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Cardiovascular Flashcards

1
Q

Diastole can be roughly divided into early ________ _________ and late filling that is altered primarily by compliance (1/stiffness).

A

myocardial relaxation

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2
Q

Diastole can be roughly divided into early myocardial relaxation and ________ __________ that is altered primarily by compliance (1/stiffness).

A

late filling

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3
Q

Diastole can be roughly divided into early myocardial relaxation and late filling that is altered primarily by ______________ (1/stiffness).

A

compliance

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4
Q

Most ventricular diastolic dysfunction severe enough to cause heart failure is due to _________ __________.

A

myocardial fibrosis

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5
Q

When a ventricle is less compliant or stiffer than normal, for any given volume of blood that fills the chamber in diastole, the pressure is ___________.

A

higher

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6
Q

Causes of diastolic dysfunction (3)

A
  • Hypertrophic cardiomyoptathy
  • Restricive cardiomyopathy
  • Pericardial diseases (pericardial effusion, constricitive pericarditis)
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7
Q

With pericardial disease, right heart failure (eg, ascites) predominates because systemic (eg, hepatic) capillaries leak more easily (leak profusely at a pressure of ____ mmHg) than pulmonary capillaries (which can generally withstand a pressure up to 20 mmHg without leaking).

A

10 mmHg

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8
Q

With pericardial disease, right heart failure (eg, ascites) predominates because systemic (eg, hepatic) capillaries leak more easily (leak profusely at a pressure of 10 mmHg) than pulmonary capillaries (which can generally withstand a pressure up to ____ mmHg without leaking).

A

20 mmHg

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9
Q

With pericardial disease, _________ heart failure (eg, ascites) predominates because systemic (eg, hepatic) capillaries leak more easily (leak profusely at a pressure of 10 mmHg) than pulmonary capillaries (which can generally withstand a pressure up to 20 mmHg without leaking).

A

Right

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10
Q

Dilated cardiomyopathy is an example of ______________ dysfunction in which an inherent myocardial disease results in a _______________ in _____________.

A
  • systolic
  • decrease in myocardial contractility (myocardial failure)
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11
Q

What is the low dosage of Epinephrine used in CPR?

A

0.01 mg/kg

High dosage is 0.1 mg/kg after prolonged CPR, and 10 times the dosage may be required when given intratracheally.

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12
Q

How often should Epinephrine be administered during CPR?

A

Every 3-5 minutes early in CPR (every other cycle)

Used for asystole, ventricular fibrillation, and pulseless electrical activity (PEA).

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13
Q

What is the alternative to Epinephrine, and how frequently is it administered for BLS?

A

Vasopressin; every 3-5 minutes (every second BLS cycle)

Used for asystole, bradycardia, and PEA.

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14
Q

Indications for Atropine administration in CPR?

A

Sinus bradycardia, asystole, or PEA associated with high vagal tone

Dosage is 0.04 mg/kg or 0.1 mL/5 lb (0.5 mg/mL solution).

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15
Q

What is the dosage of Lidocaine for pulseless ventricular tachycardia?

A

2-4 mg/kg

Effective for ventricular fibrillation resistant to defibrillation.

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16
Q

When is Sodium bicarbonate indicated during CPR?

A

Severe metabolic acidemia (pH < 7.0) and hyperkalemia

Dosage is 1 mEq/kg and must be adequately ventilated to be effective.

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17
Q

What is the recommended dosage of Calcium gluconate, and when is it used?

A

1 mL/5-10 kg (2% soln w/out epi); used for documented hypocalcemia or severe hyperkalemia

Routine use is not recommended.

Calcium gluconate treats hyperkalemia by stabilizing the cardiac cell membrane, which helps to prevent or reduce the risk of life-threatening arrhythmias caused by high potassium levels, without directly lowering serum potassium

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18
Q

What is the dosage of Amiodarone used in CPR?

A

5 mg/kg

Indicated for refractory ventricular fibrillation or pulseless ventricular tachycardia.

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19
Q

Indications for Magnesium sulfate administration?

A

Hypomagnesemia, torsades des pointes

Dosage is 30 mg/kg.

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20
Q

What are the defibrillation energy levels for external monophasic?

A

4-6 J/kg

For external biphasic: 2-4 J/kg; internal monophasic: 0.5-1 J/kg; internal biphasic: 0.2-0.4 J/kg.

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21
Q

What should be done immediately after a defibrillation shock?

A

Resume CPR efforts for one cycle (2 minutes) and reassess ECG

Dosage escalation by 50% may occur after reassessment, with a maximum dosage of 10 joules/kg.

22
Q

True or False: Dosage should be doubled if given via the intratracheal route.

A

True

This applies to certain medications during CPR.

23
Q

What is first degree AV block characterized by?

A

Prolongation of PR interval: p-R > 140 msec

First degree AV block indicates a delay in conduction through the AV node.

24
Q

What usually causes first degree AV block?

A

Fibrosis in the AV node

Fibrosis can result from various systemic diseases or aging. First degree AV block also leads to low conduction in the AV node

25
Q

What can increase vagal tone, leading to first degree AV block?

A
  • Systemic disease
  • Drugs (beta-blockers)

Increased vagal tone can slow conduction through the AV node.

26
Q

What is the origin of the impulse in second degree AV block?

A

Sinus node

This indicates that the electrical impulse starts from the sinus node in the heart.

27
Q

What characteristic is observed in lead II for second degree AV block?

A

Positive P wave

A positive P wave in lead II indicates atrial depolarization.

28
Q

What happens to some P waves in second degree AV block?

A

They are blocked in the AV node

This means that not all atrial impulses are transmitted to the ventricles.

29
Q

What is the underlying cause of second degree AV block?

A

Fibrosis in the AV node

This condition is often due to age-related changes in the heart tissue. Older dogs.

30
Q

What is second degree AVB Type 1?

A

Communication through the AVN is blocked with only some atrial signals passing through to the ventricles.

31
Q

What are the symptoms associated with second degree AVB Type 1?

A
  • Severe bradycardia
  • Collapse
  • Episodic weakness/disorientation
  • Lethargy
  • Exercise
32
Q

What is the typical cause of second degree AVB Type 1?

A

Typically idiopathic, rarely caused by masses and infection/inflammation.

33
Q

What tests are performed to rule out electrolyte or metabolic abnormalities in second degree AVB?

34
Q

What is the treatment for second degree AVB Type 1 when associated with clinical signs?

A

Pacemaker implantation.

35
Q

What type of second degree AVB is characterized by 3:1 conduction?

A

Mobitz Type 1 with 3:1 conduction (low grade).

36
Q

What is the characteristic of the P-R interval in 2nd Degree AV Block Mobitz Type 2?

A

The P-R interval is steady

This indicates a consistent conduction time through the atrioventricular node.

37
Q

What does 2nd Degree AV Block Mobitz Type 2 suggest about the type of disease?

A

More suggestive of nodal disease than type 1

This implies a more significant issue with the AV node itself.

38
Q

What is the recommended treatment for 2nd Degree AV Block Mobitz Type 2?

A

Pacemaker implantation

A pacemaker is used to maintain an adequate heart rate by providing electrical stimulation.

39
Q

What is a characteristic of 3rd Degree AV Block?

A

NO relationship between P’s and QRS

This means that the atrial and ventricular activities are completely dissociated.

40
Q

What beats are often observed in 3rd Degree AV Block?

A

Ventricular escape beats or AV nodal beats

These beats occur when the atrial signals are not conducted to the ventricles.

41
Q

What is the treatment for 3rd Degree AV Block?

A

Pacemaker implantation

This is necessary to restore an adequate heart rhythm.

42
Q

What is a characteristic rhythm of Atrial Fibrillation?

A

Irregularly irregular

Atrial Fibrillation often presents with an irregular heartbeat.

43
Q

What is often observed on imaging in patients with Atrial Fibrillation?

A

Marked atrial enlargement

Atrial enlargement can be a significant finding in Atrial Fibrillation.

44
Q

Name a condition associated with Atrial Fibrillation.

A
  • DCM
  • DVD
  • Congenital malformations
  • HCM/RCM
  • Thoracic trauma

DCM: Dilated Cardiomyopathy, DVD: Double Valve Disease, HCM: Hypertrophic Cardiomyopathy, RCM: Restrictive Cardiomyopathy.

45
Q

What effect does Atrial Fibrillation have on cardiac output?

A

Decrease CO

Atrial Fibrillation can lead to reduced cardiac output due to ineffective atrial contraction.

46
Q

What is another name for VPC?

A

Ventricular Premature Contraction = Premature Ventricular Contraction

47
Q

What is the origin of a VPC?

48
Q

Does a VPC have a P wave?

49
Q

What type of QRS complex is associated with a VPC?

50
Q

What are the two morphologies of VPC in lead II?

A
  • Tall R wave (+) right VPC
  • Deep S wave (-) left VPC
51
Q

In a VPC, the T wave is large and in which direction relative to the QRS?

A

Opposite direction to QRS

Anki PI (22 decks)

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