Cardiology Chapter Flashcards
1
Q
What is the leading cause of death in the US?
A
Heart disease
2
Q
What disease is the leading cause of premature, permanent disability among working adults is called
A
Coronary heart disease
3
Q
There are three different types of risk factors for heart disease, what are they?
A
Nonmodifiable: Heredity, race, gender
Modifiable: High BP, Diabetes, tobacco use
Contributing factors: Stress, Alcohol intake
4
Q
A group of disorders related to body metabolism that appear to promote the development of artherosclerotic cardiovascular disease is called?
A
Metabolic Syndrome High BP Elevated insulin levels Excess body weight And one or more Abnormal cholesterol levels
5
Q
Where are baroreceptors found?
A
In the carotid artery and aortic arch
6
Q
What does a small box or 1mm box represent in seconds?
A
.04 seconds
7
Q
A large box has 5 small boxes and represents how many seconds?
A
.20 seconds
8
Q
Five large boxes represent how many seconds?
A
1 second
9
Q
Fifteen small boxes represent how many seconds?
A
3 seconds
10
Q
Thirty small boxes represent how many seconds?
A
6 seconds
11
Q
The vertical access measures what on an ECG?
A
Voltage
12
Q
Voltage is measured in what?
A
Millivolts
13
Q
The height of a waveform is usually measured in what?
A
Millimeters
14
Q
Normal p wave in height are how high?
A
2.5 mm
15
Q
Normal p wave in length are no more than how long?
A
.11 seconds in duration
16
Q
A normal Q wave is how long and how high?
A
.04 seconds in duration and <1/3 of the height of the R wave.
17
Q
In adults what is the normal duration of the QRS complex?
A
.11 seconds or less
18
Q
T waves are usually how high?
A
5mm or less in a chest lead and 10mm or less on any limb lead
19
Q
Peaked t waves are commonly seen in what?
A
hyperkalemia
20
Q
Low amplitude t waves may be seen in what?
A
hypokalemia
21
Q
The point where the QRS complex and the ST segment meet is called what?
A
J point or ST junction
22
Q
The j point is considered to be elevated in men over 40 when it is how high?
A
2mm above the isoelectric line in leads v2 and v3 and 1mm in all others
23
Q
The j point is considered to be elevated in men under 40 when it is how high?
A
2.5mm above the isoelectric line in leads v2 and v3 and 1mm in all others
24
Q
The j point is considered to be elevated in women under when it is how high?
A
1.5mm above the isoelectric line in leads v2 and v3 and 1mm in all others
25
When assessing the rhythm how much variation can be between A P-P or R-R interval?
10% or 1 box per 10
26
A normal PR interval is how long?
.12 - .20 seconds
27
The QRS is considered normal at how many seconds?
.11 seconds or less
28
The QRS complex is considered wide at how many seconds?
>.11 seconds
29
Less than .11 seconds on the QRS complex is considered to be what?
Supraventricular
30
A wandering atrial pacemaker is also known as what?
Multiformed atrial rhythm
31
What is the most common cause of cardiovascular disease death?
Coronary heart disease
32
The risk of cardiovascular disease doubles every ___ point increase in diastolic BP and every ____ point increase in systolic BP?
10; 20
33
_____ are bad cholesterol and carry most of the cholesterol in the blood?
LDL's
34
_____are good cholesterol and prevent buildup of cholesterol in the arterial walls?
HDL's
35
Quitting smoking reduces the risk of heart attack up to ____% after the first year?
50
36
Where is the base of the heart in correlation to the ribs?
2nd rib
37
Where is the apex of the heart in correlation to the ribs?
In between the 5th and 6th ribs in the midclavicular line
38
What is the anterior surface of the heart mostly composed of?
The right ventricle as the heart is slightly turned towards the left
39
Refers to a change in heart rate?
Chronotropic
40
Refers to a change in myocardial contractility?
Inotropic
41
Refers to the speed of conduction through the AV junction?
Dromotropic
42
How is stroke volume determined?
preload, afterload, and myocardium contractile state
43
The main electrolytes that affect the heart are?
Sodium, Potassium, Calcium and Chloride
44
What are the phases of cardiac action potential?
```
Phase 0: rapid depolarization
Phase 1: early rapid repolarization
Phase 2: Plateau
Phase 3: Final rapid repolarization
Phase 4: Resting membrane potential
```
45
Relative refractory period is also known as?
The vulnerable period
46
A weaker than normal stimulus can cause cardiac cells to depolarize during this period is called?
Supernormal period
47
A record of electrical activity between two electrodes is called?
A lead
48
Chest leads are also called?
precordial leads
49
What does the vertical axis on ECG paper represent?
Amplitude
50
What does the horizontal axis on ECG paper represent?
Time
51
A normal p wave is no more than ___mm in height and ____seconds in duration?
2.5 and .11
52
The p wave is positive in what leads?
1, 2, aVF, and V2-V6
53
Normal duration of the QRS is what?
.11 seconds or less
54
Low amplitude t waves or Peaked t waves are commonly seen in what?
Hypokalemia or hyperkalemia
55
A normal PRI is how long?
.12-.20 seconds
56
A normal QT interval is how long?
.38 seconds however many clinicians don't consider it long unless the QTc exceeds .44
57
What segments should be used to estimate the position of the isoelectric line?
TP and PR segments
58
To evaluate regularity look at what?
P-P or R-R
59
In general a variation of ____% is considered acceptable when measuring regularity or irregularity?
10
60
The most inaccurate way to count rate is?
count the QRS complexes in 6 seconds and multiply by 10
61
What is the most common type of tachycardia?
AVNRT
62
Monomorphic VT with a ventricular rate greater than 200 beats/min is called?
Ventricular Flutter
63
When should procainamide be avoided in tachycardic rhythms?
If the patient has a prolonged QT segment or signs of heart failure
64
True or false, VT is a potentially life threatening dysrhythmia?
True
65
Polymorphic VT that is triggered by stress or exercise and occurs in the absence of QT prolongation or structural heart disease is called?
chatecholaminergic PMVT
66
Polymorphic VT that is caused by acute myocardial ischemia or infarction and occurs in the absence of QT prolongation is called?
Ischemic PMVT
67
What interval is the key to differentiating the type of AV block.
The PR interveral
68
What artery is associated with AV block occuring in the AV node?
RCA
69
True or false, Second-degree type II is usually an indication for a permanent pacemaker?
True
70
What does a pacemaker system consist of?
Pacing lead and pulse generator
71
A pacemaker malfunction that occurs when the pacemaker fails to deliver an electrical stimulus or when it fails to deliver the correct number of electrical stimulations per minute is called?
Failure to pace
72
The inability of the pacemaker stimulus to depolarize the myocardium is called?
Failure to capture
73
When the pacemaker fails to recognize the patients's ECG waveforms this is called?
Failure to sense
74
A pacemaker malfunction that results from inappropriate sensing of unrelated electrical signals is called?
Oversensing
75
Blockage of the left main coronary artery is nicknamed what?
The "Widow Maker"
76
True or false, Posterior wall infarctions usually occur in conjunction with an inferior or lateral infarction.
True
77
Inferobasal wall refers to what?
posterior wall
78
If a patient is having an inferior infarction what should also be checked for infarction?
Right sided MI
79
Right ventricular infarction involves three main areas, what are they?
hypotension, jugular venous distention, and clear breath sounds
80
During normal ventricular depolarization, what side of the interventricular septum is stimulated first?
Left side
81
The best lead to determine right and left bundle branch blocks is what?
V1
82
A QRS duration between between ___mm and ___mm is called an incomplete block?
.10 and .12
83
In adults a QRS measuring more than ___mm is considered a complete BBB.
.12
84
RSR pattern (also known as an M or rabbit ear pattern) is characteristic of what?
Right BBB
85
A QS pattern is characteristic of what?
Left BBB
86
A fib can occur when the body reaches less than ____degrees Celsius?
32
87
Patients with a temperature less than 32 celsius can form a unique ECG pattern called a what?
J wave or Osborn wave (the wave follows the QRS segment or is in the junction of the QRS complex and ST segment. It increases in size with temp depression and disappears with rewarming).
88
What should be done under the primary survey?
General impression, appearance, work of breathing, and circulation. (ABC's)
Airway and C-spine, Breathing, Circulation/Bleeding control, LOC, Expose/Environment
89
Dyspnea that occurs on inspiration suggests what?
obstruction of the upper airway including an allergic reaction, foreign body, laryngeal infection or chemical or thermal injury.
90
Dyspnea that occurs on expiration suggests what?
lower airway obstruction including pulmonary embolism, pneumothorax, acute pulmonary edema, pneumonia, asthma, and emphysema
91
Dyspnea relieved by squatting is most often caused by what?
Tetralogy of Fallot, a congenital heart condition
92
Dizziness with or without blackout is called?
Gray-out (with syncopal episodes)
93
Prescribed antiarrhythmics are?
digitalis, procainamide, amiodarone, Verapamil
94
Prescribed anticoagulants are?
enoxaprin, Clopdogrel (plavix), warfarin (coumadin)
95
Prescribed Angiontensin converting enzyme inhibitors are?
Captopril, enalapril, and Lisinopril
96
Prescribed beta blockers are?
atenolol, metoprolol, and propranolol
97
Prescribed diuretics are?
furosemide (lasix)
98
Prescribed vasodilators are?
Nitroglycerin
99
Pulsations in the epigastric area is a sign for what?
aortic aneurysm
100
Clubbing of the fingernails is associated with what?
a variety of respiratory and cardiovascular conditions
101
S1 occurs when?
during ventricular contraction when the tricuspid and mitral valves are closing
102
S2 occurs when?
Ventricular relaxation when the when the pulmonic and aortic valves are closing.
103
S3 is also called what?
Ventricular gallop
104
The usual cause of an ACS is what?
the rupture of atherosclerotic plaque
105
Prinzmetal's Angina results in what and often at what time?
Spasm of a segment of artery and occurs usually at rest or night from midnight to eight am
106
MI usually results from what?
Thrombus
107
A type of myocardial infarction caused by a sharp, direct blow to the chest such as by a baseball is called?
Commodio cordis
108
The severest form of blunt cardiac injury is what?
Cardiac rupture
109
Complications of MI can be categorized into five categories what are they?
ischemic, electrical, mechanical, inflammatory, and embolic
110
When is the incidence of VF highest after a STEMI?
the first 4 hours after onset
111
Angina means squeezing or tightening not what?
Pain
112
What is the most common symptom of MI?
Chest discomfort
113
For patients with ACS a 12 lead should be obtained how quickly?
Within 10 minutes of patient contact
114
Right ventricular failure is often a result of what?
LVF
115
Cardiac output is calculated how?
stroke volume x heart rate
116
Heart failure accompanied by hypotension is called?
Cardiogenic shock
117
What does treatment of heart failure focus on?
correcting hypoxia, reducing preload, reducing afterload, and improving myocardial contractility
118
A patient with heart failure should weigh themselves every day and should call a physician if he or she gains ____lbs in 1 day or ____over 3-4 day period.
2; 5
119
The most common cause of cardiogenic shock is what?
MI
120
The silent killer is called?
hypertension
121
Normal BP is what?
120/80 and less
122
Pre-hypertension is what?
120-140/80-90
123
Hypertension is considered?
Above 140/90
