Apea FNP CARDIO Exam 2024 (Best Revision Material Updated (Actual
Exam Questions, Answers
in and around the ankle joint.
in the calf muscle.
radiating down his leg from the thigh.
pain in his lower leg which waxes and wanes. - in the calf muscle
This patient's symptoms are typical of arteriosclerosis. The term for this symptom is
intermittent claudication. When there is compromised arterial blood flow in the lower
legs, a common complaint is reproducible pain in a specific group of muscles. The pain
occurs because there is an incongruence between blood supply and demand. This
produces pain that causes a patient to stop exercising in order to obtain relief of pain.
A patient with mitral valve prolapse (MVP) reports chest pain and frequent arrhythmias.
In the absence of other underlying cardiac anomalies, the drug of choice to treat her
symptoms is a(n):
ACE inhibitor.
beta blocker.
calcium channel blocker.
diuretic. - BETA BLOCKER
Beta blockers are recommended to alleviate atrial or ventricular arrhythmias associated
with mitral valve prolapse
The valve most commonly involved in chronic rheumatic heart disease is the:
aortic.
mitral.
pulmonic.
tricuspid. - MITRAL
The mitral valve has a propensity for disorders secondary to rheumatic heart disease.
Rarely is the pulmonic valve involved, but the aortic and tricuspid valves follow in
descending order of involvement. Following an episode of rheumatic fever, which
occurs infrequently in the US today but is common in developing countries, the valves
can become stenotic or regurgitant. This is a major cause of valvular disease in the US
seen primarily in immigrants
A decrease in blood pressure can occur in men who take sildenafil and:
,amlodipine.
tamsulosin.
metoprolol.
any antihypertensive medication. - ANY B/P MED
Any antihypertensive medication could have an additive effect with sildenafil (or another
medication in this class). Caution is advised and should only be used if the male has
stable blood pressure. A specific drug-drug interaction to be aware of is the one that can
occur with sildenafil and alpha blockers like tamsulosin, alfuzosin, prazosin, doxazosin,
or terazosin. This combination of medications may increase the risk of symptomatic
hypotension because the effect of these two drugs is additive.
IE ALPHA BLOCKERS ARE COREG AND LABETALOL ARE BOTH ALPHA AND
BETA BLOCKERS
Which choice below characterizes a patient with aortic regurgitation?
Long asymptomatic period followed by exercise intolerance, then dyspnea at rest
An acute onset of shortness of breath in the fifth or sixth decade
Dyspnea on exertion for a long period of time before sudden cardiac death
A long asymptomatic period with sudden death usually during exercise - LONG
ASYMPTOMATIC PERIOD FOLLOWED BY EXERCISE INTOLERANCE THEN
DYSPNEA AT REST.
The natural course of aortic regurgitation (AR) is that the patient has a long
asymptomatic period with slowing of activities but remains essentially asymptomatic.
Then, shortness of breath develops with activity and finally, shortness of breath at rest.
The left ventricle eventually fails unless the aorta is replaced.
Most hypertension in pre-adolescents and children is:
related to elevated BMI.
primary hypertension.
secondary hypertension.
endocrine related - SECONDARY HTN
Most hypertension in children and pre-
adolescents is secondary hypertension.
60-70% is due to renal parenchymal disease. Rarely does primary hypertension exist in
this age group. However, 85-90% of adolescents have primary hypertension.
, A 77 year-old patient has had an increase in blood pressure since the last exam. The
blood pressure has risen to 168/88 with 2 readings. The last exam's reading was
144/90. If medication is to be started on this patient, what would be a good first choice?
ACE inhibitor
Beta blocker
Calcium channel blocker
Thiazide diuretic - CCB
This patient is 77 years old and should have a goal blood pressure of < 150/90. A
thiazide diuretic is not a good first choice in this patient because it will not be potent
enough to decrease blood pressure by 25 points to get him to goal. A long acting
calcium channel blocker is appropriate for patients with isolated systolic hypertension,
ISH and will be more likely to get this patient to goal pressure than HCTZ. Beta-blockers
are no longer recommended first line for uncomplicated hypertension. ACE inhibitors
are very effective in patients who are high renin producers. Elderly patients tend to
produce lower amounts of renin.
Mrs. Brandy is having contrast dye next week for a heart catheterization. What drug
does NOT need to be stopped prior to her catheterization?
Naproxen
Furosemide
Metformin
Losartan - LOSARTAN
Naproxen and furosemide should be stopped for 24 hours prior to the catheterization.
Metformin should be stopped 48 hours prior to the catheterization. Furosemide is
stopped because it contributes to volume depletion. NSAIDs like naproxen are withheld
because of the impact on renal prostaglandin production. Metformin has been
implicated in lactic acidosis when combined with contrast dye in an impaired kidney.
WHAT MEDS AFTER AN MI - ACE, ASA, BB, STATIN
After a myocardial event, an aspirin, ACE inhibitor, beta-blocker, and statin should be
taken daily. The goal for statin dose is LDL measurement of less than 70-100 mg/dL.
The aspirin will provide anticoagulation, and the ACE inhibitor and beta-blocker are
associated with reduced morbidity and mortality if given soon after ACS.
Niacin can:
decrease total cholesterol and triglycerides. decrease serum glucose and LDLs.
cause flushing and hypertension.
increase liver enzymes - INCREASE LFT
Exam Questions, Answers
in and around the ankle joint.
in the calf muscle.
radiating down his leg from the thigh.
pain in his lower leg which waxes and wanes. - in the calf muscle
This patient's symptoms are typical of arteriosclerosis. The term for this symptom is
intermittent claudication. When there is compromised arterial blood flow in the lower
legs, a common complaint is reproducible pain in a specific group of muscles. The pain
occurs because there is an incongruence between blood supply and demand. This
produces pain that causes a patient to stop exercising in order to obtain relief of pain.
A patient with mitral valve prolapse (MVP) reports chest pain and frequent arrhythmias.
In the absence of other underlying cardiac anomalies, the drug of choice to treat her
symptoms is a(n):
ACE inhibitor.
beta blocker.
calcium channel blocker.
diuretic. - BETA BLOCKER
Beta blockers are recommended to alleviate atrial or ventricular arrhythmias associated
with mitral valve prolapse
The valve most commonly involved in chronic rheumatic heart disease is the:
aortic.
mitral.
pulmonic.
tricuspid. - MITRAL
The mitral valve has a propensity for disorders secondary to rheumatic heart disease.
Rarely is the pulmonic valve involved, but the aortic and tricuspid valves follow in
descending order of involvement. Following an episode of rheumatic fever, which
occurs infrequently in the US today but is common in developing countries, the valves
can become stenotic or regurgitant. This is a major cause of valvular disease in the US
seen primarily in immigrants
A decrease in blood pressure can occur in men who take sildenafil and:
,amlodipine.
tamsulosin.
metoprolol.
any antihypertensive medication. - ANY B/P MED
Any antihypertensive medication could have an additive effect with sildenafil (or another
medication in this class). Caution is advised and should only be used if the male has
stable blood pressure. A specific drug-drug interaction to be aware of is the one that can
occur with sildenafil and alpha blockers like tamsulosin, alfuzosin, prazosin, doxazosin,
or terazosin. This combination of medications may increase the risk of symptomatic
hypotension because the effect of these two drugs is additive.
IE ALPHA BLOCKERS ARE COREG AND LABETALOL ARE BOTH ALPHA AND
BETA BLOCKERS
Which choice below characterizes a patient with aortic regurgitation?
Long asymptomatic period followed by exercise intolerance, then dyspnea at rest
An acute onset of shortness of breath in the fifth or sixth decade
Dyspnea on exertion for a long period of time before sudden cardiac death
A long asymptomatic period with sudden death usually during exercise - LONG
ASYMPTOMATIC PERIOD FOLLOWED BY EXERCISE INTOLERANCE THEN
DYSPNEA AT REST.
The natural course of aortic regurgitation (AR) is that the patient has a long
asymptomatic period with slowing of activities but remains essentially asymptomatic.
Then, shortness of breath develops with activity and finally, shortness of breath at rest.
The left ventricle eventually fails unless the aorta is replaced.
Most hypertension in pre-adolescents and children is:
related to elevated BMI.
primary hypertension.
secondary hypertension.
endocrine related - SECONDARY HTN
Most hypertension in children and pre-
adolescents is secondary hypertension.
60-70% is due to renal parenchymal disease. Rarely does primary hypertension exist in
this age group. However, 85-90% of adolescents have primary hypertension.
, A 77 year-old patient has had an increase in blood pressure since the last exam. The
blood pressure has risen to 168/88 with 2 readings. The last exam's reading was
144/90. If medication is to be started on this patient, what would be a good first choice?
ACE inhibitor
Beta blocker
Calcium channel blocker
Thiazide diuretic - CCB
This patient is 77 years old and should have a goal blood pressure of < 150/90. A
thiazide diuretic is not a good first choice in this patient because it will not be potent
enough to decrease blood pressure by 25 points to get him to goal. A long acting
calcium channel blocker is appropriate for patients with isolated systolic hypertension,
ISH and will be more likely to get this patient to goal pressure than HCTZ. Beta-blockers
are no longer recommended first line for uncomplicated hypertension. ACE inhibitors
are very effective in patients who are high renin producers. Elderly patients tend to
produce lower amounts of renin.
Mrs. Brandy is having contrast dye next week for a heart catheterization. What drug
does NOT need to be stopped prior to her catheterization?
Naproxen
Furosemide
Metformin
Losartan - LOSARTAN
Naproxen and furosemide should be stopped for 24 hours prior to the catheterization.
Metformin should be stopped 48 hours prior to the catheterization. Furosemide is
stopped because it contributes to volume depletion. NSAIDs like naproxen are withheld
because of the impact on renal prostaglandin production. Metformin has been
implicated in lactic acidosis when combined with contrast dye in an impaired kidney.
WHAT MEDS AFTER AN MI - ACE, ASA, BB, STATIN
After a myocardial event, an aspirin, ACE inhibitor, beta-blocker, and statin should be
taken daily. The goal for statin dose is LDL measurement of less than 70-100 mg/dL.
The aspirin will provide anticoagulation, and the ACE inhibitor and beta-blocker are
associated with reduced morbidity and mortality if given soon after ACS.
Niacin can:
decrease total cholesterol and triglycerides. decrease serum glucose and LDLs.
cause flushing and hypertension.
increase liver enzymes - INCREASE LFT
