Cardiac abnormalities

Question 1

QTc is prolonged if it exceeds ___ in men or ____ in women

Answer 1

440 ms, 460 ms

Question 2

_____ administration can speed conduction of cardiac impulses through the AV node. When would this be useful?

Answer 2

Atropine. 1st degree heart block

Question 3

_______ is more likely to progress to third-degree block, especially in the setting of acute MI

Answer 3

Mobitz Type II

Question 4

Which second-degree block is usually symptomatic?

Answer 4

type II

Question 5

Tx of third-degree AV block occurring during anesthesia

Answer 5

transcutaneous or transvenous pacing

Question 6

a cardiac rhythm greater than ___ is considered a tachydysrhythmia

Answer 6

100 bmp

Question 7

tachydysrhythmia with average HR 160-220 bmp

Answer 7

Paroxysmal supraventricular tachycardia

Question 8

How does multifocal atrial tachycardia differ from a fib? What is the usual rate?

Answer 8

rate is not excessively rapid & each QRS is a/w a P wave; 100-180 bmp

Question 9

What should you do if new-onset a fib occurs before induction?

Answer 9

postpone sx if possible until ventricular rate is controlled or conversion to SR

Question 10

Characterized by an organized atrial rhythm with an atrial rate of 250-350 bpm with varying degrees of AV block

Answer 10

atrial flutter

Question 11

What should you do if a pt has atrial flutter lasting longer than 48 hrs

Answer 11

anticoagulant therapy

Question 12

The purpose of cardioversion is to recoordinate the electrical pathways of the heart by delivering a single dominant burst of electricity where?

Answer 12

on the R wave of the ECG

Question 13

Where are the leads in a dual chamber pacemaker?

Answer 13

1 in R atrium, 1 in R ventricle

Question 14

uncontrolled BP despite 3 or more antihypertensive drugs of different classes

Answer 14

resistant HTN

Question 15

uncontrolled BP on 5 or more drugs

Answer 15

Refractory HTN

Question 16

First-line antihypertensive therapy

Answer 16

diuretics, CCBs, ACE inhibitors, & ARBS (NOT BBs)

Question 17

Delaying surgery is not generally recommended unless there is marked HTN of ____

Answer 17

systolic > 180, diastolic > 110

Question 18

How do you get diagnosis of pulmonary HTN?

Answer 18

right heart cath

Question 19

Most common cause of right heart failure

Answer 19

left sided failure

Question 20

How is orthopnea relieved?

Answer 20

sitting up

Question 21

Tx for systolic HF

Answer 21

ACE inhibitors &Beta Blockers

Question 22

Best tx strategy for diastolic heart failure

Answer 22

prevention

Question 22

What are 3 anesthetic considerations for VADs

Answer 22

anticoagulation, plug device into an electrical outlet, & avoid chest compressions

Question 23

What is used as a substitute for pulse oximetry with VADs?

Answer 23

cerebral oximeter that does not rely on pulsatile flow

Question 24

The balloon pump ______ in diastole, and _____ in systole

Answer 24

inflates; deflates

Question 25

Optimal functioning of the TandemHeart depends on what?

Answer 25

good RV function

Question 26

The most common cause of restrictive CM

Answer 26

amyloidosis

Question 27

What do you not want to see with restrictive CM?

Answer 27

bradycardia

Question 28

Oxygen supplementation to maintain the PaO2 above ___ and sat above ___ is useful in both acute and long-term tx of RHF

Answer 28

60mmHg, 90%

Question 29

a heart murmur that occurs during systole is d/t what?

Answer 29

stenosis of the aortic or pulmonic valves

Question 30

When is prophylactic abs recommended?

Answer 30

dental procedures and invasive procedures involving the respiratory tract

Question 31

What is the normal mitral valve orifice?

Answer 31

4-6 cm

Question 32

An opening snap is a/w mitral ________ while a holosystolic murmur is a/w mitral _______.

Answer 32

stenosis; regurgitation

Question 33

What is the normal aortic valve area?

Answer 33

2.5-3.5 cm

Question 34

What drug is given to close the PDA?

Answer 34

indomethacin (cyclooxygenase inhibitor)

Question 35

What is the classic presentation tetralogy of fallot?

Answer 35

hypercyanotic spell “TET spell” cyanosis, hyperapnea, possible loss of consciousness etc

Question 36

How can you prevent TET spells?

Answer 36

avoid stressful situations & premedicate to prevent catecholamine release that triggers infundibular spasms

Question 37

When does acute pericarditis commonly appear?

Answer 37

1-3 days following a transmural MI

Question 38

What is Beck,s triad and when is it observed?

Answer 38

distant heart sounds, increased jugular venous pressure, & hypotension;
observed in 1/3 of pts w/ acute cardiac tamponade

Question 39

BP monitoring must be via an artery in the ___ arm since occlusion of the aorta can prevent measurement of BP in the ____ arm

Answer 39

right; left