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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

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
What is the formula for HR max?
220-age
26
What is the VO2 peak?
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
Define submax stress testing
Terminated on a predetermined end point, it is a % of predicated HR max
28
What type of exercise testing would you do on a person who has a MI and is now in the recuperative phase?
Low-Level Testing Special subset of submax testing, performed on pts during the recuperative phase after MI or cornoary bypass surgery
29
What is the most highly used exercise protocol?
Bruce
30
What are the differences between the Bruce and the Blake protocol?
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
What happens if you answer Yes to any of the questions on the PAR-Q and You?
Go see you Dr. before becoming more physically active
32
What is a doppler electrocardiography?
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
What is the gold standard for blood flow measurement and metabolic assessment
PET Scan | *Uses a specialized camera and radioactive tracer
34
The proportion of individuals with a disease that tests positive for that disease *Low false negatives
Sensitivity
35
The proportion of individuals without a disease that test negative for the disease *Low false positive
Specific
36
What is considered abnormal when taking ABI in PVD patient's during treadmill test?
A decrease of ankle systolic pressure by more than 20% after exercise testing
37
What is the formula for HR max?
220-age
38
What is the VO2 peak?
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
Define submax stress testing
Terminated on a predetermined end point, it is a % of predicated HR max
40
You ask your patient to count to 15 and they require 4 breaths. What level is this on the dyspena scale?
Level 3 ``` Level 0=Single breath Level 1= 2 breaths Level 2=3 Breaths Level 3=4 Breaths Level 4=Unable to count ```
41
What is the most highly used exercise protocol?
Bruce
42
What are the differences between the Bruce and the Blake protocol?
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
What happens if you answer Yes to any of the questions on the PAR-Q and You?
Go see you Dr. before becoming more physically active
44
Your patient resting angina, is it safe to do exercise testing?
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
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?
3+ skin rebounds in 15-30 secounds
46
PVD treadmil test components
2-3 mph, 10%grade, 5 minutes, every minute collect the VAS pain scale, preform ABI test before and after
47
You press your thumb into your patient's thigh and the skin shows a barely perceptible depression. What level is this?
1+ barely perceptible depression
48
What is considered abnormal when taking ABI in PVD patient's during treadmill test?
A decrease of ankle systolic pressure by more than 20% after exercise testing
49
What population of patients would you use the 6 minute walk test with?
Elderly (predicts peak VO2), CHF (predicts peak VO2, mortality and need for heart transplant) and COPD ( predicts VO@ and need for lung transplant)
50
What instruments are needed for the 6 minute walk test?
- Timer - Stethoscope and Sphygmomanometer - O2 saturation monitor - EKG, way of measuring distance ambulated - RPE scale
51
Your patient score a 17 on the RPE scale, what rating is this?
``` 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
You ask your patient to count to 15 and they require 4 breaths. What level is this on the dyspena scale?
Level 3 ``` Level 0=Single breath Level 1= 2 breaths Level 2=3 Breaths Level 3=4 Breaths Level 4=Unable to count ```
53
What are some signs that exercise needs to be terminated?
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
Name things that are contraindicated for exercise testing but NOT for activity
- 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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