN drugs can cause
anemia/polycythemia



Why would you draw a uric acid level w/HTN? - Correct answers✔✔Thiazide diuretics can
increase uric acid levels



Why would you draw a calcium level w/HTN? - Correct answers✔✔Low calcium intake in the
diet can increase BP



HTN differentials - Correct answers✔✔1) White coat syndrome