Know It! Pt.2 Flashcards
LV angiogram is also known as what three other words ?
1.Ventriculography
2. Selective angiography
3. Angiocardiography
Ventriculography is a.k.a?
Angiography
What is the best Cath Lab technique for LV function?
Using an LV angiogram
What 5 things can angiography measure in the LV and blood vessels?
-vessel narrowing
-Regurgitation
-Shunts
-EF
What is the fick method?
A method used to measure O2 consumption in the Cath Lab
How does the fick method measure O2 consumption in the Cath Lab?
O2 consumption /divided by the difference in O2 content between arterial and pulmonary systems
What’s oximetry?
Measuress O2 saturation in various chambers and can detect shunts by O2 changes
How is a shunt size calculated?
By the difference between the pulmonary and systemic blood flow
Pulmonary capillary wedge pressure comes from what kind of catheter?
Swan-Ganz
AS is usually asymptomatic until what aortic valve area?
<1cm
What is a normal aortic valve area?
3-4cm
What’s a moderate mild and severe aortic valve area?
3-4normal
Mild- >1.5
Mod - 1.5-1 five
Severe - <1
In the Cath Lab, they can determine aortic stenosis by placing catheters where?
1 in the LV and 1 in the aorta with two separate sensors
What is the key difference between fundamental imaging and harmonic imaging?
Fundamental imaging- send and receives at the same frequency
Harmonic Imaging - transmits one frequency and receives at the 2nd harmonic (twice the transmit frequency)
What results in thicker valve leaflets ?
A) High Gain
B) fundamental Imaging
C) low wall filter
D) harmonic Imaging
D
With Echo contrast agents bubbles are ____than red blood cells
Smaller
Echo contrast agents cross the ____ circuit
Pulmonary
When should an echo contrast be used for left ventricular opacification?
A) all segments can be seen
B) when 1 segment cannot be seen
C) when two more segments cannot be seen
D) none of the above
C
Apical swirling of echo contrast is can be caused by what 2 things
A high MI
Amount of contrast injected is too low
Attenuation of contrast being pushed all the way to the Apex can be caused by what two things?
Too much contrast was injected
Contrast was injected too fast
Should you use extension cords for electrical safety when scanning patients?
No this is not safe
You should inspect your ultrasound systems?
A) monthly
B) routinely
C) monthly
D) every 2 years
B
During an EKG, what should be grounded the patient or the machine?
The machine
In what year did Congress Pass HIPAA?
1996
What does HIPAA stand for?
Health insurance, portability, and accountability act
Sonographers should do peer to peer reviews. How often for quality?
Two times a month
Whose responsibility Is it to obtain the informed consent prior to a TEE?
The physician
Can sonographers interpret exams to the patient?
No
When moving the patient in the wheelchair, make sure the ___ engaged and the foot rests are ___
Brakes; retracted
Always keep a urinary drainage bag ___ the ____
Below; bladder
Or else if it’s above the bladder urine can collect and regur back into the bladder
What is the difference between sterilization and disinfection?
Sterilization eliminates, all agents, good and bad
Disinfection eliminates only those organisms that can cause disease
What is an opportunistic infection?
Bad bacteria that was being controlled multiplies and causes harm to the host
What is the preferred principle for sterilization?
Heat and pressure
What kind of sterilization method is an auto clave?
Heat sterilization
Auto cleaves use_____ to heat up
Steam
At what temperature is an autoclave heated to?
121°C or 250°F
What pressure is a autoclave at?
15 PSI or 103 kPa
How long should an auto clave run for effective sterilization?
15 minutes
Can chemicals also be used for sterilization?
Yes
Although the sterilization is the most effective way to destroy agents. Why is it not always appropriate?
Because the degree of heat can destroy objects such as a fiber optics, electronics and plastics
What is Ethylene oxide?
A gas used to sterilize objects that cannot survive past 60°C like a plastics, fiber optics and electric
What is another option of sterilization if he sterilization is too harsh for certain objects?
Ethylene oxide gas
Aseptic means?
Without organisms
What is meant by a aseptic technique?
A practice that reduces post procedure infections by decreasing the likelihood that organisms will enter during clinical procedures
Aseptic technique is just ensuring a sterile field during procedures
The sterile field should be draped starting from the area ___ to the person and then ____ outwards
Closest; extended
Is it OK to allow sterile personnel to reach across
unsterile areas or hand them under sterile objects?
No
Chest compressions should be how many inches deep?
2inch
PIM stands for?
Potentially infected material
What is the first thing you should do when cleaning up a blood spill?
Mark the area so that others do not enter that area until cleanup is complete
What are the percentages and parts of a good true disinfectant?
10% bleach solution
One part bleach, nine parts water
When cleaning up a blood spill, he should soak the area for at least ___minutes with the ____% disinfectant solution
20minutes; 10% bleach
When cleaning up a blood spill at least ___ minutes for the disinfectant to completed the decontamination
20minutes
True or false -goggles cannot be disinfected and reused. They must be thrown away.
False
___% of AV calcific/degenerative stenosis starts off as____?
50%; Bicuspid AV
How common in bicuspid congenital valve?
1-2%
What’s a secondary finding of AS?
LVH
AS can be caused by ____valvuar & ____valvuar obstructions?
Supra and sub valvuar
AS causes ?
A) LV dilation
B) Diastolic pressure overload increase
C) LA dilation
D) systolic pressure overload increase
D
AS causes ____ pressure overload which leads to ____
Systolic; LVH
AS causes increased ____ pressure in the LV. This ends up causing increased ___ pressure in the ___
Squeezing; diastolic; LA
What’s it called when there is valvular thickening but no hemodymanic gradient?
Aortic sclerosis
What are symptoms of AS?
- syncope
-sudden death
-angina - Dyspena
AS murmur is?
Harsh systolic ejection murmur RSB crescendo -descendo
AS murmur had a decreased or absent ?
A2 meaning a valve doesn’t move
With AS what can occur in the carotids?
Delayed or decreased carotid upstroke due to sentosed AV with a bruit/thrill
With AS there’s post stenotic ____ of the aorta
Dilation
Mild, mid, severe AV jet velocity ?
Mild- 2.6-2.9m/sec
Mod- 3.0-4.0 m/sec
Severe - > or equal to 4m/sec
Mild, mid & severe Mean gradient for AS?
Mild - < 20mmhg
Mod- 20-40mmhg
Severe - > or equal to 4mmhg
What’s the calculation for the AV dimensionless index?
LVOT VTI / AV VTI
What’s the mild, mod & severe dimensionless index for the AV?
Mild- > 0.50
Mod- 0.50-0.25
Severe - <0.25
A patient had AS. The jet velocity is 2.7m/sec and how do you calculate the Mean gradient?
You use the jet velocity and put it into the bernouli equation P= 4v^2
Pt. With a bicuspid AV will have a possible ____ on m-mode
Eccentric closure
___% of people with a Bicuspid AV will have a ____ AV midline closure on m-mode
25% ; normal
Bicuspid AV will show a ____ doming (tethering) in PLAX
Systolic
How will a bicuspid AV look like in PSAX?
Football shaped
If a pt. Has a bicuspid AV what 3 things should we additionally look for?
Aortic coarctation
Post stenotic dilation of the aorta
LVH
What’s the best view to diagnosis a bicuspid AV?
A) short axis diastole
B) short axis systole
C) Long axis diastole
D) long axis systole
B
Another name for doming is?
Tethering
What is a normal descending aorta jet velocity that we take in the suprasternal view?
1 m/sec
What’s a common system of aortic coarctation?
Systemic HTN
Subvalvular aortic issues is a ___ membrane or ridge in the ____ under the ___
Congenital ; LVOT ; AV
Subvalvular aortic issues cause early ___ ____of the AV
Systolic Closure
Subvalvar aortic issues can cause have left ventricular pathology?
LVH
What’s the best echo view to see aortic subvalvuar issues?
Ap5
Often aortic Subvalvular issues are repaired with surgery but about ___% will grow back afterwards
15%
What is Aortic Supravalvuar issues?
Discrete narrowing of the Aortic root or ascending aorta above the AV
Aortic subvalvuar and supravalvuar issues cause what LV issue
LVH
Because supravalvuar aortic issues may occur in the ascending aorta past the AV. We should use the ___ probe and scan in multiple windows.
PEDOFF
With Subvalvular or supravalvuar aortic issues there will be increased ____ & ____at the site of obstruction
Velocity and turbulence
Use ___ or ___ flow Doppler to locate level of obstruction with subvalvuar or supravalvuar aortic issues
PW or color
Mean gradient and cath lab gradients correlate better than?
A) peak instantaneous
B) peak to peak
C) highest gradient
B) peak to peak
What is Takayusu Arteritis is also called?
Aortic arch syndrome
Takaysau arteritis occurs more in ____ from ___
Young women ; Asia
Takaysau arteritis is ___ of the ____ and ____ ___ of unknown etiology
Fibrosis ; aorta ; descending aorta
Takaysasu arteritis is?
A) narrowing of the aorta
B) Fibrosis of the aorta
C) Regur of the aorta
D) PDA
B
A pt. Has AS. The jet velocity is 5m/sec & BP is 110/84. With this information how do you calculate the LV peak pressure?
You use the Bernoulli equation first to convert the 5msec. Then you add that to the systolic BP.
Correct answer is 210mmhg
What is the continuity equation? And what’s it describe?
It’s describes that FLOW 2 is = to FLOW 1
What is better peak velocities of AI or VTI with mod-severe AI
VTI is always better than peak velocities
when using the continuity equation when would the severity of aortic stenosis be underestimated?
If you measure the LVOT too large
When the LVOT cannot be accurately measured or in the setting of LV dysfunction, what calculation may help evaluate the severity of AS?
Dimensionless index
What is the calculation for the dimensionless index?
LVOT VTI / CW VTI AS
What pressure is obtained during echo dopplers?
Peak or peak instantaneous
What is usually higher Cath Lab gradients or Echo gradient?
Echo gradients are usually higher
What kind of gradients do Cath Lab use?
A) peak peak
B) peak instantaneous
B) mean ingredient
A
