RCIS refresher Flashcards
Help study for the RCIS exam
What would have the highest impact on vascular resistance?
vessel radius
Where is the ideal transseptal puncture site?
fossa ovalis
Which drug would reduce chest pain and decrease the workload on the heart?
Beta Blockers
A patient takes a diuretic in the morning of a cath, what lab results may be affected?
potassium
Pulmonary edema – Which position would you place the patient?
Fowlers When the patient is placed with the head of the bed needs to be elevated as high as possible. The upper half of the patient’s body is between 60 degrees and 90 degrees in relation to the lower half of their body.
As a circulating technologist, what should you pay close attention to following a coronary injection using high osmolarity contrast?
arterial pressure and ECG
What would you WITHOLD during a cardiac arrest on a patient who has an LVAD?
chest compressions
What medication would be used to treat a narrow complex SVT?
Adenosine
What is yearly occupational radiation allowance?
5 REM
What is most likely to be successful in tortuous vessels?
open cell
Why may you need to do a transseptal puncture?
Mitral clip A. Fib abblation
For safety purposes the “maximum permissible dose” of whole body x-radiation allowed to radiologic personnel is _________ per year.
50 milliSieverts 5 REM 5000 milliREm 5 centiSieverts
How long are vital signs monitored post procedure?
15 minutes x4, every 30 mins x2, then every hour until discharge
What supplies should be on hand for performing manual femoral arterial hemostasis?
Atropine Non Invasive BP with automatic cycling IV with easy access to drip control Easy access to patient’s call light
What are the components of the QP/QS formula?
Oxygen consumption pulmonary AV O2 saturations Systemic AV O2 saturations Hemoglobin
Diphenhydramine is the generic name for which drug?
Benadryl
Sublimaze is the generic name for which drug?
Fentanyl
Alprazolam is the generic name for which drug?
Xanax
Prasugrel is hte generic name for which drug?
Effient?
Midazolam is the generic name for which drug?
Versed
Abciximab is the generic name for which drug?
ReoPro
Lorazepam is the generic name for which drug?
Ativan
Eptifibatide is the generic name for which drug?
Integrilin
Diazepam is the generic name for which drug?
Valium
You are monitoring blood pressure by radial arterial line on your patient. When the patient is in a sitting position where should the zeroing port of the pressure monitoring system be positioned?
At the level of the radial artery
How much heparin should transeptal heart cath patients receive at the beginning of the case?
No Heparin
What percentage of normal individuals have a “probe patent” atrial septum? In these individuals the transseptal catheter can be pushed into the LA without needle puncture across the atrial septum?
10-20%
Which catheter is used to cross a stenotic aortic valve?
Feldman
Your patient is NPH-insulin dependent. What specific precautions should be taken?
Avoid reversing heparin with protamine
Your patient has had an endomyocardial biopsy. The histomyocardial technology report describes finding amyloid protein infiltration of myocardial tissue. What does this indicate?
Restrictive cardiomyopathy
Left ventricular hypertrophy is commonly associated with which condition?
Aortic stenosis
Lung diseases that obstruct the flow of blood through the lungs are most likely to increase what?
afterload in the pulmonary trunk
Which component of the conduction system is located in the crista terminalis area ?
Sinoatrial node
What safety hazard is associated with uncapped temporary pacing electrodes protruding unprotected from beneath a sterile dressing?
Ventricular fibrillation
An EP patient with Brady-Tachy Syndrome and bipolar disorder, is having a bi-ventricular pacemaker implanted. What structure is accessed for placing the LV electrodes?
coronary sinus
Which RV/PA flood catheters will recoil the LEAST during high flow pressure injection?
Pigtail/Berman
What procedure uses 1% lidocaine instead of 2% lidocaine for local anesthesia?
Permanent Pacemaker implant (PPM)
The Internal mammary catheter (IMA) looks similar to what other catheter?
Judkins Right coronary
You just received a list of add-ons for EP/Cath lab. Which is likely the most urgent? - A hx of A. Fib - first degree AV block whose cardiac monito now reveals type 2 second degree AVB - A history of heart failure who has bibasilar crackles and pitting edema in both feet - a demand pacemaker whose monitor shows normal sinus rhythm at a rate of 90 BPM
First degree AVB whose cardiac monitor now reveals second degree type 2 AVB
Your patient is having a endomyocardial biopsy. Where was the specimen taken from?
Interventricular septum on the right side (RV septum)
What is the dosage of ergonovine (powerful vasoconstrictor) in a provocative study of Prinzmetal?
0.1 mg
What is the name of the congenital connective tissue disorder which includes mitral valve prolapse, coarctation on the aorta, a supravalvular mitral ring and membranous aortic stenosis.
Shone syndrome
(mitral valve prolapse, coarctation on the aorta, a supravalvular mitral ring and membranous aortic stenosis)
A 20 year old male asymptomatic patient is reffered for percutaneous ASD closure. A transthoracic echo indicates right atrial and right ventricular dilation. TEE shows a 5 mm ostium secundum defect. The followng data is optained at cardiac catheterization:
SVC 91%
RA 85%
IVC 77%
RV 84 %
MPA 82%
LA 98%
What is the most appropriate step?
Further assess for possible partial anomalous pulmonary venous return as well as ASD
What reverses benzodiazepines?
Flumazenil
Dofetilide belongs to which antiarrhythmic class?
Class III
potassium channel blockers - prolong QT
What is the reversal agent for coumadin?
Phytonadione
True or False?
High amounts of radiation during CTO procedures have the potential to create bone loss in the catheterization patient.
True
What are the CTO preprocedure risk factors to consider before exposing the catheterization patient to radiation?
- The patient’s weight, if greater than 150 kg
- Whether the patient has been previously irradiated
- If the operator anticipates encountering steep angles
Concious sedation is defined as a medically controlled state of depressed consciousness that include which characteristics?
- allows protective reflexes to be maintained
- Retains the patient’s ability to maintain a patent airway without the loss of protective reflexes independently and continuously
- permits appropriate respinse by the patient to physical stimulation or command, such as “open your eyes”
What is the angiographic catheter most commonly used in a pediatric right heart cath?
Berman catheter
Who developed the law:
Tension = (pressure x radius) / 2 x wall thickness
A cardiovascular application is that “When the size of a vessel or heart chamber enlarges, the wall tension must increase to maintain the same fluid pressure.”
Laplace
What is the most common cause of aortic stenosis in patients younger than 70 years of age?
Congenital bicuspid aortic valve
True or False?
Since athletes are in better than average condition, their hearts beat faster at rest.
False
True or False?
Cor pulmonale results when the left ventricle fails, causing blood to back up into the lungs.
False
The wheatstone bridge converts fluid pressure to an electrical signal using what?
variable resistors
During ventricular flutter, how many ectopic foci are firing and at what rate?
1 focus, 200-300 BPM
Normally, which wall is the first wall of the ventricle to be excited?
interventricular septum
True or False?
An increase in afterload reduce the heart’s ejection fraction.
True
True or False?
If the SA node is destroyed, the heart will stop beating.
False
The first heart sound occurs at the same time as the P wave of the ECG.
False
Where do the coronary arteries arise from?
Proximal end of the aorta
True or False?
Being larger than the right ventricle, the left ventricle pumps more blood in each beat.
False
True or False?
The myocardium begins to relax at the end of the plateau in the action potential.
True
True or False?
Cells of the SA node exhibit a long plateau in their action potential.
False
True or False?
The parasympathetic nervous system has a negative chronotropic effect on the heart.
True
True or False?
The bundle of His originates at the AV node.
True
True or False?
The unusually long refractory period of the myocardium prevents wave summation and titanic contraction.
True
True or False?
Papillary muscles help to prevent prolapse of semilunar valve.
False
True or False?
The myocardium receives the least amount of blood when the ventricles are contracting.
True
True or False?
The resting heart rate would be slower if not for the fact that sympathetic nerve fibers continually stimulate it.
False
True or False?
Most blood enters the ventricles even before the atria begin to contract.
True
Your patient develops upper airway obstruction after receiveing dilaudid and versed in divided doses for sedation during a PCI. What would be your initial response?
Support the airway using jaw thrust maneuver and encourage the patient to breath
