CVT Exam- 1 Flashcards by Brad Koester

T/F:
PDE inhibitors work on arterial and venous by vasodilating through blocking the metabolism of cGMP.

a. True

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Your patient has a history of moderate aortic stenosis. You know you should avoid:
a. Tachycardia
b. Decreased SVR
c. Increased afterload
d. All of the above
e. None of the above

d. All of the above

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Your patient has afib and rales. With dilated cardiomyopathy, you should avoid increased high volume fluids and ______.

Decreased afterload

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Large or bulging V waves on your CVP indicate?
a. Mitral or tricuspid regurg
b. Complete AV block
c. Junctional rhythm
d. diastolic dysfunction

a. Mitral or tricuspid regurg

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T/F:
Predisposition to LV failure: elderly, LV hypertrophy, etc ?

True

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All of the following promote eccentric hypertrophy except: ?
a. Volume overload
b. Aortic regurgitation
c. Diastolic heart failure
d. Thickening of the L ventricular wall

d. Thickening of the L ventricular wall

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T/F:
Dobutamine increases myocardial oxygen demand and is commonly used for ECG stress tests to test patients with CAD?

a. True

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Which is the least likely to be used during an MI due to its increase for myocardial oxygen?
a. Epi
b. Norepi
c. Dopamine
d. Dobutamine

d. Dobutamine

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Cardiac output decreased due to which factor?
a. Low calcium
b. Increased afterload
c. Increased preload

a. Low calcium

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What cardiovascular reflex produces an increased HR as a result of increased BP due to venous baroreceptors?
a. Bainbridge
b. BJ
c. Celiac

a. Bainbridge

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Auto coronary blood flow is regulated via all EXCEPT?
a. Somatic nervous system
b. ANS
c. Local metabolism
d. Myofilament response

a. Somatic nervous system

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Which patients are most likely to have HF with preserved EF? (Select 2)
a. 80 year old man, aortic stenosis, with 30 BMI
b. 72 year old female with 40 BMI, HTN, afib
c. 50 something year old with 40 BMI
d. 30 something year old with OSA high BMI

a. 80 year old man, aortic stenosis, with 30 BMI
b. 72 year old female with 40 BMI, HTN, afib

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Mix and match waveforms for PA cath:
a. Wedge pressure
b. R atrium
c. R ventricle
d. Pulm artery

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What vessel runs posterior on the heart branching off of the left coronary?
a. LAD
b. Circumflex
c. Interior descending

b. Circumflex

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What is the bottom left corner of the PV loop?
a. Opening of mitral valve
b. Closing of mitral valve
c. Opening of aortic valve
d. Closing of aortic valve

a. Opening of mitral valve

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SATA: what is true regarding the Pressure Volume loop? (select 2)
a. Y axis is pressure
b. X axis is volume
c. Its measured over time

a. Y axis is pressure
b. X axis is volume

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What two factors (similar to ejection fraction of the left ventricle) contribute to the EF of the left atrium?
a. Compliance
b. Contraction
c. Afterload
d. Preload

b. Contraction
d. Preload

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SATA: what is true about preload? (Select 2)
a. Same as LVEDV
b. Pressure left in the LV at diastole
c. Same as SVR
d. Pressure the ventricle must overcome to open the aorta

a. Same as LVEDV
b. Pressure left in the LV at diastole

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Definition of afterload: (Choose 2) ?
a. Is also known as SVR
b. Resistance required to overcome aortic valve
c. Is also known as LVEDP
d. Is ventricular stretch at end diastole

a. Is also known as SVR
b. Resistance required to overcome aortic valve

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What is true about baroreceptors? (select 2)
a. Valsalva maneuver identifies patients at risk for autonomic system instability
b. Impulse from carotid and aortic reach medulla by the glossopharyngeal and vagus nerve
c. Baroreceptors are receptors least attuned to blood pressure
d. Marley’s law relates pulse propulsion to blood pressure

a. Valsalva maneuver identifies patients at risk for autonomic system instability
b. Impulse from carotid and aortic reach medulla by the glossopharyngeal and vagus nerve

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What wave form on the CVP waveform represents atrial filling and late systole?

a. V-wave

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Cholinergic stimulation of the SA node causes what?
a. Bradycardia
b. Tachycardia
c. Increased conductance

a. Bradycardia

What does C represent? in flow volume loop?
a. Aortic stenosis
b. Mitral stenosis
c. Mitral regurg
d. Aortic regurg

a. Aortic stenosis

Patient is on sodium nitroprusside for 12 hours and an increased dose each hour. What is your management?
a. STAT ABG
b. Switch to NTG
c. STAT head CT head to assess for midline shift
d. Bolus albumin

a. STAT ABG
b. Switch to NTG

Another PV loop: what represents but for E ? a. Aortic regurgitation

a. Aortic regurgitation

Which beta adrenergic blocker is not metabolized by the liver and must be decreased in renal disease? a. Atenolol b. Carvedilol c. Metoprolol d. Propranolol

a. Atenolol

Which of the following drugs is an alpha antagonist? a. Yohimbine b. Precedex c. Verapamil d. Epinephrine

a. Yohimbine

Which medication is a sympathetic agonist? a. Precedex b. Phentolamine c. Sodium nitroprusside d. Atropine

a. Dexmedetomidine/ Precedex

What is the T wave on the ECG? a. Ventricular repolarization b. AV conduction c. Delay of something

a. Ventricular repolarization

Which law describes monitoring of arterial oxygen through spectrometry? a. Beer lambert b. Poiseuille’s c. Frank Starling d. LaPlace

a. Beer Lambert

Which are true about LaPlace’s Law: (select 2) ? a. Myocardial thickening is a compensatory mechanism from wall stress b. Wall tension has an inverse relationship with wall thickness c. Myocardial oxygen demand significantly decreases with stress

a. Myocardial thickening is a compensatory mechanism from wall stress b. Wall tension has an inverse relationship with wall thickness

Which heart sound is best heard at the PMI? a. S1 b. S2 c. S3 d. S4

a. S1

SATA: What do you want with CAD? (Select 2) a. Maintain hypertension b. Achieve hypotension c. Tachycardia d. Bradycardia e. Increase contractility

a. Maintain hypertension d. Bradycardia

Most vulnerable to ischemia? a. Subendocardium b. Epicardium c. Subepicardium

a. Subendocardium

Which of the following is False regarding coronary blood flow? a. The LV is perfused mostly during systole b. The right atrium is supplied by the LCA LAD c. The RV RA LA are perfused during systole and diastole

a. The LV is perfused mostly during systole

Which are true about your PA catheter: (Choose 2) a. Passes through the right ventricle outflow tract b. Should sit in west zone III c. Passes through left ventricle outflow tract d. Should be advanced 1-2 cm further before cardiopulmonary bypass

a. Passes through the right ventricle outflow tract b. Should sit in west zone III

T/F: Sympathetic nervous system innervates only one organ or organ system?

False

T/F: EF is the most common parameter used to measure Left ventricular function?

a. True

During what phase do calcium channels open? a. 0 b. 1 c. 2 d. 3

c. 2

Large V-waves on the CVP waveform would indicate what? A. Mitral or tricuspid regurgitation B. Diastolic dysfunction C. Junctional Block

A. Mitral or tricuspid regurgitation

What is the afferent limb of the oculocardiac reflex? a. Vagus b. Oculomotor c. Trigeminal

c. Trigeminal

SATA:Which of the following occur during diastole of the cardiac cycle? (Select 4) A. Dicrotic notch B. LV pressure increases C. Mitral valve closes D. Mitral valve opens E. Increased ventricular volume F. AV valve open

A. Dicrotic notch D. Mitral valve opens E. Increased ventricular volume F. AV valve open

T/F: Patient with moderate mitral stenosis needs an increased normal HR?

False - it is Low normal

Which drug of this class is most lipophillic and crosses the blood brain barrier more readily? a. Nimodipine b. Clevidipine c. Nifedipine d. Nicardipine

a. Nimodipine- helps decrease cerebral vasospasms

T/F: Phosphodiesterase inhibitors lead to arterial and venous vasodilation through stimulation of cGMP?

True

How would your heart primarily respond to an increase in myocardial oxygen demand? a. Increasing cardiac blood flow b. Increased cerebral perfusion pressure c. Increased oxygen extraction d. Collateral vessels

a. Increasing cardiac blood flow

Patient with JVD, rales, afib presents for small bowel obstruction with recent diagnosis of dilated cardiomyopathy. Goals for dilated cardiomyopathy include avoid large volumes & ______? a. Decrease afterload b. Increase afterload c. Increase preload d. Decrease heart rate

a. Decrease afterload

Pt in cath lab with myocardial ischemia, what medication will you least likely administer due to an increase myocardial oxygen demand and should be avoided in patients with ischemia? a. Dobutamine b. Dopamine c. Epinephrine d. Levophed

a. Dobutamine

T/F: Hypertension is not a major risk factor for heart failure?

a. False

Patient has dyspnea, angina, and syncope, what do you assume is their diagnosis? a. Aortic stenosis b. Aortic insufficiency c. Heart rate 70 d. Nothing, they’re fine

a. Aortic stenosis

You have these parameters, what disorder would this treat? Full preload, increased afterload, depressed contractility, normal HR, NSR a. Hypertrophic cardiomyopathy b. Mitral stenosis c. Aortic stenosis d. Aortic regurgitation

a. Hypertrophic cardiomyopathy

How do you compensate with you have congestive heart failure? a. Increased SNS activation b. Decreased BNP

a. Increased SNS activation

You have a decreased SV, what is this due to? a. Blood alcohol of 0.2 b. Decrease serum Ca++ c. Decreased afterload

b. Decrease serum Ca++

Question about what increases myocardial oxygen requirements (it was select 4) ? a. HTN b. SNS stimulation c. Tachycardia d. Contractility

a. HTN b. SNS stimulation c. Tachycardia d. Contractility