RCIS continued Flashcards

1
Q

Which drug for conscious sedation has a duration of 30 minutes (not therapeutic half life)?

A

Valium/Diazepam

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2
Q

Where is the site of action for benzodiazepines?

A

GABA receptors

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3
Q

If the EKG exhibits a nodal rhythm, where is the heart beating from?

A

Beating at a slow rate set by the AV node

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4
Q

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?

A

the quiescent period

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5
Q

What does heparin do?

A

Blocks the conversion of prothrombin to thrombin

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6
Q

What drug is derived from curare, a poison found on some frogs?

A

Pavulon

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7
Q

In order to view an angiogram from a prior procedure in a digital systel, which device is required to display the image?

A

digital to analog converter

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8
Q

What is the hydrophylic coating on guidewires?

A

silicone

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9
Q

What catheter should be used for a Sheperd’s crook RCA?

A

Champ
Right Voda
Arani 75
Amplatz left II

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10
Q

Your patient has a CTO with bridging collaterals, what is the est treatment for your patient?

A

Bypass surgery

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11
Q

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?

A

RadiWire

Verrata wire

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12
Q

Your patient has an inferior take-off saphenous vein graft to the RCA. Which catheters would be the logical choices?

A

Amplatz left
Amplatz right
Judkins Right
Multipurpose

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13
Q

What is a AL II short tip guiding catheter suited for?

A

Superior take off LMCA

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14
Q

Which catheter would be most suitable for an RCA with a superior directed orientation?

A

Champ

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15
Q

A heart rate of 45 BPM and an absence of P waves from the EKG would suggest what?

A

Damage to the SA node

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16
Q

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?

A

Mixed respiratory and metabolic acidosis

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17
Q

What is the fast-rising phase of the SA nose action potential due to?

A

Calcium influx

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18
Q

True of False:

Constrictive myocarditis is a medical diagnosis.

A

False

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19
Q

Which medical gas is used for inflating septostomy balloon?

A

Carbon dioxide

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20
Q

Which medical gas is used for pulmonary hypertension?

A

Nitrous oxide

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21
Q

Which medical gas is used for powering rotablator turbine?

A

Nitrogen

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22
Q

Which medical gas is used for gas sterilization?

A

Ethylene oxide

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23
Q

Which medical gas is used for excimer laser?

A

Xenon chloride

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24
Q

What is a friction rub a result from?

A

A deficiency of pericardial fluid

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25
Q

What is the electrical synchrony of the ventricular myocardium a result from?

A

Gap junctions of the intercalated discs

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26
Q

What is diastasis?

A

slow ventricular filling

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27
Q

Where is the cardiac center, which modifies the heart rate, located?

A

Medulla oblongata

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28
Q

How doe the Cardioinhibitory center communicate with the heart ?

A

Vagus nerves

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29
Q

At the end of ventricular contraction, what is the name of the amount of blood remaining in the ventricle?

A

end-systolic volume

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30
Q

The heart’s normal _________________ of 54% can rise as high as 90% during strenuous exercise.

A

Ejection fraction

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31
Q

What is the pressure in the arteries that opposes the opening of the semilunar valves called?

A

Afterload

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32
Q

When does the second heart sound occur on the EKG?

A

T wave

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33
Q

Heart rates tend to be higher in which sex?

A

women

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34
Q

The _______________ commonly measures about 75 ml.

A

Stroke volume

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35
Q

Where is the conduction of electrical signals fastest?

A

Purkinje Fibers

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36
Q

Frank-Starling’s law states that stroke volume is proportional to what?

A

the end-diastolic volume

37
Q

Where are baroreceptors located?

A

aorta and carotid sinus

38
Q

During isovolumetric contraction, what happens to the pressure in the ventricles?

A

rises rapidly

39
Q

What anatomical arrangement reduces the risk for myocardial infarction?

A

Arterial anastomoses in the coronary circulation

40
Q

What is the overall mortality rate involved in cardiac catheterization?

A

0.1%

41
Q

What kind of stenting techniques are designed to prevent jailing of side branches at bifurcating stenosis?

A

Crushing stents
Culotte stenting
Trousers stents

42
Q

Inoperable patients who underwent a TAVR, as compared to the standard therapy, display significantly higher incidents of what outcome 1 year later?

A

Major vascular complications
Major bleeding events
All neurological events

43
Q

Name a calcium channel blocker that is vasoselctive.

A

Amlodipine/Norvasc

44
Q

ICD conductor fracture should be suspected when there is an impedance of ______ Ohms.

A

250

45
Q

Lead conductor fracture typically results in what type of impedance?

A

high impedance

46
Q

What type of stylet is used for counter traction of the laser sheath during lead extraction.

A

lead locking

47
Q

What happens when a magnet is applied to a defibrillator?

A

Pacing and shock therapies become disabled

48
Q

What is the approximate percentage of oxygen delivered by a simple facemask at 8 to 10 l/min?

A

40-60%

49
Q

Which catheter would be used for renal and adrenal arteriography?

A

Cobra

50
Q

Which catheter is used for a patient with normal carotid anatomy that can selectively catheterize all arch vessels by direct advancement?

A

Hinks Headhunter (H1)

51
Q

Which type of catheter is necessary for optimal WEDGE pressures?

A

End-hole only

52
Q

What is the annual average exposure to background radiation?

A

360 mRem

53
Q

How would you describe the resolution in line pairs/mm of an imaging system?

A

image sharpness
visibility of anatomical detail
differentiation between closely spaced objects
discrimination of small structures

54
Q

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?

A

Extend the 190 cm wire with an extension wire

55
Q

What does a Rated Burst Pressure (RBP) of 16 atm for a PTCA balloon mean statistically?

A

99.9% will hold their pressure without rupturing up to 16 atm

56
Q

What blade is used in a Sones technique skin incision?

A

15

57
Q

What does the Venturi effect explain?

A

Airplane “lift”
carburetor mixing of fuel and air
venti-mask mixing oxygen and room air
rheolytic thrombectomy

58
Q

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 )

A

0 - 10 RAO

59
Q

When selecting the proper size of a filter wire the expanded outer diameter should be what size?

A

0.5 - 1.0 mm larger than the vessel reference diameter, snug fit in the vessel

60
Q

How should the filter wire be prepared prior to insertion?

A

pulling it into the sheath under water to remove bubbles

61
Q

In a severe bifurcation stenosis, when there is intent to treat both branches which stent should be deployed first?

A

Side Branch stent

62
Q

When atherosclerosis is found in a coronary artery bifurcation, which area of the bifurcation is usually free of plaque?

A

carina/flow divider

63
Q

What is usually the final step in bifurcation lesion stenting?

A

Kissing balloon inflation

64
Q

In the Medina classification of bifurcation lesions a 1:0:1 rating means there is a >50% diameter stenosis in which branch?

A

Proximal MB and SB (main branch and side branch)

65
Q

Teflon is often used in the construction of sheaths and dilators. What is one of the dangers with Teflon?

A

Has dangerously hard and sharp tip

66
Q

In addition to the initial administration of lidocaine and venous needle insertion, what step may be associated with pain and potential Vagal reaction?

A

Small skin incision prior to inserting percutaneous needle

67
Q

What kind of coating is on the outside of the catheter?

A

Hypothrombogenic coating

68
Q

Thirty minutes after the removal of right femoral vein and femoral artery sheaths, your patient complains of back pain. What should you do?

A

Turn the patient to side

69
Q

What is a therapeutic range for INR?

A

2.1 - 4.0

70
Q

What is severe acute mitral regurgitation is likely to lead to?

A

Pulmonary edema

71
Q

A dry nonproductive cough and dyspnea in your cardiac patient, may be a product of what?

A

Left ventricular failure

72
Q

What does a triangular shaped aortic pressure of 180/50 with no dicrotic notch suggest?

A

Severe AR

73
Q

What can severe acute mitral regurgitation likely lead to?

A

pulmonary edema

74
Q

LV electrical potential is about _______ than that of the RV.

A

ten times

75
Q

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?

A

Regular insulin IVP

76
Q

In the imaging chain what is the copper equivalent filters are used for what?

A

Protect the patient from low energy radiation

77
Q

A Major advantage of using high “MA” settings during angiography is what?

A

Decreased pulse width duration

78
Q

What has the least effect on resolution of an x-ray?

A

KvP (energy level)

79
Q

What makes a balloon noncompliant?

A

Polyethyleneterephthelate (PET)

80
Q

If a guide-wire tip breaks, it may embolize into the vascular system. How do modern cardiovascular guide-wires reduce this complication?

A

safety wires and ribbons welded at each end of spring

81
Q

In a patient that has a prosthetic tilting disc aortic valve, what should be the physician’s choice for left heart catheterization?

A

transseptal

82
Q

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?

A

Due to obstruction in the arterial system between the two pulses

83
Q

Quinidine toxicity increases the risk of what?

A

Torsades des pointes (Prolonged QT)

84
Q

What is the precedex/dexmedetomidine, a short acting alpha 2 agonist, used for?

A

Sedation

85
Q

Statins lower which inflammatory marker blood levels?

A

C-reactive protein

86
Q

Resuvastatin/Crestor, like other statins, may put the patient at risk for rhabdomyolysis. What are the signs and symptoms of this condition?

A

muscle pain and weakness

87
Q

Increased impedance indicates what?

A

Lead fracture or loose connection at header

88
Q

Name 3 ways to treat Torsades des pointe

A

Temporary pacing
Magnesium IV
Quinidine