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Physiology > Cardiac Diseases and Rehabilitation > Flashcards

Cardiac Diseases and Rehabilitation Flashcards

1
Q

The powerful contributor of cardiovascular morbidity and mortality

A

Hypertension

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2
Q

JNC 8: SBP <120 & DBP <80 mmHg

A

Normal

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3
Q

JNC 8: >60 years old

A

SBP <150 & DBP <90 mmHg

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4
Q

JNC 8: Stage 1

A

SBP 130-139 & DBP 80-89 mmHg

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5
Q

JNC 8: <60 years old and > 18 yeards old with CKD or DM

A

SBP <140 & DBP <90

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6
Q

JNC 8: SBP 120-129 & DBP <80 mmHg

A

Elevated

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7
Q

JNC 8: Hypertensive Crisis

A

SBP >180 & DBP >120

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8
Q

JNC 8: SBP >140 & DBP >90 mmHg

A

Stage 2

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9
Q

Three factors of Acute Coronary Syndrome

A

Atherosclerosis, Thrombosis, and Vasospasm

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10
Q

Narrowing of blood vessels due to fatty plaque formation

A

Atherosclerosis

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11
Q

Theories behind Atherosclerosis

A

Intimal Injury

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12
Q

Blood vessel with the highest resistance

A

Arterioles

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13
Q

Blood vessel with the highest compliance

A

Vein

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14
Q

Narrowing of arteries due to hardening of the vessel

A

Arteriosclerosis

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15
Q

What layer of the blood vessel is thick in arteries?

A

Tunica Media

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16
Q

What layer of the blood vessel contains endothelial cells?

A

Tunica Intima

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17
Q

The obstruction due to intimal injury that creates clot formation in the blood vessel

A

Thrombosis

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18
Q

What component of a cigarette is a systemic vasoconstrictor?

A

Nicotine Factor

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19
Q

Blood vessel with the highest cross-sectional area

A

Capillaries

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20
Q

Six modifiable factors of CAD

A

Physical inactivity, tobacco smoking, increase serum cholesterol, increase BP, DM, and Obesity

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21
Q

Four non-modifiable factors of CAD

A

Age, Male, Family history, and Race

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22
Q

What race has a high risk for CAD?

A

African-American

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23
Q

The three common manifestations of CAD

A

Angina, Ischemia and Infarction

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24
Q

“Pre-infarction or Crescendo Angina”

A

Unstable Angina

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25
Q

Angina occurs during activity

A

Stable Angina

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26
Q

A cardiac-related chest pain

A

Angina

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27
Q

“Variant Angina”

A

Prizmental Angina

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28
Q

A potent vasodilator medicine usually given to patient’s with angina

A

Nitroglycerin

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29
Q

Angina occurs at rest

A

Unstable Angina

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30
Q

Angina due to vasospasm of coronary arteries

A

Prizmental Angina

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31
Q

“New acute MI”

A

Myocardial Injury

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32
Q

The most common cause of myocardial infarction

A

Thrombosis

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33
Q

The total occlusion of an artery

A

Myocardial Infarction

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34
Q

In patients experiencing MI, how long does chest pain lasts?

A

20 mins to 2 hours

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35
Q

Zone of MI: (+) ST elevation

A

Infarction and Injury

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36
Q

What is the ultimate complication of MI?

A

Cardiogenic shock

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37
Q

Zone of MI: (+) ST depression

A

Ischemia

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38
Q

How much urine output a patient undergoing is cardiogenic shock have?

A

<30ml/hr

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39
Q

What specific artery is the intra-aortic balloon pump inserted?

A

Subclavian artery

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40
Q

Zone of MI: (+) Abn Q-wave

A

Infarction

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41
Q

Five usual distribution of cardiac pain

A

(L) UE (shoulder, arm, and FA), Jaw, (R) Chest, Epigastric pain, and Back (in between shoulder blades and scapula)

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42
Q

What nerve distribution usually the cardiac pain referred to?

A

Ulnar distribution

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43
Q

Fist of the chest

A

(+) Levine Sign

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44
Q

ECG: start of ST segment

A

J point

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45
Q

ECG: (+) Large acute MI

A

STEMI

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46
Q

The golden hour of laboratory findings of MI

A

15-32 hours

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47
Q

Four cardiac enzymes tested in laboratory exams for MI

A

CKMB, Troponin I, Myoglobin, and LDH

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48
Q

ECG: (+) Small MI

A

NSTEMI

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49
Q

Cardiac Enzyme: CKMB 5-10%

A

(+) MI CKMB

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50
Q

Cardiac Enzyme: Myoglobin (+) MI

A

200-500 μg/ml

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51
Q

Cardiac Enzyme: 100-225 μg/ml

A

Normal LDH

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52
Q

Cardiac Enzyme: peak 24-36 hours

A

Troponin I

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53
Q

Cardiac Enzyme: >5-10 μg/ml

A

(+) MI Troponin I

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54
Q

Cardiac Enzyme: <100 μg/ml

A

Normal Myoglobin

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55
Q

Cardiac Enzyme: peak 14-36 hours

A

CKMB

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56
Q

Cardiac Enzyme: Normal CKMB

A

0.3%

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57
Q

Cardiac Enzyme: Normal Troponin I

A

0-0.2 μg/ml

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58
Q

Cardiac Enzyme: LDH (+) MI

A

300-750 μg/ml

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59
Q

PTCA healing time

A

2 weeks

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60
Q

Most common donor vessel used in CABG

A

Saphenous Vein

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61
Q

What are the two arteries inserted by catheter in PTCA?

A

Femoral and Radial artery

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62
Q

Most effective donor vessel used in CABG

A

Internal mammary artery

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63
Q

Triceps strengthening is postponed until when?

A

4 weeks post-op

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64
Q

What activities are contraindicated after CABG?

A

STS or Supine to Long sitting

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65
Q

The three donor vessels in CABG

A

Saphenous Vein, Internal mammary artery, and Radial artery

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66
Q

Impaired cardiac pump

A

Heart Failure

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67
Q

Percentage of ejected blood

A

Ejection Fraction

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68
Q

The clinical syndrome caused by the accumulation of fluid in the pericardial space, resulting in the reduced ventricular filling.

A

Cardiac Tamponade

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69
Q

What kind of dysfunction has a compromised ventricular contraction?

A

Systolic Dysfunction

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70
Q

The normal range of Ejection Fraction

A

55-78%

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71
Q

True or False: There is an increased ejection fraction in diastolic dysfunction

A

False (no change)

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72
Q

How much ejections fraction decreases in systolic dysfunction?

A

40%

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73
Q

What kind of dysfunction has a compromised ventricular filling & relaxation?

A

Diastolic Dysfunction

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74
Q

Right or Left Heart Failure: Jugular Vein Distention

A

Right

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75
Q

Right or Left Heart Failure: Ortopnea & Trapopnea

A

Left

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76
Q

Right or Left Heart Failure: SOB

A

Left

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77
Q

SOP in an upright position

A

Platypnea

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78
Q

Right or Left Heart Failure: Ascites

A

Right

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79
Q

Right or Left Heart Failure: Bipedal Edema

A

Right

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80
Q

Right or Left Heart Failure: Pulmonary Edema

A

Left

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81
Q

SOP in a supine position

A

Orthopnea

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82
Q

Right or Left Heart Failure: Cerebral Hypoxia

A

Left

83
Q

Right or Left Heart Failure: Cyanosis

A

Right

84
Q

SOP in a side-lying position

A

Trapopnea

85
Q

Right or Left Heart Failure: Muscle Fatigue

A

Both

86
Q

Right or Left Heart Failure: Weight Gain

A

Right

87
Q

Right or Left Heart Failure: Cough

A

Left

88
Q

Right or Left Heart Failure: Muscle Weakness

A

Left

89
Q

What heart sound is present in patients with CHF?

A

S3

90
Q

NYHA: Marked Limitation

A

Class III

91
Q

NYHA: Ordinary activity presents symptoms

A

Class II

92
Q

NYHA: (+) Cardiac disease with no limitation of activity

A

Class I

93
Q

NYHA: Symptoms presents at rest

A

Class IV

94
Q

NYHA: Less ordinary activity presents symptoms

A

Class III

95
Q

NYHA: 1.5 METs

A

Class IV

96
Q

NYHA: 3-4 cal/min

A

Class II

97
Q

NYHA: Class I METs

A

6 METs

98
Q

NYHA: Class IV power

A

1-2 cal/min

99
Q

NYHA: 4.5 METs

A

Class II

100
Q

NYHA: Class I power

A

4-6 cal/min

101
Q

NYHA: 2-3 cal/min

A

Class III

102
Q

NYHA: Class III METs

A

3.0 METs

103
Q

Four manifestations in NYHA

A

Fatigue, Palpitation, Dyspnea, and Angina

104
Q

Cardiac neurohormones send signals to the kidney to decrease fluid volume

A

Atrial and Brain Natriuretic Peptide

105
Q

What is a diuretic drug that decreases fluid volume?

A

Furosemide

106
Q

Narrowing of heart valve

A

Stenosis

107
Q

Backflow due to the incomplete valve closure

A

Regurgitation

108
Q

Enlarged valve cusps

A

Prolapse

109
Q

Most common valve involved in prolapse

A

Mitral Valve

110
Q

Disturbance in electrical activity that leads to absent rhythm

A

Arrhythmia

111
Q

A beat from a site other than SA node

A

Ectopic Beats

112
Q

Beats from the ventricles create an irregular rhythm

A

Ventricular Ectopy

113
Q

Quivering of atria

A

Atrial Fibrillation

114
Q

Run of 4 or more PVCs

A

Ventricular Tachycardia

115
Q

Quivering of ventricles

A

Ventricular Fibrillation

116
Q

ECG: (-) P-wave and (+) QRS widening

A

Ventricular Ectopy

117
Q

ECG: (+) P wave - non-sinus

A

Atrial Fibrillation

118
Q

Two types of Ectopic Beats

A

PACs and PVCs

119
Q

(+) Decrease Atrial Kick

A

Atrial Fibrillation

120
Q

Symptom: no palpable pulse

A

Ventricular Tachycardia

121
Q

The normal range of Atrial Kick

A

15-20%

122
Q

“Irregularly Irregular”

A

Atrial Fibrillation

123
Q

Firing from any location above the ventricle

A

Supraventricular Ectopic Beats

124
Q

A lethal electrical conduction abnormality that can lead to cardiac arrest

A

Ventricular Tachycardia

125
Q

(+) 150-250 bpm

A

Supraventricular Tachycardia

126
Q

What are the two PT management that you can provide in a patient with Supraventricular Ectopic Beats?

A

Activate Baroreceptors by Carotid massage and Breathing technique such as holding breath

127
Q

AV block: (+) prolonged PR interval only

A

First Degree AV block

128
Q

AV block: (+) mismatch of the atrium and ventricular contraction

A

Third Degree AV block

129
Q

AV block: (+) Prolonged PR interval + drop a beat

A

Mobitz I AV block

130
Q

AV block: Normal PR interval + drop a beat

A

Mobitz II AV block

131
Q

“Not a true arrhythmia”

A

Bundle Branch Block

132
Q

“Wenckebach”

A

Mobitz I AV block

133
Q

What is the ECG finding that presents a Bundle Branch Block?

A

Widen QRS

134
Q

Bening Bundle Branch Block

A

Right Bundle Branch Block

135
Q

Pathological Bundle Branch Block

A

Left Bundle Branch Block

136
Q

How long before an artificial pacemaker gets replaced?

A

5-10 years

137
Q

Infection of the inner lining of the heart

A

Endocarditis

138
Q

Wall inflammation that presents an MI like symptoms (Sharp shooting pain for days)

A

Pericarditis

139
Q

A rare wall inflammation condition

A

Myocarditis

140
Q

Three things to watch out for in patients with wall inflammation?

A

HR, SOB, and Fever

141
Q

The dilation of the arterial wall

A

Aneurysm

142
Q

Four most common sites of Aneurysm

A

Thoracic Aorta, Femoral Artery, Popliteal Artery and Abdominal Artery

143
Q

Two risk factors of Aneurysm

A

Ehlers-Danlos Syndrome and Marfan Syndrome

144
Q

One way to detect an aneurysm

A

Pulsating sensations at the abdomen

145
Q

Most common artery affected with Aneurysm

A

Abdominal Artery

146
Q

Most common congenital defect

A

Ventricular septal defect

147
Q

Septal defect due to the patent foramen ovale

A

Atrial septal defect

148
Q

A congenital heart defect where the blood that travels from the aortal will go back to the pulmonary artery.

A

Patent Ductus Arteriosus

149
Q

Four presenting conditions of Tetralogy of Fallot

A

Pulmonary stenosis, (R) ventricular hypertrophy, ventricular septal defect, and an overriding aorta.

150
Q

A presenting sign of babies with TOF where a cry elicits for cyanosis on their body

A

Tet spells

151
Q

Right to Left or Left to Right shunt: Atrial Septal Defect

A

Left to Right

152
Q

Right to Left or Left to Right shunt: Patent Ductus Arterious

A

Left to Right

153
Q

Right to Left or Left to Right shunt: Tetralogy of Fallot

A

Right to Left

154
Q

Right to Left or Left to Right shunt: Ventricular Septal Defect

A

Left to Right

155
Q

A condition caused by the reversal of shunting (left to right shunts lead to the right to left shunt due to the overfilling of (R) side of the heart

A

Eisenmenger Syndrome

156
Q

The ability of the individual to do work or perform an exercise

A

Aerobic capacity

157
Q

The formula for Rate Pressure Product

A

RPP = HR x SBP

158
Q

Unit of Aerobic Capacity

A

VO2max

159
Q

True or False: VO2max = MET

A

True

160
Q

The normal range of RPP

A

25-35 mmHg x bpm/10*3

161
Q

Karvonen’s Formula

A

THR = RHR + 60-70% (MHR - RHR)

162
Q

Blood volume per heartbeat

A

Stroke Volume

163
Q

Blood volume per minute

A

Cardiac Output

164
Q

Five factors to consider before doing aerobic training

A

Aerobic Capacity, HR, SV, CO and MVO2

165
Q

An increase of what will lead to an increase of MVO2?

A

Workload

166
Q

Four determinants of exercise

A

Frequency, Intensity, Time and Type of Exercise (FITT)

167
Q

Minimum time for aerobic exercise

A

20-30 minutes

168
Q

The frequency for moderate-intensity exercise

A

3x/wk

169
Q

Components of Intensity in exercise

A

Max HR and THR

170
Q

The frequency for low-intensity exercise

A

5x/wk

171
Q

What benefits of exercise should increase?

A

VO2 max, CO, and SV

172
Q

What factors should decrease after constant aerobic training?

A

HR at rest, MVO2, Peripheral Resistance

173
Q

True or False: Maximum HR doesn’t change after exercise

A

True

174
Q

Three factors that increase MVO2

A

Cold weather, after eating, after smoking

175
Q

METS: 5

A

Sex with wife

176
Q

METS: Office Work

A

1.3-2.3

177
Q

RPE: weak

A

2

178
Q

METS: 1.5

A

Eating

179
Q

METS: 5.7

A

2 step climb

180
Q

RPE: 5

A

very strong

181
Q

RPE: 7

A

very very light

182
Q

METS: 4

A

Bed Pan

183
Q

METS: 7.4

A

Running

184
Q

METS: 1.4-2.0

A

Standing

185
Q

RPE: very very hard

A

19

186
Q

METS: Walking 3mph

A

4.3

187
Q

RPE: 3

A

Moderate

188
Q

RPE: 11

A

Fairly Light

189
Q

METS: Ascending Stairs

A

9

190
Q

METS: Wheelchair and drive

A

2.8

191
Q

METS: Walking 1mph

A

2.3

192
Q

RPE: 13

A

Somewhat Hard

193
Q

METS: 3.5

A

Shower

194
Q

METS: sitting

A

1.2-1.6

195
Q

Cardiac Rehab Phase: MET 1-2, RPE 11

A

Phase 1

196
Q

Cardiac Rehab Phase: 70-85% HR max

A

Phase 2

197
Q

Cardiac Rehab Phase: 3-4x/wk

A

Phase2

198
Q

Cardiac Rehab Phase: Maintenance

A

Phase 3

199
Q

Phase I Level: Increase ambulation by frequency and time

A

Level 4-6

200
Q

Phase I Level: ICU

A

Level 1

201
Q

Phase I Level: Increase ambulation

A

Level 3

202
Q

Phase I Level: Bed Side

A

Level 2

203
Q

Phase I Level: 2-2.5 METs

A

Phase 3-6

204
Q

Phase I Level: 1.5-2 METs

A

Phase 2

Physiology (9 decks)

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