Cardiovascular, Pulmonary, and Lymphatic Flashcards by Thomas Bryan | Brainscape

Q

What heart enzyme stays elevated the longest

A

Cardiac Troponin (elevated for 14 days)

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Q

What is the patient at risk for when INR is high

A

Excessive bleeding

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Q

What is the patient at risk for when INR is low

A

Clots

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Q

Normal value for PO2

A

Greater than 80

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Q

Normal value for PaCO2

A

35-45

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Q

Normal value for HCO3 (bicarbonate)

A

22-26

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Q

What happen when HCO3 is too low

A

Metabolic acidosis

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Q

What happens when HCO3 is too high

A

Metabolic alkalosis

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Q

What occurs when S1 heart sound is absent

A

Heart block

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Q

What occurs when S2 heart sound is absent

A

Aortic stenosis

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Q

What does S3 heart sound indicate

A

CHF

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Q

Normal HR for babies-age 1

A

100-160 bpm

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Q

Normal HR for children 1-10

A

60-140 bpm

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Q

Normal HR for children 10+ and adults

A

60-100 bpm

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Q

Normal HR for well conditioned athletes

A

40-60 bpm

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Q

Below what ABI would you not want to use compression

A

0.6

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Q

ABI less than what is considered abnormal

A

0.9

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Q

An ABI less than what is would indicate PAD

A

0.9

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Q

Normal WBC level

A

43,000-10,800

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Q

Borderline ABI =

A

0.91-0.99

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Q

Is restrictive lung disease a volume or flow problem?

A

volume (issue getting air in)

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Q

Is obstructive lung disease a volume or flow problem

A

flow (issue getting air out)

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Q

S3 Heart sound will be heard for what

A

CHF

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Q

What will be seen with left sided HF?

A

Lung issues

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Q

What will be seen with right sided HF?

A

Peripheral sx (asictes and jugular distension)

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Q

What is cor pulmonale

A

pulmonary HTN

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Q

What CV condition can present with back pain

A

abdominal aortic aneursym

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Q

Valsalva can be helpful in doing what

A

Slowing down tachycardia

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Q

Muscles of inspiration

A

Diphragm
External intercostals
SCM
Pec minor

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Q

Muscles of expiration

A

Internal intercostals
Abdominals
QL

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Q

Normal respiration rate for 0-1 yr old

A

30-60

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Q

Normal respiration rate for 1-3 year old

A

24-40

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Q

Normal respiration rate for 3-6 year old

A

22-34

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Q

Normal respiration rate for 6-12 yr old

A

18-30

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Q

Normal respiration rate for 12-18 yr old

A

12-16

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Q

Normal respiration rate for 18+

A

12-20

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Q

What is Kussmaul breathing due to

A

Too much acid in the body

-often due to Metabolic acidosis due to diabetes

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Q

What does Kussmaul breathing look like

A

rapid deep breathing

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Q

What does Biot’s respiration look like

A

periodic breathing with hyperopnea and then aponoea

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Q

What is Biot’s respiration due to

A

Neuron damage

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Q

What are some things that can cause an abnormality in pulse ox

A

nail polish
anemia
low perfusion

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Q

Which way would the trachea shift with:

-tension penumothorax

A

CL

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Q

Which way would the trachea shift with:

Pleural effusion

A

CL

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Q

Which way would the trachea shift with:

Space-occupying lesion

A

CL

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Q

Which way would the trachea shift with:

Pneumonectomy

A

IL

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Q

Which way would the trachea shift with:

Pleural fibrosis

A

IL

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Q

Which way would the trachea shift with:

Atlectasis

A

IL

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Q

What type of breath sound is commonly heard in CHF and is due to bubbles/fluid in the alvoli

A

Crackles

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Q

What type of breath sound would be heard with asthma

A

wheezes

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Q

What type of breath sound would be heard with pneumonia or chronic bronchitis

A

Ronchi (low pitched wheezing)

**deep snoring sound

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Q

What type of breath sound would be heard if there was blocking of upper airway

A

Stridor

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Q

What type of breath sound is a low pitched wheezing and is heard in CF, COPD, and secretions in larger airways

A

Ronchi

Q

Examples of restrictive lung dz

A

Sarcoidosis
Pneumoconiosis
Chest wall NM diseases
Intersitital lung dz

Q

What are the two main things that are found to be decreased in obstructive lung diseases

A

FEV1 AND FEV1/FVC ratio will be decreased in obstructive lung dz

Q

Will FEV1 be normal in obstructive lung dz

A

No

Q

Will FEV1 be normal in restrictive lung dz

A

yes

Q

What are the main two things that are decr in restrictive lung dz

A

TLC and FVC

Q

Is FVC normal in restrictive lung dz

A

No

Q

Is FVC normal in obstructive lung disease

A

Yes

Q

Is FEV1/FVC ratio normal in restrictive lung dz

A

yes

Q

Is FEV1/FVC ratio normal in obstructive lung dz

A

no

Q

What types of diseases have a decr FEV1

A

obstructive

Q

What types of diseases have a decr FVC

A

restrictive

Q

What will nail clubbing be seen with

A

COPD

Q

A flattened diaphragm will be seen with what type of dz

A

COPD

Q

Name the three diseases in COPD

A

Emphysema
Chronic Bronchitis
Asthma

Q

Enlargement of air spaces in the alveoli, loss of elasticity

A

Emphysema

Q

What types of medicines are given for asthma

A

B-agonists

Q

What will beta agonists due to HR

A

incr it

Q

True or false B-agonists cause vasoconstriction

A

true

Q

What can a Pancoast tumor mimic

A

TOS

Q

What can be seen in Pancoast’s tumor

A

Horner’s syndrome (miosis, ptosis)
sharp shoulder pain
C8, T1, T2 dermatome paresthesia
Pulmonary sx- dyspnea, cough, hemoptysis

Q

Normal EKG response during exercise

A

P wave increases height
R wave decreases
ST segment becomes sharply upsloping
QT interval shortens

Q

What does inverted T wave mean (2 things potentially)

A

) Left ventricular hypertrophy

2. ) Myocardial ischemia

Q

What does ST segment elevation mean

A

MI

Q

What do alpha adrengeric antagonist agents do

A

Reduce BP

Dilates peripheral arterioles and veins

Q

-pril drugs

A

ACE Inhibitors

Q

What do ACE Inhibitors do

A

Reduce BP

Q

-artan drugs

A

Angio-tension 2 receptor antagonist agents

Q

What do angio-tension 2 receptor antagonists do

A

Reduce BP

Q

What type of drugs are heparin, coumadin, warfarin, and lovenox

A

Anticoagulants

Q

Stains do what

A

Decr LDL and incr HDL

Q

Aspirin, Bayer, Plavix are what type of drugs

A

Antithrombotic

Q

What type of drugs inhibit platelet formation

A

Antithrombotic

Q

-olol drugs

A

Beta blockers

Q

What do beta blockers do

A

-Decr HR

Q

What is a key thing to remember when a patient is on beta blocker and/or calcium channel blockers

A

use RPE instead of HR bc HR will be blunted

Q

Procardia, Cardizem are what type of drugs

A

Calcium Channel Blockers

Q

What do Calcium Channel blockers do

A

Reduce the demands of the heart

Q

What is a major side effect of calcium channel blockers

A

Edema in the legs/feet and hypotension

Q

Thiazide and Lasix are what type of drugs

A

Diuretics (can lead to hypokalmia)

Q

What would be an indication for someone to be on a diuretic

A

HTN or edema due to CHF

Q

Nitrostat or Nitrogylcerin are what type of drugs

A

Nitrates

Q

What do nitrates do

A

cause smooth muscle dilation and peripheral vessel dilation

Q

When to use nitrates

A

angina or acute angina

Q

Digoxin and Lanoxin are wha type of drugs

A

Positive Inotropic

Q

When to use positive inotropic drugs

A

HF

Q

What do positive inotropic drugs do

A

Incr contractility of heart and slow HR

Q

Urokinase, Activose, and Linlytic are what type of drugs

A

Thrombolytic

Q

What positions would you NOT want someone exercising in if they have CHF

A

supine

prone

Q

Milroy’s disease is what type of lymphedema

A

Primary (B LE lymphedema)

Q

Filariasis is what type of lymphedema

A

Secondary (nematode infection)

Q

Is lymphedema pitting or non pitting in later stages

A

Non pitting

Q

What is the Stemmer’s sign

A

When the dorsal foot/hand skin cannot be lifted

Q

Is left or right draining area larger for the lymphatic system

A

Left is larger

Q

Where is lymph fluid pump back into

A

Subclavian v

Q

How much difference in size from one limb to the other would be positive for lymphedema

A

2 cm

Q

Radiological imaging of lymphatic nodes/vessels

A

Lymphoscintingraphy

Q

What stage of lymphedema:

Heaviness, minimal edema, patient feels fullness in extremity, mild fluid and fibrotic changes

A

Preclinical (Stage 0)

Q

What stage of lymphedema:
Reversible lymphedema.
Fluid accumulation, pitting edema, reduces with elevation

A

Stage 1

Q

What stage of lymphedema:
Spontaneously irreversible lymphedema. Fibroblast formation, connective tissue proliferation, minimal to no pitting edema, moderate swelling, pos stemmer’s sign

A

Stage 2

Q

Will stage 1 have pos stemmer’s sign

A

no, but stage 2 will

Q

What stage of lymphedema:

Hardening of dermal tissues, papillomas present, skin induration, elephant-like skin

A

Stage 3

Q

What stage of pitting edema scale:

Indentation barely detectable

A

1+

Q

What stage on pitting edema scale:

Slight indentation, returns in 15 sec

A

2+

Q

What stage on pitting edema scale:

Deeper indentation, returns in 30 sec

A

3+

Q

What stage on pitting edema scale:

Deep indentation, lasting more than 30 sec

A

4+

Q

What would be a normal pulse

A

3+

Q

What would be a bounding pulse

A

4+

Q

What type of bandages are best for lymphedema

A

Short stretch

Q

Short stretch bandages have ______resting pressure and ______working pressure

A

Low resting pressure

High working pressure

Q

Should you decongest lymphatic system proximal to distal

A

Yes

Q

Should you decongest lymphatic system distal to proximal

A

no

Q

What type of exercise is best for lymphedema

A

Low impact that is functional

Q

Should strokes for lymphedema be in the direction of flow

A

Yes

Q

Manual Lymphatic Drainage CIs

A

Acute infection
Cellulitis
Cardiac edema
Renal failure
Cancer

Q

CI for Compression therapy for lymphedema

A

PAD…..ABI <0.8

Q

An ABI less than what would be a CI to compression

A

ABI less than 0.8

Q

Superficial or deep pressure for MLD

A

superficial