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Cardiopulmonary > Cardiovascular Diagnostic Tests and Procedures > Flashcards

Cardiovascular Diagnostic Tests and Procedures Flashcards

1
Q

Name the 3 Gold Standard lab values that are used to diagnose cardiac injury

A
  1. ) Creatine Phosphokinase (CPK-MB)
  2. ) Troponin
  3. ) Myoglobin
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2
Q
  • Dimeric enzyme found in large quantities in skeletal and cardiac muscle
  • When caridac mm is injured this is released but is too large to enter capillaries so it enters lymph system
A

Creatine Phophokinase

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3
Q

This lab value modulates mm contraction by initiating or inhibiting the sliding of thin filaments.

A

Troponin

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4
Q

The lab value is a heme protein found in all muscle tissue, can be detected as early as 2 hours post injury, peaks 3-15 hours

A

Myglobin

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5
Q

Name the 3 sub-units of CK. Which one is most important to cardiac function?

A
  1. ) CK-MB = Most important, abundant in myocardial cells.
  2. ) CK-MM
  3. ) CK-BB
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6
Q

Normal Serum Cholesterol Level

A

<200 mg/dL

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7
Q

Normal LDL level

A

<160 mg/dL

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8
Q

Normal HDL

A

> 40 mg/dL

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9
Q

Normal Triglyceride

A

<150 mg/dL

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10
Q

What is included in a complete blood count?

A
  • Hemoglobin
  • Hematocrit
  • WBC
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11
Q

What is included in a coagulation profile?

A
  • PTT
  • PT
  • INR
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12
Q

Normal lab value for BUN

A

8-23 mg/dL

*Can be an indicator of heart or renal failure

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13
Q

Normal creatinine level

A

<1.5 mg/dL

*Measure of renal efficiency, high creatinine indicates renal failure

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14
Q

Normal Serum Glucose

A

80-110 mg/dL

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15
Q

Mild Hyperglycemia

A

120-130 mg/dL

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16
Q

Severe hyperglycemia

A

> 300 mg/dL

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17
Q

Hemoglobin A1C measure what?

A

Measures insulin control over the past 90 days

4.8-6%

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18
Q

What is holter monitoring?

A

Continuous 24 hour electrocardiograph monitoring of heart rhythm, helps to dx cardiac arrhythmia, ID sx caused by dizziness, syncope and SOB

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19
Q

Used to ID the particular area that is causing an arrhythmia. The arrhythmia is induced and one ore more meds are given to restore normal rhythm

A

Electrophysiologic Mapping Study

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20
Q

What is a doppler electrocardiography?

A

It uses pulses of reflected ultrasound to evaluate the heart, it is non-invasive and can be difficult to perform on pt’s w/. pulmonary disease, chest deformity, and obesity

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21
Q

What is the gold standard for blood flow measurement and metabolic assessment

A

PET Scan

*Uses a specialized camera and radioactive tracer

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22
Q

The proportion of individuals with a disease that tests positive for that disease
*Low false negatives

A

Sensitivity

23
Q

The proportion of individuals without a disease that test negative for the disease
*Low false positive

A

Specific

24
Q

What type of exercise testing is considered the gold standard?

A

Maximal Exercise Testing
*Either measure or predict the max oxygen consumption (VO2max)–defined as the plateau of VO2 with further increases in workload

25
Q

What is the formula for HR max?

A

220-age

26
Q

What is the VO2 peak?

A

When a max test is performed but the criteria for VO2max is not met, the max VO2 that is achieved is called the VO2 peak

27
Q

Define submax stress testing

A

Terminated on a predetermined end point, it is a % of predicated HR max

28
Q

What type of exercise testing would you do on a person who has a MI and is now in the recuperative phase?

A

Low-Level Testing

Special subset of submax testing, performed on pts during the recuperative phase after MI or cornoary bypass surgery

29
Q

What is the most highly used exercise protocol?

A

Bruce

30
Q

What are the differences between the Bruce and the Blake protocol?

A

Bruce: The grade/slope get very high but it has a starting speed of 1.7 which is very comfortable for people

Blake: The grade/slope is smaller in increments but the starting speed is 3.3 which is often too fast for older/deconditioned people

31
Q

What happens if you answer Yes to any of the questions on the PAR-Q and You?

A

Go see you Dr. before becoming more physically active

32
Q

What is a doppler electrocardiography?

A

It uses pulses of reflected ultrasound to evaluate the heart, it is non-invasive and can be difficult to perform on pt’s w/. pulmonary disease, chest deformity, and obesity

33
Q

What is the gold standard for blood flow measurement and metabolic assessment

A

PET Scan

*Uses a specialized camera and radioactive tracer

34
Q

The proportion of individuals with a disease that tests positive for that disease
*Low false negatives

A

Sensitivity

35
Q

The proportion of individuals without a disease that test negative for the disease
*Low false positive

A

Specific

36
Q

What is considered abnormal when taking ABI in PVD patient’s during treadmill test?

A

A decrease of ankle systolic pressure by more than 20% after exercise testing

37
Q

What is the formula for HR max?

A

220-age

38
Q

What is the VO2 peak?

A

When a max test is performed but the criteria for VO2max is not met, the max VO2 that is achieved is called the VO2 peak

39
Q

Define submax stress testing

A

Terminated on a predetermined end point, it is a % of predicated HR max

40
Q

You ask your patient to count to 15 and they require 4 breaths. What level is this on the dyspena scale?

A

Level 3

Level 0=Single breath
Level 1= 2 breaths
Level 2=3 Breaths
Level 3=4 Breaths
Level 4=Unable to count
41
Q

What is the most highly used exercise protocol?

A

Bruce

42
Q

What are the differences between the Bruce and the Blake protocol?

A

Bruce: The grade/slope get very high but it has a starting speed of 1.7 which is very comfortable for people

Blake: The grade/slope is smaller in increments but the starting speed is 3.3 which is often too fast for older/deconditioned people

43
Q

What happens if you answer Yes to any of the questions on the PAR-Q and You?

A

Go see you Dr. before becoming more physically active

44
Q

Your patient resting angina, is it safe to do exercise testing?

A

No, this is an absolute contraindication.

  • Recent MI
  • Acute pericarditis or myocarditis
  • Resting and Unstable Angina
  • Serious ventricular or rapid atrial arrhythmia
  • Untreated 2nd or 3rd degree heart block
  • Overt CHF (pulmonary rales, S3 heart sound or both)
  • Acute illness
45
Q

You press your thumb into your patient’s thigh and the skin rebounds in 20 seconds. What level is this on the pitting edema scale?

A

3+ skin rebounds in 15-30 secounds

46
Q

PVD treadmil test components

A

2-3 mph, 10%grade, 5 minutes, every minute collect the VAS pain scale, preform ABI test before and after

47
Q

You press your thumb into your patient’s thigh and the skin shows a barely perceptible depression. What level is this?

A

1+ barely perceptible depression

48
Q

What is considered abnormal when taking ABI in PVD patient’s during treadmill test?

A

A decrease of ankle systolic pressure by more than 20% after exercise testing

49
Q

What population of patients would you use the 6 minute walk test with?

A

Elderly (predicts peak VO2), CHF (predicts peak VO2, mortality and need for heart transplant) and COPD ( predicts VO@ and need for lung transplant)

50
Q

What instruments are needed for the 6 minute walk test?

A
  • Timer
  • Stethoscope and Sphygmomanometer
  • O2 saturation monitor
  • EKG, way of measuring distance ambulated
  • RPE scale
51
Q

Your patient score a 17 on the RPE scale, what rating is this?

A 
Very Hard
(6-20)
6=No exertion
7=Extremely Light
9=Very Light
11-Light
13=Somewhat hard
15=Hard
19=Extremely Hard
20=Max Exertion
52
Q

You ask your patient to count to 15 and they require 4 breaths. What level is this on the dyspena scale?

A

Level 3

Level 0=Single breath
Level 1= 2 breaths
Level 2=3 Breaths
Level 3=4 Breaths
Level 4=Unable to count
53
Q

What are some signs that exercise needs to be terminated?

A

O2 saturation 250, DBP >115
Failure of HR to increase with activity
Exercise Hypotension, drop in SBP > 10 mg despite increase workload
Noticeable changes in heart rhythm

54
Q

Name things that are contraindicated for exercise testing but NOT for activity

A
  • Acute Systemic Infection
  • Acute pericarditis or myocarditis
  • Acute Pulmonary Embolus
  • Aortic Stenosis
  • Recent changes in resting EKG suggesting significant MI or actue cardiac event

Cardiopulmonary (7 decks)

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