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Cardiology > Heart knows > Flashcards

Heart knows Flashcards

1
Q

Systematic approach

A
  1. rate, 2. rhythm, 3. P waves, 4. PRI, 5. QRS
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2
Q

Normal Sinus

A

All WNL

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3
Q

Sinus Tachycardia

A

All WNL but HR >100

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4
Q

Sinus Brady

A

All WNL but HR <60

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5
Q

Sinus arrhythmia

A

All WNL but is not in cadence

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6
Q

P wave:
Wandering atrial pacemaker:
Double hump morphology:
Sharp P morph/:

A

= Atrial depolarization
= dif/ pacemaker spots in atrium
= atrium ballooning or>1 firing
= pulmonale from R-atrium lungs

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7
Q

QRS complex:
T wave:
U wave:
QT segment:

A

= ventricular depolarization
= ventricular depolarization
= “late bloomer
= all ventricle’s action

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8
Q

RVR:
SVR:

A

= Rapid ventricular response
= Slow ventricular response

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9
Q

PRI:
ST segment:
P-T is:
RR:

A

= AV holding impulse for sync
= ventricular contraction
= 1 full cardiac cycle
= gives rate & rhythm

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10
Q

Rs 6sec strip method:
big box method:
Small box method:
Triplicate method:

A

= # of Rs x 10
= 1R to R BB#s then 300/BB#
= 1R-R SB#s then 1500/ SB#
= descend W/ SB 300, 150, 100, 75, 50, 43, 38

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11
Q

Atrial fibrillation:

A

= no P waves & irregularly irregular rhythm

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12
Q

WPW definer:
Name of assessory pathway:

A

= has delta wave “wave leaning into R wave”
= Bundle of Kent

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13
Q

Lown-Ganong) definer:
Pathway name & path:

A

= has short PRI interval
= Bundle of James connects posterior internodal pathway to bundle of his

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14
Q

Heart blocks are

A

blocks in AV node partial or complete
“Putting a rock or pebble on a cable”

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15
Q
  1. (Cardiac Pharmacology)
  2. NA Channel Blockers:
  3. Beta-Blockers:
  4. Potassium Channel Blockers:
  5. Calcium Channel Blockers:
  6. Miscellaneous:
A

1= (Vaugh-Will) Classes: 1]Na, 2]Beta, 3]K, 4]Ca, Misc] Adenosine
2= (Procainamide & Lidocaine) both Widened QRS & Prolongs QT
3= (Propranolol) Prolonged PRI & Bradycardias
4= (Amiodarone) Prolonged QT
5= (Diltiazem & Verapamil) Prolonged QT & Bradycardias
6= (Adenosine & Digoxin) Prolonged QT & Bradycardias

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16
Q

Propranolol, Labetalol, Metoprolol) class
Labetalol
Metoprolol

A

= class 2 Beta Blockers
= 2nd line med for SVT after Adenosine, A-fib/flutter w/RVR, Reduce myocardical ischemia in AMI PT’s w/elevated HR, Antihypertensive
= Hypertension, 2nd line med for A-Fib/A-Flutter w/ RVR, & SVT

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17
Q

(Procainamide & Lidocaine) class

A

= class 1A&B Na Channel Blockers
= Alterative to Amiodarone in cardiac arrest V-Fib/pVT, Stable monomorphic Ventricular TachyC w/ presserved LVF
= V-Tach with a pulse, pre-excitation rhythms (WPW) >50% QRS width

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18
Q

Amiodarone class & indication

A

Class 3 K channel blocker> VF/Pulseless VT unresponsive to shock, CPR & Epi, BradyCs to include AV blocks, Recurrent, hemodynamically unstable VT w/ pulse

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19
Q

(Diltiazem & Verapamil) class
Diltiazem
Verapamil

A

= class 4Ca channel blocker
= 1st line med for A-Fib/Flutter w/ RVR >150 bpm, 2nd line med for SVT
refractory to adenosine
= 2nd line med for A-Fib/Flutter w/ RVR. May use as alterative after adenosine, narrow QRS complex tachycardia w/ preserved LV fn.

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20
Q

Cardiac Output:
Cardiac Output Formula:
Blood Pressure formula:

A

= amount of blood pumped by the heart in 1 min (70mL)
= SV x HR
= (SV x HR) x SVR

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21
Q

(Refractory periods) Absolute:
Relative:

A

= end of P to apex of T wave- cells absolute Beginning of repolarization
= “some really could happen” lot of cells repolar but not all so can throw out of rhythm Commodo cordis

22
Q

Natural pacemaker of the heart is:
If SA Node failed to initiate a impulse, what is 1st back-up firing site?
If both SA & AV fails what is last firing site:

A

= SA node
= AV node
= Purjunkie

23
Q

DIgoxin for

A

heart failure usually fools refractory Na K pumps

24
Q

Orthodromic Re-entry loop:
Antidromic Re-entry loop

A

= Clockwise rentry conduction loop >narrow QRS
= counterclockwise reentry conduction loop > wide QRS

25
Q
  1. (A-Fib) know:
  2. Definer:
A

1= most common, only treated when >150BPM, more Js b/c more sites
2= No definite P waves, Totally Irregular

26
Q

Digoxin) Typically for:
Dynamics
works bc

A

= CHF
= allows more Ca for better contraction
= confuses K/Na pumps

27
Q

WPW) Orthodromic loop;
Antidromic loop:
Treatmeats:

A

= Clockwise reentry w/ narrow complex
= Counterclockwise reentry w/ wide QRS
= procainamide 1a Na blocker, (if no procain) sedate & cardiovert) cardioversion

28
Q

only condition A-Fib has cadence:

A

Afib w/ 3rd degree In rhythm “Gandalf dead so Atriums & Ventricles doing own thing

29
Q

!!Poiseuille’s law:

Example:

A

= vessel w/ relative radius of 1 would transport 1mL per min at BP difference of 100mmHg. Keep pressure constant
= Less blood = vaso-press

30
Q

Which coronary artery feeds the inferior wall of the heart?

A

Right Coronary Artery (RCA)

31
Q

Which coronary artery feeds the left lateral wall of the heart?

A

Left Circumflex (LCX)

32
Q

A blockage of which of the following would result in the entire left ventricle not receiving blood supply?

A

Left Main Coronary Artery (LMCA)

33
Q

The upward slurring of the isoelectric line after the P wave up into the QRS complex that is associated with Wolff Parkinson White Syndrome (WPW) is known as the:
The accessory pathway associated with Wolff Parkinson White Syndrome (WPW) is known as the:

A

= Delta wave
= Bundle of Kent

34
Q

Typically, we don’t attempt to control the rate of Atrial Fibrillation unless it is

A

above 150 per minute and the patient is presenting with signs and symptoms related to the rhythm.

35
Q

Before shocking someone:
since unstable, contraindicated meds:
since unstable, Indicated meds:

A

= Sedate em! sedate to keep pain away
= Sodium Thiopental, Propofol (Diprivan), Diazepam (Valium), Midazolam (Versed)
= Etomidate (Amidate (0.2-0.4 mg/kg), Ketamine (Ketalar(1-2mg/kg)

36
Q

Adenosine & Digoxin class & indication

A

class misc> Adenosine 1st line med for stable narrow complex SVT,
Regular & monomorphic wide-complex tachyC thought to be from a reentry SVT (SVT w/ BBB) Does not convert A-fib/flutter

37
Q

Water is contained in what 3 compartments in the human body? What are the percentages?

A

60% of body weight is water 45%=intracellular & 15% extracellular (outside cell)
Interstitial 10.5%
Intravascular 4.5%

38
Q

If you were administering isotonic crystalloid solutions, how much would move out of the intravascular compartment within 1 hour?

A

2/3s would move out

39
Q

What is hydrostatic pressure in the vascular system & what creates it?

What is oncotic pressure in the vascular system and what creates it?

A

=Pressure from heart in blood vessels & forces water to cross the capillary membrane into the interstitial space.
=Pulling water back into the blood vessels by the presence of large proteins in the blood (pulling back in)

40
Q

Med causing a direct increase in PSNS:
Med/ directly blocking the PSNS is:
Parts of heart innervated by PSNS:
Difference in agonist & antagonist:

A

= Parasympathomimetic
= Parasympatholytic
= AV & SA node
= Ag: stims & Ant: inhibits

41
Q

Ectopic foci:
Phases 0 & 3 of AP:

A

= abnormal impulse then is propagated throughout the heart
= Depolarization & Repolarization

42
Q

Phases 0, 1, 2, 3, 4 of CC: Phase0:

Phase1:
Phase2:

Phase3:
Phase4:

A

= depolarization Cell gap Junction rapid Na influx by an impulse gen/ed elsewhere in heart. Na then stops entering cell once inside +
= K slowly leaves cell slowly returning cell to normal negative charge
= “plateau” M contraction: Ca+ interrupts w/ influxing into cell. (M.s ussing Ca for contraction). This plateau phase slows repolarization
= Repolarization: cessation Ca influx & rapid K efflux
= Refractory & moving ions back to original seats for RP

43
Q

Oxy Dissociation Curve:
Bohr Effect:
Haldane Effect:

A

= H-globin “Train” taking & dropping oxy
= Acidotic with R-shift of hemoglobin w/ decrease oxy affinity
= Alkalotic w/ L-shift Loves oxy in Lungs

44
Q

Bohr Effect:
Influences by:
What does it do to hemoglobin:

A

= Acid> Hemoglobin droping oxy off in body
= + CO2, +temp, -pH+ BPG 2,3 in body
= -oxy affinity

45
Q

Haldane Effect:
Influences by:
What does it do to the hemoglobin?

A

= Alk> Hemoglobin Loves oxy in Lungs
= -CO2, -temp, +pH -BPG 2,3, in Lungs,
= +oxy affinity

46
Q

“Natural Pacemaker” of heart & firing rate:
“Gate-Keeper” of heart & firing rate:
Purkinje System inherent firing rate:
Electrical impulses get from right to L-Atrium via:

A

= SA Node 60-100
= AV Node 40-60
= 15-40
= Backman’s Bundle

47
Q

Equation for cardiac output:
Heart & SV volumes:

Equation for BP:
How can you make a + & - effect on it?

A

= CO= SV x HR
= usually squeezes 70mLs & heart holds 100-110mL
= BP=(SV X HR) X SVR
= Meds: diuretics, vaso-constructors

48
Q

Vaughn Williams Classification System:
Class I meds:
Class II meds:
Down regulation:
Never mix what w/ what b/c:
Class III meds:
Class IV meds:
Miscellaneous meds:

A

= Antiarrhythmic med classes by pharmacodynamics
= Sodium channel blockers
= Beta-Blockers
= takes away/blocks CA cells channels:
= Never mix Ca blocker w/ Beta blockers→ stops heart
= Potassium channel blockers “phase 3 K”
= Calcium channel blockers
= Miscellaneous EX Adenosine→ dif/ & adenosine receptors

49
Q

Beta-Blocker:
Cardio-Selective Beta-Blockers:–
Non-selective Beta-blockers:

A

= blocks β adrenergic receptors
= Atenolol, Esmolol, Metoprolol
= Propranolol, Nadolol, Labetalol, Sotalol.

50
Q

(Vaughn-Williams Antiarrhythmics) Procainamide & Lidocaine:
Aminodrone:
“lol” Labetalol:
Aminodrone:
Diltiazem:
Adenosine & Digoxin:

A

= Class I: Na Channel Blockers:
= Class 3: K+ Channel Blockers (“phase 3 repolar”):
= class 2 beta blockers
= class 4 Ca blockers
= miscellaneous

Cardiology (9 decks)

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