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Cardiology > ACLS > Flashcards

ACLS Flashcards

1
Q

MOA of nitroglycerin

A

peripheral arterial + venous dilation reduces LV + RV preload

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2
Q

contraindications of nitroglycerin & why

A

inferior wall MI + RV infarction, bc they depend on RV filling pressures to maintain CO + BP

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3
Q

MOA of morphine

A

reduces LV preload + reduces LV afterload by decreasing systemic vascular resistance

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4
Q

benefits of morphine

A

alleviates dyspnea + redistributes blood volume in pt with acute pulm edema

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5
Q

negatives of morphine

A

reduces absorption of oral antiPLT

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6
Q

characteristics of STEMI on EKG (ST segment)

A

ST segment elevation in 2 or more contiguous leads/1mm or more in all other leads OR new LBBB

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7
Q

characteristics of STEMI on EKG (J point)

A

J point elevation of >2mm in leads V2 + V3

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8
Q

characteristics of High Risk NSTE-ACS (3)

A

ischemic ST segment depression of 0.5mm or greater/dynamic T wave inversion with pain or discomfort/transient ST segment elevation of 0.5mm or greater for <20min

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9
Q

never give fibrinolytics to these two pt’s

A

> 24h after symptoms & those with ST segment depression (unless a true posterior MI is suspected)

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10
Q

what tidal volume is needed for adults in respiratory arrest

A

6-7 ml/kg (500-600 ml)

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11
Q

what to do with a pt that has a pulse but not breathing

A

ventilate q6sec

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12
Q

2nd degree type 1 AV block (Wencheback)

A

PR interval progressively longer until a beat is dropped

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13
Q

2nd degree type 2 AV block

A

PR interval stays same length but random QRS complexes are dropped

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14
Q

3rd degree AV block

A

p wave and QRS are completely independent of each other

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15
Q

Tx for poor perfusion s/t bradycardia

A

atropine 1mg (up to 3x for 3mg total)

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16
Q

Next steps if atropine is ineffective for poor perfusion s/t bradycardia

A

TCP/DA/EPI

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17
Q

when to avoid atropine for bradycardia

A

2nd or 3rd degree blocks

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18
Q

MOA of atropine

A

reverses cholinergic mediated decreases in HR + AV node conduction

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19
Q

infusion rate for DA

A

5-20 mcg/kg/min

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20
Q

infusion rate for EPI

A

2-10 mcg/min

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21
Q

TCP HR considerations

A

set to 60-80/min, but lowest HR to reduce myocardial O2 demand is preferred

22
Q

safety margin for TCP

A

2mA above level at which consistent capture occurs

23
Q

unstable tachycardia: action

A

immediate synchronized cardioversion

24
Q

stable tachycardia: action

A

determine if QRS is wide/narrow and regular/irregular

25
Q

stable tachycardia: wide QRS >0.12

A

adenosine if regular + monomorphic and antiarrhythmic

26
Q

stable tachycardia: normal QRS

A

vagal maneuver + adenosine if regular and BB/CCB

27
Q

what is SV

A

volume of blood ejected by both ventricles with each contraction

28
Q

equation for CO

A

CO = SV x HR

29
Q

limits for sinus tach

A

100-130

30
Q

stable tach: narrow QRS + regular rhythm –> what to do when vagal maneuvers fail

A

adenosine 6mg + flush & elevate arm immediately

31
Q

stable tach: narrow QRS + regular rhythm –> what to do if first dose of adenosine doesn’t convert within 1-2 min?

A

give another dose of 12mg + flush and elevate the arm immediately

32
Q

MOA of adenosine

A

slows AV conduction

33
Q

which rhythms does adenosine not convert

A

atrial flutter + fibrillation

34
Q

big caution with adenosine

A

may cause bronchospasm

35
Q

what does synchronized cardioversion mean

A

delivers the shock on the R

36
Q

procainamide infusion dosing + max dose

A

20-50 mg/min + max dose = 17 mg/kg

37
Q

amiodarone infusion dosing (bolus + maintenance)

A

150 mg over 10 min + 1 mg/min for 6 hours

38
Q

sotalol infusion dosing

A

100 mg over 5 min

39
Q

what two rhythms require CPR until a defibrillator is available to deliver unsynchronized shocks

A

VF + pVT

40
Q

MOA of EPI

A

improve aortic diastolic BP + coronary artery perfusion pressure

41
Q

MOA of amiodarone

A

blocks Na channels at rapid pacing frequencies + lengthens action potential of cardiac cells + antisympathetic

42
Q

MOA of lidocaine

A

suppresses automaticity of conduction tissue

43
Q

magnesium sulfate only indicated for

A

torsades

44
Q

EPI dosing for cardiac arrest

A

1mg q3-5 min

45
Q

amiodarone dosing for cardiac arrest unresponsive to defibrillation (first)

A

300 mg

46
Q

lidocaine dosing for cardiac arrest unresponsive to defibrillation (first)

A

1-1.5 mg/kg

47
Q

what is PEA?

A

any organized rhythm w/o a pulse

48
Q

h’s and t’s of cardiac arrest

A

hypovolemia/hypoxia/acidosis/hypo-hyperkalemia/hypoglycemia/hypothermia
toxins/tamponade/tension pneumo/thrombosis/trauma

49
Q

TTM target temp

A

32-36 C for 24h

50
Q

Tx for hypotension post ROSC: DA dosing

A

5-20 mcg/kg/min

51
Q

Tx for hypotension post ROSC: NE dosing

A

0.1-0.5 mcg/kg/min

52
Q

Tx for hypotension post ROSC: EPI dosing

A

2-10 mcg/min

Cardiology (5 decks)

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