Cardio Exam 3

Question 1

Discuss the basic densities of X ray

Answer 1

Air= black
Fat = dark grey
Water = light grey
Metal = white

Question 2

Which view is best for seeing pleural effusions?

Answer 2

Lateral Decubitus

Question 3

How is heart size determined on xray?

Answer 3

Width of thorax/width of heart =

Question 4

How can you tell there is left atrial enlargement?

Answer 4

1. Double density along right heart border

2. Splaying of the carina

Question 5

How can you tell there is rigt atrial enlargement?

Answer 5

1. Lateral bulge along right heart border

Question 6

How can you tell there is Left ventricular enlargement?

Answer 6

Leftward AND downward displacement of the apex

Question 7

How can you tell there is right ventricular enlargement?

Answer 7

Left heart border enlarged and laterally only

Question 8

What is CT angiography best used for?

Answer 8

1. Good for assessing pulmonary embolism

2. Best for assessing aortic aneurysm and aortic dissection

Question 9

What are the advantages of MRI?

Answer 9

No ionization radiation; good for children

Question 10

What is the use of Nuclear medicine?

Answer 10

Assess myocardial ischemia and myocardial infarction

Question 11

How do you analyze a nuclear stress test?

Answer 11

If there is perfusion at rest but not during stress = ischemia
If no perfusion during either = infarction

Question 12

What can cause fixed splitting of S2?

Answer 12

ASD, right ventricular failure

Question 13

What can cause paradoxical splitting of S2?

Answer 13

LBBB and aortic stenosis

Question 14

Whats the difference between a grade 3 murmur and a grade 4 murmur?

Answer 14

Grade 4 is as loud as grade 3 but has a thrill.

Question 15

How does aortic stenosis effect S2?

Answer 15

Its diminished or absent

Question 16

What are some uses of Transesophogeal echo?

Answer 16

1. Detecting ASD

2. Detecting endocarditis

Question 17

Differentiate the risk of stroke in a patient with A-fib vs Atrial flutter.

Answer 17

They are the same

Question 18

What are the 3 treatment imperatives in an A-fib patient?

Answer 18

Anticoagulate, Rhythm, rate control

Question 19

Discuss the CHADSVASc socre

Answer 19

CHF or EF < 35% = 1
Hypertension = 1
Age >75 = 2
Diabetes = 1
Stroke or prior TIA =2
Vascular Disease = 1
Age 65-74 = 1
Sexual category = (females 1)

Question 20

Discuss analysis of CHADSVASc score?

Answer 20

Score 0 = aspirin or nothing
Score 1 = aspirin of anticoagulant
Score 2 or more = anticoagulant

Question 21

Why do A-fib patients need immediate attention?

Answer 21

Want to get patients back to sinus rhythm quickly to avoid fibrosis.