Cardiology Quiz 1 Flashcards
During the refractory period:
A) the cell is depolarized or in the process of repolarizing.
B) the heart is in a state of partial repolarization.
C) the heart muscle is depleted of energy and needs to recharge.
D) the heart is partially charged, but cannot contract.
A) the cell is depolarized or in the process of repolarizing.
If the heart’s secondary pacemaker becomes ischemic and fails to initiate an electrical impulse:
A) you should expect to see a heart rate slower than 40 beats/min.
B) the P wave and PR interval will have an abnormal appearance.
C) the AV junction will begin pacing at 40 to 60 times/min.
D) you will see a brief period of bradycardia followed by asystole.
A) you should expect to see a heart rate slower than 40 beats/min.
In most patients, the SA node is supplied with blood from the:
A) left circumflex coronary artery.
B) left anterior descending coronary artery.
C) right coronary artery.
D) left main coronary artery.
C) right coronary artery.
The circumflex branch of the left coronary artery supplies the _________ wall of the left ventricle.
A) septal
B) inferior
C) anterior
D) lateral
D) lateral
Under normal conditions, the strength of cardiac contraction is regulated by:
A) the nervous system.
B) physical exertion.
C) the Frank-Starling mechanism.
D) the heart rate.
A) the nervous system.
An electrical impulse is slightly delayed at the AV node so that the:
A) ventricles can contract completely.
B) primary cardiac pacemaker can reset.
C) atria can empty into the ventricles.
D) bundle of His can depolarize fully.
C) atria can empty into the ventricles.
In contrast to the right side of the heart, the left side of the heart:
A) drives blood out of the heart against the relatively high resistance of the systemic circulation.
B) is a relatively low-pressure pump that must stretch its walls in order to force blood through
the aorta.
C) drives blood out of the heart against the relatively low resistance of the pulmonary
circulation.
D) is a high-pressure pump that sends blood through the pulmonary circulation and to the
lungs.
A) drives blood out of the heart against the relatively high resistance of the systemic circulation.
The area of conduction tissue in which electrical activity arises at any given time is called the:
A) bundle of His.
B) pacemaker.
C) sinus node.
D) myocyte.
B) pacemaker.
The farther removed the conduction tissue is from the SA node:
A) the longer the PR interval will be.
B) the faster its intrinsic rate of firing.
C) the narrower the QRS complex will be.
D) the slower its intrinsic rate of firing.
D) the slower its intrinsic rate of firing.
The left main coronary artery subdivides into the:
A) left posterior ascending and circumflex arteries.
B) left anterior ascending and descending arteries.
C) right coronary and left posterior descending arteries.
D) left anterior descending and circumflex arteries.
D) left anterior descending and circumflex arteries.
Which of the following electrolytes maintains the depolarization phase?
A) Sodium
B) Potassium
C) Calcium
D) Magnesium
C) Calcium
A loud S 3 heart sound, when heard in older adults, often signifies:
A) valve rupture.
B) heart failure.
C) emphysema.
D) pulmonary hypertension.
B) heart failure.
Depolarization, the process by which muscle fibers are stimulated to contract, occurs when:
A) calcium ions rapidly enter the cell, facilitating contraction.
B) cell wall permeability changes and sodium rushes into the cell.
C) cardiac muscle relaxes in response to a cellular influx of calcium.
D) potassium ions escape from the cell through specialized channels.
B) cell wall permeability changes and sodium rushes into the cell.
The right atrium, right ventricle, and part of the left ventricle are supplied by the:
A) left main coronary artery.
B) right coronary artery.
C) left anterior descending artery.
D) circumflex artery.
C) left anterior descending artery.
Which of the following statements regarding the SA node is correct?
A) The SA node is the dominant cardiac pacemaker in healthy patients.
B) The SA node is located in the superior aspect of the right ventricle.
C) Impulses generated by the SA node travel through the right atrium only.
D) SA nodal ischemia occurs when the left coronary artery is occluded.
A) The SA node is the dominant cardiac pacemaker in healthy patients.
Name the different parts of the heart in order:
- Right Atrium
- Tricuspid Valve
- Right Ventricle
- Pulmonic Valve
- Left Atrium
- Mitral Valve
- Left Ventricle
- Aortic Valve
What is the longest phase, known as the plateau phase during the cardiac action potential?
A) 3
B) 0
C) 2
D) 1
C) 2
What electrolyte does not play a direct part in the cardiac action potential?
A) Calcium
B) Sodium
C) Potassium
D) Magnesium
D) Magnesium
S1 sounds represent what?
A) ventricles relaxing
B) pulmonic and aortic valves closing
C) ventricles contracting
D) tricuspid and mitral valves closing
D) tricuspid and mitral valves closing
List out the three main coronary arteries
Left main, right main, circumflex coronary
Describe five different complaints that need a cardiac assessment completed.
Jaw pain
Left arm pain
SOB
Pressure in the chest
diaphoretic
A 48-year-old man with a history of hypertension presents with a severe headache, tinnitus, and blurred vision. He is conscious and alert and denies any other symptoms. His BP is 204/120mm Hg, his pulse rate is 100 beats/min, and his oxygen saturation is 96%. The closest appropriate facility is 20 minutes away. You should:
A) keep him in a supine position and transport.
B) start an IV line and administer labetalol.
C) monitor his cardiac rhythm and transport.
D) administer high-flow oxygen and transport.
C) monitor his cardiac rhythm and transport.
A 67-year-old woman presents with severe dyspnea, coarse crackles to all lung fields, and anxiety. She has a history of several myocardial infarctions and hypertension. Which of the following interventions will have the MOST immediate and positive effect?
A) IV or IO access and 20 to 40 mg of furosemide
B) 0.4 mg sublingual nitroglycerin, up to three doses
C) Positive end-expiratory pressure ventilation
D) Supplemental oxygen via nonrebreathing mask
C) Positive end-expiratory pressure ventilation
Acute coronary syndrome is a term used to describe:
A) a clinical condition in which patients experience chest pain during exertion.
B) acute chest pressure or discomfort that subsides with rest or nitroglycerin.
C) a sudden cardiac rhythm disturbance that causes a decrease in cardiac output.
D) any group of clinical symptoms consistent with acute myocardial ischemia.
D) any group of clinical symptoms consistent with acute myocardial ischemia.
Common complaints in patients experiencing an acute coronary syndrome include all of the
following, EXCEPT:
A) palpitations.
B) fatigue.
C) headache.
D) chest pain.
C) headache.
The MOST important initial pieces of equipment to bring to the side of an unresponsive
patient are the:
A) drug kit and stretcher with a long backboard.
B) defibrillator and airway management equipment.
C) intubation kit and equipment for vascular access.
D) pocket face mask and equipment for intubation.
B) defibrillator and airway management equipment.
Which of the following underlying medical conditions would be of LEAST pertinence when obtaining the past medical history from a patient who complains of acute chest pain or pressure?
A) Renal disease
B) Cancer
C) Diabetes
D) Hypertension
B) Cancer
List the physical exam you want to perform on the chest for a cardiac assessment.
I would exam the chest for any signs of a pacemaker, surgical scars indicating open heart surgery, any signs of trauma, any medication patches that would help identify any other medical conditions. I would be looking for any signs of edema or pulsating masses. I would also listen to heart tones and lung sounds
What is the difference between a pacemaker and defibrillator?
A pacemaker takes over the part of the SA node and keeps the rhythm and pace of the heart. A defibrillator initiates a shock to correct a rhythm that is not correct.
Where should we be assessing heart tones at?
At the 2nd, 3rd, 4th, 5th intercostal spaces
Describe phase 0:
Sodium goes in
Describe phase 1:
Potassium goes out
Describe phase 2:
Calcium comes in through calcium channel
Describe phase 3:
Potassium leaves through the potassium channel
Describe phase 4:
Leaky potassium channels
What drug class affects Phase 0?
Class 1, Na+ channel blockers (e.g. Lidocaine 1-1.5mg/kg IV)
What drug class affects Phase 2?
Class 4, Ca2+ channel blockers (e.g. Diltiazem 0.25mg/kg IV)
What drug class affects Phase 3?
Class 3, K+ channel blockers (e.g. Amiodarone 300mg IV/IO, 150mg IV over 10 mins)
What drug class affects phase 4?
Class 2, beta blockers (e.g. Metoprolol 5mg IV max 15mg)
Describe how Thiazide diuretics work:
Inhibit sodium and chloride channels in the kidneys
Describe how Calcium channels blockers work:
prevent calcium from entering the cells of the heart
Describe how Beta blockers work
Block the effects of the hormone epinephrine to reduce heart rate
Describe how ACE inhibitors work
Prevents angiotensin-converting enzyme in the lungs from combining with angiotensin I to produce angiotensin II to raise blood pressure
Describe how Angiotensin II receptor antagonists (ARBs)
by blocking angiotensin II receptors that the hormone acts on to raise blood pressure
