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1st Year Med > CVR Investigations > Flashcards

CVR Investigations Flashcards

1
Q

what is the function of the ECG?

A

detect PD changes between 2 electrodes on the heart surface and the limbs

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2
Q

what does the P wave of an ECG represent?

A

atrial depolarisation

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3
Q

what does the delay between P and Q mean on an ECG?

A

delay at AV node

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4
Q

what does point Q show on an ECG?

A

conduction through bundle branches (purkinje fibres)

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5
Q

what does the QRS wave show on an ECG?

A

ventricular depolarisation

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6
Q

what does the ST segment show on an ECG?

A

plateau phase of ventricular repolarisation

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7
Q

what does the T wave show on an ECG?

A

rapid ventricular repolarisation

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8
Q

explain what the ECG leads are and what they measure

A

ECG leads are electrical vectors
unipolar leads measure potential variation at a single point
bipolar leads measure PD at a single point

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9
Q

name the 12 ECG leads

A

chest leads: V1-6
augmented limb leads: aVR, aVL, aVF
limb leads: I, II, III

(I = RA-LA, II = RA-LL, III = LA-LL)

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10
Q

what can HR be determined by in an ECG?

A

QRS complex

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11
Q

what should a standard ECG have for interpretation?

A

paper speed of 25mm/s
determined QRS axis
gain of 10mV/mm

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12
Q

what is the general rule of interpreting HR from an ECG?

A

300 divided by number of large squares between each QRS complex

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13
Q

what is the normal range for:
PR interval
QRS
QT interval

A

PR interval: <200ms
QRS: <120ms
QT interval: <400ms

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14
Q

what does the QRS axis show and how is this approximated?

A

direction of average depolarisation in heart (mainly LV)
determined by limb leads
normal is -30 to +90 degrees
approximated by finding lead with most positive QRS

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15
Q

how can P waves be described?

A

positive, negative or biphasic

a normal P wave is upright in the inferior leads

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16
Q

how can ST segments be described?

A

isoelectric, elevated or depressed

a normal ST segment is flat

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17
Q

how can T waves be described?

A

upright, inverted or flat

a normal T wave has the same polarity as the QRS

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18
Q

how can the QRS complex be described?

A

R - positive deflection
Q - first negative deflection
S - additional negative deflection

capital letters = dominant waves
non-capital = non dominant waves

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19
Q

what are the purposes of cardiac imaging?

A

defines heart size/structure
details functions/physiology (valves, ventricular function)
image heart during stress (ischaemia)

20
Q

what are the functions of echocardiography?

A

assesses heart structure/function
assesses valves/pericardium
assesses inducible ischaemia

21
Q

what are the advantages and disadvantages of echocardiography?

A

adv - cheap, available, no radiation, portable

disadv - requires good acoustic window, user dependant

22
Q

what does an increase of gadolinium indicate in cardiac MRI?

A

fibrosis

23
Q

what are the functions of cardiac magnetic resonance imaging (CMR)?

A

assesses perfusion/stress
accesses great vessels
defines tissue characterisation

24
Q

what are the advantages and disadvantages of cardiac magnetic resonance imaging?

A

adv - shows anatomy/volume/function, reproducible, no radiation

disadv - costly, poor availability

25
Q

what are the purposes of coronary angiography?

A

indicates ischaemia
primary percutaneous coronary intervention (PCI)
assesses ventricular pressure/valves

can intervene during procedure (invasive and uses radiation)

26
Q

describe nuclear perfusion imagine and state its advantages and disadvantages

A

assesses ischaemia and ejection fraction

adv - readily available
disadv - uses radiation, shows no structural assessment

27
Q

describe cardiac CT imaging and state its advantages and disadvantages

A

assesses coronary artery and great vessel anatomy

adv - can rule out CAD, low risk
disadv - uses radiation, requires low HR

28
Q

compare transthoracic and transoesophageal echocardiography

A

transthoracic (TTE) - takes pictures of anterior heart
thransoesophageal (TOE) - takes pictues of posterior heart

both image cardiac structure and valve function

29
Q

what is bubble contrast echocardiography used for?

A

access interatrial septum
(looking for oatent foramen ovale or atrial septum defect)

30
Q

what is LV contrast echocardiography used to look for?

A

LV apical thrombus

31
Q

what structures are visible from the parasternal long axis (PLAX) view?

A

LA
mitral valve
LV
LV outflow tract (LVOT)
aortic valve
aortic arch

32
Q

what structures can be seen from the parasternal short axis (PSAX) view?

A

LV
RV
all valves except mitral
interatrial septum
pulmonary artery
papillary muscles

33
Q

how can the LV systolic function be measured?

A

calculating LV ejection function using figures from LV end diastolic volume and LV stroke volume

34
Q

describe echo doppler imaging

A

assess valve flow

patterns present help assess diastolic function and valve disease severity

35
Q

what are the pros of using MRI imaging in respiratory investigations?

A

used magnetic properties of H+
easily generated images in different planes
lower resolution
can determine chest wall/mediastinum invasion by cancer

36
Q

describe the action of a PET scan

A

positron emission topography
uses radioactive liquid (tracer) to show areas of the body with overactive cells

37
Q

how is a bronchoscopy carried out?

A

bronchoscope inserted down mouth/nose, passes down to bronchi allowing lung/air passage visualisation

biopsies can be performed during bronchoscopies

38
Q

what can an EBUS technique be used for?

A

endobronchial ultrasound samping

diagnoses different lung disorders (inflammation, infection, cancer)

39
Q

explain the process of a thoracoscopy

A

done under anaesthetic
visualises pleural cavity
pleural biopsy can be taken

40
Q

what is a CT pulmonary angiography used for?

A

scans for perfusion and ventilation function of lungs

41
Q

what 4 categories can respiratory sampling be categorised in to? give an example for each

A

ward tests: blood/urine

bronchoscopy: biopsy

percutaneous: fine needle aspiration

surgical: mediastinoscopy

42
Q

what can pulmonary function be assessed through?

A

spirometry
arterial blood gases (ABG)
progressive exercise tests
sleep studies

43
Q

describe the results of type 1 respiratory failure

A

low O2 (<8kPa) on an ABG

result of pneumonia, cardiac failure or pulmonary embolism

44
Q

describe the results of type 2 respiratory failure

A

low O2 (<8kPa) and high CO2 (>6kPa) on an ABG
patient suffering severe respiratory fatigue

result of opiates overdose, neuromuscular weakness, advanced COPD

45
Q

what factors are considered when choosing an investigation test?

A

patient - anxiety, discomfort, complications

test - sensetive, specific, reliable, repeatable

convenience - cost, ease, time

1st Year Med (52 decks)

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