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Clin Med III > Cardiac Pathology Part 2 > Flashcards

Cardiac Pathology Part 2 Flashcards

1
Q

What is a lipid panel

A

Blood test to assess the amount and type of serum lipid

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2
Q

What is a normal lipid panel

A

Less than 200 mg/dL

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3
Q

What is the purpose of the lipid panel (2)

A
  1. Identify risk of CAD and atherosclerotic lesion formation

2. Monitors response to therapeutic intervention

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4
Q

What is lipid panel also called

A

Total cholesterol

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5
Q

What does LDL do

A

Carry cholesterol from the liver to other parts of the body such as peripheral tissues and blood vessels

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6
Q

At what level do LDLs start to cause atherogenesis

A

Above 100 mg/dL

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7
Q

What does HDL do

A

Carry cholesterol to the liver for removal decreasing atherogenic plaque deposits in the blood

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8
Q

What is atherogenesis

A

Plaque formation in the blood

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9
Q

At what level in men and women does HDL star to decrease atherogenic plaques

A

Men: Above 40 mg/dL
Women: Above 50 mg/dL

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10
Q

What is a triglyceride

A

A fat produced by the liver that is stored as glycerol, fatty acids, monoglycerides, and reconverted when body is in need

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11
Q

What is a coagulation profile

A

Blood test used to assess clot formation activity

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12
Q

What is the purpose of a coagulation profile (2)

A
  1. Screen for clotting factor deficiencies

2. Assess therapeutic range of anticoagulation therapy

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13
Q

What is the prothrombin time (PT)

A

Measures thrombin production and plasma clotting factors

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14
Q

What does prothrombin time determine

A

How long it takes plasma to clots

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15
Q

What does prothrombin time screen for

A

Bleeding disorders, anticoagulation effectiveness, and used to calculate international normalized ratio (INR)

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16
Q

What is partial thromboplastin time (PTT)

A

Speed of clotting and plasma clotting factors

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17
Q

In the presence of increased clotting time what should be considered for physical therapy (5)

A
  1. Avoid high intensity impact aerobic exercise
  2. Low resistance/high rep resistance exercise
  3. Avoid vigorous manual techniques and modality use
  4. Do not perform debridement
  5. Hold exercise and manual intervetion when PT or PTT is greater than 2.5 times reference range or INR greater than 3.0
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18
Q

In the presence of decreased clotting time what should be considered for physical therapy

A

Hold exercise until physician clearance determines emboli risk

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19
Q

What is the purpose of blood glucose

A

Indicates carbohydrate metabolism

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20
Q

What happens if fasting blood sugar is below 60 mg/dL

A

Hold PT due to CNS symptoms

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21
Q

What happens if fasting blood sugar is above 250 mg/dL

A

Hold PT due to risk of ketoacidosis

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22
Q

When is an oral glucose tolerance test done

A

Pregnancy

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23
Q

What is the 2 hour postprandial blood sugar

A

Testing your blood sugar 2 hours after you eat

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24
Q

What is the target range of glycated hemoglobin (HbA1c)

A

Regular: 4-5.9%

With DM: Below 7%

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25
Q

What is the purpose of the cardiac angiography

A

Determine patency of coronary arteries and identify cardic valve disease

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26
Q

What is a cardiac angiography

A

Angiogram/catheterization where a long catheter is inserted into brachial or femoral artery which is passed to the heart chambers or coronary arteries where a contrast dye is injected and visualized by fluoroscopy

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27
Q

What can be visualized/monitored with cardiac angiography

A

Cardiac valves are visualized and chamber pressures can be monitored

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28
Q

True or False:

Activity should not be done for a while after undergoing a cardiac angiography

A

True

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29
Q

True or False:

PT should assess LE pulse, temperature and sensation frequently following a cardiac angiography

A

True

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30
Q

How long do you have to avoid resistance exercise after a cardiac angiography

A

2 weeks

31
Q

When should a PT apply direct pressure to the catheter site

A

If bleeding or large bulge forms rapidly under the skin

32
Q

What is the purpose of an echocardiography (3)

A
  1. Determine heart structure abnormalities
  2. Assess prosthetic valve function
  3. Detect valve pathology (stenosis) and septal wall defects
33
Q

What is an echocardiography

A

Ultrasound image used to create a dynamic image of the heart

34
Q

What are the 4 different modes of an echocardiography (4)

A
  1. M-mode
  2. 2-D
  3. Spectral doppler ECC
  4. Color doppler ECC
35
Q

What does an M-mode ECC do

A

Records heart motion

36
Q

What does a 2-D ECC do

A

Provides a cross sectional view of the heart

37
Q

What does a spectral doppler ECC do

A

Measures the blood flow detecting turbulence and septal defects

38
Q

What does a color doppler ECC do

A

Shows the direction of blood flow detecting valve regurgitation and shunts

39
Q

True or False:
The PT should resume activity shortly after an ECC but take into consideration any findings on heart valve function or septal wall defects

A

True

40
Q

What is the purpose of an electrocardiography (2)

A
  1. Detect cardiac dysrhythmias

2. Diagnose myocardial ischemia and determine region of involvement

41
Q

What is an electrocardiography

A

Records electrical activity of the heart from different leads

42
Q

True or False:
The PT should resume activity shortly after and EKG but take into consideration findings on exercise induced ischemia or heart failure

A

True

43
Q

True or False:

The PT should monitor patients closely that have dysrhythmias

A

True

44
Q

What is a Holter monitoring

A

Ambulatory EKG worn for 24-48 hours that is able to relate symptoms or activities to cardiac dysrhythmias or diagnose variable angina

45
Q

True or False:
The PT should continue normal activity and record exercise intervention, vitals, exercise tolerance that day in patient’s note

A

True

46
Q

True or False:

The Holter monitor should never be removed of gotten wet

A

True

47
Q

What are the 2 types of stress testing

A
  1. Pharmacological stress test

2. Exercise stress test (GXT graded exercise test)

48
Q

Who is a pharmacological stress test for

A

Patients that cannot stress the cardiovascular system via treadmill

49
Q

What is a pharmacological stress test

A

Agents are injected to dilate coronary arteries and mimic exercise demands and nuclear imaging techniques (PEt and SPECT) and ECC are used to determine areas of ischemia in the myocardium

50
Q

What is an exercise stress test

A

Monitoring Hr, BP, and EKG while the patient is on the treadmill watching for changes in wave or presence of abnormal findings

51
Q

What happens at the peak of exercise during an exercise stress test

A

Tracer is injected and images are acquired better able to see areas of ischemia or block with exercise

52
Q

What does SPECT stand fo

A

Single Photon Emission Computed Tomography

53
Q

What does a SPECT scan do

A

Assists in detecting CAD and assessing myocardial perfusion

54
Q

True or False:

A SPECT scan is difficult if the patient cannot lie still for at least 15 minutes

A

True

55
Q

What does PET stand for

A

Positron Emission Tomography

56
Q

What does a PET scan do (3)

A
  1. Determine reversible/permanent injury assessing amount of useful tissue fir surgical revascularization and coronary angioplasty
  2. Assesses myocardial perfusion, tissue visibility, autonomic regulation
  3. Assesses lung metabolism as well (pulmonary nodules/masses
57
Q

Which scan is more useful at detecting cancer a SPECT or a PET scan

A

Pet scan

58
Q

What does MUGA stand for

A

Multiple-uptake Gated Acquisition

59
Q

What is another name for a MUGA scan

A

Thallium scan

60
Q

What is a MUGA scan

A

First pass scan that allows for identification of all heart chambers and measurement of ejection fraction

61
Q

What does ejection fraction equal

A

EF=stroke volume/end diastolic volume

62
Q

True or False:

With a MUGA scan a radiolabeled bolus (thallium) of blood as it goes through the heart is monitored by a gamma camera

A

True

63
Q

What triggers a picture to be taken on a MUGA scan

A

Each R wave on the EKG

64
Q

What does the QRS complex equal

A

Ventricular depolarization/ventricular systole

65
Q

True or False:

A MUGA scan is difficult if a patient has an irregular HR (afib)

A

True

66
Q

True or False:

A MUGA scan is often performed with a stress test

A

True

67
Q

What is a venography/arteriography

A

Fluoroscopy or x-ray of the deep leg veins or arteries after injection of a contrast dye

68
Q

When is a venography/arteriography used

A

After a doppler ultrasound to confirm obstruction or insufficiency

69
Q

What is a venography/arteriography used to help diagnose

A

DVT or check for vein patency for a CABG

70
Q

How does the electrical impulse travel through the heart (5)

A
  1. SA node
  2. AV node where the single is delayed
  3. Down the bundle of His’
  4. Down the bundle branches
  5. Up the purkinje fibers
71
Q

What does the right coronary artery supply (6)

A
  1. Right atrium
  2. Right ventricle
  3. Bundle of His
  4. 55% of the SA node
  5. AV node
  6. Inferior part of the left ventricle
72
Q

What are the 2 left coronary arteries

A
  1. Left anterior descending coronary artery

2. Circumflex coronary artery

73
Q

What does the left anterior descending coronary artery supply (5)

A
  1. Left ventricle
  2. Inter-ventricular septum
  3. Anterior right ventricle
  4. Apex of the right and left ventricles
  5. Right and left bundle branches (RBB/LBB)
74
Q

What does the circumflex coronary artery (3)

A
  1. Left atrium
  2. Lateral left ventricle
  3. 45% of the SA node

Clin Med III (9 decks)

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