Cardiovascular Emergencies

Question 1

What is a bruit? What does it indicate?

Answer 1

Abnormal whooshing sound heard over main blood vessel

Indicates turbulent flow within blood vessel

Question 2

What is a bruit usually a sign of?

Answer 2

Localized arteriosclerotic disease

Question 3

What is arteriosclerotic disease?

Answer 3

Thickening or hardening of arteries

Question 4

What is atherosclerosis?

Answer 4

Disorder in which cholesterol and other fatty substances build up and form plaque inside walls of blood vessels

Question 5

What is angina pectoris?

Answer 5

When heart tissue isn’t getting enough oxygen and causes chest pain for a brief time

Question 6

What is angina pain described as?

I

Answer 6

Crushing
Squeezing
Someone standing on my chest

Question 7

Chronotroptic state refers to?

Answer 7

Hearts rate

Question 8

Dromotropic state refers to?

Answer 8

Hearts conduction

Question 9

Inotropic state refers to?

Answer 9

Hearts strength of contraction

Question 10

What supplies oxygen and nutrients to the heart?

Answer 10

Coronary arteries

Question 11

What is a class of clot busting drugs used to remove plaque from the coronary artery?

Answer 11

Fibrinolytics

Question 12

What are three ways pain from an AMI differs from angina?

Answer 12

May or may not be caused by exertion
Doesn’t resolve in a few minutes
May or may not be relieved

Question 13

What are two classes of drugs that will help cardiogenic shock?

Answer 13

Inotropics

Antiarrhythmias

Question 14

What happens during congested heart failure?

Answer 14

The heart fails to pump blood effectively and it backs up into the pulmonary veins

Question 15

What color sputum occurs with pulmonary edema?

Answer 15

Pink frothy sputum

Question 16

Chronic pedal edema may indicate what?

Answer 16

Underlying heart disease (right sides heart failure)

Question 17

How should you position a patient with congestive heart failure?

Answer 17

Sitting up

Not laying down

Question 18

What is cardiomegaly?

Answer 18

Enlarged heart

Question 19

What can continued hypertension lead to?

Answer 19

Stroke

Question 20

What are some signs of hypertension?

Answer 20

Vertigo
Epistaxis
Tinnitus
Vision changes
Nausea
Seizures

Question 21

What are four drugs used or cardiac chest pain?

Answer 21

Oxygen
Aspirin
Nitroglycerin
Morphine

Question 22

What does the left coronary artery subdivide into?

Answer 22

Left anterior descending artery

Circumflex coronary artery

Question 23

What electrolyte flows into the cell to initiate depolarization?

Answer 23

Sodium (NA+)

Question 24

What electrolyte flows out of the cell to initiate repolarization?

Answer 24

Potassium (K+)

Question 25

Hypokalemia can lead to what?

Answer 25

Increased myocardial irritability

Question 26

Hyperkalemia can lead to what?

Answer 26

Decreased automaticity/conduction

Question 27

Hypocalcemia can lead to what?

Answer 27

Decreased contractility and increased myocardial irritability

Question 28

Hypercalcemia can lead to what?

Answer 28

Increased contractility

Question 29

Which electrolyte maintains depolarization and involved in heart tissue contraction?

Answer 29

Calcium (Ca++)

Question 30

What electrolyte stabilizes cell membrane and opposes action of calcium?

Answer 30

Magnesium (Mg++)

Question 31

Hypomagnesium can lead to?

Answer 31

Decreased conduction

Question 32

Hypermagnesium can lead to?

Answer 32

Increased myocardial irritability

Question 33

What agents will affect only the heart?

Answer 33

Beta agents

Question 34

The arteries have receptors for what agents?

Answer 34

Alpha and beta

Question 35

Alpha agents will cause what?

Answer 35

Vasoconstriction

Question 36

Beta agents will cause what?

Answer 36

Vasodilation

Question 37

Beta 1 drugs act primary on the?

Answer 37

Cardiac beta receptors

Question 38

Beta 2 drugs act primarily on the?

Answer 38

Pulmonary beta receptors

Question 39

What kind of agent is norepinephrine (levophed)?

Answer 39

Sympathetic agent (primarily alpha) Causes vasoconstriction

Question 40

S1 heart sounds occur when which valves close?

Answer 40

Tricuspid and mitral valves

Question 41

S2 heart sounds occur when which valves close?

Answer 41

Semi lunar valves: | Pulmonary and aortic valve

Question 42

When s3 heart sounds are heard in older adults, what does that indicate?

Answer 42

Heart failure

Question 43

Which lead tracing is most useful on an ECG?

Answer 43

Lead 2

Question 44

What are two main groups of leads?

Answer 44

Limb leads | Precordial leads

Question 45

What leads are limb leads?

Answer 45

``` I II III aVR aVL aVF ```

Question 46

What are bipolar leads?

Answer 46

Leads that contain a positive and negative pole

Question 47

Which leads are bipolar?

Answer 47

I II III

Question 48

What are augmented unipolar leads?

Answer 48

Has one true pole while the other end of the lead is referenced against a combination of other leads

Question 49

What leads are augmented unipolar leads?

Answer 49

aVR aVL aVF

Question 50

What is the j point?

Answer 50

Point in ECG where QRS complex ends and ST segment begins It depresses or elevates if myocardium is ischemic

Question 51

What are precordial leads?

Answer 51

6 limb leads you attach with 12 lead | V1-V6

Question 52

What leads look at the septum?

Answer 52

V1 | V2

Question 53

What leads look at the anterior wall of left ventricle?

Answer 53

V3 | V4

Question 54

Which leads look at the lateral wall of the left ventricle?

Answer 54

V5 V6 I aVL

Question 55

Which leads look at the inferior wall of the left ventricle?

Answer 55

II III aVF

Question 56

What is a vector?

Answer 56

Term to describe the direction and force of an electrical charge

Question 57

What is an electrical axis?

Answer 57

The sum of all the vectors

Question 58

What's the axis if lead 1 is positive and aVF is positive?

Answer 58

Normal axis

Question 59

What is the axis if lead 1 is positive and aVF is negative?

Answer 59

Left axis deviation

Question 60

What is the axis if lead 1 is negative and aVF is positive?

Answer 60

Right axis deviation

Question 61

What is the axis if lead 1 is negative and aVF is negative?

Answer 61

Extreme right axis deviation

Question 62

What happens to axis deviation if one of the ventricles is enlarged?

Answer 62

More electrical energy is contributed with larger ventricle and causing the vector to point in the direction of enlargement

Question 63

What happens to axis deviation if one of the ventricles is infarcted?

Answer 63

No electrical activity is being contributed to dead tissue and vector with point away from it

Question 64

Which leads do you look at to determine axis deviation?

Answer 64

I | aVF

Question 65

What is collateral circulation?

Answer 65

Physiological response during 4-5 decade that creates different pathways for blood flow in case of an occlusion

Question 66

ST segment that that depresses below the isoelectric lines is considered?

Answer 66

Ischemia

Question 67

ST segment that elevated above the isoelectric line is considered?

Answer 67

Myocardial injury

Question 68

What are two primary causes for left atrial enlargement?

Answer 68

Systemic hypertension | Mitral/aortic stenosis

Question 69

What primarily caused right atrial enlargement?

Answer 69

Chronic pulmonary disorders

Question 70

How do you see right atrial enlargement on an EKG?

Answer 70

P wave has amplitude greater than 2.5mm in lead 2 and/or higher than 1.5 in V1

Question 71

How do you determine left atrial enlargement on EKG?

Answer 71

P wave longer than 110 ms in lead II Notched P wave P wave in V1 primarily negative

Question 72

What is a murmur? What does it indicate?

Answer 72

Abnormal whooshing sound heard over heart | Indicators turbulent blood flow within heart