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CMC Exam!!! <3 > CMC - miscellaneous > Flashcards

CMC - miscellaneous Flashcards

1
Q

What is the sign of pulsus paradoxus?

A

Arterial wave tracing that varies 10+ points with inspiration/exhalation.

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2
Q

What should be suspected with pulsus paradoxus?

A

Tamponade

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3
Q

What organ clears the BNP?

A

Kidney clearance

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4
Q

Where should the tip of the IABP be placed for optimal perfusion?

A

Between 2nd and 3rd intercostal space.

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5
Q

What does the delta wave represent? Which arrhythmia is it seen in?

A

Delta wave - seen in WPW. It is the “slurring” upstroke seen before QRS complex that represents early depolarization of part of the ventricles.

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6
Q

Nipride - arterial or venous vasodilator?

A

Strong arterial vasodilator (used to reduce afterload.)

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7
Q

Nitroglycerin - arterial or venous vasodilator?

A

Venous (use to reduce preload). It will reduce afterload at high doses. However, it will also dilate coronary arteries.

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8
Q

What is the purpose of spironolactone in systolic CHF?

What is the side effect?

A

Slows hypertrophy and fibrosis of myocardium.

Hyperkalemia

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9
Q

Staph in the valves - what is the surgical treatment?

A

Early surgical debridement/replacement without full course of antibiotics.

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10
Q

In septic shock, will SvO2 be increased or decreased?

A

Decreased (hypermetabolic state characterized by increase in metabolic consumption.)

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11
Q

When a patient is in v-fib, the IABP should be in which mode?

A

Internal or Pressure support.

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12
Q

What is obstructive shock?

A

Blockage in the great vessels leading into or out of the heart. (decreased venous return or excessive afterload. - as caused by dissecting aortic aneurism.)

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13
Q

ST segment elevation in all heart areas is associated with what condition? What is the treatment?

A

Pericarditis - NSAIDS

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14
Q

What type of medication is used in treatment of aortic aneurysm?

A

calcium channel blocker - Clevidipine

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15
Q

Is a lack of radial pulses and no pulse oximetry normal in a patient on an LVAD?

A

Yes this is normal but it is not normal if you can’t auscultate the pump.

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16
Q

Metformin may increase serum creatinine levels true or false

A

true

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17
Q

What type of patient is most at risk for contrast-induced nephropathy?

A

diabetics, hypertensives, pts with heart failure, pre-existing renal insufficency, pts on nephrotoxic meds (ACE-I, NSAIDS), dehydrated people

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18
Q

what can happen to people who take metformin whose kidneys are dysfunctional?

A

lactic acidosis

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19
Q

Which endocrine disorder may cause a-fib?

A

hyperthyroidism

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20
Q

What is normal wedge pressure?

A

8-12

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21
Q

What are the absolute contraindications to ablation?

A

apical thrombus, unstable angina, bacteremia

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22
Q

hyperphosphatemia will cause what symptoms?

A

muscle spasm, prolonged QtC, and joint pain.

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23
Q

PVR

A

pulmonary vascular resistance

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24
Q

low magnesium will present how on the EKG?

A

pronged QT, prolonged PR

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25
Q

which medicine can cause pulmonary toxicity?

A

Amiodarone

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26
Q

Which valve is the most common valvular pathologic cause of AFIB?

A

Mitral valve stenosis

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27
Q

Patients in hypovolemic shock will have mild (acidosis/alkalosis)?

A

Mild acidosis

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28
Q

How can diuretics hurt a person with restrictive cardiomyopathy?

A

They lower ventricular filling pressure and can decrease cardiac output.

29
Q

Why is amiodarone used cautiously in pts with thyroid disease?

A

It has high iodine content and can cause hypo- and hyper-thyroid I am.

30
Q

Difference between SCUF, CVVH, and CVVHDF

A

SCUF-clearance of plasma water only.
CVVH-clears solutes(BUN, Cr)
CVVHDF-clears solutes and potassium.

31
Q

Svo2 decrease with:

A

Increased oxygen consumption and decreased oxygen delivery.

32
Q

What is the gradient variance?

A

PAD pressure - PCWP

Gradient above 3 on swan insertion indicates pHTN.

33
Q

What does the pathological Q wave signify?

A

A previous infarct.

34
Q

Inferior Leads

A

II, III and aVF

35
Q

Lateral Leads

A

I, aVL, V5 and V6

36
Q

Septal leads

A

V1, V2

37
Q

Anterior leads

A

V3 and V4

38
Q

Lateral leads correlate to which coronary arteries?

A

Left Circumflex or diagonal of LAD.

39
Q

Inferior leads correlate to which coronary arteries?

A

Left circ or RCA

40
Q

Anterior or septal leads correlate to which coronary artery?

A

LAD

41
Q

chest pain, shortness of breath with minimal exertion, and syncope are the classic symptoms of which valvular disorder?

A

Aortic stenosis

42
Q

symptoms of PE

A

Shortness of breath, tachycardia, tachypnea, low O2 sat, dry cough, chest pain, anxiety, dizzness

43
Q

Mean PAP above 25 on RHC indicated?

A

Pulmonary hypertension

44
Q

Why are ACE-I’s withheld from pts receiving CRRT?

A

They can cause anaphylactic reactions

45
Q

Shoulder blade pain for patient on an IABP May indicate what?

A

Poor perfusion to the arterial vessels - balloon removal is indicated.

46
Q

Cloudy urine can be a sign of what type of AKI? Why?

A

Intra-renal AKI, proteinuria can cause urinary casts that obstruct the renal tubules.

47
Q

What is mechanism of action of Isuprel?

A

Accelerated AV conduction and shortens the QT interval.

48
Q

Normal QT interval

A

Less than or equal to 0.12 seconds

49
Q

When serum albumin is low, serum ______ will be low also. Why?

A

Calcium - half of total blood calcium is bound to protein (mostly albumin.)

50
Q

Pts with LVADS have anticoagulation yes or no

A

Yee (heparin gtt)

51
Q

Endocarditis usually affects which valve?

A

Tricuspid valve

52
Q

P2Y12 drugs are what type of drugs?

Common adverse effect?

A

Anti-platelet.

Neutropenia

53
Q

Benzocaine administration can cause what condition, associated with blue coloring, air hunger and decreased spo2?what is the treatment?

A

Methemoglobinemia

IV methylene blue

54
Q

Most common cause of sudden cardiac death in those under 30?

A

A preexisting cardiac abnormality, such as hypertrophic cardiomyopathy.

55
Q

signs of epidural hematoma (bleeding on the dura between dura mater and skull, increased intracranial pressure)
What is the treatment?

A 
AMS, confusion, enlarged pupil on one side, severe headache, loss of consciousness followed by a period of alertness, then decreased LOC
Clot evacuation (crani)
56
Q

First line treatment for HF with reduced EF?

A

Ace inhibitors (block angiotensin 2, therefore lowering BP. also, lowers salt and water retention.)

57
Q

Mechanism of action of amiodarone

A

Blocks potassium channels.

58
Q

What is a q wave?

A

Any negative deflection that precedes an R WAVE.

59
Q

A serious side effect of amiodarone use that warrants discontinuation is?

A

Pulmonary fibrosis

60
Q

First line treatment for symptomatic bradycardia

A

Atropine

61
Q

First line treatment for complete heart block

A

Transcutaneous pacing

62
Q

What causes prinzmetal’s angina? What is the treatment?

A

Coronary artery vasospasm - calcium channel blockers.

63
Q

How can you differentiate between pericarditis and STEMI on EKG?

A

PR depression is generally transient in pericarditis.

64
Q

Where to hear the mitral valve?

A

5th intercostal space in the midclavicular line

65
Q

In a stable patient with tachycardia, regular QRS, which should be attempted first, Adenosine or Cardioversion?

A

Adenosine first (6mg bolus, followed by 12 mg if unsuccessful.)

66
Q

When a patient is on an LVAD, what is the highest priority complication?

A

Cvp 1 (low circulating volume)

67
Q

What is normal Vt in a spontaneously breathing person?

A

5 ml/kg

68
Q

What’s the difference between peak airway pressure and plateau pressure?

A
69
Q

What is the most important safety precaution for a patient with an LVAD?

A

Always be connected to a power source, never disconnect both batteries simultaneously.

CMC Exam!!! <3 (3 decks)

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