MCC of HTN in children < 6 yrs Correct Answer: renal parenchymal dz (urinalysis, urine culture, and renal ultrasonography should be ordered for all
... [Show More] children presenting with hypertension)
TZDs should not be used in patients Correct Answer: with New York Heart Association class III or IV heart failure
next step in management if patient is already on maximum therapy for CHF? Correct Answer: cardiac resynchronization therapy (look for bundle branch block and EF less than or equal to 30%)
what dietary recommendation has been shown to decrease the rate of a sudden death due to cardiovascular disease? Correct Answer: Increased intake of omega-3 fax
chest radiograph shows widening of the mediastinum, enlargement of the aortic knob, or tracheal displacement -> Dx?
Management? Correct Answer: dissecting aortic aneurysm
Acute dissection of the ascending aorta is a surgical emergency, but dissections confined to the descending aorta are managed medically unless the patient demonstrates progression or continued hemorrhage into the retroperitoneal space or pleura.
initial medical management aortic dissections confined to the descending aorta? Correct Answer: reduce the systolic blood pressure to 100-120 mmHg or to the lowest level tolerated (use beta blockers such as propranolol or labetalol to get the heart rate below 60 beats per minute, if systolic blood pressure remains over 100 mmHg, IV nitroprusside should be added... but must have beta-blockade before her nitroprusside because of vasodilation from nitroprusside will induce reflex activation of the sympathetic nervous system,, causing increased ventricular contraction and increased shear stress on the aorta)
If supraventricular tachycardia is refractory to adenosine or rapidly recurs, the tachycardia can usually be terminated by the administration of intravenous ___ Correct Answer: verapamil or a β-blocker. If that fails, intravenous propafenone or flecainide may be necessary. electrical cardioversion may be necessary if these measures fail to terminate the tachycardia arrhythmia (also remember to treat contributing causes such as hypovolemia, hypoxia, or electrolyte disturbances).
monotherapy for hypertension and African American patients is more likely to consist of ___ Correct Answer: diuretics for calcium channel blockers (rather than 8 a blockers or ACE inhibitors; it has been suggested that hypertension and African American does not as angiotensin II dependent as it appear [Show Less]