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Co-Existing Disease 1 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

SV equation

A

EDV-ESV

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2
Q

Normal CO:

A

3-9

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3
Q

What do these factors do to CVP:

  • hypervolemia
  • forced exhale
  • tension pneumothorax
  • HF
  • pleural effusion
  • decreased CO
  • cardiac tampon are
  • mechanical ventilation and PEEP
A

Increase

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4
Q

What do these factors do to CVP:

  • hypovolemia
  • deep inhalation
  • distributive shock
A

Decrease

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5
Q

What are these the gold standard of?

  • acute pulmonary edema
  • severity of LVF and mitral stenosis
A

PCWP

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6
Q

What does pulmonary edema with normal PCWP suggest? 2

A

ARDS or non-cardiogenic pulmonary edema (opiate poisoning)

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7
Q

Normal CI:

A

2-5

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8
Q

Equation for PaO2:

A

102-(age x .3)

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9
Q

Equation for SVR:

A

(80)(MAP-CVP)/CO

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10
Q

Increase conduction velocity

A

Dromotropic effect

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11
Q

If afterload increases, what happens to CO?

A

Decreases

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12
Q

Tension upon muscle fibers in heart wall is the pressure within ventricle multiplied by volume within ventricle, divided my wall thickness (pressure x radius / 2 x wall thickness)

A

LaPlace’s Law

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13
Q

These cause what?

  • rheumatic fever
  • calcification or congenital
  • bacterial endocarditis
A

Mitral stenosis

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14
Q

Acute treatment for mitral regurgitation?

A

Nitroprusside (decrease afterload)

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15
Q

Chronic treatment for mitral regurgitation?

A

ACE-I, hydralazine, diuretics, digoxin, anti arrhythmics

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16
Q

What do you want to avoid in mitral valve prolapse?

A

Increase HR

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17
Q

These cause what?

  • degeneration and calcification
  • early-bicuspid, late-tricuspid valve
  • rheumatic, infectious endocarditis
A

Aortic valve stenosis

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18
Q

Drug therapy for valvular heart disease (7)

A
  1. BB
  2. CCB
  3. Digitalis
  4. ACE-I
  5. Vasodilators
  6. Diuretics
  7. Inotropes
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19
Q

Which disease is Afib most common with?

A

Mitral disease

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20
Q 
Anesthesia management with Mitral regurgitation: 
Preload 
Afterload 
HR 
Contractility
A

Maintain to slight increase
Reduce
Elevated
Maintain or increase

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21
Q 
Anesthesia management with aortic regurgitation: 
Preload 
Afterload 
HR 
Contractility
A

Maintain to slight increase
Reduce
Elevated
Maintain; NO DEPRESSION

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22
Q 
Anesthesia management for aortic stenosis: 
Preload 
Afterload 
HR 
Contractility
A

Maintain
Increase
Avoid tachycardia
Maintain

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23
Q

Anesthesia management with mitral stenosis:
Preload
Afterload
HR

A

Increase
Maintain
Slower

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24
Q

Anesthesia management with tricuspid regurgitation:

Use N2O?

A

NO

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25
Q

Pulsating, encapsulated hematoma in communication with the lumen of a ruptured vessel; must continue communication with artery

A

False or pseudoaneurysm

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26
Q

Circumferential, relatively uniform in shape aneurysm:

A

Fusiform

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27
Q

Pouch like with narrow neck connecting bulge to one side of arterial wall aneurysm:

A

Saccular

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28
Q

What do these 3 syndromes affect?

Marfan, ehlers-danlos, loeys-dietz

A

Blood vessel wall integrity

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29
Q

DeBakery system:
Originates in ascending aorta, propagates at least to aortic arch and often beyond distally; pts less than 65 and most lethal form

A

Type 1

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30
Q

DeBakery system:

Originates in and is confined to ascending aorta

A

Type 2

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31
Q

DeBakery system:
Originates in descending aorta, rarely extends proximally but will extend distally; elder pts with atherosclerosis and HTN

A

Type 3

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32
Q

Primary vascular action to spinal cord?

A

Vertebral arteries and 10 medullary arteries

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33
Q

Loss of posterior supply generally leads to loss of?

A

Sensory functions

34
Q

Loss of anterior supply more often causes loss of?

A

Motor

35
Q

Infants or adults tolerate longer periods of DHCA?

A

Infants

36
Q

which drug augment/increase renal perfusion?

A

Fenoldopam

37
Q

The higher the clamp the greater what?

A

Increase in preload

38
Q

Baroreceptor reflex: high pressure zones (>60)

2 areas

A

Aortic arch and carotid sinus

39
Q

Baroreceptor reflex: low pressures (<60)

3 areas

A

Vena cava
Pulmonary veins
Atria

40
Q

Increase in HR due to increase in CVP

A

Bainbridge reflex (atrial reflex)

41
Q

Cause of primary HTN:

A

Overactive RAAS

42
Q

Cause of secondary HTN:

A 
Renal and endocrine disorders 
Pregnancy 
OSA
Drugs
Malformed aorta 
White coat HTN
43
Q

How soon should discontinuation of ACE-I and ARBS be?

A

24-48 hrs

44
Q

Is RBB or LBB more vulnerable?

A

RBB

45
Q

Which artery supplies blood to LBB and RBB?

A

LAD

46
Q

What arrhythmia can sevo cause in infants?

A

Bradycardia

47
Q

What arrhythmia can des cause?

A

Prolong QT

48
Q

Treatment for tachycardia?

A

Fix underlying disorder and BB

49
Q

Treatment for PAC?

A

Rarely necessary, but limit sympathetic stimulation and BB or CCB

50
Q

4 things if adenosine doesn’t resolve after few seconds?

A

Adenosine antagonist (theophylline 250mg)
Atropine
Adrenaline
CPR

51
Q

Patients with what syndrome can you see PSVT?

A

Wolff Parkinson’s white

52
Q

10 treatments for PSVT?

A 
Vagal maneuver (carotid sinus massage)
Adenosine (6mg)
Verapamil (2.5-10ml)
Amiodarone 
Esmolol
Phenylpherine 
Digitalization (digoxin or ouabain)
Synchronized cardioversion 
Electrode catheter ablation with radio frequency energy 
CCBs
53
Q

What 3 things should be avoided in PSVT?

A

Sympathetic simulation
Acid base imbalance
Electrolyte imbalance

54
Q

What is accompanied with an arterial flutter?

A

AV block

55
Q

Arterial HR in atrial flutter

A

250-350

56
Q

3 treatments for atrial flutter?

A

BB
CCB
Synchronized DC cardioversion

57
Q

Most common postop arrhythmia?

A

Afib

58
Q

Which arrhythmia does Afib have the same treatment with?

A

Atrial flutter

BB, CCB, synchronized DC cardioversion

59
Q

What drug is recommended with long term Afib?

A

Warfarin (coumadin)

60
Q

What 2 things can junctional rhythm decrease?

A

BP and CO

61
Q

Treatment for junctional rhythm?

A

None

62
Q

What abnormalities is common with ventricular tachycardia? (2)

A

Decreased serum potassium

Low arterial oxygen tension

63
Q

2 big treatments for VT?

A

Amiodarone

Lidocaine

64
Q

Most successful treatment for VF?

A

External electrical defibrillation

65
Q

Ventricular pre-excitation causes an earlier than normal deflection of QRS complex called a delta wave

A

Wolf Parkinson white

66
Q

Treats for narrow QRS WPW? (3)

A

Vagal maneuvers
Adenosine
Dipyridamole

67
Q

Treatment for wide QRS WPW?

A

Procainamide

68
Q

Afib with WPW, what should you avoid?

A

Digoxin and verapamil

69
Q

What else is torsades de pointes known as?

A

Prolonged QT syndrome

70
Q

First choice in treating long QT syndrome?

A

BB

71
Q

What makes the cardiac murmurs louder in hypertrophic cardiomyopathy?

A

Valsalva maneuver

72
Q

5 treatments options for LVOT?

A 
BB
CCB
Anti-dysrhythmias 
Septal myomectomy 
IV phenylephrine
73
Q

What 3 things to avoid in LVOT?

A

Sympathetic stimulation
Hypovolemia
Vasodilation

74
Q

What 4 drugs to avoid in LVOT?

A

Pancuronium
Sux
Ephedrine
Dobutamine

75
Q

Is there a 3rd heart sound in DCM pts?

A

Yes

76
Q

ECG changes in acute pericarditis:
Accompanies onset of acute pain and is hallmark of acute pericarditis. ECG changes include diffuse concave upward ST elevation, except in leads aVR and V1. T waves are upright in leads with ST elevation and PR segment deviates opposite to P wave polarity

A

Stage 1

77
Q

ECG changes in acute pericarditis:

Several days later with return of ST segment baseline, followed by flattening of T waves

A

Stage 2

78
Q

ECG changes in acute pericarditis:

T waves become inverted but without Q wave formation

A

Stage 3

79
Q

ECG changes in acute pericarditis:
ECG returns to prepercarditis baseline weeks to months after initial onset. T wave inversion may persist indefinitely in chronic inflammation observed with tuberculosis, uremia, or neoplasm

A

Stage 4

80
Q

Paradoxical increase in peripheral venous dissension and pressure during inspiration.
Major mechanism is a change in shape of pericardium with resulting increase in intrapericardial pressure and obstruction to venous return to heart

A

Kussmaul’s sign

81
Q

With cardiac tamponade, will kussmaul’s sign increase or decrease jugular emptying during inspiration?

A

Decrease

82
Q

Do you wanna use PEEP for cardiac tamponade?

A

No

Co-Existing Disease 1 (8 decks)

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