Cardiovascular, Pulmonary, and Lymphatic Flashcards
1
Q
What heart enzyme stays elevated the longest
A
Cardiac Troponin (elevated for 14 days)
2
Q
What is the patient at risk for when INR is high
A
Excessive bleeding
3
Q
What is the patient at risk for when INR is low
A
Clots
4
Q
Normal value for PO2
A
Greater than 80
5
Q
Normal value for PaCO2
A
35-45
6
Q
Normal value for HCO3 (bicarbonate)
A
22-26
7
Q
What happen when HCO3 is too low
A
Metabolic acidosis
8
Q
What happens when HCO3 is too high
A
Metabolic alkalosis
9
Q
What occurs when S1 heart sound is absent
A
Heart block
10
Q
What occurs when S2 heart sound is absent
A
Aortic stenosis
11
Q
What does S3 heart sound indicate
A
CHF
12
Q
Normal HR for babies-age 1
A
100-160 bpm
13
Q
Normal HR for children 1-10
A
60-140 bpm
14
Q
Normal HR for children 10+ and adults
A
60-100 bpm
15
Q
Normal HR for well conditioned athletes
A
40-60 bpm
16
Q
Below what ABI would you not want to use compression
A
0.6
17
Q
ABI less than what is considered abnormal
A
0.9
18
Q
An ABI less than what is would indicate PAD
A
0.9
19
Q
Normal WBC level
A
43,000-10,800
20
Q
Borderline ABI =
A
0.91-0.99
21
Q
Is restrictive lung disease a volume or flow problem?
A
volume (issue getting air in)
22
Q
Is obstructive lung disease a volume or flow problem
A
flow (issue getting air out)
23
Q
S3 Heart sound will be heard for what
A
CHF
24
Q
What will be seen with left sided HF?
A
Lung issues
25
What will be seen with right sided HF?
Peripheral sx (asictes and jugular distension)
26
What is cor pulmonale
pulmonary HTN
27
What CV condition can present with back pain
abdominal aortic aneursym
28
Valsalva can be helpful in doing what
Slowing down tachycardia
29
Muscles of inspiration
Diphragm
External intercostals
SCM
Pec minor
30
Muscles of expiration
Internal intercostals
Abdominals
QL
31
Normal respiration rate for 0-1 yr old
30-60
32
Normal respiration rate for 1-3 year old
24-40
33
Normal respiration rate for 3-6 year old
22-34
34
Normal respiration rate for 6-12 yr old
18-30
35
Normal respiration rate for 12-18 yr old
12-16
36
Normal respiration rate for 18+
12-20
37
What is Kussmaul breathing due to
Too much acid in the body
| -often due to Metabolic acidosis due to diabetes
38
What does Kussmaul breathing look like
rapid deep breathing
39
What does Biot's respiration look like
periodic breathing with hyperopnea and then aponoea
40
What is Biot's respiration due to
Neuron damage
41
What are some things that can cause an abnormality in pulse ox
- nail polish
- anemia
- low perfusion
42
Which way would the trachea shift with:
| -tension penumothorax
CL
43
Which way would the trachea shift with:
| Pleural effusion
CL
44
Which way would the trachea shift with:
| Space-occupying lesion
CL
45
Which way would the trachea shift with:
| Pneumonectomy
IL
46
Which way would the trachea shift with:
| Pleural fibrosis
IL
47
Which way would the trachea shift with:
| Atlectasis
IL
48
What type of breath sound is commonly heard in CHF and is due to bubbles/fluid in the alvoli
Crackles
49
What type of breath sound would be heard with asthma
wheezes
50
What type of breath sound would be heard with pneumonia or chronic bronchitis
Ronchi (low pitched wheezing)
| **deep snoring sound
51
What type of breath sound would be heard if there was blocking of upper airway
Stridor
52
What type of breath sound is a low pitched wheezing and is heard in CF, COPD, and secretions in larger airways
Ronchi
53
Examples of restrictive lung dz
- Sarcoidosis
- Pneumoconiosis
- Chest wall NM diseases
- Intersitital lung dz
54
What are the two main things that are found to be decreased in obstructive lung diseases
FEV1 AND FEV1/FVC ratio will be decreased in obstructive lung dz
55
Will FEV1 be normal in obstructive lung dz
No
56
Will FEV1 be normal in restrictive lung dz
yes
57
What are the main two things that are decr in restrictive lung dz
TLC and FVC
58
Is FVC normal in restrictive lung dz
No
59
Is FVC normal in obstructive lung disease
Yes
60
Is FEV1/FVC ratio normal in restrictive lung dz
yes
61
Is FEV1/FVC ratio normal in obstructive lung dz
no
62
What types of diseases have a decr FEV1
obstructive
63
What types of diseases have a decr FVC
restrictive
64
What will nail clubbing be seen with
COPD
65
A flattened diaphragm will be seen with what type of dz
COPD
66
Name the three diseases in COPD
1. Emphysema
2. Chronic Bronchitis
3. Asthma
67
Enlargement of air spaces in the alveoli, loss of elasticity
Emphysema
68
What types of medicines are given for asthma
B-agonists
69
What will beta agonists due to HR
incr it
70
True or false B-agonists cause vasoconstriction
true
71
What can a Pancoast tumor mimic
TOS
72
What can be seen in Pancoast's tumor
- Horner's syndrome (miosis, ptosis)
- sharp shoulder pain
- C8, T1, T2 dermatome paresthesia
- Pulmonary sx- dyspnea, cough, hemoptysis
73
Normal EKG response during exercise
- P wave increases height
- R wave decreases
- ST segment becomes sharply upsloping
- QT interval shortens
74
What does inverted T wave mean (2 things potentially)
1. ) Left ventricular hypertrophy
| 2. ) Myocardial ischemia
75
What does ST segment elevation mean
MI
76
What do alpha adrengeric antagonist agents do
Reduce BP
| Dilates peripheral arterioles and veins
77
-pril drugs
ACE Inhibitors
78
What do ACE Inhibitors do
Reduce BP
79
-artan drugs
Angio-tension 2 receptor antagonist agents
80
What do angio-tension 2 receptor antagonists do
Reduce BP
81
What type of drugs are heparin, coumadin, warfarin, and lovenox
Anticoagulants
82
Stains do what
Decr LDL and incr HDL
83
Aspirin, Bayer, Plavix are what type of drugs
Antithrombotic
84
What type of drugs inhibit platelet formation
Antithrombotic
85
-olol drugs
Beta blockers
86
What do beta blockers do
-Decr HR
87
What is a key thing to remember when a patient is on beta blocker and/or calcium channel blockers
use RPE instead of HR bc HR will be blunted
88
Procardia, Cardizem are what type of drugs
Calcium Channel Blockers
89
What do Calcium Channel blockers do
Reduce the demands of the heart
90
What is a major side effect of calcium channel blockers
Edema in the legs/feet and hypotension
91
Thiazide and Lasix are what type of drugs
Diuretics (can lead to hypokalmia)
92
What would be an indication for someone to be on a diuretic
HTN or edema due to CHF
93
Nitrostat or Nitrogylcerin are what type of drugs
Nitrates
94
What do nitrates do
cause smooth muscle dilation and peripheral vessel dilation
95
When to use nitrates
angina or acute angina
96
Digoxin and Lanoxin are wha type of drugs
Positive Inotropic
97
When to use positive inotropic drugs
HF
98
What do positive inotropic drugs do
Incr contractility of heart and slow HR
99
Urokinase, Activose, and Linlytic are what type of drugs
Thrombolytic
100
What positions would you NOT want someone exercising in if they have CHF
supine
| prone
101
Milroy's disease is what type of lymphedema
Primary (B LE lymphedema)
102
Filariasis is what type of lymphedema
Secondary (nematode infection)
103
Is lymphedema pitting or non pitting in later stages
Non pitting
104
What is the Stemmer's sign
When the dorsal foot/hand skin cannot be lifted
105
Is left or right draining area larger for the lymphatic system
Left is larger
106
Where is lymph fluid pump back into
Subclavian v
107
How much difference in size from one limb to the other would be positive for lymphedema
2 cm
108
Radiological imaging of lymphatic nodes/vessels
Lymphoscintingraphy
109
What stage of lymphedema:
| Heaviness, minimal edema, patient feels fullness in extremity, mild fluid and fibrotic changes
Preclinical (Stage 0)
110
What stage of lymphedema:
Reversible lymphedema.
Fluid accumulation, pitting edema, reduces with elevation
Stage 1
111
What stage of lymphedema:
Spontaneously irreversible lymphedema. Fibroblast formation, connective tissue proliferation, minimal to no pitting edema, moderate swelling, pos stemmer's sign
Stage 2
112
Will stage 1 have pos stemmer's sign
no, but stage 2 will
113
What stage of lymphedema:
| Hardening of dermal tissues, papillomas present, skin induration, elephant-like skin
Stage 3
114
What stage of pitting edema scale:
| Indentation barely detectable
1+
115
What stage on pitting edema scale:
| Slight indentation, returns in 15 sec
2+
116
What stage on pitting edema scale:
| Deeper indentation, returns in 30 sec
3+
117
What stage on pitting edema scale:
| Deep indentation, lasting more than 30 sec
4+
118
What would be a normal pulse
3+
119
What would be a bounding pulse
4+
120
What type of bandages are best for lymphedema
Short stretch
121
Short stretch bandages have ______resting pressure and ______working pressure
Low resting pressure
| High working pressure
122
Should you decongest lymphatic system proximal to distal
Yes
123
Should you decongest lymphatic system distal to proximal
no
124
What type of exercise is best for lymphedema
Low impact that is functional
125
Should strokes for lymphedema be in the direction of flow
Yes
126
Manual Lymphatic Drainage CIs
```
Acute infection
Cellulitis
Cardiac edema
Renal failure
Cancer
```
127
CI for Compression therapy for lymphedema
PAD.....ABI <0.8
128
An ABI less than what would be a CI to compression
ABI less than 0.8
129
Superficial or deep pressure for MLD
superficial
