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Principles II > Review for Test 1 > Flashcards

Review for Test 1 Flashcards

1
Q

Side effects of radiation: Brain

A

-Fatigue
-Hair loss
-N/V
-Skin changes
-Headache
-Blurry Vision

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2
Q

Side effects of radiation: Breast

A

-fatigue
-hair loss
-skin changes
-edema
-tenderness

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3
Q

Side effects of radiation: Chest

A

-fatigue
-hair loss
-dysphagia
-cough
-SOB

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4
Q

Side effects of radiation: Head/Neck

A

-fatigue
-hair loss
-mouth changes
-taste changes
-dysphagia
-hypothyroidism

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5
Q

Side effects of radiation: Pelvis

A

-fatigue
-diarrhea
-N/V
-Sexual problems
-infertility
-urinary changes

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6
Q

Side effects of radiation: Rectum

A

-fatigue
-diarrhea
-sexual problems
-infertility
-urinary changes

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7
Q

Side effects of radiation: Abdomen

A

-fatigue
-diarrhea
-N/V
-skin changes
-urinary changes

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8
Q

T1:

A

-magnetic vector relaxes
-fat appears brighter, water appears dark
-good gray/white matter contrast-anatomy

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9
Q

T2:

A

-axial spin relaxes
-fat is darker than water
-identifies tissue edema easily-pathology

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10
Q

Estimation of Burn Injuries for Infants:

A

-head: 21%
-abdomen: 13%
-back: 13%
-each arm: 10%
-each leg: 13.5%
-buttocks: 5%
-genital area: 1%

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11
Q

CO “ebb state”:

A

-CO reduced by 60%
-hypovolemia due to permeability
-reduced response to catecholamines
-increased SVR
-myocardial ischemia d/t decreased coronary flow
-ensure appropriate fluid resuscitation

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12
Q

CO “Flow phase”:

A

-72-96 hours post-burn
-hyper-dynamic: increased CO and tachycardia
-increased myocardial O2 consumption
-increased possibility of ischemia
-decreased SVR
-this is when it’s good to give beta blockers!!

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13
Q

Carboxyhemoglobin levels: 1-3%:

A

normal nonsmoker

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14
Q

Carboxyhemoglobin levels: 4-9%:

A

smokers

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15
Q

Carboxyhemoglobin levels: 15-20%:

A

overt signs of toxicity: HA, N/V

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16
Q

Carboxyhemoglobin levels: 20-25%:

A

signs of severe toxicity: seizures, acute renal failure, myocardial ischemia

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17
Q

Carboxyhemoglobin levels: >25%:

A

unconsciousness and death

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18
Q

Reciprocal Changes for Inferior (2, 3, AVF):

A

1, AVL

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19
Q

Reciprocal Changes for Anterior (V3 and V4):

A

2, 3, AVF

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20
Q

Reciprocal Changes for Lateral (V5, V6, 1, AVL):

A

2, 3, AVF

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21
Q

Inferior MI:

A

Yes to fluids, NO to nitrates

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22
Q

Anterior MI:

A

Yes to nitrates, NO to fluid!

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23
Q

Right Atrial Hypertrophy:

A

-first part of P wave is LARGER in V1
-height of QRS >2.5mm in any limb lead

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24
Q

Left Atrial Hypertrophy:

A

-terminal part of P wave is LARGER in V1
-occurs with mitral stenosis and systemic HTN

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25
Q

Right Ventricular Hypertrophy:

A

-RV wall is VERY thick, more depolarization towards V1
-QRS in V1 are positive, R waves get smaller

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26
Q

Left Ventricular Hypertrophy:

A

-large S wave in V1, LARGER R wave in V5
-depth of V1 and height of V5= 35 mm

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27
Q

Ischemia:

A

-inverted T waves, symmetrical

28
Q

Injury:

A

-ST elevation

29
Q

Infarct:

A

-Q waves indicate necrosis
-1 mm wide or 1/3 QRS tall in 2 related leads

30
Q

Which type of electrode setup uses less energy?

A

-bipolar

31
Q

Pacemaker Code 1:

A

-chamber paced
-either O for none, Atrium, Ventricle, or dual

32
Q

Pacemaker Code 2:

A

-chamber sensed
-either O, A, V, or D

33
Q

Pacemaker Code 3:

A

-Response to sensing
-either O, T for triggered, I for inhibited, or D for dual

34
Q

Pacemaker Code 4:

A

-Rate Modulation
-either O or R for rate modulation (think artifact)

35
Q

Pacemaker Code 5:

A

-Multisite pacing
-either O, A, V, or D

36
Q

What is the MOST common response to sensing (code 3)?

A

-Dual (triggered and inhibited)

37
Q

A wave:

A

-atrial contraction, occurs after P wave
-increases atrial pressure
-provides atrial kick

38
Q

C wave:

A

-interrupts decreasing atrial pressure, end of atrial involvement
-isovolumetric contraction of the ventricle
-tricupsid valve closed and ventricle bulges toward the atria
-follows the R wave

39
Q

X descent:

A

-decrease in atrial pressure from the A wave through ventricular systole
-called systolic collapse
-sometimes called X and X^1

40
Q

V wave:

A

-venous filling of the atrium
-during late systole, tricuspid valve remains closed
-peaks just after the T wave

41
Q

Y descent:

A

-tricuspid valve opens, initial blood flow into the ventricle
-called diastolic collapse

42
Q

Abnormal CVP waveforms-atrial fibrillation:

A

-absence of A wave
-longer C wave

43
Q

Abnormal CVP waveforms- tricuspid regurg:

A

-no X descent b/c of incompetent valve

44
Q

Abnormal CVP waveforms-tricuspid stenosis:

A

-tall A wave b/c of back pressure and inability to contract
-y descent is masked

45
Q

Guidelines for PAC depth:

A

-110 cm length, marked at 10 cm intervals
-RA: 20-25 cm
-RV: 30-35 cm
-PA: 40-45 mm
-Wedge: 45-55 cm

46
Q

Abnormal PAC Waveform- Mitral Regurg:

A

-Tall V wave
-C wave fused with V wave
-no X descent
-no specificity or sensitivity to severity of MR due to LA compliance changes and volume change

47
Q

Abnormal PAC Waveform- Mitral Stenosis:

A

-slurred, early y descent
-A wave may be absent due to frequent association with a fib
-with mitral valve surgery, often have to cardiovert

48
Q

Abnormal PAC Waveform- Acute LV MI:

A

-Tall A waves due to noncompliant LV
-LV systolic dysfunction increases LVEDV and LVEDP
-PAWP increases

49
Q

Mixed Venous Oximetry Equation:

A

SvO2= SaO2-VO2/(Q x 1.34 x Hgb)

-SVO2: mixed venous Hgb saturation
-SaO2: arterial Hgb saturation
-VO2: oxygen consumption
-Q: CO
-1.34: oxygen carrying capacity of hgb

50
Q

What is true if hgb, arterial saturation, and oxygen consumption stay the same?

A

-Mixed venous oximetry is an indirect indicator of CO
-so if CO falls, mixed venous value will fall too

51
Q

Average mixed venous sat:

A

75

52
Q

Average PVR and SVR:

A

-PVR: 80
-SVR: 1200

53
Q

With bolus thermodilution, what does it mean if the temp changes alot?

A

-the CO is probably low
-change of 13% in temp is significant

54
Q

Thermodilution inaccuracies:
(measured at right heart, assumed left heart)

A

-intracardiac shunts
-tricuspid/pulmonic regurg
-mishandling of injectate
-fluctuations in temperature (following bypass)
-rapid fluid infusion-cool meds or blood?

55
Q

Pulse Contour Inaccuracies:

A

-atrial fibrillation
-site of arterial puncture
-quality of arterial trace-affected by pressors
-requires frequent re-calibration-ideally calibrated initially with a known CO

56
Q

Echo-M mode:

A

-narrow beams to measure tissue planes
-ex: ventricular wall mass

57
Q

Echo-2D:

A

-real time motion, shows function

58
Q

Echo-Doppler:

A

-can determine speed and direction, color!

59
Q

Focus Method with Echo:

A

-5 key views
-anterior structure is at top of image, closest to transducer
-windows: parasternal (3-5 ICS), apical @ PMI, Subcostal (below xiphoid)

60
Q

Parasternal long axis:

A

-great overall view, measures LA, LV, and Ao root

61
Q

Parasternal short axis:

A

-LV function and volume assessment

62
Q

Apical 4 chamber:

A

-RV and LV size, TV and MV function, and descending Ao

63
Q

Subcostal 4 chamber:

A

-4 chambers, pericardial effusion often next to right heart

64
Q

Subcostal IVC:

A

-diameter, collapsibility
(especially in spontaneous respiration)

65
Q

TEE: what’s it good for?

A

-rescue tool
-assessment of valve function

-posterior structures are now closer to transducer, at top of image! opposite of TTE setup

66
Q

Contraindications to TEE:

A

-esophageal varices
-laparoscopic banding of the esophagus

Principles II (3 decks)

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