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Medsurg > Midterms > Flashcards

Midterms Flashcards

1
Q

what are the 2 division of coronary artery?

A

Right coronary and left coronary artery

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2
Q

what do you call the right side of coronary atery?

A

posterior decending artery

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3
Q

what do you call the left side of coronary artery and what are the division of that? and means

A

left main coronary artery
Div.:
1. Circumflex coronary artery - lateral portion / side
2. Left anterior descending coronary artery - anterior portio

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4
Q

Most common site of blockage?

A

Left anterior descending coronary artery

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5
Q

heart specialized cells

A

myocytes

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6
Q

generates and conduct electrical impulse to the diff part of the heart

A

Myocytes or myocardial cell

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7
Q

hemodynamics cardiac cycle?

A

from 1 heart beat to another

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8
Q

what happend in diastole?

A

with the closing of the aortic valve (or pulmonic) and ends with the closing of the mitral valve (or tricuspid).

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9
Q

the heart distends the blood vessels, forcing blood from the ventricles into the systemic (or pulmonic) system.

A

Systole

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10
Q

how many cardiac output is normal?

A

4-6L/min

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11
Q

TOTAL AMOUNT OF BLOOD EJECTED BY ONE of the ventricles in L/min

A

Cardiac Output

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12
Q

cardiac output formula

A

Heart rate x Stroke volume

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13
Q

Normal stroke volume

A

60-130

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14
Q

degree of stretch of ventricular cardiac muscle fiber at the end of diastole

A

Preload

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15
Q

Resistance to ejection of blood from ventricles

A

Afterload

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16
Q

Force generated by the contracting myocardium

A

contractility

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17
Q

percent of the end-diastolic blood volumen that is ejected with each heartbeat

A

ejection fraction

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18
Q

normal ejection fraction

A

45-55%

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19
Q

decrease ejection fraction leads to?

A

heart failure

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20
Q

indication edema?

A

HF/Valvular disorder

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21
Q

indication in valvular disorder?

A

Edema, Fatigue, Dizziness, Syncope, SOB

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22
Q

palpitation and syncope difference in terms indication

A

palpitation is dysrhthmias
syncope arrtrhtymias

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23
Q

what medication need to be assess in Cardio

A

ASPIRIN, NTG, ANTI HYPERTENSIVE, DIGOXIN DIURETICS

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24
Q

AORTIC VALVE LOCATED

A

2nd ics Right sternum

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25
Q

Pulmonic valve located

A

2nd ics left sternum

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26
Q

tricuspid valce located

A

4th ICS L sternum

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27
Q

mitral valve located

A

5th ICS midclavicular line

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28
Q

Erb’s point located

A

3rd ICS L sternum

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29
Q

rapid venticular filling

A

s3

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30
Q

s3 is normal in?

A

children

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31
Q

35-40 s3 means

A

physiologic s3

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32
Q

heard immediately after s2 used what part of stetos?

A

bell

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33
Q

late diastole

A

s4

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34
Q

harsh grunting sound

A

friction rub

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35
Q

inflammed pericarditis surfaces

A

friction rub

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36
Q

turbulent flow of blood in the heart and valvular disorder

A

murmur

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37
Q

release by myocardial celss that becomes necrosis in myocardium

A

cardiac biomarkers:
1. Creatine kinase
2. Myoglobin
3. Troponin I

38
Q

Cardiac specific isoenzyme?

A

creatinine kinase

39
Q

increase during MI what cardiac biomarkers?

A

Creatinine kinase

40
Q

increase when; creatinine kinase

A

increase within few hours;peak within 24 hrs

41
Q

normal percentage and international unit of creatinen kinase

A

%: 3-5
IU/L 5-25

42
Q

initially used when patient having chest pain?

A

myoglobin

43
Q

myoglobin increase within?

A

within 2-3 hourse following a heart attack and back to normal within 24hrs

44
Q

myglobin increaases within 2-3 hourse following a heart attack and back to normal

A

back to normal after 24 hrs

45
Q

most realable to Myocardial infarction what cardioc biomarker?

A

Troponin I

46
Q

Normal range of troponin I?

A

0-0.04

47
Q

gym increase of what cardiac biomarker?

A

myoglobin mg/ml

48
Q

detected few hours of troponin I detected what?

A

acute myocardial infarction

49
Q

troponin I may remain high till?

A

14 days or 2 weeks

50
Q

CARDIAC BIOMARKER that can detect recent MI and who fast to detect?

A

myglobin can detect as fast as possible but troponin I is more detect MI

51
Q

total cholesterol

A

less that 200 mg/dl

52
Q

triglycerides total

A

less than 150 mg/dl

53
Q

HDL in male

A

grater than40 mg/dl M
greater than 50 mg/dl F

54
Q

LDL total amount

A

less than 100 mg/dl

55
Q

increase total choles,trigyceride. ldl leads to?

A

risk to atherosclenosis that lead to CAD and led to angina/MI

56
Q

regulate BP and fluid volume/secreted by the ventricles

A

brain natriuretic peptide

57
Q

BNP increase during?

A

MI/HF/Pulmoembolism

58
Q

prognosis for heart failure

A

BNP

59
Q

BNP more than ____ pg/ml lead to?

A

100
MI/HF/Pulmonary embolism

60
Q

C-reative protein more than ___mg/L leads to

A

3risk for CVD

61
Q

Homocystine morethan ____ leads to?

A

15mcmol/L
CAD / PVD/Stroke

62
Q

what is the scale of amplitude?

A

+4 bounding
+3 strong
+2 Normal
+1 weak
+0 absent

63
Q

normal amplitude?

A

+2

64
Q

Normal heart sound

A

S1: closure of tricuspid and mitral valve
s2: closure of pulmonic and aortic valve

65
Q

abnormal heart sound

A

S3: early in diastole - rapid ventricular filling - after s2
S4: late diastole - after s1 - atrial contraction

66
Q

Prognostic tool for heart failure

A

Brain natriuretic peptide

67
Q

what need to monitor when having exercise stress test

A

HR, rhythm, BP, skin temp, appearance, symptoms

68
Q

when to stop when having exercise stress test

A

increase, dyspnea, chest pain, dizziness, fatigue, leg cramping

stop when the target HR is achieved

69
Q

pre provedure of excercise stress test

A

NPO for several hourse / avoid stimulants / meds can be take with sip of water/ hold Beta / Ca channel blocker/ digoxin for 48hrs / post procedure monitoring for 10-15 mins

70
Q

what meds or the pharmacologic stress testing that can be revesersed by?

A

vasodilating agent/ adenosic dobutamine / aminophyline

71
Q

pharmacologic stress testing duration

A

1-3 hrs

72
Q

pharmacologic stres testing what need to be stoped/avoid?

A

stimulants 24 hrs before procedure
xantines for 24-48hrs

73
Q

what are the cardiac stress testing

A
  1. excercise stress test
  2. pharmacologic stress testing
  3. myocardial perfusion imaging
  4. magnetic resonance angiography
  5. Echocardiography
  6. Cardiac catheterization
  7. Electrophysiologic testing
74
Q

for evaluation of perfusion and detect blockage

A

radionuclide imaging / radioistopes

75
Q

2types of myocardial perfusion imaging and differences

A
  1. single photo emision computed tomography
    - most common
    - painless / non invasive but need to insert IV
    - insert radionucleotide - safe
  2. Positron emmision testin
    - provides 3 dimensional images
    -evaluates glucose metabolism - normal cbg before procedure
    - avoid stimulant for 24hrs
    - assess claustrophobia
    - needs IV access
76
Q

position of positron emission testing

A

lie still/ hands above the head
baseline 30 mins
completion 1-3hrs

77
Q

provides class sectional imaging

A

CT scan

78
Q

use to enhance the xray / improve visualization of ct scan

A

contrast

79
Q

diagnose disease use of magnetic resonance angiography

A
  • congenital lesions
  • aorta
  • heart muscle
  • pericardium
80
Q

diagnose of transthoracic?

A

pleural effusion
determine size of the chambers
etiology of murmurs

81
Q

what is transesophageal?

A
  • provides clear image
  • use topical anesthesia and sedation
  • evaluate: CVD / HF / valvular disorder / arrthymias
  • complication: Resiratory depression , Aspiration , perforation
82
Q

what measures transthoracic?

A

ejection fraction / size / shape / evaluates function of valves

83
Q

use to diagnose structural and functional disease of the heart

A

Cardiac catheter

84
Q

what need before cardiac catheter?

A

blood test / reneal fxn / coagulation / allergy for contrast / npo 8-12/

85
Q

what are the hemodynamic monitoring and differences

A
  1. central venous pressure
    - measurement of pressure in vena cava or right atrium
  2. Pulmunary artery pressure monitoring
    - Left ventricular function
    - dx: shock
    - balloon tip
86
Q

what is the normal value and indication of abnormal value of cetral venous pressure

A

N: 2-6mmhg

abnormal increase: fluid overload / hypertension
abnormal decrease: deficit/shock/hypovolemia

87
Q

complication of pulmonary artery pressure

A
  1. rupture of pulmonary artery
  2. pulmonary infection and thrombolism
  3. air embolism
  4. catheter kinking
  5. arrtythmias
88
Q

components of electrocardiogram w/ definition / height / duration

A

P wave
- electrical impulse starting SA node
- atrial depolariaztion
- HT: 2.5mm or less
- Duration: 0.11 sec

QRS wave:
- ventricular Depolarization
- HT: more than 5 mm QRS / Less than 5mm qrs

T wave
- Atrial repolarization
- Resting state

U wave
- Purkinje fiber Repolarization
- Hypokalemia

PR interval
- Beginning of P to QRS
- n less than .12 to 20 sec

ST interval
- Ventricular repolarization end of QRS to beginning of T wave

QT interval
- Total time of ventricular depo and repo
- Beginning of QRS to end of T wave
- .32 to .40 sec

TP interval
- End of T beginning of P
- Isoelectric period

PP interval
- P to P

RR interval
- R to R

89
Q

ventricular rhythm

A

rr interval

90
Q

Atrial rhythm

A

pp interval

Medsurg (5 decks)

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