Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Methods > Cardiac III: Cardiac Diseases & 12-Lead EKG Part 1.5 > Flashcards

Cardiac III: Cardiac Diseases & 12-Lead EKG Part 1.5 Flashcards

1
Q

What condition is this? BP > 140/90 on at least 2 occasions measured at least 1-2 weeks apart

A

systemic hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The following conditions can develop as a result of ____ ______.

ischemic heart disease

congestive heart failure

cerebral vascular accident

arterial aneurysm

end stage renal disease

A

systemic hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Optimal BP is: ____/_____ Normal BP is less than ____/____

A

120/80

130/85

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

High-normal BP ranges from: Systolic: ___ - _____ Diastolic: ____ - _____

A

130-139

85-89

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Stage 1 Hypertension ranges from: Systolic: ____-____ Diastolic: _____-____

A

140 - 159

90 -99

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Stage 2 Hypertension ranges from: Systolic: ____-____ Diastolic: _____-____

A

160 - 179

100 - 109

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Stage 3 Hypertension BP is ___ / ___

A

180

110

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What accounts for 95% of all cases of HTN?

A

essential HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The cause of ____ HTN cannot be identified.

A

essential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Familial incidence and patholphysiological factors such as: increased sympathetic NS activity overproduction of Na retaining hormones & vasoconstrictors high Na intake increased renin secretion deficiencies of vasodilators describe ______ hypertension.

A

essential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Known etilogy is present in _____ HTN.

A

secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common secondary type of HTN?

A

Renovascular HTN from renal artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When renovascular HTN is present, diastolic BP is usually > ____ mmHg and an ____ ____ ___ is present.

A

125

upper abdominal bruit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What test confirms secondary HTN?

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the treatment of essential HTN?

A

lifestyle modification: weight reduction, increase in physical activity, moderation in alcohol, quit smoking pharmacologic therapy: diuretics, beta-blockers, ACE inhibitors, angiotensin receptor blockers calcium channel blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Secondary HTN is treated by: (2)

A

treatment is often surgical (angioplasty, surgery for stenotic renal artery, adrenalectomy)

pharmacologic therapy reserved for patients in those where surgery is not possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hypertensive crisis when acute diastolic BP > _____mmHg.

A

130

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Need for emergent treatment determined by absolute BP rather than rate of increase. True or false?

A

False, determined by rate of increase rather than absolute BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Patients with evidence of acute or ongoing target organ damage (encephalopathy, CHF, renal insufficiency, subarachnoid hemmorage) require prompt treatment with ____ BP lowering agents.

A

IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Don’t decrease BP to normotensive levels! Desired decrease is MAP < ___% in first 2 hours, then additional decreases over next ___-___ hours.

A

20 24-48

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Meds to consider delivering during hypertensive crisis: (3)

A

Nitroprusside Hydralazine Nitroglycerine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Anesthetic considerations for HTN during preop evaluation: (3)

A

determine adequacy of BP control review drugs being administered for BP control evaluate evidence of end-organ damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

For HTN patients: induction of anesthesia considerations: (2)

A

anticipate exaggerated BP changes limit duration of DL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

For HTN patients: maintenance of anesthesia considerations: (2)

A

administer a volatile anesthetic to blunt HTN responses monitor for MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
For HTN patients: post-op management considerations (2)
anticipate periods of HTN maintain monitoring of end-organ function
26
Condition occurs when the heart is unable to provide sufficient pump action to distribute blood flow to perfuse tissues and organs of the body.
Congestive heart failure
27
What are the causes of CHF? (4)
valve abnormalities impaired contractility secondary to ischemic heart disease or cardiomyopathy systemic HTN pulmonary HTN (cor pulmonale)
28
What is the most common form of heart failure? Fluid may back up in the lungs causing SOB.
left-sided heart failure
29
What most commonly results from left-sided heart-failure?
right-sided heart failure
30
Fluid may back up into the abdomen (ascites) and legs and feet (edema) in this type of heart failure.
right-sided heart failure
31
In this type of heart failure, the left ventricle cannot contract vigorously, indicating a pumping problem. EF \< \_\_\_% in this case.
systolic 45
32
In this type of heart failure, the left ventricle cannot relax or fill fully, indicating a filling problem from noncompliant ventricles.
diastolic heart failure
33
In diastolic heart failure, EF is often normal. True or false?
true
34
NY Heart Association classification system: No limitation and no symptoms with ordinary physical activity is Class \_\_\_.
1
35
NY Heart Association classification system: Slight limitation and symptoms with ordinary physical activity. Comfortable at rest. Class \_\_.
2
36
NY Heart Association classification system: More pronounced limitation because of symptoms, even with less than ordinary physical activity. Comfortable only at rest. Class \_\_
3
37
NY Heart Association classification system: Severe to complete limitation of physical activity. Symptoms are present with any degree of physical activity and also appear at rest. Class \_\_\_
4
38
Symptoms of ____ include fatigue at rest or with minimal exertion.
CHF
39
Hallmark symptoms include dyspnea, tachypnea, orthopnea, PND, and S3. Signs include moist rales in the lungs --\> pulmonary edema.
LEFT CHF
40
Hallmark symptoms include systemic venous congestion as evidence by JVD, oranomegaly (liver and spleen), RUQ tenderness and elevation of liver tests, and pulmonary edema.
RIGHT CHF
41
In CXR, distension of the pulmonary veins in upper lobes of the lungs (pulmonary venous HTN), hilar and perihilar haze (perivascular edema, pleural effusions and pericardial effusion indicate \_\_\_\_.
CHF
42
Short-term treatment of CHF goals include: (3)
relieve symptoms of circulatory congestion increase tissue perfusion improve quality of life
43
Long-term treatment goals for CHF: (1)
slow or reverse progressive LV dysfunction (ventricular remodeling) that results in a dilated ventricular chamber and low EF
44
Non-pharmacologic management of CHF: (6)
Na restriction exercise angioplasty and bypass surgery valve repairs transplant ventricular assist device
45
List 4 drugs that are good options for CHF patients.
ketamine opioids benzodiazepines etomidate Caution: nitrous oxide & opioids/benzos = cardiac depression!
46
Volatile anesthetics are encouraged for CHF patients. True or false?
false
47
Use caution when using propofol for CHF patients. True or false?
true It is not a direct myocardial depressant, but causes peripheral vasodilation which decreases BP.
48
For severe CHF patients, consider opioids only, positive pressure ventilation, invasive monitoring, and support of CO with dopamine and dobutamine also. True or false?
true
49
What condition is characterized by myocardial dysfunction unrelated to the usual causes of heart disease (CAD, valve disease, or HTN)
cardiomyopathy
50
Common to all cardiomyopathy is progressive, life threatening CHF. True or false?
true
51
Right ventricular enlargement that develops secondary to pulmonary HTN indicates ____ \_\_\_\_.
Cor Pulmonale
52
COPD with associated loss of pulmonary capillaries and arterial hypoxemia --\> pulmonary vascular vasoconstriction --\> hypertrophy of vascular smooth muscle and increases pulmonary vascular resistance--\> ______ \_\_\_\_\_.
cor pulmonale
53
\_\_\_\_ ____ is obscured by COPD and results in: dyspnea effort -related syncope elevated pulmonary artery pressures
cor pulmonale
54
CXR reveals: right ventricular hypertrophy reflected by decreases in retrosternal space on lateral view, or, prominence of PA and decreased vascular markings are suggestive of pulmonary HTN in this type of heart condition.
cor pulmonale
55
Peaked p waves in II, III, AVF and right ventricular hypertrophy (right axis deviation and RBBB) show signs of ___ \_\_\_\_.
cor pulmonale
56
To treat cor pulmonale, decrease the workload of the right ventricle by decreasing PVR. True or false?
true
57
Treatments for cor pulmonale include: (7)
supplemental O2 anticoalgulation diuretics digitalis for CHF vasodilators antibiotics heart-lung transplant
58
Characterized by a sustained increase of pulmonary artery pressure without a demonstrable cause.
Primary pulmonary HTN
59
In primary pulmonary HTN, mean PA pressure \> ___ mmHg (rest) \> ___ mmHg (exertion)
25 30
60
Primary pulmonary HTN pathological changes include: (3)
in situ thrombosis smooth muscle hypertrophy intimal proliferation
61
Early symptoms of primary pulmonary HTN include: (2)
dyspnea fatigability
62
\_\_\_\_ ____ \_\_\_\_ to confirm diagnosis of primary pulmonary HTN.
Right heart catheterization
63
There is no cure for primary pulmonary HTN. True or false?
true
64
Treat primary pulmonary HTN with: (2)
Ca channel blockers (nifedipine & diltiazem) or, IV prostacyclin as a bridge to transplantation for non-responders
65
Inflammation of the pericardium usually caused by a viral infection is known as:
acute pericarditis
66
What do these symptoms indicate? chest pain worsening with inspiration friction rub diffuse ST segment elevation
acute pericarditis
67
Treatment for acute pericarditis: (2)
oral analgesics for pain NSAIDs
68
What is the abnormal accumulation of fluid in the pericardial cavity?
pericardial effusion
69
A pericardial effusion with enough pressure to adversely affect heart function is known as what?
cardiac tamponade
70
Signs of impending tamponade include: (3)
dyspnea low BP distant heart sounds
71
CXR reveals a "water bottle heart" indicates what?
cardiac tamponade
72
What is the treatment for cardiac tamponade?
pericardiocentesis needle is inserted through the chest wall into the pericardial space to withdraw excess fluid
73
\_\_\_\_\_ ____ is a long-term inflammation of the pericardium with thickening, scarring, and muscle tightening. Causes include heart surgery, radiation therapy to the chest and TB
Constrictive pericarditis
74
Symptoms of constrictive pericarditis include: (5)
dyspnea fatigue peripheral edema ascites weakness
75
What tests indicate constrictive pericarditis? (4)
chest CT (demonstrate thickening) TEE doppler flow studies cardiac cath
76
Treatment for constrictive pericarditis include: (2)
either resolves surgical stripping of pericardium
77
Symptoms of MI: (4)
* Anxiety, sinus tachycardia, hypotension (caused by left or right ventricular dysfunction or cardiac dysrhythmias) * Moist rales representing CHF (due to LV dysfunction) * Cardiac murmur may reflect ischemic mitral regurgitation. * Rule out other causes of CP: pulmonary embolism, aortic dissection, spontaneous pneumothorax, pericarditis, cholecystitis
78
Treatment of MI (6)
Aspirin IV Morphine: pain relief and decrease the stimulus to catecholamine release and increases in myocardial oxygen requirements. Thrombolytic Therapy: Tissue plasminogen activator (t-PA, streptokinase) within 30-60 min of hospital arrival. Coronary Angioplasty: within 1-2 hours CABG: reperfusion achieved more quickly with Thrombolytics or PTCA, emergent CABG reserved for patients who’s anatomy precludes PTCA, failed angioplasty, infarct related ventricular septal defect or MR * Adjunctive Medical Therapy: Heparin IV, Beta blockers, ACE inhibitors, nitrate therapy
79
A systolic murmur indicates what type of valve issues? (4)
AP valves open; so murmurs heard are AP stenosis or MT insufficiency * Aortic stenosis * Pulmonary stenosis * Mitral regurgitation * Tricuspid regurgitation
80
A diastolic murmur indicates what type of valve issues? (4)
MT valves open; so murmurs heard are MT stenosis or AP insufficiency (MS, TS, AR, PR)
81
What cardiac dysrhythmia is most common with rheumatic mitral valve disease & left atrial enlargement?
atrial fibrillation
82
Angina Pectoris can occur (even without ischemic heart disease) from increased myocardial O2 demand from enlarged cardiac muscle mass (hypertrophy). True or false?
true
83
What are the symptoms of mitral stenosis?
dyspnea on exertion orthopnea PND from LV dysfunction (if AR and MR also present --\> significant LV dysfunction)
84
What valve condition is characterized by an "opening snap"?
Mitral stenosis
85
What type of cardiomyopathy is indicated by: biventricular dilation increased ventricular volume decreased ejection fraction increased ventricular filling pressure decreased stroke volume
dilated cardiomyopathy
86
What cardiomyopathy is characterized by: decreased ventricular compliance increased ventricular filling pressure
restrictive cardiomyopathy
87
What cardiomyopathy is characterized by: marked increase EF marked decrease of ventricular compliance increased LV and septum size
hypertrophic cardiomyopathy
88
What cardiomyopathy is characterized by: thickened endocardium decreased ventricular compliance
obliterative cardiomyopathy

Clinical Methods (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions