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Clin Med III > 2B: Cardiac Testing > Flashcards

2B: Cardiac Testing Flashcards

1
Q

What is the typical hematocrit value for women?

A

37-47%

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2
Q

What is the typical hematocrit value for men?

A

40-54%

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3
Q

What is normal hemoglobin for women?

A

12-16 g/dL

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4
Q

What is normal hemoglobin for men?

A

13-18 g/dL

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5
Q

What is normal WBC count?

A

4,500 - 11,000 uL

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6
Q

What electrolytes are most important for cardiac function?

A

Potassium, sodium, calcium, CO2

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7
Q

What value is considered hyperkalemia?

A

Potassium > 5.9 mmol/L

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8
Q

What value is considered hypokalemia?

A

Potassium < 3.5 mmol/L

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9
Q

What happens with hyperkalemia?

A

Na cannot come in, bradycardia, decreased ability for myocardial contractility

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10
Q

What happens with hypokalemia?

A

K influx, life threatening arrhythmias with tachycardia

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11
Q

What is the normal range for Na2+?

A

136-143 mmol/L

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12
Q

What is the normal range for Ca+?

A

4.5-5.3 gm/dL

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13
Q

What value is considered high CO2, and what is the effect?

A

> 30 mmHg, can result in alkalytic state of muscle weakness

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14
Q

What is an EKG used to diagnosis?

A

Specific arrhythmias that can be causing symptoms, measure disease progression, and effectiveness of treatment

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15
Q

When is a holter monitor used?

A

After syncope or repeated arrhythmias - 24 hrs of up to 2 weeks long

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16
Q

Describe a graded exercise stress test?

A

Testing with either a treadmill or bike to assess exercise tolerance and ischemia

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17
Q

What is the most common graded exercise stress test?

A

Bruce protocol

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18
Q

When is a stress test indicated?

A

Chest pain with activity, severe dyspnea, suspicion of CAD and ischemia, risk assessment

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19
Q

What will the results of a stress test be used for?

A

Determine the need for further testing, location of ischemia, exercise prescription

20
Q

What are the three reasons why a stress test will be stopped?

A
  1. EKG changes
  2. Angina symptoms
  3. Extreme dyspnea
21
Q

What three EKG changes indicate terminating a stress test?

A
  1. > 2mm ST segment depression
  2. Inverted T wave
  3. Significant Q wave
22
Q

Describe dyspnea that would cause a stress test to be terminated?

A

3-4 on dyspnea scale with LE fatigue

23
Q

What is echocardiography?

A

Ultrasound of the heart, measure of wall motion

24
Q

What information does an echo provide?

A

Valve function, size of ventricle, thickness, integrity of interatrrial and interventricular septums. Also gives value of EF

25
Q

What are the limitations of an echo?

A

Posterior wall structure and motion due to interference from spinal bone

26
Q

When is an echo indicated?

A

After MI, CHF, unstable angina, syncope episode, cardiomyopathy

27
Q

What is a Thallium stress test?

A

Uses a radioactive nuclear marker to detect myocardial perfusion

28
Q

What does a Thallium stress test look at?

A

Ischemia by assessing Thallium in blood flow trough the myocardial tissue

29
Q

What is the risk associated with coronary angiography?

A

2% risk of stroke

30
Q

Coronary angiography is a definitive diagnosis for what?

A

CAD, valvular disease, congenital defects

31
Q

Describe how a cardio cath is placed

A

Threaded through femoral or radial artery into coronary artery and injects dye

32
Q

When is a cardiac catheter used?

A

Unstable angina, acute MI, positive stress test, positive echo

33
Q

CAD blockages up to what % are considered mild?

A

70%

34
Q

What is indicated with blockages of > 90%?

A

Conservative management unless risk of MI is imminent, surgical

35
Q

What are the precautions for cardiac cath with femoral artery entry?

A

6-12 hours of bedrest with sandbag or compression to prevent bleeding

36
Q

What are the precautions for cardiac cath with radial artery entry?

A

Nothing major, can ask MD about use of AT

37
Q

What does TEE stand for?

A

Trans Esophageal Echocardiogram

38
Q

What is a TEE?

A

Ultrasound head is fiber optic and threaded down the esophagus to give improved visualization of heart structures and function

39
Q

When is a TEE indicated?

A

Posterior views

40
Q

Describe PET

A

Nuclear technique, provides visualization

41
Q

What information will PET provide?

A

Metabolic functions: glucose and fatty acid metabolism, blood flow to the heart

Dynamic functioning of myocardium without exercise

42
Q

What are draw backs of a PET?

A

Very expensive, not readily available

43
Q

What goes MUGA stand for?

A

Multigated Acquisition Imaging or Gated Pool Imaging

44
Q

What is a MUGA?

A

Non-invasive technique to calculate left ventricular ejection fraction - uses multiple EKG views

45
Q

What is the advantage of a MUGA?

A

Less expensive than PET

46
Q

What information does a CT provide?

A

Cardiac structures and ventricular function

47
Q

When is a CT indicated?

A

Pts with probable coronary stenosis

Clin Med III (18 decks)

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