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Board Review Cardio/Pulmonary/Lymphatic System > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Increased BP results in what?

A

parasympathetic stimulation
- decreased rate and force of cardiac contraction
- sympathetic inhibition
- decreased peripheral resistance

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2
Q

Decreased BP results in what?

A

sympathetic stimulation
- increased HR and BP
- vasoconstriction of peripheral blood vessels
- increased right atrial pressure causes reflex acceleration of heart rate

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3
Q

Increased CO2 or decreased O2 cause what?

A

increase HR

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4
Q

hyperkalemia - what changes will be seen on ECG?

A

increased concentration of K+
- decreases rate of force of contraction
- widened PR interval and QRS, tall T waves

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5
Q

hypokalemia - what changes will be seen on ECG?

A

decreased K+
- flattened T waves, prolonged PR adn QT intervals
- arrhythmias that may progress to ventricular fibrillation

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6
Q

hypercalcemia

A

increased calcium concentration increases heart actions

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7
Q

hypocalcemia

A

decreased calcium concentrations depresses heart actions

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8
Q

hypermagnesemia

A

increased magnesium is a calcium blocker which can lead to arrhythmias or cardiac arrest

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9
Q

hypomagnesemia

A

decreased magnesium causes ventricular arrhythmias, coronary artery vasospasm, and sudden death

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10
Q

non-modifiable increased CVD risk factors

A

men > 45 and women > 55

cardiac event in 1st degree male relative < 55, or female relative < 65

African American

men > pre-menopausal women, after menopause, the risk equalizes

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11
Q

modifiable risk factor for CVD - cholesterol goals

A

total cholesterol < 200

LDL <160 if low risk
< 130 if moderate risk
< 100 if high risk, have CVD or diabetes

HDL > 40 in men, > 50 in women

triglycerides < 150

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12
Q

Grading scale for peripheral pulses

A

0 - absent
1+ - pulse dimenished, barely perceptible
2+ - normal
3+ - full pulse, increased strength
4+ - bounding pulse

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13
Q

POTS

A

sustained HR increase >/= 30 beats per minute within 10 min of standing (>/= 40 beats per min in teenagers)

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14
Q

weak, thready pulse means what

A

low stroke volume, cardiogenic shock

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15
Q

bounding, full pulse means what

A

shortened ventricular systole and decreased peripheral pressure; aortic insufficiency

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16
Q

auscultation landmarks - aortic valve

A

2nd right intercostal space at the sternal border

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17
Q

auscultation landmarks - pulmonic valve

A

2nd left intercostal space at the sternal border

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18
Q

auscultation landmarks - tricuspid valve

A

4th left intercostal space at the sternal border

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19
Q

auscultation landmarks - mitral valve

A

5th left intercostal space at the midclavicular area

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20
Q

S1 sound

when is it decreased?

A

“lub”
- normal closure of mitral and tricuspid valves; marks beginning of systole

decreased in 1st degree heart block

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21
Q

S2 sound

when is it decreased?

A

“dub”
- normal closure of aortic and pulmonary valves; marks end of systole

decreased in aortic stenosis

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22
Q

P wave

A

atrial deplolarization

23
Q

P-R interval

A

time required for impulse to travel from atria through conduction system to Purkinje fibers

24
Q

QRS wave

A

ventricular depolarization

25
Q

ST segment

A

beginning of ventricular repolarization

26
Q

T wave

A

ventricular repolarization

27
Q

QT interval

A

time for electrical systole

28
Q

V-tach

A

run of 4 or more PVCs sequentially

29
Q

v-fib

A

pulseless, emergency, CPR

bizarre, erratic activity w/o QRS complexes

30
Q

normal MAP

A

70-110 mmHg

31
Q

what type of angina responds well to nitroglycerin

A

variant agina (Prinzmetal)
- vasospasm in absense of occlusive disease

32
Q

left sided HF signs

A
  • pulmonary congestion
  • edema
  • low cardiac output due to backup of blood from LV to LA and lungs
33
Q

R sided HF signs

A

increased pressure load on RV
- hallmark signs of jugular vein distention and peripheral edema

34
Q

Activity restrictions after acute MI

A

activity can be increased once the acute MI has stopped

limit to 5 METs or 70% of HRmax for 4-6 weeks

35
Q

Activity restrictions for acute heart failure

A

O2 demand should NOT be increased in patients w/ acute or decompensated HF

36
Q

Peripheral artery disease (PAD) early and late signs

A

early - intermittent claudication

late - rest pain, muscle atrophy, trophic changes

37
Q

RPE has ________ reliability over time, but not ________ reliability

A

intra-rater reliability over time, but no inter-user reliability

38
Q

metabolic conditions where cardiac rehab is contraindicated

A
  • acute thyroiditis
  • hypokalemia
  • hyperkalemia
  • hypovolemia
39
Q

exercise prescription for post-PTCA (precutaneous transluminal coronary angioplasty)

A
  • wait to exercise vigorously ~ 2 weeks post-PTCA
  • use post-PTCA exercise test to perscribe exercise
40
Q

exercise prescription for post-CABG

A
  • limit UE exercise while sternal incision is healing
  • avoid lifting, pushing, pulling 4-6 weeks post-surgery
41
Q

acute cardiac rehab initial activities

A
  • low intensity (2-3 METs)
  • post MI limited to 70% max HR for 6 weeks
  • short sessions, 2-3 x per day
42
Q

HEP for acute cardiac rehab

A

gradual increase ambulation time
- goal is 20-30 min, 1-2 x per day, 4-6 days per wk

43
Q

Subacute (phase 2) cardiac rehab exercise guidelines

A

2-3 x per week

30-60 min w/ 5-10 warm-up and cool-down

44
Q

strength training guidelines during subacute (phase 2) cardiac rehab

A

After 3 weeks of cardiac rehab, 5 weeks post-MI, or 8 weeks post CABG

  • start w/ elastic bands and light hand weights (1-3lbs)
  • progress to moderate loads, 12-15 comfortable reps
45
Q

What should be avoided after pacemaker and automatic implantable cardioverter defibrillators placement

A

UE aerobic or strengthening exercises for 4-6 weeks after implant to allow the leads to scar down

46
Q

contraindications for compression therapy

A
  • ABI <0.8
  • signs of active cellulitis or infection
  • systemic arterial pressure <80 mmHg
  • advanced peripheral neuropathy and uncontrolled congestive heart failure
47
Q

S&S of lipedema

A
  • swelling stops at ankles and wrists
  • affects mainly women
  • stemmer’s sign is negative; often painful on pinching
48
Q

lymphedema management: What pressures are contraindicated for compression

A

> 45 mmHg

49
Q

Class 2 & 3 HF exercise prescription: aerobic exercise

A

time - 20-60 min
intensity - 50-90% peak VO2
frequency - 3-5 x wk
duration - 8-12 wks

50
Q

Class 2 & 3 HF exercise prescription: HIIT

A

time - >35 min
intensity - 90-95% peak VO2
frequency - 2-3 x wk
duration - 8-12 wks

51
Q

Class 2 & 3 HF exercise prescription: UE and LE resistance training

A

time - 45-60 min
intensity - 60-80% 1 RM
frequency - 3 x wk
duration - 2-3 sets per muscle group, 8-12 wks

51
Q

Class 2 & 3 HF exercise prescription: Inspiratory muscle training (IMT)

A

time - 30 min
intensity - >30% of MIP
frequency - 3 x wk
duration - 8-12 wks

52
Q

Patients with heart failure can have a ____ heart sound

A

S3

53
Q

S4 heart sound signifies

A

rapid ventricular filling after atrial contraction and is consistent with a presentation of systemic hypertension, cardiomyopathy or coarctation of the aorta

Board Review Cardio/Pulmonary/Lymphatic System (4 decks)

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