Roop final quiz Flashcards
1
Q
What type of BP medication is captopril?
A
Ace inhibitor
2
Q
what does diaphoretic mean?
A
sweating
3
Q
An EKG lead consists of two surface electrodes of opposite polarity (____and ____) or one positive surface electrode and a reference point
A
one positive and one negative
4
Q
A lead composed of 2 electrodes of opposite polarity is called a ___
A
bipolar lead
5
Q
A lead composed of a single positive electrode and a reference point is called ____
A
unipolar lead
6
Q
For a routine analysis of hearts electrical activity an ECG recorded from 12 separate leads is used. A 12 lead ECG consists of ____
A
- 3 bipolar limb leads (I, II, III)
- unipolar limb leads (AVR, AVL and AVF)
- 6 unipolar chest leads also called pericardial or V leads.
7
Q
The 12 lead placement allows you to pinpoint any deficit in ____
A
conduction
8
Q
___ right forearm or wrist
A
RA
9
Q
___left forearm or wrist
A
LA
10
Q
____left lower leg, proximal to ankle
A
LL
11
Q
___right lower leg, proximal to ankle
A
RL
12
Q
___4th intercostal space, right sternal edge
A
V1
13
Q
____4th intercostal space, left sternal edge
A
V2
14
Q
____midway between V2 and V4
A
V3
15
Q
____5th intercostal spac, mid clavicular line
A
V4
16
Q
___anterior axillary line in straight line with V4
A
V5
17
Q
____mid-axillary line in straight line with V4 and V5
A
V6
18
Q
____atrial depolarization
A
P wave
19
Q
____ventricular depolarization
A
QRS
20
Q
_____ventricular repolarization
A
T wave
21
Q
____ventricular contraction
-electrically neutral
-should be a flat line
-___elevation means something is wrong with the heart tissue
A
ST segment
22
Q
_____ventricular Tachycardia
-can not see v-fib on ECG
A
Wide QRS
23
Q
what do a wide Q wave and deviations in ST segment primarily indicate?
A
MI
24
Q
what does ST elevations indicate?
A
myocarditis, pericarditis and stress cardiomyopathy
25
how much oxygen does myocardium uptake?
95%, metabolism and blood flow through the heart must be matched normally
26
-coronary artery derives from ___
1. Right coronary artery: posterior IV and right marginal
2. Left coronary artery: LAD, left marginal and circumflex
coronary sulcus
27
____: blood flow and cardiac metabolism are NOT matched, which can cause necrosis
ischemia
28
_____: is myocardial necorsis with ECG changes showing ST-segment elevation that is NOT quickly reversed by nitroglycerin. Tropin I or tropinin T and CK are elevated
ST-segment elevation myocardial infarction (STEMI, transmural MI)
29
Patient had STEMI MI: troponin appears in plasma soon after ___ and indicated infarction most specific and most sensitive of serum markers
damage
30
____appears in the plasma soon after damage and indicated infarction most specific and most sensitive of serum markers
Troponin
31
_____: creatine Kinase myocardial bond appears 4 hours after injury and peaks at about 24 hours
CK-MB
32
____high LDL, Pain, Hypertension, obese, smoking
atherosclerosis
33
____fibrous cap is stable and not going to rupture
stable plaque
34
____fibrous cap is thin and can rupture at anytime, can become embolism
Unstable plaque
35
Immuno Picture
1. ___extravasate because of previous damage to blood vessel (inflammatory damage to the intima)
2. cells come in and release ___
3. ___moving through blood vessels and macrophages/smooth muscle cells phagocytose: foam cells to fatty streaks
4. Body tries to compensate by walling off
1. macrophages
2.cytokine
3. Fatty globules
36
stable plaque sitting there and decreasing lumen, still have blood flow going through with thrombus, can be found in ____
intermittent claudication and angina
37
____high possibility of rupturing
unstable plaque
38
___destroys collage
matrix metalloproteinase (MMP)
39
what are symptoms of MI in women?
indigestion, feel acid reflux, abdominal pain, upper back pain (between shoulders), chest pain-localized to area
40
what is a common symptom in women MI that doctors miss?
Fatigue
41
what are symptoms of MI in men?
severe, steady, chest pain that radiates to left arm, neck and Jaw
42
what are similarties in men and women MI?
fever, pallor, dyspnea, diaphoresis, anxiety and hypotension
43
What are risk factors for coronary heart disease?
high cholesterol, smoking, not taking medications had previous HTN, diet, age, lack of exercise, menopause and family history
44
what is the histology found in Acute MI
yellow necrosis with hyperemic borders, hypereosinophilla and neutrophil infiltration
45
pain stimulates sympathetic NS, How is this reflected in patients signs/symptoms?
high respiratory rate and anxious
46
increase in BP= increase workload on ___
left ventricle
47
increase in heart rate = ___
decrease duration of diastole, leading to decease in blood flow into left ventricle
48
increase ventricular contractility = _____
increase workload
49
first purpose of treatment is to ___
try to restore oxygen, suplemental oxygen to oxygenate arterial blood
50
nitroglycerin: ____
vasodilates
51
to decrease pain give ___ to decrease effects of activation of sympathetic NS
morphine
52
what are the surgical treatment options?
cardiac catherization: stent or coronary artery bypass graft
53
a decrease in myocardial oxygen consumption causes?
decrease preload, decrease left ventricular wall tension and increase subendocardial blood flow
54
-vasodilation of capacitance veins
-vasodilation of systemic and pulmonary arterial beds
-improvement in coronary collateral blood flow
-vasodilation of conductance arteries
-dilation of stenotic epicardial coronary artery segments
-vasodilation of large and medium sized coronary arteries and arterioles
-epicardial coronary artery dilation
nitroglycerin to NO
55
____ cycloxygenase inhibitor to decrease possibility of platelet plugs
aspirin
56
clot dissolving med is suspect thrombus, ex ____ greatest efficacy if given within one hour of event
tPA (tissue plasminogne activator
57
____
-irriverisible inhibition of cyclooxygenage enzyme via acetylation
-small dose 975-325 mg/d) inhibits thromboxane synthesis in platelets (TXA2) but not prostacycling (PG12) synthesis in endothelium (larger dose greater than 1000 mg)
aspirin
58
___is a fibrinolytic drug that induces successful recanalization of occluded blood vessels while making sure the surrounding region in viable
tPA
59
___breaks down blood clots via conversion of plaminogen to plasmin
MOA
60
in tPA activity is regulated by ____, which increases its catalytic efficiency (unlike uPA, other plasminogen activator)
fibrin binding
61
tPA:
1. _____binds to fibrin in thrombus
2. converts entrapped plasminogen to plasmin
3. intiates local ___
1. recombinat t-PA (alteplase)
3. fibrinolysis
62
___pain after eating
postprandial chest pain
63
does the patient have pericarditis?
1. yes- previous Gf infection
2. No-came in having pain upon eating. pain for pericarditis in the center
64
does the patient have ischemia?
1. yes- aspirin did not help and hypertension
2. no- troponin levels were normal, pain after eating (pain in subxiphoid area) 100% oxygen levels
65
what are Non-cardiac origin?
GERD, diverticulitis, Hernia, peptic ulcers and musculoskeletal
66
____yellow around the eyes
scleral icterus
67
____
-remove gallbladder because there was high probablity of cholecystitis along with cholelithiasis
-surgery revealed gallbladder filled with gallstones and thickened gangrenous wall
-post-surgically, the gallstones were determined to be of cholesterol origin
treatment for patients
68
____gallstones
cholelithiasis
69
____inflammation of gallbladder
cholecystitis
