Cardiology Flashcards

1
Q

Contraindications of Fibrinolysis

A

Systolic > 120-180 mmHg
Diastolic > 100-110 mmHg
Right vs Left arm BP difference > 15 mmHg
Stroke
Sign. Head trauma within 3 mo.
Major trauma within 2-4 weeks
Blood thinners/ blood condition
Serious systemic disease
Prego.
History of ICH

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2
Q

inotropic

A

force of contraction

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3
Q

chronotropic

A

rate

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4
Q

dromotropic

A

electrical impulse conduction

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5
Q

starlings law

A

rubber band theory of increasing the hearts ability to stretch and contract by adding fluids

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6
Q

4 properties of cardiac cells

A

Excitability
Contractility
Conductivity
Rhythmicity

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7
Q

Excitability

A

Ability to respond to electricity

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8
Q

Conductivity

A

Ability to pass on electricity

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9
Q

Rhythmicity

A

Ability to generate electricity spontaneously and rhythmically

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10
Q

Do alpha receptors constrict or dilate

A

Constrict

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11
Q

Do beta receptors restrict or dilate

A

Dilate

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12
Q

Normal PR interval length

A

0.12-0.2

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13
Q

Normal QRS length

A

0.12 or less

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14
Q

Regular rhythm

A

R to R lengths are consistent

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15
Q

Rhythms- Irregularly irregular vs regularly irregular

A

Irregularly irregular- unequal R to R distances with no pattern

Regularly irregular- unequal R to R distance with pattern

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16
Q

P waves- what 3 things do you check for?

A

Are they present?

Is there 1 P wave for every QRS (and is there one QRS for every P wave)?

Is the morphology consistent?

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17
Q

What’s 2 PVCs in a row called

A

Couplet

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18
Q

What’s more than 2 PVCs in a row called?

A

Salvos or run of v-tach

19
Q

What’s bigeminal

A

Every other beat switches between a QRS complex and a PVC

20
Q

What’s Trigeminal

A

Every 3rd QRS is replaced with a PVC

21
Q

If a Q wave is present….

A

It should be less than 0.04 in height.
If it’s longer than 0.04 it’s probably an NSTEMI

22
Q

Define STEMI

A

Persistent complete occlusion of the myocardial

23
Q

What do you do different on an RVI and why

A

Don’t use nitro because the vasodilation will crash your preload

Diagnose an RVI by moving V4 to right if you see an inferior STEMI

24
Q

RCA

A

Right Coronary Artery

Breaks off the aorta to feed the right and inferior side of the heart crossing between the right ventricle and right atrium.

Will show up in lead 1, lead 2, AVF

25
Q

LMCA

A

Comes off the aorta and splits into the LAD and the Circumflex

26
Q

LAD

A

Left anterior descending

Feeds the septal and then the anterior part of the heart showing in V1-V4 respectively

27
Q

LCX

A

Left circumflex

Goes into the lateral part of the heart on the left side showing in leads V5, V6, lead 1, and AVL

28
Q

Bundle branch block left vs right

A

The QRS will be long down the a left and tall up for a right

29
Q

PE high risk pts

A

Female
Smoker
Sedentary
Birth control pills
Post surgery

30
Q

1st degree block

A

PRI is longer than 0.2 from beginning of P wave to

31
Q

2nd degree type 1

A

Wenkebach

PRI gets longer and longer until there is a P wave without a QRS

32
Q

2nd degree type 2 block

A

Mobitz 2

PRI is in normal range and regular but you still loose QRS’s randomly

Atropine won’t help

33
Q

3rd degree block

A

Atrial and ventricles are not communicating. Ventricular rate will be bradycardic. Both P waves and QRS march out but not together

34
Q

Cardiac arrest H’s and T’s

A

Hypovolemia
Hypoxia
Hydrogen ions (acidosis)
Hypo/Hyperkalemia
Hypothermia

Tension pneumothorax
Tamponade, cardiac
Toxins
Thrombosis (cardiac)
Thrombosis (pulmonary)

Bonus point- hypoglycemia

35
Q

Start of CPR algorithm (step 1-3)

A

Compressions
Oxygen
Defib- shock or not shock?

36
Q

Shockable rhythm CPR algorithm

A

1st pulse/ rhythm check ASAP

Other rhythm/pulse checks every 2 min

Start Epi once there’s a line every other pulse check

Consider Ami after min of 2 shocks

37
Q

CPR algorithms for non shockable

A

Pulse/rhythm check ASAP

Obtain IV access

Pulse check every 2 min

Epi every other pulse check

Continue until MC calls death after 40 min, there is a shockable rhythm, or you get ROSC

38
Q

ROSC ACLS tree

A

Get 12 lead, pulse ox, ETCO2, BP, RR

Look for-
STEMI
Unstable cardiogenic shock
Mechanical heart rate
LOC

Maintain BP with bolus then Epi
Watch ETCO2 and rhythms

39
Q

Bradycardia ACLS algorithm

A

Maintain airway/ oxygen sats
Identify rhythm/ BP

Get IV, 12 lead, hx

Are they stable?
Yes- atropine
No- pace

40
Q

Tachycardia ACLS algorithm

A

Only consider after 150!!

Maintain airway/ ox sats
Identify rhythm/ BP

Iv access, 12 lead, hx

Are they stable?
Yes- vagal then adenosine then cardiovert
No- cardiovert

41
Q

3 rhythms to cardiovert

A

Vtach with pulse
SVT
Afib with increased RvR

42
Q

3 rhythms to defibrillate

A

Pulses vtach
Vfib
Torsades

43
Q

What rhythm to pace

A

Symptomatic and unstable bradycardia
(Blocks)