Cardiac physiology (exam 3)

Question 1

Preload

Answer 1

The amount of stretch in muscle fibers at the end of diastole.

Question 2

Afterload

Answer 2

The pressure in the system against which the ventricles must contract against

Question 3

Tricuspid valve

Answer 3

Inlet valve to the right ventricle

Question 4

Mitral valve

Answer 4

Inlet valve to the left ventricle

Question 5

Normal ejection fraction

Answer 5

60%

Question 6

Normal stroke volume

Answer 6

75ml

Question 7

3 causes of heart failure

Answer 7

Myocardium disfunction, abnormal loading, arrhythmias.

Question 8

HFp(n)EF vs HFrEF

Answer 8

Heart failure with preserved (normal) ejection fraction versus with reduced ejection fraction

Question 9

Define HF

Answer 9

Failure of the heart to keep up with demand.

Question 10

Congestive heart failure

Answer 10

Blood backs up into organs resulting in edema.

Question 11

Cor pulmonale (pulmonary heart disease)

Answer 11

HF in the right side due to ventricular hypertrophy.

Question 12

Tachycardia

Answer 12

Heart beat over 100 bpm at rest in untrained adult

Question 13

Bradycardia

Answer 13

Heart beat under 60 bpm at rest in untrained adult

Question 14

Advantages of ultrasound

Answer 14

Cheap relative to MRI, gives instant imaging at the bedside, and non-invasive.

Question 15

4 main cardiac assessment windows for ECHO.

Answer 15

Suprasternal, parasternal, subcostal, and apical

Question 16

3 steps to ECHO prep

Answer 16

Provide a gown for females, left lateral decubitus position, and set up 3 lead ECG.

Question 17

Normal cardiac output

Answer 17

4-8 L/min

Question 18

Ambulatory care setting BNP/NT-proBNP cut points below which HF is unlikely

Answer 18

BNP <50 pg/ml

NT-proBNP <125 pg/ml

Question 19

3 essential investigations for diagnosis of HF

Answer 19

Natriuretic peptides test, electrocardiogram, and echocardiogram

Question 20

Cold-wet HF classification

Answer 20

Cold-wet HF involves both congestion (wet) and hypoperfusion (cold).

Question 21

AHA/ACCF staging of HF

Answer 21

A - At risk for HF but without symptoms and no structural defects.
B - Structural heart disease but without symptoms.
C - Structural heart disease with prior or current symptoms.
D - Refractory HF requiring special interventions.

Question 22

New york heart association classification of HF

Answer 22

Class 1 - No limitations to physical activity, normal activity does not cause breathlessness, fatigue, or palpations.

Class 2 - Slight limitation of physical activity. Comfortable at rest but normal activity does cause breathlessness, fatigue, or palpations.

Class 3 - Marked limitations on PA. Comfortable at rest but less than ordinary PA does cause B, F, P.

Class 4 - Unable to carry out any PA without discomfort. Symptoms may occur at rest. Any PA increases discomfort.