INTERVIEW Flashcards

1
Q

S1

A

Tricuspid & mitral valve closing

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2
Q

S2

A

Pulmonic and aortic valve closing

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3
Q

S3

A

CHF

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4
Q

Cardiac output determinants

A

Stroke volume & heart rate

CO=SV x HR

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5
Q

Cardiac index?

Normal values?

A

Ci= CO/BSA (body surface area)

2.5-4 L/min/m^2

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6
Q

Mean pulmonary artery pressure (pap) normal values?

A

16 mm Hg

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7
Q

Pulmonary artery systolic and diastolic

A

25/8

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8
Q

Pulmonary artery occlusion pressure (PAOP)

A

5-15 mm Hg

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9
Q

Where does the dista port of the PA catheter lie and how is this confirmed?

A

Pulmonary artery.

PA wave form and/or PAOP wave form

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10
Q

Mean arterial pressure (MAP)

A

[SBP x 2(DBP)]/3

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11
Q

Intra-aortic ballon pump (IABP)

A
  • Decreases after load
  • Decreases myocardial oxygen demand
  • increases coronary perfusion
  • limits size of infarcts/myocardial ischemia

Patient with cardiogenic shock or circulatory support

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12
Q

Sodium nitroprusside MOA:

A

Relaxes arterial/venous smooth muscle which decrease systemic vascular resistance AND preload

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13
Q

Sodium nitroprusside doses:

A

0.3-10 mcg/kg/min

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14
Q

What coronary artery would be occluded if STE was seen in leads II, III, and aVF

A

Right coronary

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15
Q

Why give morphine to MI patients?

A

Pain management and coronary vasodilation

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16
Q

Starling’s Law?

A

The greater the volume of blood entering the heart during diastole, the greater the volume of blood that will be ejected during systole

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17
Q

CVP monitoring: A Wave

A

Atrial contraction

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18
Q

CVP Monitoring: C wave

A

Tricuspid valve elevation during early ventricular contraction

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19
Q

CVP Monitoring: V wave

A

Venous return against a closed tricuspid valve

20
Q

Normal ICP

A

< 15

21
Q

Preferred drug to treat brain swelling: and dose:

A

Mannitol 0.25-1 g/kg

22
Q

Hyperventilation affect on cerebral vessels/blood flow

A
  • Constriction of cerebral blood vessels
  • decreases cerebral blood flow
  • decreases ICP
23
Q

Noninvasive ways to decrease ICP

A
  • maintain normoglycemia
  • maintain normothermia
  • suction ONLY when indicated
  • sedation
24
Q

Normal cerebral perfusion pressure (CPP)

Calculation?

A

CPP= MAP-ICP

50-150 mm Hg

25
Q

Cushing’s triad

A

Hypertension
Bradycardia
Irregular respirations

26
Q

Syndrome of inappropriate antidiuretic hormone (SIADH)?

A

Excessive reabsorption of water due to increased production of ADH

27
Q

Common causes of SIADH

A

Carcinoma of the lungs

Various head problems

28
Q

Roles of CRNA: pre-op

A

interview pt
establish rapport
review labs/medication
Determine type of anesthesia to deliver

29
Q

Roles of a CRNA: peri-op

A

Preform safe induction
Maintain anesthesia
Safe emergence
Meticulous scrutiny of pt and monitors

30
Q

Roles of CRNA: post-op

A

Adequate pain control

Monitor for post-op complications

31
Q

Alpha 1 & 2

A

A1 stimulation leads to constriction of vascular smooth muscle therefore ⬆️ PVD

A2 stimulation inhibits norepinephrine

32
Q

Beta 1 & 2

A

B1 stimulation ⬆️ heart rate, conduction velocity & contractility.

B2 stimulation relaxes vascular smooth muscle, skeletal muscle, and bronchial smooth muscle.

33
Q

Levophed

A

Alpha adrenergic affects and beta stimulation. Intensely contracts vascular …. including kidneys. Increases PVR.

34
Q

Propofol

A

Sedation not a pain reliever, it relaxes smooth muscles and can ⬇️ CO, contains disodium odetate to help retard microbial growth

35
Q

Cerebral perfusion pressure (CPP)

A

CPP= MAP - ICP

36
Q

Transducer level for ICP

A

Foreman of Monroe (top of ear and outer of eye)

37
Q

Transducer level for A-Line

A

3rd intercostal space, mid axillary line on phlebostatic axis

38
Q

Heart sounds with papillary rupture: right ventricle

A

Rupture of right ventricular pap muscle you get tricuspid regurgitate

39
Q

Heart sounds with papillary rupture: left ventricle

A

Mitral regurgitate.

if complete transaction occurs you get mitral regurgitate not compatible with life

40
Q

ST elevation in leads: V1, V2, V3, V4

A

Coronary: LAD

Part of heart: anterior/septal wall

41
Q

ST elevation in leads: 1, avL, V5, V6

A

Coronary: Circumflex

Part of heart: lateral wall

42
Q

ST elevation in leads: II, III, avF

A

Coronary: right coronary

Part of heart: inferior wall

43
Q

ST elevation in leads: V1, V2

A

Coronary: right

Part of heart: posterior wall

44
Q

ST elevation in leads: V3R, V4R, V5R, V6R

A

Coronary: right

Part of heart: right ventricular wall

45
Q

SAo2 vs PAo2

A

SAo2- percentage of hemoglobin molecules that are bound to oxygen molecules in the blood.

PAo2- measures O2 in the blood