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The Big One > General Cardiopulm > Flashcards

General Cardiopulm Flashcards

1
Q

where is S1 and S2 best heard

A

S1: mitral area
S2: aortic area

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2
Q

compare and contrast murmers vvs. gallops

A

murmers: turbulent blood flow often through incompetant valvues

Gallop = S3 and S4
S3: flappy ventricle/poor compliance - CHF or normal in healthy young

S4: stiff atrium /exaggerated atrial contraction - MI, HTN

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3
Q

amplitude of pulse is on what number scale

and name them

A

0-4+ so 5 point scale

0: absent
1+: thready
2+: weak 
3+ normal 
4+ bounding
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4
Q

where do you assess posterior tib pulse?

A

just posterior to medial mal

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5
Q

name two reasons reasons for unilateral edema

two reasons for bilateral edema

A

unilateral: DVT, lymphadema
bilateral: CHF, liver failure etc.

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6
Q

Chest pain is unlikely to be angina if it changes with

  • deep breathing
  • jt movement or palpation
  • position changes

what would those above be indicative of individually if their action changed chest pain

A

deep breathing: pleural, pulmonary or chest wall sources

jt movement or palpation: MSK

position changes: pleuritis

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7
Q

what is orthopnea

A

difficulty breathing when supine

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8
Q

what is platypenea

A

difficulty breathing when upright

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9
Q

BORG dyspnea scale is a ____ point scale

what is the most out of breath on the scale?

A

11 point scale

goes from 0-10: 10 is maximally dyspnic

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10
Q

where on dyspnea scale would someone fall who is too dyspnic to leave the house?

A

4!!! which sounds little but thats where the scale is

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11
Q 
inspiratory mms training dosing
\_\_\_\_\_% of \_\_\_\_
Intensity of \_\_\_ on RPE scale (both 10 and 20 scale)
How many sets
How many minutes each
How do you progress intensity each week?
A

60-70% of max inspiratory pressure

RPE: 5-6/10, 12-13/20

7 sets

2 minutes each

progress by 5% intensity each week

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12
Q

Name the four main breathing exercises to control dyspnea

A

Breathing control
Pursed lip breathing
Blow as you go
Paced breathing

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13
Q

Name the four main breathing exercises to increase ventilation

A

Deep breathing/thoracic expansion
Stacked breathing
Incentive Spirometry
Inspiratory mms training

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14
Q

What are the 4 parts to active cycle of breathing

A

breathing control
thoracic expansion
Forced expiration/huff
COUGH

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15
Q

true or false active cycle of breathing can be performed in postural drainage position

A

true!

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16
Q

what are some disadvantages of active cycle of breathing?

A

congnition must be in tact, may not be great for children

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17
Q

what can the trandelenburg position result in that you need to be aware of

A

desaturation

also look out for elevated ICP etc.

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18
Q

dosing for percussion
total time per lung segment ____
___ at a time

A

total time: 5 minutes

1 minute at a time

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19
Q

what do you do after the percussion part of postural drainage

A

vibration during expiratory phase until cough produced

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20
Q

Eucapnia is what

A

normal level of CO2 in arterial blood

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21
Q

Balloon catheter is also known as what

what is its purpose

A

Swan-Ganz: in pulmonary artery to obtain pulmonary artery wedge pressure and L atrial pressure

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22
Q

Thermodilution measures what

A

CO

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23
Q

Central venous pressure line (CVP) measures what

A

pressure in vena cava

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24
Q

V/P scan most commonly used when

A

diagnosis of PE

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25
Q

Name the four classes of antiarrhythmics

Which is thought to be the most effective antiarrhythmic

A

1) BB
2) Calcium channel blocker
3) Potassium channel blocker
4) Sodium channel blocker

POTASSIUM MOST EFFECTIVE: due to blocking both potassium and sodium channels

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26
Q

What class of drug is lidocaine

A

Sodium channel blocker for arrythmias

27
Q

What class of drug is amidarone

A

Potassium channel blocker for arrythmia

28
Q

What class of drug is ditiazem

A

calcium channel blocker for arrythmia

29
Q

what two things are positive inotropic agents used for

A

heart failure and atrial fib: increases force and velocity of contraction, slows heart rate and decreases conduction velocity through AV node

30
Q

what are urokinase and alteplase used fr

A

thrombolytic agents: clot dissolution

31
Q

PRIL
PINE
SARTAN

A

PRIL: ace inhibitor
PINE: CCB
SARTAN: ARB

32
Q

what is leukotriene medication used for, potential side effects?

A

anti-inflammatory/corticosteroid

liver dysfunction

33
Q

bronchodilators used most often with what two patients

A

COPD

asthma

34
Q

what should you as a PT keep in mind with mucolytic agents

how are they administered

A

administered through nebulizer

Airway clearance within one hour of ttx

35
Q

Is 1 or 4 better on angina pain scale

better

A

1: mild
2: moderate bothersome
3: moderately severe
4: worst ever

36
Q

what ABI indicates moderate blockge and is associated with intermittent claudication during exercise

A

.4-.79

lower than .4 = severe may be at rest

ALL INDICATES PAD

37
Q 
Normal HTN
Elevated HTN
stage I HTN
stage II HTN
Hypertensive crisis
A 
Normal: <120 AND <80
Elevated 120-129 AND <80
stage one: 130-139 OR 80-90
stage two: at least 140 OR at least 90
Hypertensive crisis: >180 and/or >120 DBP
38
Q

Stridor indicates what condition

what does it sound like

A

upper airway obstruction

high pitched wheeze

39
Q

atrial flutter
vs.
atrial fibrillation

BPM

A

flutter: 250-350pbm
Fib: 350-600bpm

40
Q

no P waves = what

A

a fib

41
Q

saw tooth P waves = what

A

a flutter

42
Q

PR interval longer than .2seconds = what

A

1st degree AV block: doesn’t have to have sxs

43
Q

Mobitz type I/Wenckenbach

Mobitz type II

are both types of what
which is less dangerous

A

2nd degree AV block

type I is less dangerous

44
Q

progressive prolongation of PR interval until one impulse is not conduced is called what

A

mobitz type I or Wenchenbach; grade 2 AV block

less serious than mobitz type II

45
Q

Consecituve PR intervals followed by nonconcuction of one or more impuses is called what

A

mobitz type II; grade 2 AV block

more serious

46
Q

what degree of AV block is emergent?

A

3: all impulses are blocked at AV node so nothing gets to ventricles

47
Q

what does a PVC look like on ECG

A

absent P wave

wide and bizarre QRS

48
Q

3 or more consecutive PVC at >150 bpm is what?

can lead to what?

A

ventricular tachycardia

can lead to ventricular fibrillation

49
Q

Explain v-fib

A

quivering, no CO

Need immediate defibrillation

50
Q

What is ventricular astytole

A

flat line, CPR

51
Q

ST segment depression(1-2mm) is a sign of what three things

A

digitalis toxicity
hypokalemia
subendocardial ischemia

52
Q

what is a Q wave indicitive of

A

MI

53
Q

T wave inversion occurs days after MI due to delay in repolarization, CVA, left and right bundle branch blocks
but when does it happen normally

A

can happen in children and some adults benign.

54
Q

normal HR for

infant
child
adult
bradycardia
tachycardia
A

infant: 100-130
child: 80-100
adult: 60-100
bradycardia: <60
tachycardia: >100

55
Q

Volume or amplitude of pulse is on a scale. what is the scale

A

3+: large or bounding
2+: normal
1+: small
0: absent

56
Q

name the 6 major obstructive respiratory diseases (not including COPD itself)

A

emphysema, chronic bronchitis, asthma, cystic fibrosis, bronchiectasis

57
Q

obstructive disease hallmark is FEV1/FVC of what %

A

<70%

58
Q

what is rate pressure product (RPP)

A

myocardial oxygen consumption and coronary blood flow giving you an easy way to know when angina pectoris or ECG changes are coming in pts with heart disease.

RPP = HR x SBP (because this is a huge number you’ll normally see the value ___x10 to the 3rd

59
Q

what do you use RPP for

A

guide exercise prescription in individuals with heart disease/angina pectoralis

60
Q

on the 20 RPE scale, what correlates to ~70% of max HR

what is the upper limit of prescribed initial cardiac rehab on 20 point RPE scale

A

13-14

11-13

61
Q

What % do you begin threshold inspiratory mms trainer at

How long at treatment sessions

how many times a day

how do you progress

A

30-40% (same)

5-15 minutes

2-3x a day

40-60% MIP over 4-6 weeks

62
Q

What % do you start PFLEX inspiratory mms trainer at

how many minutes and times a day

how do you progress

A

30-40% (same)

10-15 minutes daily
increasing to 20-30 minutes 3-5x a week

Once they can tolerate 30 minutes at a level, increase resistance

63
Q

Name the related diagnosis and sputum descriptors

  • frothy
  • bloody
  • purlulent
  • mucoid
A
  • frothy: pulmondary edema
  • bloody: tuberculosis
  • purlulent: abcess in lungs
  • mucoid: asthma
64
Q

side effect of corticosteroid having to do with cardiopulm

A

increased blood pressure: others are mms wasting, OP, skin breakdown, cataracts, adrenocorticosupression, hyperglycema

The Big One (18 decks)

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