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CCRN > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is the heart sound S1? (2)

A
  1. Caused by the closure of AV valves
  2. Marks the end of diastole, the beginning of systole
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2
Q

What is the heart sound S2? (2)

A
  1. Caused by closure of the semilunar valves
  2. Marks the end of systole, beginning of diastole.
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3
Q

What is S2 splitting on inspiration caused by?

A

Right bundle branch block

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4
Q

What makes S2 louder?

A

Pulmonary Embolism

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5
Q

What is S3? (2)

A
  1. Caused by a rapid of rush of blood into a dilated ventricle
  2. Associated with heart failure; may occur before crackles.
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6
Q

What is S3 Caused by? (2)

A
  1. Pulmonary hypertension and cor pulmonale.
  2. Mitral, aortic, or tricuspid insufficiency
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7
Q

What are the 5 auscultatory points?

A

Aortic, pulmonic, erb’s point, tricuspid, mitral (apical)

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8
Q

What is S4?

A
  1. Caused by atrial contraction of blood into a noncompliant ventricle
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9
Q

What is S4 associated with? (6)

A

Myocardial ischemia, infarction, hypertension, ventricular hypertrophy and aortic stenosis

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10
Q

What is pulse pressure?

A

Systolic- Diastolic = Pulse pressure

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11
Q

Systolic blood pressure is an indirect measurement of what?

A

Cardiac output and stroke volume

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12
Q

What is narrowing pulse pressure usually seen with?

A

Severe hypovolemia or severe drop in cardiac output

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13
Q

Diastolic blood pressure is an indirect measurement of what?

A

Systemic vascular resistance

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14
Q

A widened pulse pressure may indicate what?

A

Vasodilation, a drop in systemic vascular resistance - sepsis or septic shock

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15
Q

Coronary arteries are perfused during what?

A

diastole

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16
Q

Causes of valvular heart disease

A
  1. CAD/ Ischemia, MI
  2. Cardiomyopathy
  3. Bicuspid aortic valve
  4. Fever/ infection
  5. Connective tissue diseases
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17
Q

Murmurs of insufficiency occur when the valve is what?

A

Closed

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18
Q

Murmurs of stenosis occur when the valve is what?

A

Open

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19
Q

Murmurs of stenosis are acute or chronic?

A

Chronic

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20
Q

The semilunar (pulmonic, aortic) are what during systole?

A

OPEN

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21
Q

The AV valves (tricuspid, mitral) valves are what during systole?

A

CLOSED

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22
Q

The semilunar valves are what during diastole?

A

CLOSED

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23
Q

The AV valves are what during diastole?

24
Q

Anticoagulant for acute chest pain 

A

Heparin or lovenox

25
Q

And I platelet agents for acute chest pain 

A
  1. Plavix
  2. Reopro
  3. Integrilin
  4. Aggrastat
26
Q

Cardioselective beta blocker

A

Metropolol

27
Q

Non-cardioselective beta blocker

A

Propranolol

28
Q

Contraindications to beta blockers in acute chest pain 

A

Sildenafil (viagra)

29
Q

Changes in II, III aVF

A

Right coronary artery, inferior LV

30
Q

Changed in V1, V2, V3, V4

A

Left anterior descending, anterior LV

31
Q

Changed in V5,V6, I, aVL

A

Circumflex, Lateral LV

32
Q

Changes in V5,V6

A

Low lateral LV

33
Q

Changes in I, aVL

A

High lateral LV

34
Q

Changed in VI, V2

A

Right coronary artery, posterior LV

35
Q

Changes in V3R, V4R

A

Right coronary artery, right ventricular infarct

36
Q

Inferior MI- ST elevation

A

II,III, aVF

37
Q

Inferior wall- reciprocal changes

A

Lateral wall (I, aVL)

38
Q

What is an inferior MI associated with

A

AV conduction disturbances ( 2° block, 3° block, sick sinus syndrome and sinus Brady)

39
Q

What can an Inferior MI develop into

A

Systolic murmur, mitral valve regurg

40
Q

Right ventricular infarction

A

Right coronary artery

41
Q

Signs and symptoms of right ventricular infract

A

JVD, high cvp, hypotension, clear lungs, bradyarrythmias

42
Q

Right ventricular infarct ST ST elevation

43
Q

Avoid in right ventricular infarct 

A

Preload reducers (nitrates or diuretics) beta blockers

44
Q

ST elevations/ depressions in anterior MI

A

V1-V4 / inferior wall (I,II,aVF)

45
Q

Anterior my my develop

A

2° type II block, or RVBB

46
Q

Lateral MI ST elevation

A

V5, V6 (low lateral) I, aVL (high lateral)

47
Q

Signs of retroperitoneal bleed

A

Sudden, hypotension, severe low back pain

48
Q

Evidence of reperfusion

A

Chest pain, relief, resolution of ST segment, deviations, marked elevation of troponin, reperfusion arrhythmias 

49
Q

Signs of coronary artery re-occlusion

A

Chest pain, ST elevation

50
Q

Hypertensive, emergency or crisis 

A

Elevated blood pressure where evidence of an organ damage that can be related to acute hypertension 

51
Q

Hypertension urgency 

A

Elevated blood pressure without evidence of acute and organ damage 

52
Q

Nitroprusside in HTN

A

Preload and after load reducer, assess for cyanide toxicity

53
Q

Signs and symptoms of peripheral arterial disease

A

Pain, pallor, pulse absent, parenthesia, paralysis, poikilothermia

54
Q

Normal ankle- brachial index

55
Q

WPW syndrome

A

Genetic conduction abnormality, in which abnormal conduction pathway exist, that allows re-and Trent tachycardia pathway to bypass a normal AV node conduction pathway, resulting in superventricular tachycardia, 

56
Q

EKG changes with WPW

A

Short PR interval, presence of delta wave

57
Q

Do not give what medications with WPW

A

Adenine, digoxin, or calcium channel blockers- enhance conduction through abnormal pathway by increasing refractory. And AV node resulting in ventricular fibrillation. 

CCRN (1 decks)

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