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CardioPulm > Midterm > Flashcards

Midterm Flashcards

1
Q

Risk factors for PAD:

A

ncreasing age, sex (Males>Females), DM, smoking, HTN, hyperlipidemia, hypertriglyceridemia, and hyperhomocystinemia

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2
Q

ABI > 1.10

A

normal

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3
Q

ABI 0.5-1.0

A

claudication

pain in calf with ambulation

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4
Q

ABI 0.2-0.5

A

critical limb ischemia
atrophic changes
rest pain
wounds

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5
Q

ABI < 0.2

A

severe ischemia
gangrene
severe necrosis

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6
Q

Absolute stop test indicators for exercise stress test

A 
Drop in SBP>10mmHg from baseline w/ ischemia
moderate to severe angina
ataxia, dizziness, presyncope
cyanosis or pallor
sustained VT
ST segment elevation
subject requests to stop
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7
Q

Relative stop test indicators for exercise stress test

A

Drop in SBP >10mmHg in absence of ischemia
fatigue, SOB, wheezing, leg cramps or claudication
increasing chest pain
hypertensive response (SBP>250, DBP>115)
ST or QRS changes such as ST segment depression
Arrhythmias
Development of bundle brance block

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8
Q

Expected ECG Changes in the Normal Heart

A

▪ RR interval decreases
▪ P-wave amplitude and morphology undergo minor changes
▪ Septal Q-wave amplitude increases
▪ R-wave height increases from rest to submaximal exercise and then reduces to a minimum at maximal exercise
▪ The QRS complex experiences minimal shortening
▪ J-point depression occurs
▪ Tall, peaked T waves occur (high interindividual variability)
▪ ST segment becomes upsloping
▪ QT interval experiences a rate-related shortening
▪ Superimposition of P waves and T waves on successive beats may be observed

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9
Q

Hypoglycemia S/S:

A 
o	Tremor/shakiness/anxiety
o	Tachycardia
o	Increased sweating
o	Hunger
o	Irritability
o	Weakness
o	Dizziness
o	Numbness or tingling of mouth and face
o	Nausea/vomiting
o	Headache
o	Lethargy
o	Drowsy
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10
Q

Hyperglycemia S/S

A 
o	ncreased/frequent urination
o	Dry mouth/increased thirst
o	Weakness or fatigue
o	Hunger
o	Flu-like achiness
o	HA
o	Facial flushing
o	Nausea or vomiting
o	Fruity breath
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11
Q

Ketoacidosis S/S

A 
▪	Facial flushing
▪	Dry skin
▪	N/V
▪	Abdominal pain
▪	Deep, rapid breathing
▪	Fruity smelling breath
▪	Coma Death
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12
Q

R ventricular failure S/S

A
  • Dependent edema
  • JVD
  • Weight gain
  • Liver engorgement, abdominal pain
  • Ascites
  • Anorexia, nausea, bloating
  • Cyanosis
  • Right sided S3
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13
Q

L ventricular failure S/S

A 
♣	pulmonary congestion
•	Dyspnea, dry cough
•	Orthopnea
•	Paroxysmal nocturnal dyspnea
•	Pulmonary rales, wheezing
•	s/s of acute pulmonary edema (dyspnea, pallor or cyanosis, diaphoresis, tachycardia, anxiety, agitation)
♣	low cardiac output
•	Hypotension
•	Tachycardia
•	Lightheadedness, dizziness
•	Fatigue, weakness
•	s/s of peripheral hypoperfusion (weak, thready pulse, vasoconstriction)
•	poor exercise tolerance
•	S3 and sometimes S4 (3rd heart sound or ventricular gallop, 4th heart sound or atrial gallop)
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14
Q

Stage A CHF:

A

at high risk for HF but w/out structural heart disease or symptoms of HF

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15
Q

Therapy goals and drugs for stage A:

A 
treat HTN
smoking cessation
regular exercise
treat lipid disorder
ACE or ARB
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16
Q

Stage B CHF:

A

structural heart disease but without signs or symptoms of HF

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17
Q

Therapy goals and drugs for stage B:

A

therapy same as stage A
ACE or ARB
beta-blockers in some

18
Q

Stage C CHF

A

structural heart disease with prior or current symptoms of HF
SOB, reduced exercise tolerance

19
Q

Therapy goals and drugs for stage C:

A

all measures under A and B
sodium restrictions
ACE, beta-blockers, diuretics
selected: digoxin, nitrates, ARB, aldosterone

20
Q

Stage D CHF:

A

refractory HF requiring specialized interventions

21
Q

Therapy goals and drugs for stage

A

symptoms at rest
appropriate measures for A,B,C,D
end of life care

22
Q

What levels of resting BP require referral to MD?

A

SBP> 200 or DBP> 100

23
Q

Medical clearance for PT if bp is:

A

SBP >180 & DBP > 110)

24
Q

Exercise testing should be terminated if BP:

A

SBP >250 or DBP >115

25
Q

Orthostatic hypotension

A

SBP drop of >20 or DBP drop >10

26
Q

Contraindications to low level testing

A 
o	Unstable angina or angina at rest
o	Severe heart failure (overt left ventricular failure on exam with pulmonary rales and S3 heart sound)
o	Serious arrhythmias at rest
o	Second or third degree heart block
o	Disabling musculoskeletal abnormalities
o	Valvular heart disease
o	BP > 180/105 mmHg
o	Pt refuses to sign consent form
27
Q

• Absolute contraindications to exercise testing

A

o Recent MI
o Acute pericarditis or myocarditis
o Resting or unstable angina
o Serious ventricular or rapid arterial arrhythmias
o Tachycardia a-fib
o Unrelated second or third degree heart block
o Any acute illness

28
Q

S3

A

abnormal ventricular gallop
loss of ventricular compliance
early diastole

29
Q

S4

A

increased resistance to ventricular filling
heard in hypertensive cardiac disease, CAD
just before S1

30
Q

Exercise recommendations for PAD

A 
short intervals (1-5 mins), alternating with rest
increase intervals and decrease rest
longer warm up time for colder climates
sensory exam before exercise
footwear and hygiene emphasized
31
Q

Hypertrophic cardiomyopathy:

A

diastole dysfunction
risk of sudden death in athletes
thickened left ventricular wall

32
Q

Dilated cardiomyopathy

A

enlargement of all chambers
systolic dysfunction
most common

33
Q

Restrictive cardiomyopathy:

A

rigid ventricular walls
diastolic dysfunction
least common

34
Q

Stage I of Pulmonary edema in CHF

A

redistribution
PCWP 13-18
cardiomegaly

35
Q

Stage 2 of Pulmonary edema in CHF

A 
interstitial edema
PCWP 18025
kerley lines
peribronchial cuffing
hazy contour of vessels
36
Q

Stage 3 of Pulmonary edema in CHF

A

alveolar edema
PCWP>25
consolidation
pleural effusion

37
Q

Left anterior descending artery

A

anterior ventricular septum
anterior left ventricle
the apex

38
Q

Left circumflex

A

left atrium
left ventricular lateral wall
left ventricular posterior wall

39
Q

Sinus node

A

right atrium

40
Q

Right marginal artery

A

right ventricle

41
Q

Posterior descending artery

A

posterior ventricular septum inferior wall of left ventricle

CardioPulm (22 decks)

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