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Cardiac Flashcards

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USMLE® Step 1 flashcards
1
Q

Which procedure is frequently used in the diagnosis of heart disease and dysfunction?
a. Galvanometer
b. Stylus
c. Electrocardiogram
d. Defibrillator

A

c. Electrocardiogram

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2
Q

Which of the following is a portable lightweight device that allows you to quickly administer the test, in turn allowing the provider to make efficient cardiology assessments?
a. Technical electrocardiograph
b. Analog electrocardiograph
c. Computer-based electrocardiograph
d. Manual electrocardiograph

A

c. Computer-based electrocardiograph

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3
Q

An ECG can detect:
a. disturbances in heart rhythm.
b. amount of blood flow.
c. abnormal liver function.
d. heart attacks.

A

a. disturbances in heart rhythm.

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4
Q

What can you do with the sensitivity dial if the ECG tracing is too large?
a. Turn down to 1/2
b. Turn up to 5
c. Turn down to 1
d. Turn up to 2

A

a. Turn down to 1/2

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5
Q

Irregularities in the heart’s rhythm are known as:
a. interferences.
b. impulses.
c. arrhythmias.
d. artifacts.

A

c. arrhythmias.

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6
Q

What might patients with various neurological disorders produce on an ECG tracing?
a. A wandering baseline
b. AC interference
c. Muscle voltage artifacts
d. An interrupted baseline

A

c. Muscle voltage artifacts

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7
Q

For which type of patients are exercise ECG stress tests sometimes ordered on a routine basis?
a. Men over the age of 65
b. Women over the age of 65
c. Those with a high risk of developing heart disease
d. Those who are beginning a strenuous exercise program

A

c. Those with a high risk of developing heart disease

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8
Q

Ventricular Tachycardia

A

3 or more PVCs occurring at a rate of 150 -250 bpm

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9
Q

Paroxysmal atrial tachycardia (PAT)

A

heart rate from 160-250bpm

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10
Q

pacemaker arrhythmias

A

shows up as vertical signals that represent the electrical activity

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11
Q

Premature ventricular contractions (PVCs)

A

beats that occurs early on the cycle and is followed by a pause

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12
Q

Premature atrial contractions (PACs)

A

cardiac cycle that occurs before the next cycle is due

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13
Q

Atrial fibrillation ( A-Fib)

A

heart rate can range from 400-500 bpm

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14
Q

What equipment is designed to provide counter shock to convert cardiac arrhythmias into regular sinus rhythm?

A

Defibrillator

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15
Q

the outer wall of the heart is surrounded by a sac called?

A

pericardium

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16
Q

Tissue that lines the interior surface of the heart is known:

A

endocardium

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17
Q

term for an interruption in the message from SA node to the AV node

A

heart block

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18
Q

What protein is found in plasma?

A

Fibrinogen
Serum albumin
serum globulin

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19
Q

Heart rate that is constantly rapid ( over 100 bpm)

A

Tachycardia

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20
Q

What test is used to evaluate the condition of the myocardium of the heart?

A

MUGA scan

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21
Q

What is the term for the amount of blood flow to the Myocardium?
a. Influx.
b. Contraction.
c. Perfusion.
d. Stenosis.

A

Perfusion.;

Sometimes THALLIUM. is injected into the patient’s vein during a stress test for a better understanding of perfusion blood flow to the myocardium.)

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22
Q

Which heart valve is between the left atrium and the left ventricle?

a. T Tricuspid.
b. Aortic semi lunar.
c. Right, Atrioventricular.
d. Bicuspid.

A

Bicuspid.

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23
Q

Which of the following Irregularities on an EKG would be considered the most severe.?

a. PVC.
b. Afib.
c. V Fib.
d. Tachycardia.

A

V Fib.;

In true ventricle Defibrillation, patients will be unresponsive When the ventricles are quivering without contracting. This will always be a code blue situation.

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24
Q

What does the horizon flat line that separates the various waves on an EKG gene strip represent?

a. A segment.
b. A baseline.
c. An interval.
d. Amplitude.

A

Baseline.;
the horizontal line that separates the various waves is known as a baseline.

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25
Q

What is a Segment on an EKG

A

The portion between two waves is known as a segment.

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26
Q

What is a Interval on a ECG

A

The length of the wave with a segment is known as an interval.

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27
Q

What ECG lead is considered bipolar?

a. V4.
b. I I.
c. AVF.
d. AVR.

A

I I.;

Bipolar leads of a 12 lead ECG are the first three leads: I, I I and I II.

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28
Q

You are obtaining an ECG using a 10 lead EKG machine. The patient accidentally coughs while the strip is running, causing an artifact on the strip. How can this be identified as?

A

Somatic tremor.
This is an involuntary movement of the muscle.

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29
Q

Which of the following best describes how the P wave on the ECG strip should be?

a. After each QRS complex and upright reflection.
b. Upright reflection and in front of the QRS complex.
c. Downward reflection and in front of the QRS complex.
d. Upward reflection following the QRS complex.

A

B. ;

basic rhythm interpretation involves noting whether there is a constant P wave in front of every QRS complex and that reflection is upright.

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30
Q

What is the term for the thin, fluid filled sac that surrounds the heart?

A

Pericardium.

prefix PERI means around and CARD means heart
UM means structure or thing.

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31
Q

What is the middle layer of the heart called?

A

Myocardium.;

The middle or thickest muscular layer responsible for heart contraction.

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32
Q

Which heart chambers deliver oxygen rich blood to the ascending aorta?

A

Left ventricle.;

The lower left Chamber of the heart, which pumps oxygenated blood through the body.

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33
Q

What is the average normal heart rate?

A

Normal heart rate is considered to be 60-100 beats per minute.

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34
Q

If the patient is a asystolic, the characteristics would be described as which of the following.?

a. Rate of 0 and no pulse.
b. Rapid rate and loss of consciousness.
c. Dramatic hypotension and slow thready pulse.
d. Possible palpitations and a rate of 60 Beats per minute.

A

Rate of 0 and no pulse.; A patient who is asystolic, would show a flat line on the EKG recording.

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35
Q

What is the most accurate method for acquiring a heart rate?

a. 6 * 10 method.
b. 1500 method.
c. QRS method.
d. 300-150-100-75-50 method.

A

1500 method.

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36
Q

What does the initiation of the impulse in the SA node and its movement through the Atria produce?

a. P wave.
b. PR Interval.
c. QRS complex.
d. T Wave

A

P wave.

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37
Q

Repolarization of the ventricle is represented by which of the following?

a. P wave.
b. QRS complex.
c. T Wave.
d. R. wave.

A

T Wave.

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38
Q

What are two PVC’s in a row called?

a. Double.
b. Couplet.
c. Trigeminal.
d. Salvo

A

Couplet

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39
Q

What is the heart valve that is situated between the right atrium and the right ventricle called?

a. Pulmonary valve.
b. Mitral valve.
c. Aortic valve.
d. Tricuspid valve.

A

Tricuspid valve.

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40
Q

What does each small square running horizontally represent?

a. 3 seconds.
b. 0.4 seconds.
c. 5M. M.
d. 0.1 M V

A

0.4 seconds.

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41
Q

During which of the following events would the PR interval get progressively longer?

a. First degree AV Heart block.
b. Second degree AV Heart block. Type 1
c. Third Degree AV Heart Block.
d. Sinus dysrhythmia.

A

Sinus dysrhythmia.

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42
Q

Which of the following is arial fibrillation?

a. Longer PR intervals.
b. A regular rhythm.
c. No p waves.
d. No QR complex.

A

No p waves.

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43
Q

What characteristics would you see in the patient if the patient is in asystole?

a. Possible palpitations and rate of 60 bpm
b. Rate of 0 and no pulse
c. Rapid rate and loss of consciousness
d. Dramatic hypotension and slow thread pulse

A

Rate of 0 and no pulse

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44
Q

What prefix means BESIDE, BEYOND, AROUND?
a.

A

Para-

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45
Q

What reflects the depolarization of the atria of the heart on ECG?
a.

A

P wave

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46
Q

What reflects ventricular heart depolarization on an ECG?

A

QRS Wave

47
Q

What is the universal standard speed for recording an ECG?

A

25 mm/sec

48
Q

Which electrode is not part of the ECG recording?

A

RL; Right leg is grounding leg

49
Q

What is precordial lead?

A

Chest leads, represented with V#

50
Q

One complete heartbeat (full cardiac cycle) lasts for how long?

A

0.8 sec

51
Q

What is normal heart rhythm

A

60-100 bpm

52
Q

Graphic representation of ventricular depolarization on ECG is represented by?

A

QRS complex

53
Q

Each large square represents how many seconds?

A

0.25 secs

54
Q

Each small square represents how many seconds?

A

0.04 second

55
Q

Term of the ability of the heart muscle cells to respond to an impulse or stimulus?

A

Excitability

56
Q

Term of the ability of the heart to initiate an electrical impulse?

A

Automaticity

57
Q

What initiates the heartbeat?

A

SA Node

58
Q

Term for the ability of the heart muscle cells to shorten in response to an electrical stimulus?

A

Contractility

59
Q

Term for an electrical current that initiates the contraction of the heart muscle?

A

Depolarization

60
Q

What delays the electrical conduction through the heart?

A

AV Nodes

61
Q

What distributes electrical impulses from cell to cell through the ventricles?

A

Purkinje Fibers

62
Q

What defined as when heart muscle cells return to their resting electrical state and the heart muscle relaxes?

A

Repolarization

63
Q

5 Steps of analyzing on ECG

A

Heart rate
regularity
P-wave
QRS complex
P-R interval

64
Q

Term that means “there is no consistency to the rhythm, such as atrial fibrillation?

A

Irregularly Irregular

65
Q

the muscle wall of the heart is called

A

myocardium

66
Q

Tissue that lines the interior surface of the heart

A

endocardium

67
Q

Wall muscle in the heart that divides right and left sides

A

Septum

68
Q

valve is between the right atrium and ventricle,

A

tricuspid

69
Q

valve is between the left atrium and ventricle,

A

bicuspid or mitral

70
Q

What degree block is characterized by a momentary delay at the AV node before the impulse is transmitted to the ventricles

A

First degree

71
Q

who many form does Second degree block forms and what are they?
.

A

2
One occurs in cycles of delayed impulses until the SA node fails to conduct to the AV node, then returns to near normal.

A second form is characterized by a pattern of only every second, third, or fourth impulse being conducted to the ventricles. This causes a marked decrease in heart output and usually progresses to the third degree.

72
Q

Third degree heart block is known as

A

“complete heart block.”

There is no impulse carried over from the pacemaker

73
Q

Atrial contractions are known as

A

premature atrial contractions (PACs)
cause the atria to contract ahead of the anticipated time.

74
Q
A
75
Q

Premature junctional contractions (PJCs) have:

A

ectopic pacemaker focused at the junction of the AV node and the bundle of His

76
Q

Premature ventricular contractions (PVCs)

A

They originate in the ventricle and cause contraction ahead of the next anticipated beat. They can be benign or deadly.

77
Q

Depolarization

A

contracting

78
Q

polarized

A

negative charged ‘resting’

79
Q

repolarized

A

going back to relax / neg state

80
Q

P-wave

A

represents atrial depolarization which leads to contraction of the atria

created when the atria contract

81
Q

PR segment

A

demonstrates the delay the AV node created

AV is the gatekeeper; giving the atria time to empty into the ventricles.

82
Q

PR interval

A

used to determine heart block

measured from the start of the P wave to the QRS complex.

83
Q

Prolong PR Interval indicates:

A

heart block

84
Q

QRS Complex

A

represents ventricular depolarization ( contraction of the ventricles)

Atrial repolarization (relax) occurs here, but is not visible.

85
Q

J point

A

point here the QRS complex meets the ST segment

86
Q

ST segment

A

represents completion of the ventricular depolarization and the beginning of the ventricular repolarization

should be flat

87
Q

Isoelectric describes

A

straight lines of the PQRST complex
representing resting of the heart cells

88
Q

T wave

A

represents beginning of the ventricular repolarization ( relaxation)

89
Q

QT interval

A

starts at the beginning of the QRS complex and ends after T wave

represents the time it takes for the electrical signals to cause the ventricles to contract and them rest.

90
Q

P wave measurement

A

should be less than 0.12 seconds / no more than 3 small squares

91
Q

PR interval should measure at

A

0.12-0.20 seconds / 3 - 5 small squares

more may indicated heart block

92
Q

QRS measurement

A

no more than 0.12 seconds/ no more than 3 sm sq

93
Q

QT interval measurement

A

between .035-0.44 seconds/ Men can be smaller

94
Q

on an EKG 6 sq equals how much time?

A

6 seconds

95
Q

What are the 3 Rs when reading an EKG to determine heart rate

A

Regularity
Rate
Resemblance

96
Q

When heart muscle cells are in the resting state they have what type of charge?
A. Negative
B. Positive
C. Neutral
D. Depolarized

A

A

97
Q

The process that causes a heart cell to contract is known as?
A. Repolarization
B. Polarization
C. Depolarization

A

c

98
Q

When a heart muscle cell goes back into its negatively charged state, or in other words, when it relaxes this is known as?
A. Repolarization
B. Polarization
C. Depolarization

A

a

99
Q

Which part of the electrical conduction system is located in the upper part of the right atrium and is responsible for atrial depolarization?
A. AV node
B. Bundle of His
C. Purkinje Fibers
D. SA node

A

d

100
Q

Once electrical signals pass through the Bundle of His, they next travel to?
A. AV node
B. Bundle branches
C. SA node
D. Purkinje Fibers

A

b

101
Q

Select the characteristics of the AV node: (select all that apply)
A. It is known as the pacemaker.
B. It causes a delay in electrical signal transfer so the atria can fully empty into the ventricles.
C. It’s known as the gatekeeper.
D. It fires and sends impulses to cause atrial depolarization of the right and left atria.
E. It’s found in the lower part of the right atrium just above the tricuspid valve.
F. It’s found in the upper part the right atrium.

A

B, C, E

102
Q

On an EKG/ECG strip each small square represents how many seconds of time?
A. 0.20 second
B. 0.02 seconds
C. 0.12 seconds
D. 0.04 seconds
The answer is D: 0.04 seconds

A

d

103
Q

The nurse is assessing an ECG strip and counts 30 LARGE squares. How many seconds of time did the nurse count?
A. 30 seconds
B. 10 seconds
C. 6 seconds
D. 60 seconds

A

c

104
Q

Which part of the PQRST complex represents atrial depolarization?
A. P-wave
B. QRS complex
C. T-wave
D. ST segment

A

The answer is A: p-wave

105
Q

The nurse is assessing an ECG strip and begins measuring at the beginning of the p-wave to the beginning of the QRS complex. What is the nurse measuring?
A. P-wave
B. ST segment
C. PR interval
D. PR segment

A

c

106
Q

. Which part of the PQRST complex represents ventricular depolarization?
A. P-wave
B. QRS complex
C. T-wave
D. ST segment

A

b

107
Q

Which part of PQRST complex represents ventricular repolarization?
A. QRS complex
B. ST segment
C. T-wave
D. P-wave

A

c

108
Q

What is the point where the QRS complex meets the ST segment?
A. R-point
B. PR interval
C. QT interval
D. J-point

A

d

109
Q

A normal PR interval should measure between?
A. 0.04-0.12 seconds
B. 0.20-0.36 seconds
C. 0.12-0.20 seconds
D. 0.35-0.40 seconds

A

c

110
Q

A QRS complex should measure no more than?
A. 0.20 seconds
B. 0.12 seconds
C. 0.08 seconds
D. 0.04 seconds

A

B

111
Q

. Select all the characteristics a normal p-wave should have?
A. One p-wave should accompany a QRS complex.
B. They should measure more than 0.36 seconds in duration.
C. P-waves should be flat.
D. P-waves should be round and upright.
E. Multiple p-waves can accompany a QRS complex.

A

A,D

112
Q
A
113
Q
A

Medical Assistant (8 decks)

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