Acute Illness - Midterm Week 3+4 PDF

Week 3: Hypertension (HTN) Definition: Sustained elevation of blood pressure (BP). BP: Force exerted by blood against vessel walls; must be adequate for perfusion. Risk Factors: o Nonmodifiable: Age (≥55), male sex, family history, ethnicity. o Modifiable: O...

Week 3: Hypertension (HTN) Definition: Sustained elevation of blood pressure (BP). BP: Force exerted by blood against vessel walls; must be adequate for perfusion. Risk Factors: o Nonmodifiable: Age (≥55), male sex, family history, ethnicity. o Modifiable: Obesity, smoking, alcohol, high sodium intake, diabetes, sedentary lifestyle, stress. Stages of Hypertension: o Optimal: BP within normal limits. o Stage 1-3: Increasing severity with risk of organ damage. Clinical Manifestations: o Usually asymptomatic until severe. o Symptoms (if present): Fatigue, dizziness, palpitations, angina, dyspnea. Complications: o Hypertensive Crisis: BP >180/120 mmHg. o Target-organ damage: Stroke, heart failure (HF), kidney failure, MI. Management: o Lifestyle changes: Diet (low sodium, DASH diet), exercise, smoking cessation. o Drug Therapy: ▪ Diuretics ▪ Beta-blockers ▪ ACE inhibitors ▪ Calcium channel blockers Coronary Artery Disease (CAD) Definition: Atherosclerosis causing narrowing of coronary arteries. Risk Factors: o Nonmodifiable: Age, sex, genetics. o Modifiable: Smoking, obesity, hypertension, diabetes, high cholesterol. Complications: o Acute Coronary Syndrome (ACS) o Myocardial Infarction (MI)  o Heart failure Management: o Lipid-lowering therapy (Statins) o Antiplatelet therapy (Aspirin, Clopidogrel) o Lifestyle changes Chronic Stable Angina Definition: Predictable chest pain due to myocardial ischemia. Triggers: Physical exertion, stress, cold exposure. Management: o Nitroglycerin (NTG) o Beta-blockers o Calcium channel blockers o Lifestyle changes Acute Coronary Syndrome (ACS) Unstable Angina (UA): New or worsening chest pain, unpredictable. Myocardial Infarction (MI): o NSTEMI: Partial coronary artery occlusion. o STEMI: Complete artery occlusion (life-threatening). Management: o Emergent PCI (Percutaneous Coronary Intervention) o Fibrinolytic therapy (tPA) o Antiplatelets & Anticoagulants Heart Failure (HF) Definition: Impaired cardiac pumping and/or filling. Types: o Left-sided HF: ▪ Symptoms: Pulmonary congestion, dyspnea, pink frothy sputum. o Right-sided HF: ▪ Symptoms: Peripheral edema, JVD, hepatomegaly. Compensatory Mechanisms: o Frank-Starling Mechanism (increased stroke volume). o Neurohormonal Activation (SNS, RAAS).  o Myocardial Hypertrophy (ventricular remodeling). Management: o Diuretics (reduce fluid overload). o ACE inhibitors (reduce afterload). o Beta-blockers (reduce workload). o Salt & fluid restriction 25 Multiple-Choice Questions with Answers 1. What is the primary cause of hypertension? A) High cholesterol B) Increased cardiac output C) Increased peripheral vascular resistance D) Increased stroke volume 2. Which of the following is a modifiable risk factor for hypertension? A) Age B) Ethnicity C) Smoking D) Family history 3. Which blood pressure reading is considered a hypertensive crisis? A) 140/90 mmHg B) 160/100 mmHg C) 180/120 mmHg D) 120/80 mmHg 4. Which is a complication of untreated hypertension? A) Stroke B) Anemia C) Hypotension D) Dehydration 5. What is the first-line medication for hypertension? A) Beta-blockers B) ACE inhibitors C) Diuretics D) Calcium channel blockers 6. What is the leading cause of coronary artery disease? A) High HDL B) Atherosclerosis C) Pulmonary hypertension D) Ventricular hypertrophy 7. Which cholesterol-lowering medication is commonly prescribed for CAD? A) Aspirin B) Clopidogrel C) Statins D) Beta-blockers 8. Which symptom is characteristic of stable angina? A) Sudden onset at rest B) Predictable chest pain C) Sharp stabbing pain D) Pain lasting several hours 9. What is the most serious type of myocardial infarction? A) NSTEMI B) STEMI C) Unstable angina D) Silent ischemia 10. Which cardiac enzyme is most specific for MI? A) Troponin B) CK-MB C) Myoglobin D) BNP 11. What is the initial treatment for chest pain in suspected MI? A) Oxygen, Nitroglycerin, Aspirin, Morphine B) IV fluids C) Beta-blockers only D) Antibiotics 12. Which ECG finding is characteristic of a STEMI? A) T-wave inversion B) ST-segment elevation C) U-wave prolongation D) Widened QRS 13. Which drug is a clot-buster used in MI? A) Aspirin B) tPA C) Heparin D) Clopidogrel 14. Which intervention is first-line for acute coronary syndrome? A) Beta-blockers B) Coronary artery bypass grafting (CABG) C) Percutaneous coronary intervention (PCI) D) Oxygen therapy 15. What is the hallmark symptom of left-sided heart failure? A) Peripheral edema B) Jugular vein distension C) Pulmonary congestion D) Hepatomegaly 16. Which lab value is most useful in diagnosing heart failure? A) Troponin B) BNP C) CK-MB D) WBC 17. What is the most common cause of right-sided heart failure? A) Left-sided heart failure B) Myocardial infarction C) Pulmonary embolism D) Hypovolemia 18. Which medication reduces fluid overload in heart failure? A) Beta-blockers B) ACE inhibitors C) Diuretics D) Statins 19. Which dietary recommendation is best for heart failure patients? A) High sodium B) Low protein C) Fluid restriction D) High-fat diet 20. What is the purpose of ACE inhibitors in heart failure? A) Increase heart rate B) Reduce afterload C) Increase preload D) Decrease contractility 21. Which vital sign change suggests worsening heart failure? A) Bradycardia B) Hypotension C) Sudden weight gain D) Decreased respiratory rate 22. What is a common symptom of right-sided heart failure? A) Dyspnea B) Pulmonary edema C) Peripheral edema D) Cough 23. Which position improves breathing in heart failure patients? A) Supine B) Trendelenburg C) Semi-Fowler’s D) Left lateral 24. Which diagnostic test measures ejection fraction? A) ECG B) Cardiac catheterization C) Echocardiogram D) Chest X-ray 25. Which patient should be assessed first? A) BP 140/90 mmHg B) Chest pain with ST elevation C) Heart rate 60 bpm D) Mild edema in feet Week 4: 1. Dysrhythmias Abnormal cardiac rhythms that may impact cardiac output (CO). Prompt assessment of rhythm and patient response is critical. Common Types of Dysrhythmias 1. Normal Sinus Rhythm (NSR) – Regular HR 60-100 bpm. 2. Sinus Bradycardia – HR 100 bpm; caused by stress, fever, hypoxia. 4. Atrial Fibrillation (AFib) – Irregular atrial activity leading to loss of atrial contraction. 5. Premature Ventricular Contractions (PVCs) – Early ventricular beats. 6. Ventricular Tachycardia (VT) – Run of three or more PVCs; life-threatening. 7. Ventricular Fibrillation (VFib) – Chaotic electrical activity; no CO; fatal if untreated. 8. Asystole – No electrical activity; requires CPR. 9. Pulseless Electrical Activity (PEA) – ECG shows rhythm, but no pulse. 2. ECG Interpretation P wave: Atrial depolarization. PR Interval: 0.12-0.20 sec; delay in AV node. QRS Complex: Ventricular depolarization (