Brainscape's Knowledge GenomeTM

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


See full index

Cardiology Exam III > Cardio 25: PCI > Flashcards

Cardio 25: PCI Flashcards

1
Q

Indications for Diagnostic Catheterization

A 
Acute coronary syndromes
Stable Angina
Abnormal stress test
Nonspecific chest pain/shortness of breath
Evaluation of congestive heart failure
Evaluation of valvular heart disease
Evaluation of congenital heart disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where are common sites of catheter access

A

Femoral (most common)
Radial
Brachial

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

Technique

A

Single puncture technique w/ 18-21guage needle
Place sheath w/ hemostatic check valve (artery and vein?)
Perform right heart catherization
Catheter exchanges over 0.35” guide wire
Engage arteries w/ appropriate cath
Angiograms in multiple views

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

Which vessel will the catheter enter the heart from ?

A

Superior Vena Cava –> Right atrium and into the pulmonary artery

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

Uses of catheterization

A

Measure left ventricular pressure & perform ventriculogram
Perform intervention as necessary
Remove sheath and gain hemostasis

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

Types of PCI

A 
Plain old balloon angioplasty (POBA)
Balloon expandable stents
     Bare metal (BM)
     Drug eluting stents (DES)
Rotational Atherectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

POBA has a high risk of what occuring after procedure ?

A

Re-stenosis

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

Bare Metal Stents decrease elastic recoil after ballon angioplasty. What is the px for antiplatelets after placement ?

A

ASA for life

Clopidogrel 1 mos minimum

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

Drug eluting stents do just what they say. They have drugs imbedded that help reduce the risk of restenosis.What is the anti-platelet regimen for these devices post implantation ?

A

ASA for life
Clopidogrel 12 mos minimum
Prasugrel reasonable choice

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

List some common druge eluting stents

A

Cypher™ (Sirolimus)
Taxus™ (Paclitaxel)
Xience™/Promus™ (Everalomous)
Endeavour™ (Zotarolimus)

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

Rotational atherectomy

A

Like a drill tip

Used to modify the plaque

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

Post procedural care

A

Vitals
Groin care
Bedrest
1-8°

Dont want to rest too long, clotting risk

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

List other PCI that occur

A 
Treatment of symptomatic mitral stenosis
Treatment of severe aortic stenosis
Closure of atrial septal defects
Closure of symptomatic patent foramen ovale
Closure of left atrial appendage
Closure of muscular VSD’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Complications associated with PCI

A 
Local hematoma
Retroperitoneal hematoma
Pseudoaneurysm (PSA)
Acute renal failure (0.37%)
Embolization
Arrhythmia 0.33%
Myocardial infarction 0.03%
Stroke 0.06%
Death 0.08%\

Overall these are low risk for patients

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

Risk for hematoma rises with use of …

A

anti-coagulation

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

How do you treat a hematoma ?

A

Obtain local hemostasis w/ manual compression
IV fluid and T+C for blood
Pain control
Rarely requires OR

17
Q

Describe the symptoms of a retroperitoneal hematoma

A

Usually sudden onset of hypotension associated w/ back pain, may have bradycardia

18
Q

Treatments for retroperitoneal hematoma

A 
IV fluids and blood transfusion
Manual compression of puncture site
Stop anticoagulants (not oral antiplatelets)
Can obtain CT scan to confirm
Rarely needs OR
19
Q

How would you diagnose a pseudo-aneurysm following PCI ?

A

Hear bruit on exam and may feel thrill

Diagnosis w/ ultrasound

20
Q

How would you treat pseudo-aneurysm following PCI ?

A

Thrombin injection
Manual compression
Surgical repair

21
Q

Prevention of Acute Renal Failure following PCI includes

A 
Hydration, hydration, hydration
Limit contrast amount
Limit repeat exposure
Hold metformin for 48° after contrast injection for diabetics
Sodium Bicarbonate infusion
Mucomyst
22
Q

What syndrome is associated with Embolization post PCI ?

A

Blue toe syndrome.

23
Q

What are the most common arrhyhtmias associated with PCI ?

A

V. tach
V. fib
A. fib
Bradycardia

Usually self limiting

24
Q

What kinds of strokes are more common with PCI: Embolic or Hemorrhagic ?

A

Embolic

All strokes are very rare.

25
Q

Conscious sedation is more common in …

A

Elderly
Critical illness
Obesity

26
Q

Describe long term post procedural anti platelet therapy for patients undergoing PCI

A 
ASA
   For life 81-325mg
Clopidogrel
   BMS 4 weeks
   DES 12 mos minimum

Prasugrel and Ticagrelor can also be given…

Cardiology Exam III (12 decks)

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