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DPT 930- cardioplum > Lecture 3- abnormal physiology > Flashcards

Lecture 3- abnormal physiology Flashcards

1
Q

what vital signs are concerning for a CV pt

A

HR: <50 or >120, uncontrolled arrhythmia
BP: >180/90 or <90/60, MAP <60
SpO2: <90% at rest

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2
Q

what could cause bradycardia

A

heart block
drug reactions
metabolic dysfunction
post sx
myocarditis
abnormal breathing

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3
Q

what could cause tachycardia

A

meds
anemia
hypotension
infection
anxiety
alcohol use
pain
substance abuse

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4
Q

what is the physiology for HR

A

ischemia to SA node
decrease in myocardial contractibility

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5
Q

what are red flags for HR

A

decrease HR with increase workload
irregular rhythm at rest
worsening rhythm at rest

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6
Q

what is chronotropic incompetence

A
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7
Q

what causes hypotension

A

meds
acute blood loss
diastolic dysfunction
bradycardia
shock
position changes
dehydration
arrhythmias

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8
Q

what causes hypertension

A

lifestyle factors
high BMI
smoking
co-morbidities
pain
anxiety
substance abuse

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9
Q

what is the physiology for abnormal BP

A

ischemic ventricle rapidly reaches max SV
or
abnormal rapid increase in CO, increases SVR

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10
Q

what are red flags for SBP

A

rise: >20-30 mmHG
flat: SBP doesn’t rise with increase workload
fall: SBP drops with increase workload, associated symptoms

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11
Q

what are red flags for DBP and MAP

A

> 10 mmHG drop with increase workload

<60 for end organ hypoperfusion

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12
Q

what is the most common diagnosis for a drop in MAP

A

spinal cord shock

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13
Q

what could cause a patient to be hypoxemia

A

blood loss
hypoventilation
heart or lung disease
infection/sepsis
anemia
PE
sleep apnea

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14
Q

what is an arrhythmia

A

disturbance in cardiac rhythm
abnormal in site of origin of impulse, rate, regularity, or conduction

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15
Q

what is tachyarrhythmia

A

> 100 BPM

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16
Q

what is bradyarrhythmia

A

<60 BPM

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17
Q

what can cause arrhythmias

A

ectopic foci suppressed by SA node
meds
infection
electrolytes
age
co-morbidities
substance abuse

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18
Q

what is in the 5 step ECG analysis

A

rate
rhythm (R wave)
regular/consistent QRS
P wave?
T wave?

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19
Q

what is an atrial flutter

A

regular atrial quivering
atrial contracting out of sync with ventricles

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20
Q

what is a-fib

A

irregular atrial quivering, lower amplitude
elimination of atrial kick= decrease CO
absent P wave

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21
Q

what is unifocal pre-ventricular contraction (PVC)

A

premature ventricular depolarization
ventricle fires from ectopic foci through purkinje fibers

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22
Q

what are 2 simultaneous PVC

A

couplet
no adequate CO

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23
Q

what is multifocal PVC

A

higher cardiac irritability
severe electrical conductivity

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24
Q

what arrhythmia is a contraindication for activity

A

multifocal PVC

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25
Q

what is bigeminy

A

PVC every other beat
50% of L ventricular activity is not providing good CO

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26
Q

what is trigeminy

A

PVC every 3rd normal beat

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27
Q

what is a-fib with RVR

A

abnormal ventricular response to irregular atrial contractions
HR >120
more concerning than a-fib

28
Q

what is the tx for a-fib RVR

A

electric shock or cardioversion

29
Q

what is supraventricular tachycardia

A

HR >150 set by SA node and not slowed by AV node
absent T wave

30
Q

why is an absent T wave in SVT so crucial

A

no ventricular relax so no fill
decrease CO

31
Q

how can we treat SVT

A

valsalva maneuver

32
Q

what is ventricular tachycardia

A

wide QRS with tachy
absent P waves
no atrial contraction

33
Q

what is torsades de pointes

A

specific v tach with rotation around an axis of electrical activity

34
Q

what causes torsades

A

hypomagnesium

35
Q

what is v fib

A

ventricles quiver inconsistently
no true contraction
rapid loss of CO

36
Q

what is the only rhythm an AED can shock

A

v fib

37
Q

what is an AV heart block

A

abnormality in electrical conduction between atria and ventricles
PR interval

38
Q

what is a first degree heart block

A

impulse conducted between atrial and ventricles is delayed
consistent PR intervals >.20 secs

39
Q

what arrhythmia is a very common cause of bradycardia

A

first degree AV heart block

40
Q

what is type I 2nd degree heart block

A

PR interval gets progressively longer, then QRS drops
atrial is predictably blocked

41
Q

what is type II 2nd degree heart block

A

PR interval is consistent, then QRS drop
atrial impulse to ventricle is unpredictable

42
Q

what is a 3rd degree heart block

A

atrial impulse blocked at AV node
SA and AV node are disconnected
P and R intervals are not consistent with each other

43
Q

what arrhythmia is an absolute contraindication to exercise

A

3rd degree heart block

44
Q

what biomarker is correlated to cardiac ischemia

A

toponins

45
Q

when is exertion recommended when looking at troponins

A

down trend and stable

46
Q

what biomarker is correlated to myocardial tissue damage from over-stretch

A

BNP

47
Q

what BNP level indicates HF

A

> 400

48
Q

what are symptoms of higher BNP

A

fluid overload
dyspnea
severe exercise tolerance

49
Q

what lab value is indicative of multisystem infection

A

WBC

50
Q

if patient has low values of platelets, they are at risk for

A

bleeding

51
Q

if patient has high values of platelets, they are at risk for

A

clot formation

52
Q

platelet count is <50, what is therapeutic recommendation

A

no resistive exercise

53
Q

platelet count is <20, what is therapeutic recommendation

A

consult provider

54
Q

what is the risk for high PT

A

increase bleed/bruise
>20 bleed into tissues

55
Q

if value is >70 for PTT what is the risk

A

spontaneous bleeding
inherited bleeding disorders

56
Q

if value is >5.5 for INR, what is the risk

A

spontaneous bleeding
high= bleed
low= clot

57
Q

What is this arrhythmia

A

tachycardia

58
Q

What is this arrhythmia

A

a flutter

59
Q

What is this arrhythmia

A

a fib

60
Q

What is this arrhythmia

A

unifocal PVC

61
Q

What is this arrhythmia

A

multifocal PVC

62
Q

What is this arrhythmia

A

bigeminy

63
Q

What is this arrhythmia

A

trigeminy

64
Q

What is this arrhythmia

A

a fib RVR

65
Q

What is this arrhythmia

A

SVT

66
Q

What is this arrhythmia

A

torsades de pointes

DPT 930- cardioplum (3 decks)

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