2. CARDIO CONDITION/AX/REHAB Flashcards

1
Q

Common signs and symptoms of patient with heart disease

A
  1. Angina- always accompanied by (+) Levine sign(when the patient makes a fist over the sternum
  2. Referred pain-jaw, neck, upper traps, chest area, shoulders, (L) arm
  3. Palpitations
  4. Dyspnea
  5. Cardiac Syncope
  6. cyanosis
  7. Fatigue
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2
Q

What is the pattern of the referred pain on a heart disease?

A

it will always follow the ulnar nerve distribution

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3
Q

What is the response of the unstable angina to rest and nitrates?

A

(-) rest response
(-) nitrates response

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4
Q

What is the innervation of the heart?

A

C3-T4

referred pain are felt in these dermatomal areas

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5
Q

Types of Angina

A
  1. Chronic stable angina AKA predictable angina
  2. Unstable angina aka pre-infarction angina, progressive angina, crescendo angina
  3. Nocturnal Angina

4.Prinzmetal Angina AKA variant angina

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6
Q

Other term for chronic stable angina

A

Predictable angina

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7
Q

This stable angina is secondary to ____

A
  1. Physical exertion
  2. Emotional stress
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8
Q

The chronic stable angina responds to or is relieved by ____

A

rest and nitrates

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9
Q

The chronic stable angina is secondary to ____

A
  1. Physical exertion
  2. Emotional stress
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10
Q

The chronic stable angina responds to or is relieved by ____

A

rest and nitrates

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11
Q

What is the mode of administration of nitrates

A

sublingual

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12
Q

what is the maximum tablets a patient can take?

A

3 tablets

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13
Q

What is the interval of the administration of nitrates?

A

every 5 mins

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14
Q

What is the effect of nitrates?

A

vasodilation

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15
Q

What is the interval of the administration of nitrates?

A

1 tablet every 5 mins

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16
Q

What is the effect of nitrates?

A

vasodilation

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17
Q

Patients who took nitrates are prone to ____

A

orthostatic hypotension due to the vasodilation of the blood vessels

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18
Q

Patients who took nitrates are prone to ____

A

orthostatic hypotension due to the vasodilation of the blood vessels therefore rest the pt for 5-10 mins upon taking nitrates

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19
Q

Other terms for unstable angina

A

Pre-infarction angina

Progressive angina

Crescendo Angina

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20
Q

This type of angina is contraindicated to exercise

A

unstable angina

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21
Q

What is the normal duration of unstable angina

A

20-30 mins

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22
Q

What is the normal duration of unstable angina

A

20-30 mins

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23
Q

This type of angina is triggered by exertion caused by dreams

A

nocturnal angina

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24
Q

Nocturnal angina is common in what condition?

A

Congestive Heart Failure(CHF)

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25
Q

What artery is affected in prinzmetal angina ?

A

Coronary artery

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26
Q

What artery is affected in prinzmetal angina? what happens to the artery?

A

Coronary artery spasm

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27
Q

The prinzmetal angian is common in what demographic?

A

F>M

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28
Q

This type of angina is the only type of angina that is purely vasospasm

A

Prinzmetal angina

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29
Q

This is excessive heart beat

A

Palpitations or arrhythmias

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30
Q

This is the bluish discoloration of the lips, toes, & nailbeds

A

cyanosis

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31
Q

This is also known as ischemic heart disease

A

CAD or coronary artery disease

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32
Q

This condition is secondary to atherosclerosis affecting the entire coronary artery

A

CAD or coronary artery disease

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33
Q

What is the effect of nicotine in veins

A

vasoconstrictors

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34
Q

What does the nicotine stimulates?

A

fibrinogen

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35
Q

This is clotting factor #1

A

fibrinogen

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36
Q

How many clotting factors are there?

A

13

but clotting factor 6 does not exist

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37
Q

An activated fibrinogen will activate to what? this signifies what?

A

Fibrin, this is the start of the clot formation

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38
Q

Fibrinogen is activated through what?

A

physical trauma

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39
Q

suffixes of medicines to control high blood pressure

A

-olol & -ipine

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40
Q

suffixes of medicines to control high cholesterol

A

-statin

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41
Q

What demographics is atherosclerosis common in?

A

> 65y/o

M>F
*menopause: M=F due to decrease of estrogen

african american

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42
Q

which female hormone stimulates the LDL receptor?

A

Estrogen

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43
Q

what is the bad cholesterol?

A

Low density lipoprotein

*masama pag mababa
good pag mataas

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44
Q

Other term for myocardial infarction

A

Heart attack or Coronary occlusion

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45
Q

This is the death of myocardium

A

Myocardial infarction

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46
Q

Measurement in ECG which determines the true myocardial infarction

A

ST segment elevation & increase in the cardiac enzymes

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47
Q

Other term fo r congestive heart failure

A

Cardiac decompensation

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48
Q

This is the inability of ventricle to contract effectively

A

Congestive heart failure AKA Cardiac decompensation

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49
Q

This is the most serious complication of the myocardial infarction

A

Congestive heart failure

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50
Q

2 types of congestive heart failure

A
  1. right sided heart failure
  2. Left sided heart failure
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51
Q

this is the inability of the right ventricle to contract effectively

A

Right sided heart failure

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52
Q

Common symptom of patients with right sided heart failure

A

congestion in the periphery and the organs

Bipedal edema

Ascites ( due to the accumulation of fluids in the abdomen)

Hepatomegaly

Distension of the jugular veins

cyanosis

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53
Q

Heart condition where there is only one sided LE edema

A

PAD

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54
Q

Common symptom of patients with left sided heart failure

A

pulmonary edema

cough

dyspnea

orthopnea (difficulty breathing in a supine position)

PND (paroxysmal nocturnal dyspnea)

cerebral hypoxia (due to decreased oxygenated blood distributed)

fatigue (ramdam sa lahat ng heart disease pero mas ramdam sa left sided heart failure)

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55
Q

Manifestation of right sided heart failure is found where?

A

in the system

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56
Q

Manifestation of left sided heart failure is found where?

A

lungs

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57
Q

Functional classifications of patients with diseases of the heart

Class with no limitation of physical activity

A

Class 1

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58
Q

Functional classifications of patients with diseases of the heart

In class 1, the ordinary physical activity does not cause which signs & symptoms?

A

angina, palpitation, dyspnea, & fatigue

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59
Q

Functional classifications of patients with diseases of the heart

Maximum METS for class1

A

6.5METS

60
Q

Functional classifications of patients with diseases of the heart

Class with slight limitation of physical activity

A

Class 2

61
Q

Functional classifications of patients with diseases of the heart

In class 2, the ordinary physical activity causes ___

A

anginal pain, palpitation, dyspnea, fatigue

62
Q

Functional classifications of patients with diseases of the heart

Maximum METS for Class 2

A

4.5 METS

63
Q

Functional classifications of patients with diseases of the heart

Class with Marked limitation of physical activity

A

Class 3

64
Q

Functional classifications of patients with diseases of the heart

In class3, less than the ordinary physical activity results in what?

A

Anginal pain, palpitations, dyspnea, & fatigue

65
Q

Functional classifications of patients with diseases of the heart

maximum METS in class 3

A

3.0 METS

66
Q

Functional classifications of patients with diseases of the heart

Class with inability to carry on any physical activity without discomfort

A

Class4

67
Q

Functional classifications of patients with diseases of the heart

What symptoms are present in class 4

A

(+) symptoms of cardiac insufficiency & anginal pain even at rest

increases discomfort during physical activity

68
Q

Functional classifications of patients with diseases of the heart

maximum METS in class 4

A

1.5 METS

69
Q

This is the inflammation of the pericardium secondary to bacterial/ viral agent

A

pericarditis

70
Q

Aggravating factor to mimic chest pain in pericarditis is ____

A

Trunk movements (esp. side to side)

71
Q

Relieving factor to chest pain in pericarditis is ____

A

Leaning forward or leaning on all 4’s

72
Q

3 possible reasons for congenital anomalies

A

hereditary

shunts are not closing

mother: (+) German Measles

73
Q

A heart condition with a defect on the interatrial septum

A

Atrial septal defect

74
Q

shunt of atrial septal defect

A

left to right shunt

75
Q

Atrial septal defect: cyanosis or acyanosis

A

acyanosis

76
Q

A heart condition with a defect on the interventricular septum

A

Ventricular septal defect

77
Q

shunt of ventricular septal defect

A

left to right shunt

78
Q

ventricular septal defect: cyanosis or acyanosis

A

acyanosis

79
Q

This is the construction of proximal and distal aorta

A

coarctation of the aorta

80
Q

What is the manifestation of coarctation of the aorta

A

increased BP in the UE

81
Q

Condition where there is still a connection between the pulmonary artery and aorta

A

Patent Ductus Arteriosus

82
Q

This structure connects the pulmonary artery to the aorta during the fetal stages

A

ductus arteriosus

83
Q

shunt of blood in Patent Ductus Arteriosus

A

left to right shunt

84
Q

Patent Ductus Arteriosus: cyanosis or acyanosis

A

acyanosis

85
Q

4 defects of Tetralogy of Fallot

A

P-Pulmonary artery stenosis
A- Overriding of aorta
R- Right ventricular hypertrophy AKA cor pulmonale
I- Interventricular septal defect

86
Q

This condition is the true blue baby

A

tetralogy of fallot

87
Q

shunt in tetralogy of fallot

A

Right to left

88
Q

This is the inability of the valves to open fully

A

stenosis (description in exams is usually “blood passes with difficulty”)

89
Q

this is the inability of the valves to fully close

A

insufficiency/ regugitation (description in exams is usually “there is backflow of blood”)

90
Q

This is the excessive bulging of the cusp of the valve

A

prolapse

91
Q

This condition is secondary to the weakness of the cusp of valve

A

prolapse

92
Q

Most common valve affected in prolapse

A

mitral/ bicuspid valve

93
Q

Other terms for prolapse if mitral valve is affected

A

Mitral valve prolapse
barlows syndrome
floppy valve syndrome
Click murmur syndrome

94
Q

Cardiac Enzymes that increases during heart attack

A

SGOT- Serum glutamic-oxalo acetic transaminase

CPK- Creatinine Phosphokinase

CK-MB- Creatine Kinase Myocardial Band

LDH- Lactate dehydrogenase

95
Q

When is the peak of Serum glutamic-oxalo acetic transaminase

A

24-48hrs

96
Q

Peak of Creatinine Phosphokinase

A

24 hrs

97
Q

Peak of Creatine Kinase Myocardial Band

A

12-24hrs

98
Q

Peak of Lactate dehydrogenase

A

3-6 days

99
Q

The first cardiac enzyme to rise during a heart attack is ______

A

CK-MB- Creatine Kinase Myocardial Band

100
Q

This diagnostic tool is to assess the size of the heart

A

chest x-ray

101
Q

This diagnostic tool is for the movements of the walls and the valves of the heart

A

echocardiogram

102
Q

Other name for thallium stress test

A

Nuclear stress test

103
Q

This diagnostic tool using a treadmill with an injecting of a radioactive agent (thallium) at the peak of the exercise

A

thallium stress test

104
Q

In the thallium stress test, where does the thallium attach to?

A

it attaches to the normal tissues (tissues with blood supply)

105
Q

This diagnostic tool involves an insertion of the catheter via the femoral artery

A

Cardiac catherization

106
Q

In the Cardiac catherization, in what artery is the catheter inserted?

A

femoral artery

107
Q

Other term for the Central line

A

Swan Ganz catheter

108
Q

This diagnostic tool measures the pressure inside the heart

A

Swan ganz catheter/ central line

109
Q

this is the insertion of a ballooning tip catheter

A

percutaneous transluminal coronary angioplasty

110
Q

Cardiac intervention using a Wire pliable mesh to keep the lumen of the blood vessel open

A

Intravascular stent (IV stent)

111
Q

Blood vessels in Coronary artery bypass graft (CABG) used as a bypass

A

great saphenous vein

Internal mammary artery (IMA)

Internal thoracic artery (ITA)

Radial artery

112
Q

most common blood vessel used in Coronary artery bypass graft (CABG) as a bypass

A

great saphenous vein

113
Q

least common blood vessel used in Coronary artery bypass graft (CABG) as a bypass

A

radial artery

114
Q

(Braddom)

Terms used for phase 1 of cardiac rehab

A

Acute phase or in patient

115
Q

(Braddom)

phase to prevent deformities and complications

Family education

A

Phase 1: Acute phase or in patien

116
Q

(Braddom)

discharge METS for phase 1

A

5 METS

117
Q

(Braddom)
Terms used for phase 2 of cardiac rehab

A

convalescent phase/transitional phase

118
Q

Braddom)

phase to promote a strong scar formation

A

Phase 2:convalescent phase/transitional phase

119
Q

(Braddom)

activities done for phase 2 patients

A

walking

bicycling

120
Q

(Braddom)

discharge METS for phase 2

A

9METS

121
Q

(Braddom)

Other term used for phase 3

A

Training/ out patient

122
Q

(Braddom)

This is the most vigorous phase in the cardiac rehab

A

Phase 3: training/ outpatient

123
Q

(Braddom)

activities done for phase 3 patients

A

stretching
aerobics
plyometrics
calisthenics

124
Q

(Braddom)
phase which is the most important cardiac rehab for the life long routine of the patient

A

phase 4: maintenance

125
Q

(Sullivan)

goal of phase 1: in patient

A

prepare the pt for discharge

ecg/ vital signs monitoring

126
Q

(Sullivan)

What is the phase 1 level 1METS and activities?

A

1-1.5 METS

arm support for every meal

Bed exercises

127
Q

(Sullivan)

What is the phase 1 level 2 METS and activities?

A

1.5-2 METS

(SLRC)
Sitting
Leg exercises
Reclining upright chair
commode privileges

128
Q

(Sullivan)

What is the phase 1 level 3 METS and activities?

A

2-2.5METS

bathroom privileges

Room/hall ambulation for 5mins

129
Q

(Sullivan)

What is the phase 1 level 4 METS and activities?

A

2.5-3METS

trunk exercises
room/hall ambulation 5-7mins

130
Q

(Sullivan)

What is the phase 1 level 5 METS and activities?

A

3-4METS

Arm exercise

Room/hall ambulation 8-10mins

131
Q

(Sullivan)

What is the phase 1 level 6 METS and activities?

A

4-5METS

progressive ambulation

132
Q

(Sullivan)

Phase with actual exercise traiing program

A

Phase 2 outpatient

133
Q

(Sullivan)

Target heart rate karvonens formula

A

60 to 80% (HRmax-HRrest) +HRrest

134
Q

(Sullivan)

HRmax formula (if not given)

A

220-age

135
Q

(Sullivan)
phase with endurance training and life/risk modifications continues

A

Phase 3 maintenance

136
Q

Criteria for terminating exercise

A
  1. unstable angina
  2. active pericarditis
  3. Acute systemic illness (fever)
  4. Resting BP 200/100mmHg
  5. Recent embolism
  6. Uncontrolled DM
  7. Uncontrolled arrhythmias (palpitations)
  8. 2nd to 3rd degree heart block
  9. ST segment displacement >= 2mm
  10. increase diastolic blood pressure
137
Q

Degree of heart block with prolonged PR interval

A

1st degree heart block

138
Q

Degree of heart block with progressive lengthening of the PR interval

A

2nd degree heart block

139
Q

Degree of heart block with absence of QRS complex

A

3rd degree heart block

140
Q

reaction of systolic and diastolic BP as exercise intensity increases

A

systolic BP increases
Diastolic BP remains the same

141
Q

reaction of systolic and diastolic BP as exercise intensity decreases

A

systolic BP decreases
Diastolic BP remains the same

142
Q

What are the early warning signs of heart attack?

A

Shortness of breath, confused, fatigue

143
Q

What comorbidity is prone ot silent ischemia?

A

diabetes

144
Q

What is attached to the patient post MI with DM during exercise

A

ECG

145
Q

What is the best initial exercise for patients post MI with claudication and CHF

A

Walking 10-15 mins daily

146
Q

What are the conditions to giving resistive training to patients post MI

A

> = 5METS
no angina