Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Cardiology69
Unit 1
| Question | Answer |
|---|---|
| In 90% of people the AV node and Bundle of His receive blood supply from where? | Right Coronary Artery |
| The U-wave if present may represent what? | Repolarization of the Perkinje Fibers or Hypokalemia |
| The efficient ventricular conduction system delivers an impulse within what time frame? | 0.12 sec. |
| How is CO calculated? | Stroke Volume X HR |
| What is normal adult CO? | 4-8 L/min |
| What is normal Cardiac Index? | 2.8-4.2 L/min/m2 |
| How do you calculate CI? | CO/BSA |
| Determines the amount of stretch placed on the myocardial fibers? | Preload |
| Is the peripheral resistance against which the Left ventricle must pump? | After load |
| The ability to respond to alterations in CO? | Cardiac Reserve |
| Can cause distended neck veins or liver enlargement as a result of resistance to blood flow? | ↑ Right Atrial Pressure |
| The sympathetic nervous system is mediated by which receptor sites? | Beta Adrenergic Receptors |
| The parasympathetic nervous system is mediated by which nerve? | The Vagus nerve |
| These receptors are located in vascular smooth muscle? | Alpha₁ Adrenergic Receptors |
| Decreased stimulation to Alpha₁ adrenergic receptors causes what? | Vasodilation |
| When baroreceptors and/or chemoreceptors are stimulated where is this information sent? | Vasomotor Center in the Brainstem |
| What are the two main factors influencing BP? | CO X SVR |
| The difference between SBP and DBP? | Pulse pressure |
| Refers to the average pressure in the arterial system that is felt by the organs in the body? | MAP= (SBP+2DBP)/3 |
| A MAP greater that what is needed to sustain life? | >60 mmHg |
| Two important cardiac changes with aging? | Less pacemaker cells and less ANS control (B cells) |
| Which is not considered a normal consequence of aging? | HTN |
| Arterial stiffening is caused by what? | Loss of elastin fibers |
| A condition caused by ischemia of the muscles? | Intermittent Claudication |
| A specific question regarding any allergic reaction is important if there is a chance that a cardiac cauterization may be needed? | Iodine dye |
| These drugs are contraindicated in patients taking nitrates? | Sildenafil (Viagra) |
| Oral contraceptives and/or HRT can cause what in females? | Blood clots and Heart disease |
| When obtaining postural BP, HR should not vary more that what? | <20 bpm |
| BP in the lower extremities is expected to be ___________ than the upper extremities? | 10 mmHg higher |
| What 3 things can cause extremity edema? | Gravity, interruption of venous return, or Right sided Heart Failure |
| What causes JVD? | Right sided Heart Failure |
| The term for palpable vibration? | Thrill |
| When auscultating sounds like a buzzing or humming blood flow? | Bruit |
| What causes splinter hemorrhages? | Infective endocarditis |
| What is a reddish-blue discoloration of the lower extremities? | Dependent Rubor |
| Regular rhythm but strength of pulse varies with each beat? | Pulus Alternans (Heart failure or Cardiac Tamponade) |
| The difference between an apical pulse and a peripheral pulse? | Pulse Deficit |
| This sound is known as a ventricular gallop and is associated by decreased compliance of the ventricles during filling? | S₃ |
| This sound is known as atrial gallop and is associated with atrial contraction? | S₄ |
| Are structured lifts of the chest wall in the precordial area that can be seen or palpated? | Heaves |
| What is normal Troponin level? | <0,5 mcg/L |
| Amino acid produced during protein catabolism that has been identified as a risk factor for cardiovascular disease? | Homocysteine |
| Are useful in the diagnosis of myocardial injury and necrosis? | Biomarkers |
| Elevation is specific for myocardial tissue? | CK-MB |
| What is the biomarker of choice in the diagnosis of MI? | Troponin |
| Is a protein produced by the liver during periods of acute inflammation? | CRP (C-reactive Protein) |
| Patients must fast for what type of blood draw? | Lipid panel |
| Have been found to have thrombogenic properties that increase the risk of clot formation at the site of intravascular lesions? | Lp(a) [Lipoprotein (a)] |
| Provides information about the function of the Left ventricle during systole? | EF (Ejection Fraction) |
| Causes pharmacologic stress on the heart while the patient is resting? | Dobutamine (Dobutex) |
| Is used to assess the function of the Left side of the heart? | Wedge Pressure |
| Is the gold standard in coronary imaging? | Cardiac Catheterization |
| Is a measurement of preload and can be used to monitor the pressure in the right atrium? | CVP |
| Is a neurotransmitter released from SNS nerves endings? | Noreepinephrine (NE) |
| This neurotransmitter activates receptors located in the SA node, myocardium and vascular smooth muscle? | NE |
| The smooth muscle of blood vessels has both of these receptors? | Alpha and Beta adrenergic receptors |
| These receptors located in the peripheral vasculature cause vasoconstriction when stimulated by NE? | Alpha- Adrenergic Receptors |
| Beta1- adrenergic receptors in the heart respond to NE and epinephrine with increase HR? | Chronotropic |
| Beta1 receptors that increase for of contraction? | Inotropic |
| Beta1 receptors that increase speed of conduction? | Dromotropic |
| These receptors are activated primarily by epinephrine released from the adrenal medulla and cause vasodilation (coronary arteries, skeletal smooth muscle, and lungs)? | Beta2 adrenergic receptors |
| What is one of the most significant CVD effects of aging? | ↓ responsiveness of cardiovascular cells to SNS stimulation. |
| EDRF, helps maintain low arterial tone at rest, inhibits growth of the smooth muscle layer and inhibits platelet aggregation? | Nitric Oxide |
| Local regulator that is an extremely potent vasoconstrictor? | Endothelin (ET-1) |
| Angiotensin II ↑ BP by what 2 mechanisms? | ↑ vasoconstriction and stimulates the release of Aldosterone from the adrenal cortex. |
| Antagonize the effects of ADH and Aldosterone? | ANP and BNP secreted by cardiac cells. |
| What does EDRF stand for? | Endothelium-Derived Relaxing Factor |
| What are 3 types of EDRF's? | Nitric Oxide, Prostacyclin, and Endothelium Derived Hyperpolarizing Factor. |
| Activates B-Adrenergic receptors in peripheral arterioles of skeletal muscle, causing vasodilation? | Epinephrine |
| What is HTN considered to be? | SBP >140mmHg and DBP > 90mmHg |
| What is Pre-HTN considered to be? | SBP 120-139 mmHg and DBP 80-89 mmHg |
| False HTN and occurs with advanced atherosclerosis? | Pseudohypertension |
| Is an elevated BP without an identified cause and it accounts for 90%-95% of all cases of HTN? | Primary HTN, Essential HTN, or Idiopathic HTN |
| Is an elevated BP wit a specific cause that can be identified and corrected? | Secondary HTN |
| Unexplained Hypokalemia, abdominal bruit, variable BP with tachycardia, sweating, tremors, Hx of renal disease? | Secondary HTN |
| Results in the increase conversion of angiotensin to angiotensin I? | High Plasma Renin Activity (PRA) |
| Is a physiologic process that maintains constant cerebral blood flow despite fluctuations in BP? | Auto-regulation |
| Elevated BP readings in a clinical setting? | "White Coat Syndrome" |
| May occur after a marked rise in BP if the cerebral blood flow is not decreased by auto regulation? | Hypertensive Encephalopathy |
| What is a classic symptom of PVD involving the arteries in the legs? | Intermittent Claudication |
| What is the earliest manifestation of renal dysfunction? | Nocturia |
| WHy is measuring K+ levels important in HTN? | To rule out Hyperaldosteronism a cause of secondary HTN |
| These levels are determined to establish a baseline, because the levels often rise with diuretic therapy? | Uric Acid Levels |
| Patients with HTN do not show a normal nocturnal dip in BP? | "Nondippers" |
| Elevated BP readings in a clinical setting? | "White Coat Syndrome" |
| What is the most frequent cause of secondary HTN in the US? | Alcohol induced liver cirrhosis |
| What are the 2 main actions of antihypertensives? | ↓ volume of circulating blood and ↓ SVR |
| Reduces SVR and BP by direct arterial vasodilation? | Hydralizine (Apresoline) |
| These drugs may ↓ the effects of anti-hypertensives? | ASA, NSAIDS, and oral contraceptives. |
| What is the most effective IV drug to treat HTN emergencies? | Sodium Nitroprusside (Nitropress) |
| Unstable Angina (UA) and myocardial infarction (MI) are more serious manifestations of CAD and are termed this? | Acute Coronary Syndrome |
| The earliest lesion of atherosclerosis and are characterized by lipid-filled smooth muscle cells? | Fatty Streaks |
| Is the beginning of progressive changes in the endothelium of the arterial wall? | Fibrous Plaque Stage |
| The final stage in the development of atherosclerotic lesions? | Complicated Lesion Stage |
| Two factors that contribute to the growth and extent of collateral circulation? | Inherited Predisposition and Chronic Ischemia |
| Have the highest incidence of coronary artery disease? | White, middle aged men. |
| Are vehicles for fat mobilization and transport, and vary in composition? | Lipoproteins |
| What should be LDL levels be at? | <160 |
| What should HDL levels be at? | >40 |
| What should Triglyceride levels be at? | <150 |
| What is considered HTN for a patient with DM or CKD? | BP >130/80 mmHg |
| What are two catecholamines? | Epinephrine and Norepinephrine |
| This has been shown to lower blood levels of Homocysteine? | B complex Vitamins (B6, B12 and Folic Acid) |
| Is produced by the breakdown of the essential amino acid methionine, which is found in dietary protein? | Homocysteine |
| FITT Formula? | Frequency, Intensity, Type, Time |
| Are the most widely used lipid lowering drugs? | Statin drugs |
| Which drug increases the risk for rhabdomyolosis when used with gemfibrozil (Lopid) or niacin? | Simvastatin (Zocor) |
| Is chest pain that occurs only while the person is lying down and is usually relieved by standing or sitting? | Angina Decubitus |
| (Variant Angina) often occurs at rest, usually in response to spams of a major coronary artery? | Prinzmetal's Angina |
| Cardiac cells can withstand ischemic condition for how long before cellular death begins? | Approx 20 min |
| Occurs when oxygen and nutrients supplied to the tissues are inadequate because of severe Left Ventricular failure? | Cardiogenic Shock |
| This occurs 2-3 days after an acute MI as a common complication of infarction? | Acute Pericarditis |
| Is pericarditis with effusion and fever that develops 4 to 6 weeks after MI? | Dressler Syndrome |
| Are released into the blood from necrotic heart muscle after an MI? | Serum Cardiac Markers |
| Is released into the circulation within 2hrs after and MI and peaks in 3-15hrs? | Myoglobin |
| PCI? | Percutaneus Coronary Intervention (Angioplasty) |
| What is the most serious complication of PCI? | Dissection of Coronary Artery |
| What is the major complication with Fibrinolytic therapy? | Bleeding |
| What is the most common artery used for bypass graft? | Internal Mammary Artery (IMA) |
| TMR? | Transmyocardial Revascularization |
| IV anti-platelet agents? | Glycoprotein IIb/IIIa inhibitor |
| Harvest of radial artery for bypass graft use can cause what? | Arterial Spasms |
| Which drug decreased the incidence of arterial spasms? | Calcium Channel Blockers |
| Can manifest days to weeks after surgery and may remain a permanent disorder? | Postoperative Cognitive Dysfunction (POCD) |
| What are the primary risk factors for HF? | CAD and Advancing age |
| Are used for the treatment of HF in African Americans; this copackaged drug is only approved for use in this ethnic group? | Isosorbide Dinitrate and Hydralazine (BiDil) |
| Have an extremely high risk (50%) for Ace inhibitor-related cough? | Asians (David Kim) |
| Pro-inflammatory cytokines are released by cardiac myocytes in response to various forms of cardiac injury? | TNF and IL-1 |
| Is an increase in the muscle mass and cardiac wall thickness in response to over-work and strain? | Hypertrophy |
| Are hormones produced by the heart to promote venous and arterial vasodilation? | ANP and BNP |
| Is done in patients who develop unexplained new onset HF that is unresponsive to usual care? | Endomyocardial Biopsy (EMB) |
| Is a recombinant form of BNP and causes both arterial and venous dilation? | Nesiritide (Natrecor) |
| Does not increase SVR and is preferred for short treatment of ADHF? | Dobutamine |
| Inhibit sodium reabsorption in the distal tubule, thus promoting excretion of sodium and water? | Thiazides |
| These drugs act on the ascending loop of Henle to promote sodium, chloride, and water excretion? | Loop Diuretics |
| Anti-hypertensives agent that relaxes the arteries and decrease the work of the heart? | Hydralazine |
| Anti-aginal agent, relaxes the veins as well as the arteries? | Isosorbide Dinitrate |
| What is the antidote to digoxin toxicity? | Digibind |
| Is one in which the wall of the artery forms the aneurysms, with at least one vessel layer still intact? | True Aneurysm |
| Is circumferential and relatively uniform in shape? | Fusiform Aneurysm |
| Is pouchlike with a narrow neck connecting the bulge to one side of the arterial wall? | Saccular Aneurysm |
| Is not an aneurysm but a disruption of all arterial wall layers with bleeding that is contained by surrounding anatomic structures? | False Aneurysm of Psuedoaneurysm |
| Conservative therapy typically is indicated for small aneurysm less than what? | 5cm |
| Surgical repair is done for aneurysms greater than what size? | >5.5cm M and >5cm F |
| What does EVAR stand for? | Endovascular Aneurysm Repair |
| Approx 60-70% of dissections involve this anatomical location? | Ascending Aorta |
| Results from the creation of a false lumen (between the intima and media) through which blood flows? | Dissection |
| During this time approximately half of all dissections in women younger than 40 y/o occur? | Pregnancy |
| Beta Blocker that decreases BP and force of Left ventricular contraction? | Esmolol |
| A chronic dissection would most likely be in what location? | Descending Aorta |
| What is the clasic symptom of lower extremity PAD? | Intermittent Claudication |
| Manifested as numbness or tingling in the toes or feet, may result from nerve tissue ischemia? | Paresthesia |
| Blanching of the foot in response to leg elevation? | Elevation Pallor |
| Redness of the foot? | Reactive Hyperemia |
| Developement of redness when a limb is in a dependent position? | Dependent Rubor |
| What are 2 drugs to treat intermittent claudication? | Pletal and Trental |
| Is recommended as a first-line drug therapy for patients with intermittent claudication inhibits platelet aggregation and increases vasodilation? | Cilostazol (Pletal) |
| Increases RBC flexibility and decreases blood viscosity?? | Pentoxifylline (Trental) |
| The removal of the obstructing plaque? | Atherectomy |
| Combines two procedures: ballon angioplasty and cold therapy? | Cryoplasty |
| Opening the artery and removing the obstructing plaque? | Endarterectomy |
| Opening the artery , removing plaque and sewing a patch to the opening to widen th lumen? | Angioplasty |
| Six "P"s? | Pain, Pallor, Pulselessness, Paresthesia and Poikilothermia. |
| Is a nonatherosclerotic , segmental, recurrent inflammatory vaso-occulsive disorder of the small and medium sized arteries and veins of the upper and lower and extremities? | Thromboangiitis Obliterans (Buerger Disease) |
| Is an episodic vasospastic disorder of small cutaneous arteries, most frequently involving the fingers and toes? | Raynaud's Phenomenon |
| Swollen, blue, painful legs; a very rare compplication may develop in a patient in the advanced stages of cancer?? | Phelgmasia Cerulea Dolens |
| Which test is used to monitor therapeutic levels of warfarin (Coumadin)? | INR |
| What is the antidote for Warfarin(Coumadin)?# | Vitamin K |
| What type of anticoagulant drug is Warfarin?# | Vitamin K Antagonist |
| What is normal INR value and therapeutic value?# | 0.75-1.25 and 2-3 |
| What type of anticoagulant is UH and LMWH? | Indirect Thrombin Inhibitors |
| What is the antidote for UH? | Protamine Sulfate |
| One serous side effect of heparin? | Heparin Induced Thrombocytopenia (HIT) |
| A long term side effect of heparin use? | Osteoporosis |
| Are classified as hirudin derivatives or synthetic thrombin inhibitors? | Direct Thrombin Inhibitors |
| Is approved for prophylaxis or treatment of patients with HIT? | Lepirudin |
| Is approved for HIT patients undergoing PCA? | Bivalirudin |
| Is particularly useful for VTE treatment in patients with a Hx of HIT? | Fondaparinux |
| Are smaller varicose veins that appear flat, less tortuous and blue-green in color? | Reticular veins |
| Often referred to as spider veins; are very small visible vessels, generally less than 1mm in diameter that appear bluish black, purple or red? | Telanglectasias |
| Is a condition in which the valves in the veins are damaged, which results in retrograde blood flow, pooling of blood in the legs and swelling? | Chronic Venous Insufficiency (CVI) |
| Causes a brownish skin discoloration? | Hemosiderin |
| is a continuous burning pain due to ischaemia of the lower leg. It begins, or is aggravated, after reclining and is relieved by sitting or standing. | Rest Pain |
| Patchy mottling of the feet and toes in the presence of palpable pulses? | "Blue Toe Syndrome" |
| Presence of back or flank ecchymosis? | Grey Turners sign |
| Connective tissue disorders? | Marfans or Ehlers Danlos Syndrome |
| Results from valvular destruction allowing retrograde venous blood flow? | Chronic Venous Insufficiency |
| S3 and S4 heart sounds are auscultated/present with Left or Right sided HF? | Left sided |
| Is an option for the patients with fluid overload and can rapidly remove extracellular and intravascular fluid volume? | Ultrafiltration (UF) |
| Is a device that increases coronary blood flow to the heart muscle and decreased the workload through a process called counter pulsation? | IABP |
| This drug decreases both preload and afterload, but can cause thiocynate toxicity? | Nitroprusside (Nipride) |
| Is a recombinant form of BNP and causes booth arerial and venous dilation? | Nesiritide (Natrecor) |
| An alternatic therapy that improves exercise capacity and decrease symptoms of cardiac insufficiency. Benefits or patients not willing to take prescription drugs? | Hawthorn |
| Is a selective B-adrenergic agonist and works primarily on the B-receptors in the heart? | Dobutamine |
| Inhibition of _______ increases cyclic adenosine monophosphate (cAMP) which enhances calcium entry into the cell and improves myocardial contractility? | Phosphodiaesterase (Incor, Primacore) |
| Hemoglobin A1C should be less than what? | <7% |
| Provided early evidence that certain behaviors and lifestyles contribute to developement of CAD? | The Framingham Study |
| Statin drugs block synthesis of cholesterol by blocking this? | HMG-CoA |
| What is the major route of elimination of cholesterol? | Via bile in the liver |
| Vytorin is what 2 drugs? | Zetia and Simvastatin |
| What is the main side effect of nitrates? | Headaches |
| In an attempt to compensate for infarction muscle, the normal myocardium will hypertrophy and dilate? | Ventricular Remodeling |
| Alpha Adrenergic Antagonist reduces sympathetic outlow from CNS, produces vasodilation and Decreases both SVR/BP? | Clonidine (Catapres) |
Created by:
BOjangles1006
Popular Nursing sets