Brainscape's Knowledge GenomeTM

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


See full index

Clinical Medicine LAB - Professor Sample > Cardiac Imaging and Supplemental > Flashcards

Cardiac Imaging and Supplemental Flashcards

1
Q

Holter monitor Type?

A

Electrophysiology

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

Holter monitor indications?

A

Palpitations - especially

Syncope

Unexplained fatigue or dyspnea

work up and then everything is negative well it might be time for a home monitor

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

Holter monitor - explanation?

A

Evaluates the general conduction of the heart for for 24 hours or more ( up to a month)

Creates recording

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

Holter monitor - quality of test?

A

Only useful if symptomatic while wearing the monitor

Only use full if they are symptomatic …otherwise you are just going to see sinus rhythms

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

Holter monitor methodology / procedure?

A
  1. 3-8 electrodes placed on body
  2. Records general conduction of heart
  3. Typically worn for about 24 hours
  4. Sent to medical company for evaluation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Normal Holter monitor interpretation?

A

Normal sinus rhythm

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

Abnormal Holter monitor interpretation?

A 
Atrial fibrillation or flutter
Multifocal atrial tachycardia
Paroxysmal supraventricular tachycardia ( AVNRT)
Ventricular tachycardia
Bradycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Holter monitor Interpretation and diagnosis ?

A 
Atrial fibrillation or flutter
Multifocal atrial tachycardia
Paroxysmal supraventricular tachycardia
bradycardia
Ventricular tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Further testing after holder monitor?

A

Event monitor
Stress test
Cardiac catheterization

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

Types of stress testing?

A

Electrophysiology OR

Perfusion OR ( nuclear study yo ID blood flow and actual perfusion in the heart)

Echocardiography US of heart, ID abnormalities of the heart walls

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

Indications of stress testing

A

Angina - especially
Abnormal EKG- LBBB people may not have pain but EKG s abnormal indicative of CAD

Unexplained:
Fatigue
Dyspnea

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

Stress test explanation?

A

Stresses the heart by exercise or medication which causes damage and demand for the heart so we look for areas that become ischemic.

Evaluates for reproducible ischemia

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

Stress test quality of test?

A

Considered a provocative test
Less invasive than cardiac catheterization

Not the gold standard for evaluation of coronary artery disease

When is a stress test not appropriate - COPD, >65 abnormal EKG finding then we can jump right to cardiac catheterization instead of stress test. low risk chest pain individuals is the best indication to use stress test.

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

Contraindication to Stress test?

A

recent MI

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

Complications to stress test?

A

Ischemia

MI, 1 in 1000 ( more common if recent one)

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

Limitations or interferences to stress test?

A

Exercise tolerance, or overweight and have severe osteoarthritis (knees hurt to much to run)

10-30% false positive rate

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

Methodology / Procedure for Stress test?

A

12 lead EKG electrodes set up on patient

Option of echo OR
Perfusion

Treadmill ( cheap but they need to be in decent health) or medication like Dobutamine or
Adenosine ( induces ischemia)

Evaluate for ischemia

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

Stress Test Interpretation, normal values?

A

Tachycardia with no ischemia

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

Stress Test Interpretation, abnormal values?

A

> 1mm ST depression - (60-80% of people with significant CAD identified ( but remember the false positive rate) we will still probably move on to cardiac catheter cause it is abnormal stress test. )

> 2mm ST depression ( severe CAD)

convex - fowny face - bad

concave - happy face - good

ST depression indicates ischemia during stress but not death of the heart - so this is a positive stress test ( 2mm or more is a positive stress test )

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

Stress Test abnormal perfusion interpretation?

A

Mismatches

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

Stress Test abnormal echo interpretation?

A

Valve abnormalities

Ejection fraction
is it changing?

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

Diagnosis of stress test ?

A

Coronary Artery Disease

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

A stress test can indicate further testing is needed, like what?

A

Cardiac catheterization - coronary angiography

if stress test is positive ? yes

some patients we just go right to this

if stress test is neg? we are done we do nothing

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

Cardiac Catheterization ( angiography) type?

A

Imaging

25
Q

Cardiac Catheterization indications?

skip stress test a go right to CC

A

MI
Angina
Abnormal stress test
Cardiac surgery prep

ST segment elevation - standard of care is within 90 min get then to the cath lab and and have a balloon angioplasty ready

26
Q

Background for CC?

A

Evaluates for stenosis of coronary vessels

Gold standard for coronary artery disease

May also be used to look at valves and cardiac output

27
Q

Contraindications with CC?

A

Severe contrast allergy

28
Q

Complications for CC?

A

Puncture
Hematoma - femoral artery
Aneurysm

29
Q

Methodology / Procedure for CC?

A

Cather placed in artery (typically femoral)

Threaded to ascending aorta

Fluoroscopy:

  • Cather placed in right coronary and contrast injected
  • Placed in left coronary and contrast injected
30
Q

Normal value for CC interpretation?

A

No stenosis

no plaques or “areas bitten out of it” - nice vessel outlines as it goes down - 0% stenosis - clean vessels

31
Q

Abnormal value for CC interpretation?

A

Stenosis

32
Q

Diagnosis using CC?

A

CAD - severity (% stenosis)

33
Q

Mild CAD?

A

<50% stenosis - do not do anything - just watch it, no angioplasty

a lot of people have coronary disease but it has not yet caused symptoms

34
Q

> 50% stenosis on CC?

A

clinically significnt

35
Q

> 70% stenosis on CC?

A

very significant ( likely to cause ischemia)

36
Q

CC is the gold standard for CAD and is better than stress tests but they are more _________ and ________ and you can also imply ____ (stents)

A

expensive
invasive
PCTA

severe symptoms require stenting

some people have many stents at one time

37
Q

Patient education if pos. CC?

A

Educate about CAD and lifestyle risk factors

May be candidate for CABG

38
Q

ABI type?

A

manual test

39
Q

Indications for ABI?

A 
Signs of Peripheral arterial disease
Leg pain
Leg swelling
Discoloration of legs
Abnormal pulses
intermittent claudication
40
Q

Where is the main site for atherosclerosis to occur?

A

superficial femoral artery

41
Q

ABI background?

A

checks for decrease in blood flow in peripheral arteries

42
Q

ABI quality of test?

A

sensitive for significant PAD

specificity is not as high cause other causes like DM, vasculitis and dissection

43
Q

Methodology / Procedure for ABI?

A

Take systolic blood pressure of b/l brachial artery

Take systolic blood pressure of b/l dorsalis pedis and posterior tibialis

Calculate ratios:
Right= Lower extremity/ Upper extremity
Left= Lower extremity/ Upper extremity

44
Q

ABI interpretation, Normal value?

A

> 0.9 (0.9-1.30) - Normal

45
Q

ABI, mild PAD value?

A

0.89-0.60  Mild PAD

46
Q

ABI, moderate PAD value?

A

0.59-0.40  moderate PAD

47
Q

ABI, severe PAD value?

A

<0.39  Severe PAD

48
Q

ABI interpretation and diagnosis?

A

Decreased lower extremity blood flow

Degree of peripheral arterial disease

49
Q

ABI interpretation diagnosis of further testing include?

A

Peripheral angiogram

Can identify site
stent can be placed

50
Q

Peripheral Angiography type?

A

Imaging

51
Q

Indications for Peripheral Angiography?

A

Abnormal ABI

Concern for PAD

52
Q

Test Explanation and background for Peripheral Angiography?

A

Evaluates for stenosis with contrast in lower extremity arteries

GS for identifying a PAD

53
Q

Peripheral Angioplasty Quality of test?

A

Gold standard for identifying lesions in PAD

54
Q

Peripheral Angiography contraindications?

A

Severe contrast allergy

55
Q

Complications for Peripheral Angiography?

A

Arterial damage

56
Q

Methodology / Procedure for Peripheral Angiography?

A
  1. Catheter placed in artery (most commonly femoral)
  2. Threaded to aorta
  3. Contrast injected
  4. Fluoroscopy identifies blood flow ) live X-RAY
57
Q

Normal Peripheral Angioplasty finding?

A

No stenosis

58
Q

Abnormal Peripheral Angioplasty finding?

A

Stenosis

59
Q

Peripheral Angioplasty will diagnose PAD and the location of stenosis, where are some locations?

A

Superficial femoral artery
Popliteal Artery

Degree of stenosis
can place a stent
helps with planning for bypass

Clinical Medicine LAB - Professor Sample (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions