Quiz 2 - Module 4

Question 1

Cardiac S/S

Answer 1

chest pain
SOB
edema
palpitations
syncope
fatigue
skin –> CWMS, mottling

Question 2

ACS

Answer 2

acute coronary syndrome
consists of MI (NSTEMI vs. STEMI) + unstable angina

Question 3

Unstable angina

Answer 3

could portend an MI
chest pain >20 minutes
crushing, squeezing, tightness

Question 4

STEMI definition

Answer 4

symptomatic myocardial ischemia w/ evidence of cardiac dysfunction on EKG (elevated ST-segment)
transmural ischemia

Question 5

NSTEMI definition

Answer 5

non-transmural ischemia

Question 6

Non-cardiac chest pain ddx

Answer 6

aortic dissection
PE (pleuritic)
pneumothorax
pneumonia/chest infection
esophageal disorders
musculoskeletal (pain on palpation)
anxiety
post-op pain

Question 7

S1 sound

Answer 7

closure of AV valves

Question 8

S2 sound

Answer 8

closure of semilunar valves

Question 9

S3 sound

Answer 9

occurs during early diastole
reflects dysfunction or volume overload of ventricles
dilated ventricle (systolic hf)
“kentucky”

Question 10

S4 sound

Answer 10

forceful atrial contraction against poorly compliant left ventricle
stiff ventricle (diastolic hf)
“tennessee”

Question 11

Auscultation areas

Answer 11

aortic
pulmonic
erbs point
tricuspid
mitral

Question 12

Right ventricle A&P

Answer 12

thinner walls (3-5 mm thick)
pressure 8-12 mmHg = low contractile power
easily overwhelmed when pulmonary BP increases

Question 13

Left ventricle A&P

Answer 13

thicker walls (8-10 mm)
more contractile power
capacity 100-120 cc

Question 14

Normal EF

Answer 14

> 50%

Question 15

Coronary arteries

Answer 15

right coronary artery –> posterior descending artery
left coronary artery –> left circumflex, left anterior descendingC

Question 16

CHF definition

Answer 16

inability of heart to maintain effective cardiac output for adequate end-organ perfusion

Question 17

Inotropy

Answer 17

contractility

Question 18

Chronotropy

Answer 18

heart rate

Question 19

Types of heart failure

Answer 19

systolic or reduced EF (<40%)
diastolic or preserved EF >50)

Question 20

Compensatory mechanisms during HF

Answer 20

RAAS –> decreased renal perfusion = prolonged raas = dilutional anemia, hyponatremia, fluid overload
sympathetic nervous system activation = increased cardiac demand (d/t higher heart rate + contractility), ventricular remodeling
peripheral shunting = blood shunted from non-critical organs (kidneys) worsening RAAS

Question 21

Nitrates administration

Answer 21

pts should have 8-10 periods without it to prevent tolerance
(usually patch taken off at night)