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Cardiopulmonary > General Cardiopulmonary > Flashcards

General Cardiopulmonary Flashcards

1
Q

Name 3 modifiable risk factors for cardiopulmonary disease.

A

Smoking
Hypertension
High Cholesterol
Physical Inactivity

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2
Q

Name 3 non-modifiable risk factors for cardiopulmonary disease

A

Genetics
Male sex
Aging

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3
Q

Reduced circulating red blood cell mass relative to an individual’s gender and age. Results in impaired RBC production and could be due to dietary deficiency

A

Anemia

  • Can have hemolysis
  • Can be caused by chronic inflammation, neoplasms, bone marrow diseases
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4
Q

S/S of this sided heart failure(left or right) secondary to pulmonary congestion includes: dyspnea, dry cough, orthopnea, wheezing, pulmonary edema, cyanosis, diaphoresis, tachycardia.

A

Left ventricular failure

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5
Q

S/S of this sided heart failure(left or right) secondary to low cardiac output include: hypotension, tachycardia, dizziness, fatigue, peripheral hypoperfusion

A

Left ventricular failure

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6
Q

T/F S3 heart sound can be heard with left ventricular failure

A

True- ventricular gallop

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7
Q

T/F S4 cannot be heard with left ventricular failure

A

False- 4th heart sound is atrial gallop, can sometimes be heard

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8
Q

What is the most common cause of R ventricular failure?

A

Left ventricular failure

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9
Q

This sided lung failure involves the following s/s:

Jugular vein distention, fatigue, weight gain, ascites, dependent edema, increased venous peripheral pressure

A

Right sides ventricular failure

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10
Q

Cor pulmonale is another name for:

A

Right ventricular failure

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11
Q

Would you heard S3 or S4 with right sided heart failure?

A

S3

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12
Q

Which side, right or left, presents with more of a pulmonary presentation?

A

Left: orthopnea, wheezes, cough, tachpnea, dyspnea,

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13
Q

Define orthopnea

A

SOB/dyspnea relieved with upright position

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14
Q

Define paroxysmal nocturnal dyspnea

A

SOB that awakens you from your sleep often in conjunction with heart failure

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15
Q

Patient presents with dyspnea, rales, jugular venous distention, peripheral edema, and fluid in the lungs. What could they have?

A

CHF

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16
Q

The following are all symptoms of CHF except:

a. paroxysmal nocturnal dyspnea
b. weight gain
c. pulsus alterans
d. sinus bradycardia
e. peripheral edema

A

D. Sinus bradycardia

Will have sinu tachycardia

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17
Q

What heart sound indicated a non-compliant left ventricle?

A

S3

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18
Q

What heart sound is associated with CHF, left ventricular failure, and right ventricular failure?

A

S3

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19
Q

Described as tightness, indigestion, pressure in chest that diminishes with rest or nitroglycerin

A

Classic Stable Angina

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20
Q

Female patient enters clinic with c/o nausea, indigestion, discomfort between the shoulder blades and excessive fatigue. It is possible she had:

a. CHF
b. Heartburn
c. Prinzmetal Angina
d. Stable Angina
e. Pericarditis

A

D. Stable angina

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21
Q

Patient presents with chest discomfort that changes in frequency and severity. He reports he has had this pain while sitting down. What type of angina may he have?

A

Unstable Angina, not responsive to nitroglycerin

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22
Q

You read a ECG and see an elevated ST segment. The patient states the pain in his chest is most prevalent in the morning and does not precede activity(increase in myocardial O2 demand). What type of angina may he have?

a. Stable
b. Unstable
c. Prinzmetal

A

C. Prinzmetal- does not occur during predictable level of activity

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23
Q

This type of angina occurs during a predictable level of activity and often associated with an increase in myocardial O2 demand?

A

Stable

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24
Q

Patients pain appears at rest and worsens with activity. Does not respond to nitroglycerin but does respond NSAIDS.

A

Pericarditis- not relieved with rest of NTG

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25
Q 
Patient has pain/discomfort that is increased with palpation over the chest wall. What 
might he have?
a. pericarditis
b. chest wall pain
c. pleuritic pain
A

chest wall pain- MSK in nature

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26
Q

Patient has pain or discomfort with changes of breathing. This pain may be:

a. pleuritic
b. chest wall apin
c. pericarditis

A

pleuritic

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27
Q

Patient experiences SOB and chest pain with activity that increases in extreme cold whether. Patient requires a bronchodilator or to stop exercises. What might they have?

a. pleuritic pain
b. bronchospasms
c. peircarditis

A

b

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28
Q

Chest pain described as substernal pressure that can refer to right or left arm, jaw, cervical spine, or between shoulders

A

Angina

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29
Q

Unstable angina is also called:

A

Acute Coronary Syndrome/ Acute Myocardial Infarction - chest discomfort accelerating in frequency or severity

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30
Q

Angina is often a precursor to what major cardiac dysfunction?

A

Heart attack- prolonged symptoms can lead to this, lightheadedness, and squeezing pressure sensation.

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31
Q

What happens to SV, HR, and CO for a hypertensive patient performing exercises?

A

Increased SV, decreased HR, decreased CO

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32
Q

Exercise is beneficial for HTN patient because it decreased Systolic, Diastolic, or Both?

A

Both

33
Q

At what Systolic BP should you terminate exercises?

A

SBP >250

34
Q

At what Diastolic BP should you terminate exercises?

A

DPB >115

35
Q

Orthostatic HTN occurs when SBP drop more than ___ and DBP drops more than ___

A

20, 10

36
Q

Normal BP

A

<120/<80

37
Q

Prehypertension BP

A

120-139/80-89

38
Q

HTN Stage 1 BP

A

140-159/90-99

Thiazide diuretics, ACE inhibitor, angiotensin II, Beta blocker, CCB

39
Q

HTN Stage 2 BP

A

> 159/>99

Two drug combo

40
Q

Disease where there is a destruction of pancreatic beta cells, decreasing ability to create insulin

A

Type I DM

41
Q

Disease where hyperglycemia causes insulin resistance and progressive decline in beta cell function.

A

Type II DM

42
Q

Function of insulin

A

Suppresses glucose production by the liver and promotes glucose transport across the cell membrane

43
Q

Major concern while DM patient exercises

A

Hypotension, hypglycemia

44
Q

Exercises benefits DM patient by providing:

A

glycemic control

45
Q

What intensity should a DM patient with mild-mod hyperglycemia perform their exercises?

A

Low-mod intensity exercises increases glucose uptake

46
Q

Which type of DM would have a higher concern for hypoglycemia?

A

Type 1

47
Q

T/F Insulin should be injected near the exercising muscle to decrease hypotension during exercise..

A

False, avoid being near the exercising muscle

48
Q

Frequent urination, dry mouth, increased thirst, and weakness are S/S of what?

A

Hyperglycemia

49
Q

Increased hunger, flue like aches, HA, and blurred vision are S/S of what?

A

Hyperglycemia

50
Q

Facial flushing, dry skin, N/V, abdominal pain, deep rapid breathing and coma are S/S of what?

A

Ketoacidosis

51
Q

This organ controls extracellular fluid volume, electrolyte and acid balance and secretion of hormones

A

Kidneys

52
Q

Impairment of glomerular filtration results in ____ insufficiency

A

renal/kidney

53
Q

Patient on dialysis for kidney dysfunction is more likely to ave right or left sided heart problems?

A

Left ventricular problems

54
Q

What is the treatment of ESRD?

A

Hemodialysis- leads to pulmonary complications(decreased arterial PA02)

55
Q

Name that Stage!

Kidney Failure

A

Stage 5, GFR <15

56
Q

Name that Stage!

Severely decreased GRF

A

Stage .4. GRR 15-29

57
Q

Name that Stage!

Kidney Damage with normal or increased GFR

A

Stage 1, GFR >90

58
Q

Name that Stage!

Kidney damage with mildly decreased GFR

A

Stage 2, GFR 60-89

59
Q

Name that Stage!

Moderatley decreased GFR

A

Stage 3, GFR 30-59

60
Q

GFR for the differing kidney stages increases by what each stage? And how many stages are there for kidney disease?

A

5 stages, 30 each time

61
Q

Exercises compliance is highest when sessions are performed _____ the dialysis treatment?

a. a day before
b. during
c. a day after
d. right before

A

During

62
Q

T/F PVD and PAD are normally used interchangeably

A

True

63
Q

Name major S/S of PAD

A

 Painful walking (intermittent claudication)
 Elevated foot develops increased pallor
 Venous filling developed following foot elevation
 Redness of distal limb (dependent rubor)
 Death of tissue (gangrene)

64
Q

Should the intervals of exercises be short or long with PAD patients?

A

Short: 1-5 minutes with rest periods

65
Q

Normal prothrombin time and what it is

A

11.6-13 seconds, time it takes to form a clot

66
Q

A high INR woul indicate:

A

Thinner blood

67
Q

A low INR would indicate:

A

Thicker blood

68
Q

Normal INR:

A

<1.1

69
Q

Therapeutic range for INR:

A

2.0-3.0 for people of Warfin(to prevent venous thrombus or PE)

70
Q

Normal troponin level

A
71
Q

Troponin of >.4 indicates

A

Diagnostic for MI(acute, recent, or evolving)

72
Q

Name 3 contraindications for exercise:

A

• Contraindications to low level testing
o Unstable angina or angina at rest
o Severe heart failure (overt left ventricular failure on exam with pulmonary rales and S3 heart sound)
o Serious arrhythmias at rest
o Second or third degree heart block
o Disabling musculoskeletal abnormalities
o Valvular heart disease
o BP > 180/105 mmHg
o Pt refuses to sign consent form
• Absolute contraindications to exercise testing
o Recent MI
o Acute pericarditis or myocarditis
o Resting or unstable angina
o Serious ventricular or rapid arterial arrhythmias
o Tachycardia a-fib
o Unrelated second or third degree heart block
o Any acute illness
• Relative contraindications
o Aortic stenosis
o Known left main coronary artery disease
o Severe HTN
o Idiopathic hypertrophic subaortic stenosis
o Severe depression of ST segment on resting ECG
o Compensated heart failure

73
Q

Beta blockers, CCB, nitrates are all considered what type of drug?

A

Anti-ischemic

74
Q

o Event – closing of tricuspid and mitral valve
o Corresponding event – onset of ventricular systole
o Location to auscultate – tricuspid ( 4th and 5th intercostal space, L sternal border) mitral (L 5th intercostal space midclavicular line)
o Best heard with – diaphragm

A

S1

75
Q

o Event – closing of the aortic and pulmonic valves
o Corresponding event – start of ventricular diastole
o Location to auscultate – aortic (2nd intercostal space at R sternal border) pulmonic (2nd intercostal space at L sternal border)
o Best heard with – diaphragm

A

S2

76
Q

Event – possible CHF indicative of ventricular dysfunction
o Corresponding event – early diastole
o Location to auscultate – apex of the heart (pt L sidelying 45 deg forward)
o Best heard with – bell
Abnormal
Ventricular gallop

A

S3

77
Q

Abnormal
atrial gallop
o Event – increase resistance to ventricular filling
o Corresponding event – late diastole (just before S1)
o Location to auscultate – apex of the heart
o Best heard with – bell

A

S4

78
Q

Best heard at erb’s point – 3rd L intercostal space

A

murmurs

Cardiopulmonary (8 decks)

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