1.
The pulmonary vein carries deoxygenated blood & the pulmonary artery carries oxygenated blood.
Correct Answer
B. False
Explanation
Opposite...pulmonary vein carries oxygenated blood from lung --> heart (to then go to rest of body). The pulmonary artery carries deoxygenated blood from the heart --> lung (to get oxygen). This is the opposite of how we usually think of arteries carrying oxy blood & veins carrying de-oxy blood
2.
Indicate ALL the general changes that occur with age to the cardiovascular system.
Correct Answer(s)
A. Narrowing of vascular lumen
E. Men's stroke volume remains stable, while women's increases
Explanation
Age-Related Changes of CV System: - Inc thickness of arterial walls - Narrowing of vascular lumen - Inc vascular stiffness (dec ineffectiveness of elastin) - Inc LV wall thickness (dec myocyte #, but inc myocyte size) - Inc plaques in arteries - Overall mild dec in HR (mild dec when sitting, normal when standing) - Inc stroke volume in women, stable for men - Peak O2 consumption dec during exercise - Dec in the function of sarcoplasmic reticulum
3.
What is the leading cause of coronary artery disease?
Correct Answer
C. Atheroslerosis
Explanation
Atherosclerosis is the buildup of plaque in the arteries, which narrows and hardens them over time. This condition is the leading cause of coronary artery disease. It occurs when cholesterol, fat, and other substances accumulate in the artery walls, causing them to become thick and less flexible. This restricts blood flow to the heart, leading to various cardiovascular problems. Smoking, high blood pressure, and arteriosclerosis (hardening of the arteries) can contribute to atherosclerosis, but atherosclerosis itself is the primary cause of coronary artery disease.
4.
Which of the following types of angina can often lead to a heart attack and does not respond to nitroglycerin?
Correct Answer
B. Unstable angina
Explanation
Stable: not enough blood flow during exercise, but ok at rest Unstable: can occur during exercise OR rest
5.
Which of the following would NOT be a good choice for viewing actual structures of the heart?
Correct Answer
C. Electrocardiogram
Explanation
ECHO: ultrasound to visualize structures of the heart EKG: measure the electrical activity of heart Cardiac Catherization: catheter placed in heart, dye injected, an x-ray taken to visualize coronary arteries & heart valve fxn Also... Cardiac Enzyme: creatine kinase & troponin released when heart damaged MUGA: inject radioactive material to visualize pumping action of heart Exercise stress test: treadmill + monitor heart
6.
Omega 3 can be beneficial to pts with CV compromise bc it helps reduce clotting.
Correct Answer
A. True
Explanation
Be careful if pt is already on another blood thinner...
7.
Which of the following would be considered a 'last resort' medication for cardiovascular compromise?
Correct Answer
D. Thrombolytics
Explanation
Thrombolytics or 'clot busters' dissolve blood clots quickly and are used if someone is experiencing a heart attack or stroke; administered via IV (ex. streptokinase) Other Meds: - Aspirin/Plavix: blood thinners to prevent clots - Nitrates: open up blood vessels - Beta-Blockers: dec HR - Calcium Channel Blockers: relax arteries, dec HR - Statins: Dec chl to dec plaque formation
8.
A doctor will consider coronary bypass surgery if there is ____% blockage.
Correct Answer
70
Explanation
A doctor will consider coronary bypass surgery if there is 70% blockage. This means that when the patient's coronary arteries are narrowed by 70% due to plaque buildup, the doctor will consider performing bypass surgery. This procedure involves redirecting blood flow around the blocked or narrowed part of the artery to improve blood supply to the heart. It is typically recommended when the blockage is severe and other treatments such as medication or angioplasty are not sufficient.
9.
Pre-hypertension falls under which of the following systolic/diastolic ranges?
Correct Answer
C. 120-139 / 80-89
Explanation
Pre-hypertension falls under the systolic/diastolic range of 120-139 / 80-89. This means that if a person's blood pressure readings fall within this range, they are considered to have pre-hypertension. It is important to monitor blood pressure in this range closely, as it indicates an increased risk for developing hypertension. Lifestyle modifications such as a healthy diet, regular exercise, and stress management may be recommended to prevent the progression to hypertension.
10.
The shorter the vessel length the greater the systemic vascular resistance?
Correct Answer
B. False
Explanation
Longer BV length = more resistance = inc BP
11.
Indicate which of the following meds can lead to secondary hypertension.
Correct Answer(s)
A. NSAIDs
C. Steroids
D. Migraine Meds
Explanation
NSAIDs: retain fluid Migraine meds: BV constriction
12.
Describe what Pseudo-Hypertension is caused by and how docs can differentiate it from true hypertension.
13.
While taking a BP reading in the clinic you get multiple readings with an average of 187/108. What do you diagnose this as?
Correct Answer
C. HTN Urgency
Explanation
HTN Urgency: >/= 180 &/or >/= 110 HTN Emergency: > 200-220 &/or 120-130
14.
Subclavian Steal Syndrome is a condition where there is stenosis of the subclavian artery proximal to the origin of the vertebral artery resulting in reduced blood flow to the heart.
Correct Answer
B. False
Explanation
Blockage of the subclavian artery at the location will cause reversal of blood in the vertebral artery which is sending blood up to the brain. Can lead to brain damage. There will be decreased BP on affected side usually greater than 20 mmHg and is a common reason for unequal pressures between the 2 arms.
15.
Osteoporosis is diagnosed ff bone loss is greater than ____ standard deviations below the normal mean bone mineral density (BMD) of a young adult
Correct Answer
2.5
Explanation
Osteoporosis is diagnosed if the bone loss is greater than 2.5 standard deviations below the normal mean bone mineral density (BMD) of a young adult. This means that if an individual's BMD falls more than 2.5 standard deviations below the average BMD of a young adult, they are considered to have osteoporosis. This measurement is used to determine the severity of bone loss and diagnose the condition.
16.
Bisphosphonates (e.g. Fosomax & Boniva) work by stimulating osteoblasts which results in increased bone density & reduced fractures by 50%
Correct Answer
B. False
Explanation
Bisphosphonates work by inhibiting osteoCLASTS
17.
Desribe the main symptomatic difference between osteoarthritis and rheumatoid arthritis.
18.
Methotrexate & Plaquenil are medications for which of the following conditions?
Correct Answer
A. Sjorgren's
Explanation
Methotrexate is a last resort med in Sjorgren's
19.
Indicate all of the associated symptoms/demographics for Giant Cell Arteritis
Correct Answer(s)
C. Tenderness of scalp
D. Jaw pain when chewing
E. Can often occur with polymalgia rheumatica
Explanation
Symptoms of Giant Cell Arteritis: - Mean age of onset is 70 yo - 3x more common in females - 35% of time occurs w/ polymyalgia rheumatic (pain of shoulders/pelvic girdle) - fever & weight loss - new-onset temporal HA - tenderness of scalp (where the temporal artery is located) - jaw claudication - vision issues
20.
The following equations are used to determine the typical ESR:
Men: age/2
Women: (age+10)/2
Correct Answer
A. True
Explanation
ESR helpful in the diagnosis of giant cell arteritis
21.
What is the gold standard for diagnosing giant cell arteritis?
Correct Answer
C. Temporal artery biopsy
Explanation
Before initiating tx for giant cell arteritis, a temporal artery biopsy should be conducted.
22.
If acute vision loss occurs secondary to giant cell arteritis oral steroids should be adminstered, once symptoms have stabalized, administer IV steroids as well.
Correct Answer
B. False
Explanation
- If acute vison loss occurs w/ giant cell arteritis, give IV steroids followed by oral steroid
- If no vision loss occurs, give oral steroids
23.
Which of the following is found to be low in post-traumatic stress syndrome pts?
Correct Answer
B. Cortisol
Explanation
Cortisol is found to be low in post-traumatic stress syndrome (PTSD) patients. PTSD is a mental health disorder that occurs after experiencing or witnessing a traumatic event. Cortisol is a hormone released by the body in response to stress, and it helps regulate the body's stress response. In individuals with PTSD, the chronic activation of the stress response system can lead to a dysregulation of cortisol levels. Studies have shown that PTSD patients often have lower levels of cortisol, which may contribute to the symptoms and difficulties associated with the disorder.
24.
Over 65 yo, women are more constipated than men.
Correct Answer
A. True
Explanation
Lame
25.
Which of the following procedures also allows for a biopsy to be performed to check for colorectal cancer?
Correct Answer
B. Colonoscopy
Explanation
Sigmoidoscopy: rectum & lower colon --> every 5 years
Colonscopoy: rectum & entire colon & biopsy --> every 10 years
Usually recommend fecal occult blood test (FOBT)
26.
Which form of hepatitis is most commonly found in the elderly?
Correct Answer
C. C
Explanation
Hep treated w/ interferon --> can lead to interferon retinopathy
27.
BpH significantly increases the risk for prostate cancer
Correct Answer
B. False
Explanation
BPH does NOT increase the risk for prostate cancer
28.
After age 60, men should get a PSA (prostate spcific antigen) how often?
Correct Answer
A. Every year
Explanation
No more screening after 75 yo
29.
Any woman with hx of breast cancer or man with hx of lung cancer should have a DFE due to the high risk of metastasis with these conditions.
Correct Answer
A. True
Explanation
The statement is true because women with a history of breast cancer and men with a history of lung cancer have a high risk of metastasis, which refers to the spread of cancer cells from the primary site to other parts of the body. A DFE (Digital Fundus Examination) is a medical procedure that examines the back of the eye for signs of metastasis. Therefore, it is recommended for individuals with a history of these types of cancer to undergo a DFE to monitor for any potential spread of cancer cells to the eye.
30.
Which of the following is considered the 'aging pigment'?
Correct Answer
D. Lipofuscion
Explanation
Lipofuscion: yellow/brown pigment granules mostly composed of lipid residues deposited into nerve cells secondary to mitochondiral/lysozyme damage
Amyloid: hard deposits composed of proteins/polysacchardies
31.
Brain weight decreases by ____% with age
Correct Answer
10
Explanation
There is also a 20% decrease in cerebral flow
32.
The 1st line of treatment for a TIA is:
Correct Answer
A. Aspirin
Explanation
Carotid endarterectomy is indicated if there is 70% narrowing, shown to not be effective if less than 50% blockage
33.
Ischemic strokes are much more common that hemorrhagic strokes.
Correct Answer
A. True
Explanation
Ischemic: BVs in brain get clogged
Hemorrhagic: weakened BV bursts and blood compresses brain (much more deadly) (2 types: intracerebral & subarachnoid)
34.
If someone had a stroke and presents with a ptosis, weakened extraocular muscles, dilated pupils and nystagmus, what area of the brain do you think was most affected?
Correct Answer
C. Brainstem
Explanation
Brainstem --> think cranial nerves
35.
Most diabetic patients will also be on an ACE-inhibitor for what reason?
Correct Answer
A. Renal protection
Explanation
Diabetic patients are often prescribed ACE inhibitors for renal protection. ACE inhibitors help to lower blood pressure and reduce the strain on the kidneys, which can be beneficial for individuals with diabetes who are at a higher risk of developing kidney disease. By protecting the kidneys, ACE inhibitors can help to prevent or slow down the progression of diabetic nephropathy, a common complication of diabetes that can lead to kidney failure.
36.
What is the minimum fasting blood sugar to be considered a diabetic?
Correct Answer
126
Explanation
Normal: < 100
Pre-DM: 100-125
37.
Which of the following drugs can mask the symptoms of hypoglycemia?
Correct Answer
C. Beta blockers
Explanation
Beta blockers can mask symptoms of hypoglycemia such as sweating & palpitations
38.
What is the first sign of renal disease?
Correct Answer
D. Albumin in urine
Explanation
Thickening of BM of glomerulus --> protein leak in urine
39.
Amiodarone & lithium are two drugs that can potentially cause hyperthyroidsm.
Correct Answer
B. False
Explanation
Amiodarone & lithium can cause HYPOthyroidism
40.
Age leads to decreased RBC lifespan and decreased total blood volume
Correct Answer
B. False
Explanation
RBC lifespan + total blood volume are stable w/ age
41.
What is the most common cause of anemia?
Correct Answer
D. Dec. iron
Explanation
The most common cause of anemia is a decrease in iron levels. Iron is essential for the production of hemoglobin, the protein in red blood cells that carries oxygen throughout the body. When iron levels are low, the body is unable to produce enough healthy red blood cells, leading to anemia. Sickle cell anemia is a specific type of anemia caused by a genetic mutation, while vitamin B12 deficiency and blood loss can also contribute to anemia but are not as common as low iron levels.
42.
Emphysema usually leads to hypoxia
Correct Answer
B. False
Explanation
Bronchitis --> Blue Bloaters --> Hypoxic --> chronic cough (inc CO & weight)
Emphysema --> Pink Puffers --> usually not hypoxic --> SOB (dec CO & weight)
43.
Tetracycline & doxycycline are commonly prescribed for what skin disorder?
Correct Answer
C. Rosacea
Explanation
Tetra 250 mg QID
Doxy 100 mg BID
+ Metro gel given (antibiotic)
44.
Indicate the appropriate dosage for Acyclovir for the treatment of postherpetic neuralgia.
Correct Answer(s)
B. 800 mg
D. 5x per day
F. For 10 days
Explanation
The appropriate dosage for Acyclovir for the treatment of postherpetic neuralgia is 800 mg, 5 times per day, for 10 days. This dosage and frequency is recommended to effectively manage the symptoms and duration of postherpetic neuralgia, which is a painful condition caused by the reactivation of the varicella-zoster virus. By taking 800 mg of Acyclovir 5 times a day for 10 days, the medication can help reduce the severity and duration of the pain associated with postherpetic neuralgia.