SD D2 Flashcards by Ian Christopher Mangaoang

Formula of ABI

LE SBP/UE SBP

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Special Test to determine the latency of the radial and ulnar arteries.

Allen Test

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Test wherein you examine color changes in skin during elevation followed by dependency (seated hanging position).

Rubor of Dependency

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Exercise induced pain in the leg which is absent at rest.

Intermittent Claudication

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This test determines the competence of the greater saphenous vein.

Percussion Test

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This test checks the competence of the communication veins and saphenous vein.

Trendelenburg test or Retrograde filling test

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LE is elevated and a tourniquet is placed on the thigh, leave for 1 min. Then check for venous distention before removing the tourniquet.

What is this special test and + sign

Trendelenburg test or Retrograde filling test

10 sec - valvular valve incompetence

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This is a controversial special test because it promotes thrombus dislodgment.

Homans Sign

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Disease wherein there is narrowing of the lumen of the coronary artery.

CAD - coronary artery disease

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Main cause of CAD

Atherosclerosis

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Three main cause of atherosclerosis.

Plaque Formation - fats, calcium and fibrous scar
2, Thrombus - blood clot
Spasm - sudden constriction of the arteries (Reynauds Dse)

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Two component of hyperlipidemia.

Hypercholeterolemia + hyepertriglyceridemia

with decreased HDL

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Meds for hyperlipidemia

Statin drugs

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Examples of Statin drugs

Lipitor, Zocor, Mevacor

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Severe side-effect of statin drugs

Rhabdomyolysis

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SSx of rhabdomyolysis

Dark Urine and mm weakness

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Give the 6 modifiable risk factors of CAD

Hyperlipidemia
Hypertension
Smoking
Diet
Physical Inactivity
Stress

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Give the 5 Non-Modifiable risk factors of CAD

Age
Sex (Male>Female)
Race (African)
Family History
Post Menopause (decreased estrogen)

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Other name of resting angina

angina decubitus

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Other name of unstable angina

Crescendo angina
Preinfarction angina
Progressive angina

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Angina caused by dreams

Nocturnal Angina

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Common condition with nocturnal angina

CHF

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Other name of Prinzmetal Angina

Variant Angina

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What time does Prinzmetal angina often occur.

Morning, due to increase in blood clot mechanism.

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Referred pain areas in angina pectoris (5)

1. L upper rib cage 2. L jaw 3. L upper cervical area 4. L ulnar nerve distribution 5. L shoulder

Most common cause of Myocardial Infarction

Thrombosis

This is caused by sudden coronary perfusion or sudden decrease in blood to the heart

Myocardial infarction

Ssx of MI

1. Sudden loss of responsiveness 2. No Normal breathing 3. No signs of circulation

What time is MI most common

Morning

Earliest Enzyme present in an MI

CKMB

This is the sole marker for MI, this enzyme stays elevated the longest in MI.

Cardiac Troponin

Give the three zones of infarction in Mi.

1. Zone of Ischemia 2. Zone of Injury 3. Zone of Infarction

Zone of MI: Intact function deprived O2, T wave inversion with ST depression.

Zone of Ischemia

Zones of MI: Reversible with treatment, ST segment elevation

Zone of Injury

Zones of MI: Total deprevation of O2, necrosis, 75% dead (transmural MI) 25% still alive, ST segment elevation with Shrap Q wave

Zone of Infarction

ECG Changes: ST segment depression and T wave inversion

Zone of Ischemia

ECG Changes: ST segment elevation

Zone of Injury

ECG Changes: Sharp Q wave

Zone of Infarction/Transmural MI

number of mins for unstable angina.

20-30 min.

S/sx Mi in women 1 month prior (4)

``` SHAG Sleep Disturbances Heart Racing Anxiety Gerd ```

S/Sx MI in women during the attack (MI) (4)

``` We Cold (called) DiNa Weakness Cold Sweats Dizziness Nausea ```

what structures rub during pericarditis (inflammation of the pericardium)

Parietal and visceral pericardium

Area for auscultation for pericardium.

auscultate at the 3rd and 4th ICS atelier to the axillary line

What sound will you hear during auscultation of pericarditis

Scratching sound that is loud during exhalation and forward being

This happen in pericarditis, where in there is build up of pressure in the right side of the heart due to the accumulation of fluid.

Cardiac tamponade

A decrease in systolic BP of >10mmHg during inhalation

Pulsus Paradoxus

Becks Triad

Jugular Vein distention Hypotension Distant/muffled heart sounds (due to abnormal fluid fluid accumulation)

State in which the heart is unable to pump enough blood to meet metabolic needs of the body, even filling pressures are inadequate.

CHF

Failure of one ventricle leads to failure fo the other ventricle

Ventricular Interdependence

Abn accumulation of fluid in the abdomen

Ascites

This type of aneurysm affects the ascending, transverse and descending portions of the aorta

Thoracic Aneurysm

This occurs when there is a tear in the two layers of the Intima

Pseudolumen

(+) Pulsating mass in the abdomen with abdominal pain and back pain

AAA Abdominal Aortic Aneurysm

Type of shock experienced during ruptures aneurysm

Hypovolemic Shock - failure of the circulatory system to supply blood to the organs

Narrowing/constriction that prevents the valve from fully opening

Valve Stenosis

Valve does not close properly causing blood back flow

Valvular Insufficiency

Only happens in the Mitral Valve, Enlarged valve bulges backward in the atrium

Valvular Prolapse

Inflammatory dse that affects heart, joint, skin and brain. Mainly caused by streptococcal bacteria in the throat

Rheumatic Fever

Scarring and deformity of the heart valves due to rheumatic fever

RHD

Flat and Painless skin rash in RF

Erythema Marginatum

Hole in the wall between R Atrium and L atrium.

Atrial Septal Defect

Hole in the wall between R Ventricle and L Ventricle.

Ventricular Septal Defect

Failure of score int ascending aortas and pulmonary artery

Patent Doctus Arteriosus

Give the tetralogy of Fallot.

Pulmonary Stenosis R Ventricular Hypertorphy Overiding of the Aorta (shift of the aorta to the right) Ventricular Septal Defect AKA: true BLUE baby

Tx for "Tet Spell"

Knee to Chest Position: decreases the return of the systemic venous return

SA node fires too slow

Sinus Brady Cardia

T or F: Sinus Brady Cardia is normal in Athletes and during Sleep

True

SA Node Fires too Fast

Sinus Tachycardia

T or F Sinus Tachycardia is normal during exercise

True

Premature beats that originate from the atria

Premature Atrial Contraction

camel hub appearance in the ECG

Premature Atrial Contraction

Rate of Atrial Flutter

251-350 bpm

Sharp P wave, saw tooth appearance, ratio 1:4 (Q wave: P wave)

Atrial Flutter

T or F: can you exercise patients with Sinus Bradycardia or Tachycardia?

Yes as long as pt. is asymptomatic

Condition where in HR is 351-450 BPM

Atrial Fibrillation

Caused by AV junction problem

Heart Block

Negative QRS complex is called?

Drop Beats

T or F: First degree heart block does not have dropped beats

True

>(+) Dropped Beats >Irregular Rhythm >Caused by Acute MI >Safe for Exercise*

Wenckebach Heart Block (2nd Degree Heart Block) *with close monitoring

>Irregular Rhythm >Normal PR interval preceding dropped beats >Not safe for exercise

Mobitz Heart Block (2nd degree heart block)

> mismatch of ventricular and atrial conduction > (+) Stokes-Adam syndorme* > multiple P waves > regular RR interval

Third Degree Heart Block * sudden syncope due to sudden decrease in brain blood supply

Ventricular cell fire occasionally from 1 or more foci

Premature Ventricular Contractions

>Wide and Bizarre QRS Complex >Normal HR >No P wave

Premature Ventricular Contractions

Grounds for Exercise for PVC:

1. < 6 PVC/min, must be unifocal (uniform appearance)

Exercise contraindications for PVC

1. Multifocal PVC 2. >6 PVC/min 3. 3 consectutive PVC (ventricular tachycardia)

>3 or more >PVC/min >No P Wave >Greater than 100BPM >Usually Regular Rhythm

V Tach: | Ventricular Tachycardia

Give the 2 types of V tach:

1. Sustained VTACH - greater than 30 seconds | 2. Non-sustained VTAVCH - less than 30 seconds

>Multifocal PVC with No regular rate or rhythm >Needs to stopped within 1-3 min or will be fatal >Requires CPR

Ventricular Fibrillation

1 normal PQRST + 1 PVC with no P Wave

Bigeminy - indicated for exercise

2 normal PQRST + 1 PVC

Trigeminy - indicated for exercise

3 normal PQRST + 1 PVC

Quadrigeminy - indicated for exercise

2 PVC joined together

Couplet - contraindicated for Exercise