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Board Prep > Module 9 Cardiovascular > Flashcards

Module 9 Cardiovascular Flashcards

1
Q

Phase 0 of cardiac cycle ion movement

A

Depolarization

Na in

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2
Q

Phase 1 cardiac cycle ion movement

A

Brief repolarization

Cl in and K out

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3
Q

Phase 2 cardiac cycle ion movement

A

Plateau

Ca in

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4
Q

Phase 3 cardiac cycle ion movement

A

Delayed repolarization

K out

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5
Q

Phase 4 cardiac cycle ion movment

A

RMP

Na-k pump maintains

K leak

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6
Q

SA or AV action potential differences from ventricular AP

A

No phase 1 or 2

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7
Q

Change in what phase leads to a change in HR

A

Phase 4 depolarization

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8
Q

Absolute refractory period of ventricular AP

A

Phase 2 plateau

Sodium channel is in inactive state

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9
Q

Relative refractory period for ventricular AP

A

Phase 3 repolarization

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10
Q

What leads do you look at for BBB

A

V1 and V6

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11
Q

QRS results from what phase of ventricular AP

A

Phase 0- depolarization

Na influx

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12
Q

T wave results from what phase of ventricular AP

A

Phase 3 repolarization

K efflux

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13
Q

QT interval reflects what phase of ventricular AP

A

Phase 2 plateau

Ca influx

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14
Q

How do changes in serum Ca levels effect EKG

A

Hypocalcemia- prolonged QT

Hypercalcemia- shortened QT

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15
Q

EKG changes seen with K+ abnormalities

A

Hyperkalemia peaked T

Hypokalemia U waves

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16
Q

Leads V1-V2 monitor which area/vessel

A

Posterior

Left circumflex

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17
Q

Leads II, III, and aVf monitor what area/vessel

A

Inferior

RCA

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18
Q

Leads 1, aVL, V1-V4 monitor which area/vessel

A

Septum, anterior wall

LAD

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19
Q

Leads 1, AVL, V5-V6 monitor which area/ vessel

A

Lateral

Left circumflex

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20
Q

What is the major determinant of intravascular volume in the body

A

Sodium

**aldosterone

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21
Q

Concentric Hypertrophy of LV develops in response to what

A

Pressure overload

AS

Coarctation of aorta

Chronic HTN

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22
Q

Eccentric hypertrophy develops in response to what

A

Volume overload

AI

MR

Morbid obesity

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23
Q

In response to acute increase in afterload (neo) the PV loop shifts how

A

Up and right (greater pressures and greater volumes)

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24
Q

In response to acute decrease in afterload the PV loop shifts where

A

Down and left (smaller pressure and smaller volumes)

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25
Q

When contractility increases acutely how does PV loop change

A

Up and left (greater pressure and smaller volumes)

Dig or Ca++

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26
Q

When contractility decreases acutely how does PV shift

A

Down and right (lower pressure and higher volume)

CHF

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27
Q

HOCM shifts PV loop how

A

Left and up

Smaller volume and larger presssure

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28
Q

SVR formula

A

((MAP-CVP)/CO) x 80

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29
Q

SVR normal value

A

900-1500 dynes/sec/cm-5

30
Q

BRR afferent and efferent limb

A

Afferent- vagus from aortic arch
Hering’s (glossopharyngeal)from carotid

efferent- vagus to SA
SNS nerves to ventricles and systemic vasculature

31
Q

MOA for Inamrinone and milrinone

A

Block breakdown of cAMP = increased myocardial contractility and decreased SVR

32
Q

If newborn has systolic and diastolic murmur what is the problem

A

PDA

More intense during systole- machinery murmur

33
Q

What are the 2 determinants of BP. Whose law applies

A

SVR and CO

Ohms law

34
Q

Bainbridge reflex receptor location

A

RA and great veins

35
Q

Afferent and efferent limb of bainbridge reflex

A

Afferent- vagus to medulla

Efferent- SNS nerves to increase HR

36
Q

What is the most potent local vasodilator released by cardiac cells?

37
Q

What are the 2 most significant risk factors for non cardiac surgery

A

MI

S3 Gallup

38
Q

What inhalation agent can cause myocardial depression. Especially with opioids

39
Q

Becks triad

A

Hypotension

JVD

Distant, muffled heart tones

40
Q

Induction agent of choice for cardiac tamponade

A

Ketamine- maintains high sympathetic tone

41
Q

Where is the J point on ECG

Significance

A

Where QRS ends and ST begins

Point to measure ST elevation or depression

42
Q

Which lead assesses a majority of the LV? Best detects LV ischemia

43
Q

identifying features of LBBB on ECG

A

Notched R wave in Left side leads (I, AVL, V5, V6)

Deep S in right leads

44
Q

Identifying features of RBBB

A

Notched R wave in Right side leads (aVR, V1)

Wide S on Left leads

45
Q

Which is more ominous LBBB or RBBB

A

LBBB does not occur normally

Associated with ischemic heart diseases, HTN, and valvular heart disease

46
Q

Clonidine is what drug class

MOA

A

A2 agonist. Stimulates inhibitory neurons in medulla inhibiting SNS outflow

47
Q

MOA A2 receptors in periphery

A

Decrease release of NE from presynaptic nerve terminal

48
Q

What category of drugs are helpful for shivering (other than Demerol)

A

A2 agonists inhibit thermoregulatory vasoconstriction

49
Q

Direct acting vasodilators NTG and Nipride MOA

A

Donate NO which activates soluble guanylate cyclase = increased cGMP = relaxes vascular smooth muscle

50
Q

Cyanide toxicity with nipride results in what ABG changes

A

Metabolic acidosis

Look at BE

51
Q

Treatment for cyanide toxicity from nipride

A

Sodium thiosulfate

52
Q

NTG works where

A

Venous dilator

53
Q

Hydralazine works where

A

Greater dilation of arterioles than veins

54
Q

Class I antidysrhythmics

A

Sodium channel blockers

Stabilize membranes- delays phase 4 depolarization

1A- procainamide and quinidine

1B- lidocaine, tocainide, phenytoin

55
Q

Class II antidysrhythmics

A

Beta-blockers

56
Q

Class III antidysrhythmics

A

Potassium channel blockers (prolong repolarization)

Amiodarone, ibutilide, dofetilide

Prolong effective refractory period in SA and AV node

57
Q

Class IV antidysrhythmics

A

Slow calcium channel blockers

Verapamil and diltiazem

Slow phase 4 depolarization

58
Q

How does adenosine work for dysrhythmias

A

Hyperpolarizes AV node = decreases excitability

59
Q

MOA for inocor and primacor

A

PDE inhibitors- increase cAMP in cells

Aka inodilators

60
Q

Glucagon MOA on cardiac

A

Increases contractility and heart rate

Binds to own receptor to increase cAMP

61
Q

Digoxin MOA

A

Inhibits NA-K pump

Increases contractility, decreases HR, slows impulse propagation through AV node (enhances PNS)

62
Q

3 electrolyte disturbances that enhance digoxin toxicity

A

Hypokalemia

Hypercalcemia

Hypomagnesemia

63
Q

CVP would be higher than PCWP in what conditions

A

RV failure

Pulmonary HTN

PE

64
Q

Most common complication of CVC

65
Q

Most common complication of PAC

A

PA perforation and hemorrhage

66
Q

How is cardiac output related to area under thermodilution curve

A

Inversely related

Smaller area = higher CO

67
Q

Insufficiency of what 2 valves may lead to falsely high thermodilution cardiac outputs

A

Tricuspid or pulmonic regurgitation

68
Q

If pt has mitral stenosis or pulmonary HTN does PCWP over estimate or under estimate CVP

A

Overestimates

69
Q

In patients with AI does PCWP over or underestimate CVP

A

Underestimate

70
Q

Over dampening of arterial line results in what false interpretation of BP

A

Underestimates SBP

Overestimates DBP

71
Q

For every inch cuff is above heart how does pressure change

Board Prep (19 decks)

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