General 1 Flashcards

1
Q

Vitamin B-12 aka

A

cobalamin

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2
Q

what vitamin is Folic Acid

A

B9

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3
Q

COMPASS study - anacronym means ?

A
Cardiovascular 
Outomes for 
People 
Using
Anticoagulation 
Strategies
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4
Q

COMPASS study LIMA failure rate

A

6.4% at one year

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5
Q

COMPASS study Radial artery failure rate

A

9.9% at one year

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6
Q

COMPASS study - SVG failure rate at one year

A

10.4%

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7
Q

COMPASS Study - RIMA failure rate at one year

A

26.4%

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8
Q

COMPASS study - LIMA patency is related to

A

Target vessel stenosis

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9
Q

COMPASS study - 1 year SVG patency is related to

A

Target vessel quality and proximal location

composite or sequential had worse patency than direct to the aorta

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10
Q

Definition of vasoplegia

A

unified definition
if they had following conditions for at least three consecutive hours during the first 48 h after ICU arrival:
*a vasodilation criterion: *
1. MAP ≤50 mmHg or SVR ≤800 dynes·s·cm− 5;
* hemodynamic criterion: *
1. CI ≥ 2.5 l·min− 1·m− 2;
*high vasopressor requirement:**
use of norepinephrine ≥200 ng·kg− 1·min− 1 or equivalent doses of vasopressors (epinephrine ≥200 ng·kg− 1·min− 1; dopamine ≥30 μg·kg− 1·min− 1; phenylephrine ≥2 μg·kg− 1·min− 1, or vasopressin ≥0.08 U·min− 1)
proposed in the ATHOS-3 trial
**

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11
Q

The estimated annualized rate of sudden death for asymptomatic patients with severe AS is?

A

The estimated annualized rate of sudden death for asymptomatic patients with severe AS is 1% per year

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12
Q

operative mortality associated with sAVR in patients aged <70?

A

Operative mortality associated with sAVR
age < 70: 1%–3%
age > 70: 3%–8%

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13
Q

operative mortality associated with sAVR in patients > 70 years?

A

operative mortality associated with sAVR in patients
> 70 years: 3%–8%

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14
Q

Indications for sAVR in aysmptomatic AS patients with low surgical risk ?

A

Vmax presenting a low surgical risk (class IIa recommendation)
≥5 m/s in US guidelines
>5.5 m/s in European guidelines

Finally, the latest European guidelines add:
* markedly elevated brain natriuretic peptide (BNP) levels
* severe pulmonary hypertension at rest (systolic pulmonary artery pressure >60 mm Hg)

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15
Q

Other parameters validated as strong predictors of poor outcome in asymptomatic severe AS?

might represent incentives for AVR referral:

A

indexed stroke volume by Doppler echocardiography
* <30mL/m2)
LVEF
* between 50% and 55%,
left atrial enlargement
* left atrial volume >95mL or
* indexed left atrial volume >50mL/m2in patients in sinus rhythm).
*

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16
Q

Indicators of very severe aortic stenosis

A

Peak aortic jet velocity: >5m/s
MTAPG: > 60 mmHg
AVA: 0.6 cm 2
Indexed Aortic valve area :
0.4 cm/m2 (BSA)
0.45 cm/m (height)
Dimensionless index: < 0.2

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17
Q

Dimensionless index for
1. Severe AS
2. Very severe AS

A

Severe AS: <0.25
Very severe AS: <0.2

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18
Q

Peak aortic velocity for Very severe AS

A

> 5m/s

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19
Q

MATPG for very severe AS?

A

> 60 mmHg

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20
Q

Mean AVA for very severe AS ?

A

< 0.6 cm 2

21
Q

severe aortic stenosis

Indexed aortic valve area

A

0.4 cm2/m2
0.45 cm2/m

22
Q

B vitamin for vasoplegia

A

hydroxocobalamin

23
Q

mechanism of action for

hydroxocobalamin

for Vasoplegia

A

free NO scavenger (similar to methelene blue)

24
Q

Vasoplegia

Dose for hydroxocobalamin

A

2 mg/kg bolus
* one of the patients receiving an additional 0.5 mg/kg/hr for 6 hours

25
Q

what level of Bilirubin is associated with jaundice

A

2.5-3 mg/dl

26
Q

louche

A

disreputable or sordid in a rakish or appealing way.
“the louche world of the theater”
louche
/lo͞oSH/
adjective
adjective: louche; comparative adjective: loucher; superlative adjective: louchest

27
Q

tel·e·o·log·i·cal

A

/ˌtelēəˈläjəkəl/
adjective
PHILOSOPHY
relating to or involving the explanation of phenomena in terms of the purpose they serve rather than of the cause by which they arise.

28
Q

heu·ris·tic
/hyo͝oˈristik/

A

heu·ris·tic
/hyo͝oˈristik/
adjective
1.
enabling someone to discover or learn something for themselves.
“a “hands-on” or interactive heuristic approach to learning”
2. COMPUTING
proceeding to a solution by trial and error or by rules that are only loosely defined.

29
Q

Epistemology —

A

Epistemology — The theory of knowledge. The method of what distinguishes belief from opinion.

30
Q

Cardiac power output

A

MAP x CO/451
Shock < 0.6W

31
Q

Cardiac power index

A

MAP x CI / 451
Shock < 0.4 W/m2

32
Q

Description of SCAI A shock

A
  • At Risk
    not currently experiencing signs or symptoms of CS
    at risk for its development.
    may include:
    those with large acute MI or prior
    MI and/or acute on
    chronic heart failure symptoms.
33
Q

Description of Physical Exam

SCAI A Shock

A

Normal JVP
Lung sounds clear
Warm and well perfused
* Strong distal pulses
* Normal mentation

34
Q

Descripton of SCAI A biochemical markers

A

Normal labs
* Normal renal function
* Normal lactic acid

35
Q

SCAI A
Hemodynamics

A

Normotensive (SBP≥100 or
normal for pt.)
If hemodynamics done
* cardiac index ≥2.5
* CVP <10
* PA sat ≥65%

36
Q

Fried Frailty

A
  1. Weight loss
  2. Exhaustion
  3. Low Physical activity
  4. Slowness (gait speed )
  5. Weakness
37
Q

VT Storm

A

cardiac electrical instability characterized by: multiple episodes of ventricular tachycardia (VT storm)
ventricular fibrillation (VF storm)
within a relatively short period of time, typically 24 hours

38
Q

Clinical Signs and symptoms of RHF

A
  1. Positive JVD
  2. Peripheral Edema
  3. Bloating/Ascites
  4. Fatigue
  5. Bilirubin elevation
  6. Creatinine elevation
  7. Lactate elevation
39
Q

Hemodynamic criteria for RHF

A

 Decreased systolic pressure <90 mmHg
 Cardiac index <2.2 L/min/m²
 CVP >15 mmHg
 RAP/PCWP >0.8
 PAPi <1.5
 Decreased SvO2 <60%
 Mean PA >20 mmHg

40
Q

RAP/PCWP indicative of RHF

A

RAP/PCWP >0.8

41
Q

Mean PA pressure indicative of RHF

A

Mean PA >20 mmHg

42
Q

systolic pressure indicative of right heart failure

A

systolic pressure <90 mmHg

43
Q

PAPi indicative of right heart failure

A

PAPi <1.5

44
Q

Quantitative ECHO signs consistent with RHF

A

 TAPSE <17 mm
 RV basilar diameter >42 mm
 RV mid-cavity diameter >35 mm
 Global hypokinesis
 IVC evaluation >2.5cm
 Septal bowing into LV
 Tricuspid regurgitation

45
Q

TAPSE consistent with right heart failure ?

A

 TAPSE <17 mm

46
Q

RV basilar diameter consistent with right heart failure ?

A

RV basilar diameter >42 mm

47
Q

RV mid-cavity diameter consistent with right heart failure ?

A

RV mid-cavity diameter >35 mm

48
Q

 IVC diameter consistent with right heart failure ?

A

 IVC evaluation >2.5cm

49
Q

PAPi consistent with RHF in an LVAD supported patient

A

 PAPi <1.85