cardio exam Flashcards

1
Q

what can S3 heart sound indicate? what are a few potential signs and symptoms?

A

CHF, ventricular filling

u may see edema, cold hands and feet!

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2
Q

if someone has an active occluded artery, should you do any exercise?

A

NO ACTVITY because u don’t wanna increase BP

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3
Q

what is Heparin and what does it treat?

A

an anticoagulant used to treat DVT

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4
Q

For pleural pain, pain is alleviated by laying a what side?

A

lay on the affected side

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5
Q

reduced CO leading to a backup of fluid in the lungs producing SOB and coughing are signs of what?

A

CHF

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6
Q

S4 sound can incidate?

A

MI or HTN

ventricular filling and atrial contraction

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7
Q

differing BP reading in both arms, drop in diastolic BP, extremities are cold to touch, abdominal bulge are signs of what?

A

ruptured aneurysm

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8
Q

what does Digitalis treat and how does it work?

A

treats CHF, lowers HR and increases strength of contraction

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9
Q

what’s the normal respiratory rate?

A

12-20

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10
Q

how can I drain posterior segments of lower lobes?

A

pt lies on abdomen with pillows under hips and legs and the foot of bed is elevated to 18 inches. percussion is over the lower ribs close to the spine

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11
Q

during acute exercise, INITIAL increase in HR is d/t withdrawal of ____ and not stimulation of _____

A

PNS, SNS

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12
Q

the SNS causes RR to ______ d/t stimulation of beta 2 receptors

A

increase

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13
Q

dyspnea, cyanosis of lips, cramping of calf muscle are all signs of…

A

signs of respiratory distress

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14
Q

In COPD, PaCO2 is __________, PaO2 is _________, pH is ___________

A

increased, decreased, decreased

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15
Q

HR * SBP =

A

RPP (measures metabolic demand of the heart)

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16
Q

CO =

A

HR * SV

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17
Q

does MAP increase with exercise?

A

yes, linearly

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18
Q

does systolic BP increase with exercise? Does diastolic?

A

systolic increases, diastolic remains fairly constant

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19
Q

should you do a warm up for the 6MWT?

A

no

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20
Q

normal BP

A

less that 120/80

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21
Q

elevated BP is …

A

120-129 and diastolic less than 80

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22
Q

stage 1 HTN is

A

systolic 130-139 or diastolic 80-89

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23
Q

stage 2 HTN is…

A

systolic at least 140 or diastolic at least 90

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24
Q

what are the numbers for a hypertensive crisis?

A

180 systolic or above and/or diastolic of 120 or above

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25
Q

what is VO2 predictive of?

A

aerobic capacity

volume of oxygen

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26
Q

when VO2 reaches steady state during exercise, the ATP demand is _____ _________

A

met aerobically

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27
Q

in a high altitude environment, the body makes more _____s to account for the decreased level of oxygen

A

RBCs

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28
Q

if you go somewhere with high altitude, what happens to BP, CO, HR, and SV?

A

BP increases
CO increases
HR increases
SV remains unchanged

once acclimated, BP and CO will become normal, HR stays increased, SV decreases

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29
Q

will venous return increase or decrease with aquatic therapy?

A

increase, d/t hydrostatic pressure exerted by water

30
Q

what happens to HR, BP, and VO2 during aquatic therapy?

A

all decrease

31
Q

what happens to CO and SV during aquatic therapy?

A

they increase

32
Q

what happens to work of breathing during aquatic therapy?

A

increases

33
Q

what happens to vital capacity during aquatic therapy?

A

decreases

34
Q

what do beta blockers do to HR and contractility? what conditions are they used for?

A

decrease them

pts with HTN and CAD

35
Q

what scale do you use for exercise prescription for people on beta blockers d/t decreased HR?

A

RPE (scale is 6-20)

SHVEM:
13 - somewhat hard
15 - hard
17 - very hard
19 - extremely hard
20 - max exertion

36
Q

the best way to measure change in fitness from pre and post training is to measure…

A

the time it takes for the HR to return to baseline, quicker it returns to baseline the more fit

37
Q

what are the auscultation landmarks

A

A P
T M
Aortic: 2nd IC space, R sternal border
Pulmonic: 2nd IC space, left sternal border
Tricuspid: 4th IC space, left sternal border
Mitral: 5th IC space, midclavicular line

38
Q

what heart sound is “lub” associated with?

A

S1, closure of mitral and tricuspid valves, onset of systole

39
Q

what heart sound is “dub” associated with?

A

S2, closure of aortic and pulmonary valves, onset of diastole

40
Q

which heart sound is the loudest at the base (top) of the heart?

A

S2

41
Q

what heart sound is loudest at the apex (bottom) of the heart?

A

S1

42
Q

what condition is an increase in both the RBCs and the hemoglobin, increased blood viscosity, resulting in HTN?

A

polycythemia

43
Q

what can be used to determine myocardial O2 demand of a patient at the onset of chest pain symptoms?

A

rate product pressure (RPP)

44
Q

at what point are S1 and S2 heard equally loud?

A

Erb’s point (in between base and apex)

45
Q

what heart sound is associated with early systole?

A

S1 “lub”

46
Q

what heard sound is associated with late diastole?

A

S4 (abnormal)

47
Q

what heart sound is associated with early diastole?

A

S3 (abnormal)

48
Q

what heart sound is associated with late systole?

A

S2 “dub”

49
Q

the SA node initiates _____________

A

depolarization

50
Q

the AV node passes ________ to ventricles

A

depolarization

51
Q

the P wave on an ECG represents ______ __________

A

atrial depolarization

52
Q

the QRS complex on an ECG represents

A

ventricular depolarization and atrial repolarization

53
Q

the T wave on an ECG represents

A

ventricular repolarization

54
Q

depolarization =

A

contraction

55
Q

repolarization =

A

relaxation

56
Q

how to find the HR on a 6 second ECG strip?

A

count the R waves

57
Q

which AV heart block is there a delay in conduction?

A

1st degree (P-R interval is 1 large box)

58
Q

which AV heart block is there a dropped QRS but it is expected (PR interval gets progressively longer)? What is the correct response?

A

2nd degree/Mobitz Type 1

lower intensity of exercises and monitor ECG

59
Q

which AV heart block is there an intermittently dropped QRS and no pattern can be discerned? What is the correct response?

A

2nd degree/Mobitz type II

stop exercise!

60
Q

which AV heart block is the atrial rate independent of the ventricular rate, and there is no relation at all of the P-R intervals? what should you do?

A

third degree AV block, call 911!

61
Q

what are the main symptoms of L sided HF?

A

Lung problems, pulmonary edema

62
Q

what are the main sx of R sided HF?

A

peripheral edema

63
Q

what is cor pulmonale?

A

R ventricle failure

64
Q

myocardial ________ is when there is a decrease in blood supply and a ST segment depression of 2mm and higher?

A

ischemia (loss of blood)

65
Q

myocardial _________ is when there is a complete occlusion of blood supply and cell death, ST segment is elevated 1mm and higher?

A

infarction

66
Q

which arrhythmia is the saw tooth pattern?

A

atrial flutter

67
Q

which arrhythmia doesn’t let the T wave fully finish?

A

PAC

68
Q

are the supra ventricular arrhythmias (PAC, atrial tach, atrial flutter, and Afib) 911 situations?

A

no

69
Q

palpitations, SOB, and fatigue are sx of what?

A

afib

if exercising stop and report to physician

70
Q

is ventricular tachycardia and emergency situation?

A

yes

71
Q

PVCs that occur ___ or more in a row is called ventricular tachycardia

A

3

call 911

72
Q

if you see a unifocal PVC while a pt is exercising, what should you do?

A

keep exercising at a lower intensity

consult with physician is not required here