Cardiac

Question 1

Aortic regurgitation is heard where?

Answer 1

2nd ICS, R sternal border

Question 2

S/S of RV infarct

Answer 2

JVD @ 45 degrees, increase CVP, hypotension, clear lungs, bradyarrthymias; ST elevation in V3r, V4r

Question 3

What causes large, giant V-waves on PAOP?

Answer 3

Mitral insufficiency (regurg)

Question 4

What leads show reciprocal changes in lateral wall in inferior MI?

Answer 4

I, aVL

Question 5

What does the RCA supply blood to?

Answer 5

posterior papillary muscle

Question 6

3 leads with ST elevation in inferior MI?

Answer 6

II, III, aVF

Question 7

Inferior MI= what occlusion?

Answer 7

RCA

Question 8

What causes changes in V3R and V4R leads?

Answer 8

RV infarct

Question 9

What causes changes in leads V1-V4?

Answer 9

anterior LV MI, LAD occlusion

Question 10

What causes changes in leads V5, V6, I, and aVL?

Answer 10

circumflex, lateral LV

Question 11

What causes changes in leads V5 and V6?

Answer 11

low lateral LV

Question 12

What causes changes in leads I and aVL?

Answer 12

high lateral LV

Question 13

What causes changes in lead V1 and V2?

Answer 13

RCA, post LV

Question 14

Name AV valves. Heard where?

Answer 14

Mitral/tricuspid; apex (midclavicular, 5th ICS)

Question 15

Normal CI values

Answer 15

2.5-3.5

Question 16

Normal SVR values

Answer 16

800-1200

Question 17

You should avoid preload reducers in this patient population

Answer 17

Patients with RV infarct

Question 18

IABP balloon deflation decreases what?

Answer 18

LV afterload

Question 19

What murmur and arrhythmias are associated with anterior MI?

Answer 19

Systolic murmur (VSD, heard at sternal border, 5th ICS) and 2nd degree Type II, RBBB (ominous sign)

Question 20

Monitor for these arrhythmias if you have ST elevation in leads II, III, aVF

Answer 20

bradyarrhythmias, 2nd degree Type I AV Block, 3rd AV block, SSS; RCA supplies papillary muscles= systolic murmur may develop d/t MVR or muscle rupture

Question 21

Use these meds with caution in inferior MI

Answer 21

BB, Nitroglycerin

Question 22

Which heart sound is louder with a PE?

Answer 22

S2

Question 23

What causes S3 heart sounds?

Answer 23

rush of blood into dilated ventricle

Question 24

What diseases cause S3 heart sounds? Where are they heard?

Answer 24

pulmonary htn, cor pulmonale, heart failure, valve insufficiency (not pulmonic valve); heard at apex

Question 25

What causes S4 heart sounds?

Answer 25

atrial contraction of blood into noncompliant ventricle

Question 26

What diseases cause S4 heart sounds? Where are they heard?

Answer 26

myocardial ischemia, MI, HTN, ventricular hypertrophy, aortic stenosis; apex

Question 27

What is caused by pericarditis and has pain on deep inspiration? May be positional

Answer 27

Pericardial friction rub

Question 28

Causes of narrowing pulse pressure

Answer 28

hypovolemia, decreased CO (tamponade)

Question 29

Causes of widening pulse pressure

Answer 29

vasodilation, decrease in SVR (sepsis)

Question 30

Treatment for HTN emergency

Answer 30

Nitroprusside (decrease pre/afterload; monitor for cyanide toxicity: AMS, met acidosis); Labetalol

Question 31

Biggest risks of HTN emergency/urgency

Answer 31

STROKE

Question 32

Therapies that INCREASE preload

Answer 32

fluids, pressors

Question 33

Therapies that DECREASE preload

Answer 33

Diuretics, Dilators ( Nitroprusside, Nitrates), morphine

Question 34

Therapies that INCREASE afterload

Answer 34

Norepi, Neo, High dose dopamine (11-20), EpiTh

Question 35

Therapies that DECREASE afterload

Answer 35

Nitroprusside, NGT, ACEi, hydralazine, Ca chan blockers, IABP

Question 36

Therapies that INCREASE contractility

Answer 36

Positive inotropes: Milrinone, Dopamine (5-10), Dobutamine, Epi

Question 37

Therapies that DECREASE contractility

Answer 37

Negative inotropes: BB, Ca Chan blocker, metabolic problem