RCIS continued Flashcards
Which drug for conscious sedation has a duration of 30 minutes (not therapeutic half life)?
Valium/Diazepam
Where is the site of action for benzodiazepines?
GABA receptors
If the EKG exhibits a nodal rhythm, where is the heart beating from?
Beating at a slow rate set by the AV node
The average resting cardiac cycle takes about 0.8 sec, including 0.1 sec for atrial systole, 0.3 sec for ventricular systole, and 0.4 sec for which period?
the quiescent period
What does heparin do?
Blocks the conversion of prothrombin to thrombin
What drug is derived from curare, a poison found on some frogs?
Pavulon
In order to view an angiogram from a prior procedure in a digital systel, which device is required to display the image?
digital to analog converter
What is the hydrophylic coating on guidewires?
silicone
What catheter should be used for a Sheperd’s crook RCA?
Champ
Right Voda
Arani 75
Amplatz left II
Your patient has a CTO with bridging collaterals, what is the est treatment for your patient?
Bypass surgery
In order to determine whether an intervention is warranted on a stenosis of intermediate severity, the physician could assess the Fractional Flow Reserve using which wire?
RadiWire
Verrata wire
Your patient has an inferior take-off saphenous vein graft to the RCA. Which catheters would be the logical choices?
Amplatz left
Amplatz right
Judkins Right
Multipurpose
What is a AL II short tip guiding catheter suited for?
Superior take off LMCA
Which catheter would be most suitable for an RCA with a superior directed orientation?
Champ
A heart rate of 45 BPM and an absence of P waves from the EKG would suggest what?
Damage to the SA node
Your patient has arterial blood gases as follows:
pH: 7.30
pCO2: 52
pO2: 96
HCO3: 20
What is the most probable acid base diagnosis?
Mixed respiratory and metabolic acidosis
What is the fast-rising phase of the SA nose action potential due to?
Calcium influx
True of False:
Constrictive myocarditis is a medical diagnosis.
False
Which medical gas is used for inflating septostomy balloon?
Carbon dioxide
Which medical gas is used for pulmonary hypertension?
Nitrous oxide
Which medical gas is used for powering rotablator turbine?
Nitrogen
Which medical gas is used for gas sterilization?
Ethylene oxide
Which medical gas is used for excimer laser?
Xenon chloride
What is a friction rub a result from?
A deficiency of pericardial fluid
What is the electrical synchrony of the ventricular myocardium a result from?
Gap junctions of the intercalated discs
What is diastasis?
slow ventricular filling
Where is the cardiac center, which modifies the heart rate, located?
Medulla oblongata
How doe the Cardioinhibitory center communicate with the heart ?
Vagus nerves
At the end of ventricular contraction, what is the name of the amount of blood remaining in the ventricle?
end-systolic volume
The heart’s normal _________________ of 54% can rise as high as 90% during strenuous exercise.
Ejection fraction
What is the pressure in the arteries that opposes the opening of the semilunar valves called?
Afterload
When does the second heart sound occur on the EKG?
T wave
Heart rates tend to be higher in which sex?
women
The _______________ commonly measures about 75 ml.
Stroke volume
Where is the conduction of electrical signals fastest?
Purkinje Fibers
Frank-Starling’s law states that stroke volume is proportional to what?
the end-diastolic volume
Where are baroreceptors located?
aorta and carotid sinus
During isovolumetric contraction, what happens to the pressure in the ventricles?
rises rapidly
What anatomical arrangement reduces the risk for myocardial infarction?
Arterial anastomoses in the coronary circulation
What is the overall mortality rate involved in cardiac catheterization?
0.1%
What kind of stenting techniques are designed to prevent jailing of side branches at bifurcating stenosis?
Crushing stents
Culotte stenting
Trousers stents
Inoperable patients who underwent a TAVR, as compared to the standard therapy, display significantly higher incidents of what outcome 1 year later?
Major vascular complications
Major bleeding events
All neurological events
Name a calcium channel blocker that is vasoselctive.
Amlodipine/Norvasc
ICD conductor fracture should be suspected when there is an impedance of ______ Ohms.
250
Lead conductor fracture typically results in what type of impedance?
high impedance
What type of stylet is used for counter traction of the laser sheath during lead extraction.
lead locking
What happens when a magnet is applied to a defibrillator?
Pacing and shock therapies become disabled
What is the approximate percentage of oxygen delivered by a simple facemask at 8 to 10 l/min?
40-60%
Which catheter would be used for renal and adrenal arteriography?
Cobra
Which catheter is used for a patient with normal carotid anatomy that can selectively catheterize all arch vessels by direct advancement?
Hinks Headhunter (H1)
Which type of catheter is necessary for optimal WEDGE pressures?
End-hole only
What is the annual average exposure to background radiation?
360 mRem
How would you describe the resolution in line pairs/mm of an imaging system?
image sharpness
visibility of anatomical detail
differentiation between closely spaced objects
discrimination of small structures
You are attempting to pass over the wire dilation catheter through a tight coronary lesion. You wish to exchange the 135 cm dilation catheter without removing the initial 190 cm wire from the target lesion. What should you do?
Extend the 190 cm wire with an extension wire
What does a Rated Burst Pressure (RBP) of 16 atm for a PTCA balloon mean statistically?
99.9% will hold their pressure without rupturing up to 16 atm
What blade is used in a Sones technique skin incision?
15
What does the Venturi effect explain?
Airplane “lift”
carburetor mixing of fuel and air
venti-mask mixing oxygen and room air
rheolytic thrombectomy
Which angiographic view is perpendicular to the majority of the left main coronary artery?
( in this view the mid and distal left main coronary artery in not foreshortened )
0 - 10 RAO
When selecting the proper size of a filter wire the expanded outer diameter should be what size?
0.5 - 1.0 mm larger than the vessel reference diameter, snug fit in the vessel
How should the filter wire be prepared prior to insertion?
pulling it into the sheath under water to remove bubbles
In a severe bifurcation stenosis, when there is intent to treat both branches which stent should be deployed first?
Side Branch stent
When atherosclerosis is found in a coronary artery bifurcation, which area of the bifurcation is usually free of plaque?
carina/flow divider
What is usually the final step in bifurcation lesion stenting?
Kissing balloon inflation
In the Medina classification of bifurcation lesions a 1:0:1 rating means there is a >50% diameter stenosis in which branch?
Proximal MB and SB (main branch and side branch)
Teflon is often used in the construction of sheaths and dilators. What is one of the dangers with Teflon?
Has dangerously hard and sharp tip
In addition to the initial administration of lidocaine and venous needle insertion, what step may be associated with pain and potential Vagal reaction?
Small skin incision prior to inserting percutaneous needle
What kind of coating is on the outside of the catheter?
Hypothrombogenic coating
Thirty minutes after the removal of right femoral vein and femoral artery sheaths, your patient complains of back pain. What should you do?
Turn the patient to side
What is a therapeutic range for INR?
2.1 - 4.0
What is severe acute mitral regurgitation is likely to lead to?
Pulmonary edema
A dry nonproductive cough and dyspnea in your cardiac patient, may be a product of what?
Left ventricular failure
What does a triangular shaped aortic pressure of 180/50 with no dicrotic notch suggest?
Severe AR
What can severe acute mitral regurgitation likely lead to?
pulmonary edema
LV electrical potential is about _______ than that of the RV.
ten times
Your patient has a glucose level of 800 mg/dl. She is unconscious and hypotensive. Kussmaul’s respiration are noted. What does she urgently need?
Regular insulin IVP
In the imaging chain what is the copper equivalent filters are used for what?
Protect the patient from low energy radiation
A Major advantage of using high “MA” settings during angiography is what?
Decreased pulse width duration
What has the least effect on resolution of an x-ray?
KvP (energy level)
What makes a balloon noncompliant?
Polyethyleneterephthelate (PET)
If a guide-wire tip breaks, it may embolize into the vascular system. How do modern cardiovascular guide-wires reduce this complication?
safety wires and ribbons welded at each end of spring
In a patient that has a prosthetic tilting disc aortic valve, what should be the physician’s choice for left heart catheterization?
transseptal
While you are palpating the brachial pulse and the femoral pulse simultaneously, you notice a marked difference in the force and quality of the two pulses. What causes this?
Due to obstruction in the arterial system between the two pulses
Quinidine toxicity increases the risk of what?
Torsades des pointes (Prolonged QT)
What is the precedex/dexmedetomidine, a short acting alpha 2 agonist, used for?
Sedation
Statins lower which inflammatory marker blood levels?
C-reactive protein
Resuvastatin/Crestor, like other statins, may put the patient at risk for rhabdomyolysis. What are the signs and symptoms of this condition?
muscle pain and weakness
Increased impedance indicates what?
Lead fracture or loose connection at header
Name 3 ways to treat Torsades des pointe
Temporary pacing
Magnesium IV
Quinidine
