APP CVS 1-4 exam Flashcards
Slow conduction through the AV node allows
filling of ventricles
what is the effect of carotid massage on HR? Explain
carotid massage increases pressure on the carotid artery; increasing stretch and in turn decreases heart rate
Which of the following is the best description of second degree heart block type II (Mobitz II)?
A constant PR interval
funky graph we’ve never seen… divided by Systole and Diastole at top; time on x axis
The curve X represents ___
Coronary blood flow
Which of the following is INCORRECT regarding coronary artery perfusion?
Blood flow is continuous both in systole and diastole
The normal pressure of the Right Ventricle (Point D on graph of circulatory pressures)
<25/<5
In ____ an abnormal conduction pathway b/w atrium and ventricle leads to early depolarization of the ventricle.
Wolff-Parkinson-white syndrome
Angiotensin-I is converted to angiotensin-II by ACE in __
Lungs
During surgery, a 72-year-old patient shows EKG signs of myocardial ischemia with PCWP = 11 mmHg. Blood pressure= 80/40 mmHg and heart rate = 70 bpm.
Describe his treatment.
decreased TPR and BP also result in decreased coronary perfusion. fluids should be given, anesthesia depth should be adjusted, and phenylephrine to improve BP and coronary perfusion.
On Ventricle loop image. (A, B, C, D)
Diastole begins at point [X] and ends at point [Y]
begins at D and ends at B
The following EKG strip is noted [they’re bradycardic] in a 70-year-old patient who is given 4 mg of neostigmine to reverse blockade. His BP is 90/60 mmHg. The most appropriate course of action in this patient is:
Atropine
What phases of ventricular action potential [image given as we’re used to seeing] are exclusively due to movement of potassium out of cell? (SELECT 2 ANSWERS)
phases 1 and 3
________ is the most important metabolite to dilate coronary arterioles.
Adenosine
Point C indicates ___
[stroke vol/PCWP preload graph - C, A, B]
Decrease afterload
What is mechanism of action of Sildenafil ?
sildenafil is a PDE 5 inhibitor; blocks the breakdown of GMP to increase relaxation and blood flow to the corpus cavernosum sustaining an erection.
Large cannon wave in CVP records indicates
Third degree HB
A 50-year-old man has had fainting “spells” for about 2 weeks. During the fainting episodes, his electrocardiogram shows a ventricular beat of 25 beats/min and 100 P waves per minute. After about 30 seconds of fainting, a normal sinus rhythm recurs. What is his likely diagnosis?
Stokes-Adams Syndrome
acethylcholine increases phase ____
SA node AP graph provided; phases 0,3,4
Phase 4
A 17-year-old boy is brought to the ER f after being injured in an automobile accident and sustaining significant blood loss. He is given a transfusion of 3 units of blood to stabilize his blood pressure. Which of the following is a consequence of the decrease blood volume in this patient?
Increased circulating levels of angiotensin -II
Which of the following is the best description of second degree heart block type I (Wenchebach)?
Progressive lengthening of PR interval
Arrange the events of ventricular action potential in an order:
- Rapid upstroke-Fast Na+ channels open, inward Na+ flow
- Initial repolarization- K+ channels open, outward K+ flow
- Plateau-Ca++ channels open, inward Ca++ flow
- Rapid repolarization- K+ channels open more, massive outward K+ flow
- Resting membrane potential- high K+ permeability through leaky K+ channels.
In cardiac cycle , curve ‘A’ represents ___________________ and curve ‘B’ represents ______________
[weird graph provided; volume pressure on y-axis and time on x-axis; QRS along base… similar to master pressure vol graph]
curve a = aortic pressure
curve B =ventricular volume
All of the following increase the venous return EXCEPT
Peep
Raised let position
muscle contraction
Respiration
PEEP
Atenolol (Tenormin) _____________
Decreases cAMP level
____________ is the largest phase of cardiac cycle.
Reduced ventricular filling
The ECG tracing shows _________________
Atrial Fibrillation
The Graph “X” indicates:
RA Pressure
Aortic pressure
LV vol
LV Pressure
Right atrial pressure
Which of the following drugs blocks angiotensin-II at the receptor?
Losartan
match the following with their MOA:
- digitalis
- verapamil
- dantrolene
- norepi
- quinidine
- digitalis = inhibits Na/K ATPase
- verapamil = blocks L-type Ca channels (dihydropyrididne receptors)
- dantrolene = blocks ca release channels (ryanodine receptors)
- norepi = increases cAMP level
- quinidine = Na ch blocker
the following ekg indicates:
Four vent beats together
V Tach
Ventricular filling occurs between point [x] to point [y]
on cardiac loop image
x= a, y = B
‘a’ wave in CVP records indicates __________
atrial contraction
Lidocaine acts on phase _____
SA node ap graph
phase 4
Following is the diagram of pacemaker action potential. Norepinephrine ______________________
SA node AP graph
Increase the rate of phase 4 depolarization
Nitric oxide synthase converts ________ to nitric oxide (NO)
arginine
Ventricular ejection occurs between point [x] to point [y]
x=c
y= d
‘c’ wave in CVP records indicates __________
right ventricular contraction
The ventricles are completely depolarized during which isoelcetric portion of ECG?
ST segment
The A-V valves (the tricuspid and mitral valves) prevent backflow of blood from _____ during systole, and the semilunar valves (the aortic and pulmonary artery valves) prevent backflow from the ________ during diastol
Ventricles to atria; aorta
and pulmonary arteries into the ventricles
If the end-diastolic volume is 92 ml and stroke volume is 37 ml. What is patient’s ejection fraction?
.40
The ventricular repolarization is represented by __________
T wave
Describe Bainbridge reflex.
the bainbridge reflex is the atria’s way of preventing atrial “bursting”. the atrial stretch signals the VMC by the vagus nerve to increase the HR and contraction to push blood forward through the heart.
Blood is withdrawn from a 56-year-old man who has a 5-year history of congestive heart failure. Plasma concentrations of angiotensin II, aldosterone, and atrial natriuretic peptide (ANP) are elevated. An increase in which of the following is the most likely explanation for the increase in plasma levels of atrial natriuretic peptide (ANP)?
Atrial pressure
Describe the formation and significance of dicrotic notch in aortic pressure cure.
the dicrotic notch is the aortic valve closing. this is a buffering action for our blood pressure. the absence of this notch there is no buffering and the heart goes straight from systole to diastole - this is seen in atherosclerosis.
How blood pressure is affected after carotid endarterectomy (CEA)?
after a carotid endarterectomy, blood pressure is high because of the loss of inhibitory feedback on the VMC. there is more sympathetic activity//flow so the bp and hr increase as a result.
If a patient undergoing spinal anesthesia experiences a large decrease in arterial pressure and goes into shock, which of the following would be the therapy of choice?
Phenylephrine
During surgery, a 52-year-old patient shows EKG signs of myocardial ischemia with PCWP = 30 mmHg. Blood pressure= 80/40 mmHg and heart rate = 70 bpm.
Describe his treatment.
becuase the pcwp is high and the bp is low, it is not likely hypovolemic but cardiogenic. fluids are inappropriate and an inotrope like dopamine should be used. could also use phenylephrine to increase bp and coronary perfusion. nitroglycerin to decrease venous return. monitor closely
Complete dissociation of P wave from QRS
Third degree (complete) heart block
S3 is produced in:
Rapid ventricular filling
