cardio di 1st test Flashcards

1
Q

cardiac ischemia

2 pathophysiological causes

A
  1. decreased blood supply

2. increased metabolic

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2
Q

2 causes of decreased blood supply

A
  1. coronary spasm

2. coronary obstruction

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3
Q

causes of coronary spasm

A
  1. rupture of coronary plaque
  2. stress
  3. endocrine disorders
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4
Q

What causes coronary obstruction?

A

atherosclerotic plaques or thrombosis

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5
Q

systemic hypertension and hypertrophy are examples of

A

increased metabolic demand of cardiac muscles

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6
Q

A decreased blood supply =

A

decreased O2 and Glucose

drop in ATP

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7
Q

A decreased blood supply results in anaerobic respiration creating ______ which activates pain receptors

A

acidosis

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8
Q

3 steps of decreased blood supply and is the step reversible

A
  1. ischemia-reversible
  2. injury-reversible
  3. necrosis-irreversible
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9
Q

2 tests for injury and necrosis

A
  1. cardiac enzymes

2. ECG

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10
Q

What enzymes are tested for cardiac injury and necrosis?

A

CK-MB

tropinin 1

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11
Q

CK-MB doesnt change for the first _ hours

A

4

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12
Q

CK-MB spikes in the first __ hours and returns to normal by ______ hours

A

24

72

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13
Q

If CK-MB levels do not return to normal a ___________ results

A

reinfarction

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14
Q

How long does troponin 1 stay elevated after MI?

A

14 days

first notable rise in troponin 1 levels 3 hours after MI

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15
Q

What shows on an ECG representing cardiac ischemia?

A

an inverted T wave and/or depression of S-T segment

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16
Q

What shows on an ECG representing cardiac injury?

A

elevation of S-T segment (above P-Q segment)

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17
Q

What shows on an ECG representing cardiac necrosis (MI)?

A

abnormalities of Q-wave!!

ascending Q-wave is > 30% of R

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18
Q

chest pain from decreased blood supply is known as?

A

angina

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19
Q

Heart Failure definition

A

when the heart can not pump enough blood to systemic circulation (decreased cardiac output

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20
Q

Top five reasons for Heart Failure in US?

A
  1. MI
  2. systemic HTN
  3. myocarditis
  4. stenosis of cardiac valves
  5. regurgitation
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21
Q

Left Sided heart failure has what target organs?

A
  1. kidneys
  2. heart
  3. brain
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22
Q

Decreased renal blood flow due to LSHF causes what?

A
  1. decreased GFR
  2. increased Angio 2 and aldosterone
  3. increased NA/H2O
  4. increased blood pressure
  5. hepato/splenomegaly
  6. increased CHP=peripheral edema
  7. Jugular Venous Distension
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23
Q

LSHF causes what to the heart?

A

decreased blood flow

ANGINA

24
Q

LSHF to the brain causes what?

A

weakness, fatigue, mental confusion

25
Q

Backup of blood from the left ventricle will cause what?

A

pulmonary edema

  1. dyspnea
  2. tachypnea
  3. COUGHING WITH SPUTUM PRODUCTION
26
Q

Increased PCO2 causes

A

acidosis (pain) (dyspnea) (tachypnea)

27
Q

Right Sided heart failure (RSHF) causes what to happen directly? (forward)

A

decreased blood supply to the lungs

  1. tachypnea
  2. dyspnea
  3. central cyanosis
28
Q

Does RSHF cause increased PCO2?

A

yes, acidosis

29
Q

Does RSHF cause pulmonary edema?

A

NO

30
Q

Positive hepatojugular reflex happens from both sides of heart failure, but is mainly associated with which side?

A

Right

31
Q

Subjective findings in LSHF?

A
  1. weakness/fatigue
  2. memory loss/confusion
  3. breathlessness/cough/insomnia
  4. anorexia/palpitations/diaphoresis
32
Q

Subjective findings in RSHF?

A
  1. weight gain/gastric distress
  2. transient ankle swelling
  3. abdominal distension
  4. anorexia/ nausea
33
Q

Objective findings RSHF?

A
  1. edema/ascites
  2. left parasternal lift
  3. increased jugular BP/ vein pulsations
  4. positive hepatojugular reflex
34
Q

Objective LSHF findings?

A
  1. Tachycardia/ moist rales
  2. decreased S1, S2, S3
  3. pleural effusion
  4. pulsus alternans/diaphoresis
35
Q

5 conditions causing heart failure

A
  1. Abnormal volume load
  2. Abnormal pressure load
  3. Myocardial dysfunction
  4. filling disorders
  5. increased metabolic demand
36
Q

Abnormal volume load causes

A
  1. aortic/mitral/tricuspid incompetence
  2. overtransfusion
  3. left-to-right shunts
  4. secondary hypervolemia
37
Q

Abnormal pressure load causes

A
  1. aortic stenosis
  2. idiopathic hypertrophic subaortic stenosis
  3. coarctation of the aorta?HTN
38
Q

Myocardial dysfunction causes

A
  1. cardiomyopathy
  2. CAD/ ishemic infarction
  3. Dysrythmias/presbycardia
  4. toxic disorders
39
Q

Filling disorders causes

A
  1. mitral/tricuspid stenosis
  2. cardiac tamponade
  3. restrictive pericarditis
40
Q

Increased metabolic demand causes

A
  1. anemias/fever
  2. thyrotoxicosis/beriberi
  3. Paget’s/ arteriovenous fistula
41
Q

Stage 1 HTN

A

140-159/90-99

42
Q

Stage 2 HTN

A

160-179/100-109

43
Q

Stage 3 HTN

A

180-199/110-119

44
Q

Stage 4 HTN

A

greater than 200/ greater than 120

45
Q

complications of systemic HTN

A
  1. MI
  2. Renal failure
  3. CVA
  4. Retinal damage
46
Q

145/105 represents what stage HTN?

A

Stage 2 because diastolic is 105 in stage two even though 145 is stage one systolic

take the largest number and label what stage it is

47
Q

P-wave represents

A

atrial depolarization

48
Q

QRS segment represents

A

ventricular depolarization

49
Q

Qrs segment length normally

A

.08-.12 sec

50
Q

T-wave represents

A

ventricular repolarization

51
Q

P-Q (P-R) segment length normally

A

.12-.2 sec

52
Q

P-Q (P-R) represents

A

how fast electricity travels from SA node to muscles

53
Q

Q-T interval normal length

A

.36-.44

HR=60-10 BPM

54
Q

Q-T interval represents

A

contraction to relaxation

55
Q

Equation for calculating HR

A

HR=60/R1-R2 (sec)