Exam 1 (CV Monitoring) Flashcards
1
Q
- In a normal 12 Lead EKG, which leads have inverted T-waves?
A
Leads aVR & V1
2
Q
- What lead do you look at for a RBBB?
A
- V1.
- If QRS goes up → RBBB
3
Q
- What lead do you look at for a LBBB?
A
- V1
- If QRS goes down → LBBB
4
Q
- What constitutes right atrial hypertrophy?
A
Initial part of P wave is larger in V1 or >2.5mm in any limb lead
5
Q
- What constitutes left atrial enlargement?
A
- Biphasic wave in V1 or
- Camel hump in lead II
6
Q
- How do you determine RV hypertrophy on a 12-Lead?
A
The QRS in V1 is positive & R wave gets smaller
7
Q
- How do you determine LV hypertrophy?
A
- Large S wave in V1,
- Larger R wave in V5
8
Q
- What is an easy way to determine myocardial ischemia on an EKG?
A
Inverted symmetrical T-wave
9
Q
- Which PPM uses less energy?
A
Bipolar
10
Q
- What are the function codes for PPM’s?
A
- I: chambers paced
- II: chambers sensed
- III: Response to sensing
- IV: Rate modulation
- V: Multisite pacing
11
Q
- What does T, O, R & I stand for with PPM’s?
A
- T= Triggered
- O=None
- R= Rate modulation
- I=Inhibited
12
Q
- Triggered is only used, when?
A
For testing devices
13
Q
- What is multisite pacing good for?
A
A-fib & dilated cardiomyopathy
14
Q
- Bi-V pacing has leads where & who gets it?
A
- Right atrium & both ventricles.
- For very sick Pts
15
Q
- What are the requirements for Bi-V PPM?
A
- EF 30-35%
- IVCD
- Hx of cardiac arrest
16
Q
- Which cautery causes more interference with PPM’s?
A
Monopolar
17
Q
- What do AICD’s measure?
A
- R-R interval
- QRS width
18
Q
- The CVP’s a wave, is what?
A
Atrial contraction
19
Q
- The CVP’s c wave, is what & what does it follow?
A
- Tricuspid valve bulging towards atrium.
- Follows the R wave
20
Q
- The CVP’s X descent, is what?
A
Decreasing atrial pressure
21
Q
- The CVP’s V wave, is what?
A
- Venous filling of atria.
- Peaks after T wave.
- Tricuspid valve is closed
22
Q
- The CVP’s Y descent, is what?
A
Tricuspid valve opens
23
Q
- What happens to the CVP waveform in Tricuspid regurgitation?
A
No X-descent
24
Q
- What happens to the CVP waveform in Tricuspid stenosis?
A
- Tall A wave &
- No Y descent
25
Q
- Which PAC lumen fills the balloon?
A
3rd lumen
26
Q
- Which PAC lumen houses the temp thermistor?
A
4th lumen
27
Q
- What are the PAC distances for RA, RV, Pulm art & wedge?
A
- RA: 20-25cm
- RV: 30-35cm
- Pulm art: 40-45cm
- Wedge: 45-55cm
28
Q
- What are the treatments for PAC rupture?
A
- PEEP
- oxygenation
- Reverse anticoagulation unless on bypass
29
Q
- What happens to the PAC waveform with MR?
A
- Tall V wave
- C & V waves fuse
- No X descent
30
Q
- What happens to the PAC waveform with MS?
A
- Slurred
- early Y descent
- Absent A wave
31
Q
- What happens to the PAC waveform with an acute LV infarct?
A
- Tall A waves.
- PAWP increases
32
Q
- What is the equation for SvO2?
A
SvO₂= SaO₂ – (VO₂ / Q x 1.34 x Hgb)
33
Q
- What are the normal ranges for SV, SVR, PVR & SvO2?
A
- SV: 60 – 90
- SVR: 800 – 1600
- PVR: 40 – 180
- SvO₂: 70-80
34
Q
- A change of ____ is significant in bolus thermodilution?
A
10%
35
Q
- What does thermodilution measure?
A
The right heart & assumes left heart
36
Q
- What is M mode on an Echo?
A
- Narrow beams to measure tissue planes.
- Ex: Ventricular mass
37
Q
- What is 2-D mode on an Echo?
A
- Real time motion
- shows function
38
Q
- What are the windows for TTE’s?
A
- Parasternal: 3-5 ICS.
- Apical: @PMI
- Subcostal: Just below xiphoid
39
Q
- What TTE view is great overall?
A
Parasternal Long axis
40
Q
- What TTE view is good for LV function & volume assessment?
A
Parasternal short axis
41
Q
- What TTE view is good for TV & MV function?
A
Apical four chamber
42
Q
- What TTE view is good to determine a pericardial effusion?
A
Subcostal four chamber
43
Q
- What TTE view is good to determine IVC collapsibility?
A
Subcostal IVC
44
Q
- What type of Echo is better to determine valve function?
A
TEE
