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Critical Care 1 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

heart if low K

A

increased heart irritiability

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2
Q

heart if high K

A

decreased automatcity/condution

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3
Q

heart if low Ca

A

decreased contractility/increased irritability

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4
Q

heart if high Ca

A

increased contractility

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5
Q

purpose of magnesium

A

stabilizes the cell membrane

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6
Q

heart if low Mg

A

decreased conduction

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7
Q

heart if high Mg

A

increased myocardial irritability

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8
Q

RCA

A

supplies right ventricle and 90% of population’s SA node

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9
Q

supplies the Right ventricle and SA node

A

RCA

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10
Q

blocked RCA

A

inferior MI

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11
Q

inferior MI

A

right coronary artery blocked & SA Node

bradycardia due to SA node involvement

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12
Q

type of MI with bradycardia

A

inferior MI b/c SA node so bradycardia

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13
Q

“widowmaker”

A

LCA block. basicically the entire left side of heart is blocked

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14
Q

LCA block

A

widowmaker

occludes both LAD & LCX so basically the entire left side of heart

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15
Q

what does LAD block MI’s

A

anterior
septal
anteroseptal MI

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16
Q

MI when left circumflex (LCX) is blxed

A

lateral & posterior MI

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17
Q

definition of STEMI via EKG

A

ST elevation in 2 contiguous leads over 2mm

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18
Q

nonSTEMP

A

positive troponin

ST depression in 2 contiguous leads

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19
Q

troponin initial rise

A

4hrs

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20
Q

troponin peak

A

14-25 hrs

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21
Q

troponin return to baseline

A

3-5 days

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22
Q

CK-MB initial rise in MI

A

3-6hrs

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23
Q

CK-MB peak in MI

A

12-24hrs

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24
Q

CK-MB duration in MI

A

2-3 days

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25
Q

myoglobin initial rise and peak

A

initial rise in 2hrs
peak 6-9hrs
return to baseline in 1 day

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26
Q

normal troponin =

A

under 0.04

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27
Q

troponin of probable MI

A

over 0.4

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28
Q

when do you need a right sied EKG

A

inferior MI

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29
Q

II, III, aVF

A

inferior MI

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30
Q

leads in inferior MI

A

II, III, aVF

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31
Q

avoid if inferior MI

A

BB & nitro

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32
Q

when don’t you give nitro if MI

A

NEVER if inferior MI b/c SA node is blocked so bradycardia

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33
Q

complications of inferior MI

A

bradycardia & AV blocks

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34
Q

needed if inferior MI

A

pacing, fluid challwnge

NO nitro or BB

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35
Q

blocked in anterior MI

A

LAD

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36
Q

type of MI where the LAD is blocked

A

anterior MI

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37
Q

V2, V3, V4

A

anterior MI = LAD

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38
Q

lead changes if the LAD is blocked

A

= anterior MI

V2, V3, V4

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39
Q

worst prognosis MI

A

anterior MI b/c large area of left ventricle is blocked

V2, V3, V4

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40
Q

what part of the 12 lead EKG is abnormal if anterior MI

A

worst prognosis
LAD blocked
bottom 2 of 3rd column = V2, V3
top on 4th column = V4

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41
Q

V1, V2, V3, V4

A

anteroseptal MI

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42
Q

anteroseptal MI

A

V1, V2, V3, V4

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43
Q

difference between anterior and anteroseptal MI

A

anterior MI = V2-V4

anteriorseptal = V1-V4

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44
Q

what is affected in anteriorseptal MI

A

left ventricel
septum
papillary muscle dysfunction = cardiogenic shock

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45
Q

I, aVL, V5, V6

A

Lateral MI (LCX)

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46
Q

Lateral MI

A

LCX

I, aVL, V5, V6

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47
Q

posterior MI

A

V1-V3

dominant R wave in V2

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48
Q

dominant R wave in V2

A

posterior MI

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49
Q

V1, V2, V3

A

posterior MI

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50
Q

needed if pt has CP w/o apparent MI

A

15 lead to look at the posterior segment

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51
Q

MI that is teh execption to MONA-B

A

inferior MI

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52
Q

5 types of MI

A 
posterior = V1-V4. LCX
anterior= V12-V4. LAD
inferior= II, III, aVF. RCA
lateral= I, aVL, V5, V6. LCX
septal = V1, V2. LAD
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53
Q

septal MI

A

V1, V2

LAD

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54
Q

V1, V2

A

septal MI

LAD

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55
Q

axis shifts

A

axis shifts towards hypertrophy

away from infarctions

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56
Q

axis shift in hypertrophy

A

axis shift towards hypertorphy

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57
Q

axis shift in infarction

A

axis shift away from hypertrophy

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58
Q

BBB

A

STEMI mimic
widened QRS over 0.12. or rabbits ear
look at V1 for changes
rabbit ears

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59
Q

where do you look for BBB

A

V1. widened QRS over 0.12 like rabbit ears

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60
Q

right versus left BBB

A

V1
widened QRS over 0.12 seconds
turn right, flip turn signal up so upright V1
turn left, flip turn signal down so downward V1

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61
Q

RBBB

A

V1
widened QRS over 0,12 seconds
turn right, flip turn signal upright so upright V1

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62
Q

rabbit ears

A

BBB

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63
Q

what is LBBB associated with

A

new MI

64
Q

another sign of new MI

A

LBBB

65
Q

used to determine if EKG changes are a normal variabt of LBBB or potentially a STEMI

A

Sgarbossa’s criteria

66
Q

benefit of Gp2B3A inhibitors

A

post MI, Ingegrillin & Aggrestat anticogulate with a half life of 8hrs versus up to 4 days w/asprin

67
Q

rx post MI to prevent ventricular remodeling

A

ACE in

68
Q

why do you receive ACE in post MI

A

prevent ventricular remodeling

69
Q

when do you give fibrinolytis post STEMI

A

within 12 hrs of MI

70
Q

contraindication to fibrinolyticcs post MI

A

cannot be in cardiogenic shock

71
Q

complication psot MI

A

cardiogenic shock

72
Q

repair blocked RCA

A

saphenous vein

73
Q

repair blocked LAD

A

inferior mammary artery

74
Q

use Adenosine

A

narrow complex SVT

6/12mg

75
Q

use amidarone

A

VF/pulseless VT

300, 150

76
Q

dose of Adenosine

A

6mg then 12mg

77
Q

dose of Adenosine

A

300 then 150

78
Q

amidarone versus adenosine

A

AMidarone - VF/pVT. 300/150

Adenosine - narrow complex SVT. 6/12

79
Q

use of atropine

A

SB or organosphosphate posioning

0.5mg q3min to 3mg max

80
Q

dose of atropine

A

0,5mg

81
Q

max dose of atropine

A

3mg

82
Q

use of dopamine

A

second line for bradycarida and low bp

83
Q

dose of dop[amine

A

2-20mcg/kg/min

84
Q

defibrillation dose

A 
biphasic = 120 -200j
monophasic= 200 then 360 joules
85
Q

code Epi dose

A

1mg of the 1:10K every 3-5min

86
Q

dose of Epi in a code

A

1mg

87
Q

frequency of EPi in code

A

3-5min

88
Q

alternative to amidarone

A

lidocaine 1mg/kg

89
Q

Class 1 antidysrhythmic examples -3

A

lidocaine, phenytoin, procainamide

aka sodium channel blockers

90
Q

how do class 1 antidysrhythmics work

A

NA CHANNEL BLOCKERS

interfers w/Na channels, reduces the velocity oif action potential transmission within the heart (negative dromotrophy)

91
Q

class 2 antidysrhythmis

A

BB.

92
Q

what else do BB block

A

NE, Epi

93
Q

2 things BB do

A

reduce HR and cardiac oxygen demand

94
Q

Class 3 antidysrhythnics

A

K CHannel BLockers like amidarone, Sotalol

95
Q

what rx class is amidarone

A

K channel blocker = class III antidysrhythmic

96
Q

what rx class is Sotalol

A

K channel blocker = class III antidysrhythmic

97
Q

what does CLass III antidysrhythmics

A

affects K efflux delaying repolarization which leads to an increae in action potential duration

98
Q

what happens in CaChB

A

Class IV antidysrhythmic

blocks Ca entery into the cell

99
Q

what happens when you block the entrance of Ca into a cell

A

CaChB = vasoD, negative inotrophy/dromotrophy/chromotrophy

100
Q

alpha 1

A

vasocontrict

101
Q

beta1

A

increase HR/contractility

you have one heart

102
Q

beta2

A

bronchodilate, blood vessel D

you have two lungs

103
Q

dopaminergic

A

gut kidney vessel dilation

104
Q

cholinergic

A

decreased HR

105
Q

action of phenylephrine

A

alpha agonist = vasoC

106
Q

action of NE/E

A

vasoC/postive inotrophic

107
Q

action of dobutamine

A

postivie introphic to improve contractility

108
Q

pressors for hypovolemic shock

A

NE, dopamine

109
Q

pressors for cardiogenic shock

A

dobutamine and nilrinone

110
Q

indicator for NE

A

hypovolemic shock

111
Q

indication for dopamine

A

hypovolemic shock

112
Q

indication for dobutamine

A

cardiogenic shock

113
Q

indication for milrinone

A

cardiogenic shock

114
Q

rx that increases SVR

A

dopamine, phenylephrine, Epi, NE

115
Q

effect of dopamine on SVR

A

increase SVR

116
Q

effect of phenylephrine on SVR

A

increse SVR

117
Q

effet of NE on SVR

A

increase

118
Q

effect of nitroprusside on SVR

A

decrease

119
Q

effect of BB/CaCHB on SVR

A

decrease

120
Q

action of nitroprusside

A

reduces preload/afterload by dilation

121
Q

SE of nitroprusside

A

cyanide toxicity

122
Q

how to tell if a med increases/decreases SVR & Preload

A 
VasoC = increase preload & SVR
VasoD= decreaes preload/SVR
123
Q

SVR & preload of dopamine

A

increased

124
Q

SVR & preload of phenylephrine

A

increased

125
Q

SVR and preload of nicardipine

A

decreased

126
Q

SVR and preload of nitroprusside

A

decreased

127
Q

SVR and preload of CaCHab

A

decreased

128
Q

accessory pathway of Wolff-Parkinson-WHite

A

accessory pathway is Bundle of Kent

Delta wave

129
Q

delta wave

A

WOlff-Parkinson White

130
Q

slurred upstroke on the leading edge of the QRS

A

WOlff-Parkingson White

aka delta wave

131
Q

EKG of Wolff-Parkinson Wite

A

delta wave = slurred usptroke on the leading ege of the WRS

132
Q

osler nodes

A

painful red fingertips in endocarditis

133
Q

janeway lesions

A

red lesions on palm/soles in endocarditis

134
Q

s/s of endocarditis

A

osler nodes & janewway lesions

135
Q

pericarditis

A

inflammation or infection outside the heart

136
Q

uremic pericarditis

A

pericarditis in pt in renal falure on dialysis

137
Q

pericarditis post MI

A

Dressler Syndrome

138
Q

dx Dressler Syndrome

A

pericarditis 4-6wks post MI

global ST elevation

139
Q

CXR of HF

A

buttlerfly/kerley B lines, bilateral diffuse infltrates

140
Q

dx mild HF

A

above 300 BNP

141
Q

severe HF

A

above 900 bnp

142
Q

pg/ml

A

picograms per mililiter

unit to measure BNP for HF

143
Q

most important intervention for HF

A

CPAP/BIPAP

144
Q

rip/tear between shoulder blades

A

aortic dissection

145
Q

s/s that pt reports in aortic dissection

A

rip/tear between shoulder blades

146
Q

CXR of aortic dissection

A

widened mediastinum, loss of aortic knowb, pleural efflusion

147
Q

difference of 20mm hg in both arms

A

aortic dissection

148
Q

treat aortic dissection

A 
FIRST BB
THEN VasoD (don't use vasoD first b/c tachycardia risk)
pain rx
restrict fluids unless hypotensive
consider Blood
149
Q

aortic aneurysm

A

NOT dissection. outpouching

150
Q

repair aortic aneurysm

A

when over 5cm or symptomatic

151
Q

HOman’s sign

A

dorsiflextion of food/contriction of the calf causes calf pain = DVT

152
Q

skin temp in DVT

A

warm b/c blood can get to the limb but can’t get out

153
Q

Virchow’s triad

A

venous risk factors for clot
vessel wall injury
stasis
hypercoagulability

154
Q

skin temp in arterial occlusion

A

cold b/c blood can’t get to limb

155
Q

skin temperatures differences in arterial versus venous occlusion

A

warm in DVT b/c blood can get in but not out

cold in aterial b/c blood can’t get to

156
Q

crampin with ambulation

A

arterial occlusion

Critical Care 1 (14 decks)

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