Laboratory - Asthma, BP, HTN & ECG Flashcards by Donny Insular

Mechanism by which Obstructive Pulmonary Diseases markedly reduce total ventilation?

A. Decrease in static compliance of the lung
B. Increase in elastic recoil of the lung
C. Difficulty in increasing thoracic volume
D. Increase in airway resistance

D. Increase in airway resistance

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There are no primary muscles of expiration since expiration is always entirely passive.

A. True
B. False

B. False

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After a quiet expiration, the additional volume of air that one can expire with a maximal effort is the __________, and this volume is __________ in Bronchial Asthma.

A. Inspiratory Reserve Volume: Increased
B. Expiratory Reserve Volume: Increased
C. Inspiratory Reserve Volume: Decreased
D. Expiratory Reserve Volume: Decreased

D. Expiratory Reserve Volume: Decreased

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The following are stimuli which trigger airway narrowing in asthma, EXCEPT:

A. Allergen
B. Viral Infection
C. Exercise
D. Heat or Cold
E. No Exception

E. No Exception

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Asthma is primarily a/an __________ disorder.

A. Bronchial muscle
B. Autoimmune
C. Inflammatory
D. Obstructive

C. Inflammatory

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How can asthma present clinically?

A. Dyspnea, cough and wheezing
B. Nocturnal or early awakening
C. Normal PE findings
D. All of the above

D. All of the above

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The reversibility of which Lung Function Test is used to confirm the diagnosis of asthma?

A. Tidal Volume
B. Forced Expiratory Volume in 1 Second
C. Residual Volume
D. Inspiratory Reserve Volume

B. Forced Expiratory Volume in 1 Second

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Inhaled B2 Adrenergic Receptor Agonist are used for treatment to alleviate __________?

A. Inflammation
B. Bronchoconstriction
C. Bronchodilation
D. Mucus Hypsecretion

B. Bronchoconstriction

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Which of the following statements is TRUE about short term regulation of arterial pressure?

A. Low pressure baroreceptors at the carotid sinus & aortic arch sense changes in arterial pressure
B. Decreased arterial pressure raises the firing rate of afferent baroreceptor nerves
C. The medulla coordinates efferent baroreceptor signals
D. Principal effectors in neural control of arterial pressure are the heart, arteries, veins & adrenal medulla
E. All of the statements are TRUE

D. Principal effectors in neural control of arterial pressure are the heart, arteries, veins & adrenal medulla

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Which of these is a determinant of mean arterial pressure (MAP)?

A. The resistance to blood flow in the systemic circulation
B. Product of the heart rate and stroke volume
C. An enzyme that is synthesized and stored in cells lining the renal afferent arteriole
D. A and B
E. All of the statements are TRUE

D. A and B

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Which ot the following CANNOT cause hypertension?

A. Narrowing of the renal artery by atherosclerotic plaque
B. Fibromuscular disease of the renal arterial wall
C. Cumulative obstruction of smaller arteries and arterioles
D. Vasodilation of larger vessels proximal to the kidneys
E. Chronic volume overload

D. Vasodilation of larger vessels proximal to the kidneys

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Which of the following statements concerning the nervous regulation of the circulation is correct?

A. The baroreceptors are mainly responsible for the long-term regulation of systemic blood pressure
B. If the arterial pressure suddenly falls, the baroreceptor reflex increases the heart rate
C. The baroreceptors are
found in the aortic and carotid bodies
D. The coronary blood flow is regulated by the cardiac volume receptors
E. All of the statements are CORRECT

B. If the arterial pressure suddenly falls, the baroreceptor reflex increases the heart rate

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Which is TRUE about the pathways for the regulation of arterial blood pressure?

A. Renin-angiotensin-aldosterone system is a critical regulator of blood volume & systemic vascular resistance
B. Baroreceptor reflex responds in a short-term manner to decreased arterial pressure
C. Both Neural and Humoral pathways regulate arterial blood pressure
D. A and B are correct
E. All are TRUE

E. All are TRUE

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Which of the following humoral substances cauae VASODILATION?

A. Epinephrine via alpha 1 receptors
B. Serotonin
C. Angiotensin II
D. Bradykinins
E. Arginine Vasopressin

D. Bradykinins

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Which of the following is NOT true regarding baroreceptors?

A. These are stretch receptors that detect distention of vascular walls
B. These can also detect changes in blood pH, PCO2 and PO2
C. These receptors operate within a reflex system
D. They mediate short term regulation of mean arterial blood pressure
E. All of the statements are TRUE

B. These can also detect changes in blood pH, PCO2 and PO2

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Which is the most common cause of PRIMARY Hypertension?

A. Volume Overload
B. Atherosclerosis
C. Excessive release of catecholamine
D. All of the choices
E. None of the choices

E. None of the choices

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Which of the following risk factors most likely can cause the elevation of blood pressure on this patient?

A. Aging
B. Lack of Exercise
C. Smoking
D. Alcohol Intake
E. All of the Choices

E. All of the Choices

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Which of the following non-pharmacological management you will NOT advice?

A. Weight reduction
B. Alcohol restriction
C. Mild salt restriction
D. Decreasing the fiber intake
E. Increasing vegetable diet

D. Decreasing the fiber intake

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Korotkoff sound is:

High or Low Pitched Sound

Low Pitched Sound

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Auscultatory Gap is best heard:

Phase 2 and 3

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Mean Arterial Pressure (MAP) formula:

DBP + 1/3 of Pulse Pressure

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Range in Normal Heart Rate

60-100 bpm

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Lower edge of cuff distance:

1 inch or 2.5 cm

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Loose cuff is better than a narrow/tight cuff?

TRUE or FALSE

TRUE

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In getting the MIL, when the radial pulse disappears, add __________?

30 mmHg

What is the ideal length of the stethoscope tube?

12 inches

Bladder width measurement:

40% around arm

Bladder length measurement:

80% around arm

Deflation rate should be?

2 mmHg per second

During palpatory method, pause at every?

10 mmHg

A properly snug cuff allows how many fingers?

2 fingers

Why get the MIL?

To determine maximum inflation when taking BP

Part of stethoscope used for High Pitched sounds?

Diaphragm of Stethoscope

You may not hear all 5 phases, but you must listen for?

Phase 1 Phase 4 Phase 5

Where to locate pulse for palpatory method?

Radial

Which is TRUE of the pacemaker activity constant?

The pacemaker with the highest frequency will be the one triggering an action potential

AV node travels to the Left Atrium through?

Gap Junctions

Electrical activation of the left atrium is through?

Bachmann's Bundle

One big square duration?

0.20 seconds

V2 lead is placed?

4th Intercostal Space on the Left Parasternal Border

Inferior Wall?

Lead II, III and aVF

V1 lead is placed?

4th Intercostal Space on Right Parasternal Border

V4 lead is placed?

5th Intercostal Space at Midclavicular Line

V3 lead is placed?

Midway between placement of V2 and V4

V5 lead is placed?

Anterior axillary line on the same horizontal line as V4

V6 lead is placed?

Mid-axillary line on the same horizontal level as V4 and V5

Normal Sinus Rhythm should show presence of?

P Wave

One small square in reference to duration?

0.04 seconds

Normal Axis

-30 to 90

Which axis uses the quadrant method?

Lead I and aVF

Lead with a positive connectuin right going to the left arm?

Lead I

Lead unipolar from medial to right?

aVR

Normal QT interval?

0.08 seconds

How to measure QT interval?

Measured from the beginning of Q until the end of T wave

How to measure PR Interval?

Beginning of P wave until the beginning of QRS

How to measure ST Segment?

End of QRS Complex to beginning if T wave

10 mm aplitude is equal to how mang mV?

1 mV

One big square amplitude?

5 mm

``` Which of the following is responsible for the movement of oxygen from the alveoli into the blood in the pulmonary capillaries? A. Active transport B. Filtration C. Secondary active transport D. Facilitated diffusion E. Passive diffusion ```

E. Passive diffusion

The concentration of 2,3-DPG in peripheral blood _______ A. Determines in part the affinity of hemoglobin for oxygen B. Increases in chronic hypoxia C. Decreases when the hydrogen concentration in red cells increases D. Reduces the affinity of oxygen to fetal hemoglobin, but not of adult

B. Increases in chronic hypoxia

``` It is the volume of gas inspired or expired during each normal (unforced) ventilation cycle A. Total lung capacity (TLC) B. Vital capacity (VC) C. Tidal volume ( TV) D. Inspiratory capacity (IC) ```

C. Tidal volume ( TV)

``` What is the approximate physiologic dead space of a normal 70kg man breathing through a tube that has a radius of 5 mm and a length of 100 cm? A. 150 ml B. 180 ml C. 230 ml D. 280 ml ```

A. 150 ml

``` The actual site of gas exchange in the lungs occurs in the: A. Alveoli B. Diaphragm C. Pleural space D. Bronchus ```

A. Alveoli

P Wave

Atrial Depolarization

Buried within the QRS

Atrial Repolarization

It is the duration of atrial activation and AV delay?

PR Interval

It is the only electrical connection between atria and ventricle?

AV Node

QRS Complex

Ventricular Depolarization

T Wave

Ventricular Repolarization

Represents the ABSOLUTE REFRACTORY PERIOD in ECG?

QRS and ST

It is the duration of ventricular depolarization and recovery?

QT Interval

Vertical in ECG represents __________, while Horizontal represents __________?

Voltage or Amplitude | Time

To determine a Sinus Rhythm the P waves should be?

- P waves are UPRIGHT in II, III, aVF | - P waves are INVERTED in aVR

LAD

less than - 30 degrees

RAD

more than + 100 degrees

Formula to determine Heart Rate in Irregular Rhythm?

HR = # of QRS Complexes within 30 large boxes x 10

Normal PR Interval?

0.12-0.20 seconds (3-5 small boxes)

QRS Duration

<0.12 seconds (<3 small boxes)

Normal QT for Male or Female?

Male: 0.35 - 0.43 secs Female: 0.35 - 0.45 secs

Lead 1: POSITIVE (+) | aVF: POSITIVE (+)

Normal

Lead 1: POSITIVE (+) | aVF: NEGATIVE (-)

LAD

Lead 1: NEGATIVE (-) | aVF: POSITIVE (+)

RAD

Lead 1: NEGATIVE (-) | aVF: NEGATIVE (-)

Extreme RAD or Extreme LAD

WALLS OF HEART ``` Inferior Wall? High Lateral Wall? Septal Wall? Anterior Wall? Lateral Wall? ```

II, III, aVF I, aVL V1, V2 V3, V4 V5, V6

``` During quiet inspiration, what is the most important muscle for inspiration? A. External intercostal B. Internal intercostal C. Diaphragm D. Sternocleidomastoid E. Scalene ```

C. Diaphragm

``` What type of disease is asthma? A. Acute inflammatory disease B. Chronic inflammatory disease C. Allergy D. Malignancy ```

B. Chronic inflammatory disease

``` Which of the following is a confirmatory test for ASTHMA? A. spirometry B. CBC C. Chest X-ray D. CT-scan ```

A. Spirometry

``` Which of the following occurs during expiration in asthmatic attack? A. External intercostal muscle contract B. Internal intercostal muscle contract C. Diaphragm contracts D. Diaphragm relaxes ```

B. Internal intercostal muscle contract

``` Airway resistance (RAW) is a dynamic process which affect airflow. Which of these parameters is more important determinant of airway resistance? A. Air density B. Length of airway C. Radius D. Pressure ```

C. Radius

``` Which of the following waveforms represent atrial depolarization? A. p wave B. QRS complex C. ST segment D. T wave ```

A. P wave

``` QRS complex is positive in lead I and negative in AVF. This denotes: A. Normal axis B. Inferior C. Lateral D. Septal ```

B. Inferior

``` What view of the heart do leads II, III, aVF represent: A. Anterior B. Inferior C. Lateral D. Septal ```

B. Inferior

``` One small square in an ECG paper which denotes time is equivalent to ______? A. 0.20 sec B. 0.02 sec C. 0.40 sec D. 0.04 sec ```

D. 0.04 sec

``` Ventricular abnormalities beikl cause morphological changes of which of the following waveforms? A. P wave B. QRS complex C. ST segment D. T wave ```

B. QRS complex

``` When ECG was taken, the Physician-on-duty noted that there are 15 small squares in an R-R interval. What is the heart rate? A. 300 bpm B. 150 bpm C. 100 bpm D. 75 bpm ```

C. 100 bpm

``` The patient's ECG revealed ST elevation on leads II, III, aVF. What is the diagnosis? A. Anterior MI B. Inferior MI C. Lateral MI D. Septal MI E. Posterior MI ```

B. Inferior MI

``` If the ECG of the patient is normal. Which of the following best describes a normal sinus rhythm? A. Biphasic p wave B. Inverted T wave C. One p wave before each QRS-complex D. Impulse originates from the AV node ```

C. One p wave before each QRS-complex

``` On further reading, the ECG of the patient has a QRS complex that is positive in lead I and negative in aVF. This denotes A. Nornal Axis B. Right Axis Deviation (RAD) C. Left Axis Deviation D. Extreme Axis Deviation ```

C. Left Axis Deviation

``` Which of the following treatment modalities given to the patient will help reduce venous return and preload of the heart? A. Morphine B. Nitrates C. Aspirin D. Oxygen E. All of the choices ```

B. Nitrates

Bronchospasm in asthma is secondary to: A. Inflammation B. Humoral substances C. Trigger (e.g pollen) D. All of the above

D. All of the above

Obstructive pulmonary disease can be acute in the following situation except: A. Aspiration of a foreign body B. Build up of mucus in airway lumen C. Constriction of airway lumen due to contraction of smooth muscle D. Destruction of alveolar walls in emphysema

D. Destruction of alveolar walls in emphysema

The following conditions are examples of restrictive pulmonary disease except:

Chronic bronchitis

It is the amount of air remaining inside the respiratory system after a quiet expiration.

Functional residual capacity (FRC)

The major leukotriene associated with asthma.

LTD4

The pulmonary function test that is most characteristic of obstructive lung disease is:

Decrease in FEV1/FVC

Oral corticosteroid may be required in asthmatic patients to suppress inflammation if the attack is:

Sustained and severe

Which of the following statements is/are TRUE in the dynamic properties of a normal lung?

Airflow is directly proportional to the difference between alveolar and atmospheric pressure and airflow is inversely proportional to airway resistance.

Which of the following increases airway resistance?

All of the above: A. Vagus nerve releases acetycholine which acts on muscarinic receptor on bronchial smooth muscle. B. Histamine constricts bronchioles and alveolar ducts C. Reduced lung volume

Restrictive lung disease refers to any disorder that reduces functional residual capacity, vital capacity and TLC.

True