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CardioPulmo > SEM > Flashcards

SEM Flashcards

1
Q

Specify the Heart block that is associated with Wenckebach.

A

2nd degree Type 1 Mobitz

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2
Q

Provide the formula for Stroke Volume (SV).

A

SV = EDV-ESV

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3
Q

What is the heart’s natural pacemaker?

A

SA node

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4
Q

What is the best determinant for intensity of exercises in pulmonary pt’s?

A

Dyspnea

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5
Q

What heart sound refers to the closure of SL valves?

A

S2 (dub)

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6
Q

A pt has a low BP and high HR. What is the pt experiencing?

A

Orthostatic Hypotension

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7
Q

How much mL is in a normal EDV?

A

120 mL EDV

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8
Q

Termination of exercise. How much increase in mmHg from resting BP to stop exercise?

A

20-10mmHg

20 sbp - 10 dbp

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9
Q

Termination of exercise. How much decrease in mmHg from resting BP to stop exercise?

A

10-5 mmHg

10 sbp - 5 dbp

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10
Q

Which side of the body is the cardiac pacemaker placed?

A

Non-dominant side

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11
Q

What condition refers to “multiple P on P phenomenon”?

A

3rd Degree Heart Block

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12
Q

What type of population are affected with Ventricular hypertrophy?

A

Athletes (especially olympians)

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13
Q

What is immediately done in a pt. with Ventricular Fibrillation?

A

CPR and then Defibrillator

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14
Q

Specify the condition with “double P on P phenomenon”?

A

2nd degree Type 2 Mobitz

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15
Q

What is the proper mmHg release in taking a pt’s BP?

A

Deflation is 2-3 mmHg/sec drop in taking BP

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16
Q

What is the greatest treatable risk factor?

A

Hypertension

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17
Q

What condition is associated with a positive finding of chronic valve murmurs?

A

Rheumatic Heart Disease RHD

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18
Q

What is the % HR max of pt’s with comorbidities?

A

40-60% HR max

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19
Q

Provide the formula for Cardio Output CO.

A

CO = HR x SV

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20
Q

What cardiac condition is associated with Brugada syndrome?

A

Sudden Unexplained Death Syndrome SUDS

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21
Q

What heart sound automatically corresponds to an abnormal pathology?

A

S4 heart sound

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22
Q

What kind of shunt is a cyanotic VSD?

A

L shunt

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23
Q

Enumerate the 4 manifestations of Tetralogy of Fallot TOF.

A
  1. Pulmonary artery stenosis
  2. RV hypertrophy
  3. Ventricular septal defect (L shunt)
  4. Overriding of the aorta
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24
Q

What invasive surgery may be done to pt’s with a thrombus?

A

Coronary Artery Bypass Graft surgery

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25
Q

What do you call the object that maintains the shape of a vessel after deflating a ballon?

A

Cardiac stent

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26
Q

What are the semilunar valves?

A

Aortic valve and Pulmonary valve

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27
Q

What heart sound is associated with congestive heart failure CHF?

A

S3

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28
Q

What technique is used to check the pulmonary arterial pressure?

A

Swan-Ganz catheter

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29
Q

Hypotension in the midst of tachycardia

A

Orthostatic Hypotension

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30
Q

Drug of choice given to patients with CHF

A

Digoxin

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31
Q

Antidote to digitalis toxicity

A

Digibind

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32
Q

What supplies the 40% of the SA node?

A

Left Circumflex artery

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33
Q

Provide the formula for Bohr Effect.

A

Co2 + Hgb –> O2

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34
Q

What are the only veins that carry highly

oxygenated blood?

A

Pulmonary veins

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35
Q

Where does the Bohr Effect take place?

A

Peripheral/systemic capillaries

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36
Q

What are the only arteries that carry deoxygenated blood?

A

R & L pulmonary arteries

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37
Q

What is the systemic pump?

A

L ventricle

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38
Q

Provide the formula for Haldane Effect.

A

O2 + Hgb –> CO2

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39
Q

What is the most prone for CAD?

A

LAD

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40
Q

If there is an impending heart disease or MI or angina pectoris, where will the referred pain be?

A

Simultaneous B shoulder referred pain

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41
Q

What are the physiologic properties of the heart?

A

Chronotropic, Bathmotropic, Dromotropic and Inotropic

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42
Q

What artery besides the R coronary artery also supplies the Right ventricle?

A

LAD

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43
Q

What condition can be seen with Levine’s sign?

A

Myocardial Infarction

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44
Q

What is the definition of Stroke Volume?

A

The amount of blood ejected by the heart per second/per cardiac cycle

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45
Q

Provide the formula for Ejection fraction (EF)

A

SV / LV EDV = x 100

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46
Q

What is the normal value of Stroke Volume?

A

70 mL

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47
Q

What do you call the structure in an adult heart that was previously called in a fetal heart ‘Foramen ovale’?

A

Fossa ovalis

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48
Q

What do you call the structure in an adult heart that was previously called in a fetal heart ‘Ductus arteriosus’?

A

Ligamentum arteriosum

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49
Q

What is the most common cause of blue babies?

A

Tetralogy of Fallot

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50
Q

What are the mainstays for an MI Myocardial Infarction?

A

Aspirin, nitroglycerin and O2 (ANO)

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51
Q

What conditions refers to the exchange places aorta becomes RV while pulmonary a.
becomes part of LV?

A

Transposition of Great vessels

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52
Q

What is the first drug to be given to a pt. with heart attack?

A

Oxygen

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53
Q

What condition refers to the aorta and pulmonary a. become one in the same trunk without normal separation?

A

Truncus Arteriosus

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54
Q

What are the 4 defects associated with Tricuspid valve atresia?

A

Defective tricuspid valve, ASD, VSD and very small RV

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55
Q

R ventricular hypertrophy may lead to ________

A

R ventricular hypertrophy may lead to cor pulmonale

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56
Q

What position should an irritable blue baby of 10 months?

A

Supine knee to chest < 1 y.o

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57
Q

What situation is the given pathway referring to VC, RA, RV, pulmo. artery (blocked) goes back to RV?

A

Pulmonary artery stenosis

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58
Q

What position should an irritable blue baby of 13 months?

A

Side lying knee to chest > 1 y.o`

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59
Q

A hole in between two atrias of the R atrium and the L atrium

A

Astrial sepal defect ASD

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60
Q

Enumerate the 4 acyanotic CHD.

A

Atrial sepal defect (ASD), Patent ductus arteriosus (PDA), Coarctation of the Aorta, VSD (R shunt)

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61
Q

What heart sound can be heard with rapid ventricular filling?

A

S3

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62
Q

What do you call when the F. ovale is open and the Ductus art. Is closed the blood can still reach the lungs?

A

Astrial sepal defect ASD

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63
Q

The F. ovale is open and the Ductus art. Is closed the blood can still reach the lungs via ___

A

L Atrium

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64
Q

What possible conditions with a (+) S4 heart sound?

A 
MI
Aortic Stenosis 
CAD
HTN
Pulmo Dse.
CABG
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65
Q

What heart sound refers to atrial gallop or abnormal atrial systole?

A

S4 heart sound

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66
Q

In what phase can you hear the S2 heart sound?

A

Diastole

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67
Q

What BP ranges do you consider normal in a 12 yo.?

A

SBP: 95-135mmHg
DBP: 53-88 mmHg

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68
Q

What BP ranges do you consider to be preyhypertension?

A

SBP: 120-139
DBP: 80-89 mmHg

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69
Q

What is the formula for the number of seconds to take a BP?

A

Pulse pressure divided by 2 mmHg and 3 mmHg

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70
Q

What are the phases of Korotkoff sounds?

A 
Tapping
Swishing, murmur
Crisp, louder
Muffling
Disappear
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71
Q

What phase of the cardiac cycle is when all of the AV valves and SL valves are closed?

A

Phase 2 (Isovolumetric contraction) and Phase 4 (Isovolumetric relaxation)

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72
Q

In the cardiac auscultation where can you hear the murmurs and mitral stenosis?

A

Erb’s point 3rd ICs on the L

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73
Q

Amount of blood ejected by the ventricle per cycle per second or per beat

A

Stroke Volume

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74
Q

What is the best determinant for exercise for pulmonary patients like Covid 19?

A

Dyspnea scale

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75
Q

Provide the formula for BP.

A

CO x TPR

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76
Q

Where does the conduction of 1st degree Heart Block patients end?

A

Conducts until the Bundle of HIS

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77
Q

What refers to ventricular repolarization on ECG?

A

T wave

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78
Q

What basis do you use for termination of exercise?

A

Blood pressure

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79
Q

What basis do you use for the adjustment of exercise intensity?

A

Determinants of exercise like dyspnea etc.

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80
Q

What is the pathway for the conduction of the heart?

A

SA Node → AV Node → AV Bundle of HIS → (R) and (L)

branches of Bundle of HIS → Purkinje Fibers → Ventricles

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81
Q

What refers to atrial depolarization on ECG?

A

P wave

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82
Q

What is the normal conduction of the heart?

A

0.12 -0.20 secs

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83
Q

On ECG what determines the conduction of the heart?

A

PR interval

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84
Q

What heart condition refers to “regularly irregular”?

A

3rd Degree Heart Block (HB)

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85
Q

What dromotropic incompetence refers to P on P phenomenon – QRS complex is gone

A

2nd Degree Heart Block (HB) Type 1 Mobitz

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86
Q

Where does physiologic delay happen to allow ventricular filling?

A

AV Node

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87
Q

What conditions has a flecked sputum?

A

Pneumoconiosis / Coal Miner’s Disease

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88
Q

What is the most common cause of Bronchiectasis in children?

A

Cystic Fibrosis

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89
Q

What condition has a purple sputum?

A

Neoplasm (bronchogenic carcinoma)

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90
Q

What condition has a gray sputum?

A

Emphysema

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91
Q

What condition has a rusty sputum?

A

Pneumonia

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92
Q

What is the consistency of a sputum that is “very viscous, white, foul smelling”?

A

Fetid consistency

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93
Q

What condition has a fetid consistency?

A

Cystic Fibrosis

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94
Q

Viscous sputum blocks the pathways may cause permanent dilatation of the bronchioles; may lead to what condition?

A

Bronchiectasis

95
Q

What adventitious or abnormal lung sound will you hear in a patient with L CHF?

A

Bibasilar rales

96
Q

What condition has s/sx such as dyspnea, wheeze, productive cough?

A

Asthmatic Bronchitis

97
Q

At what level is Liver?

A

T7-T10

98
Q

What type of pneumonia is most commonly seen on the R lung?

A

Aspiration pneumonia

99
Q

What bronchus is longer, narrow and oblique?

A

L bronchus

100
Q

What cartilage of the larynx represents the Adam’s Apple?

A

Thyroid cartilage

101
Q

What is the most effective mechanical way of secretion clearance?

A

Suctioning

102
Q

How long should suctioning take?

A

10-15 secs

103
Q

Why does the trachea have c-shaped cartilages?

A

At the posterior part it accommodates the esophagus alimentary upper GIT

104
Q

What is the bifurcation of the trachea?

A

Carina

105
Q

______ lung disease is in a way restrictive also.

A

Infectious lung disease is in a way restrictive also.

106
Q

What diseases are commonly seen on the L Bronchus

A

Bacterial, viral, streptococcal pneumonia, mycoplasma and coronavirus

107
Q

What is the best position for COVID-19 patients to improve oxygenation?

A

Prone

108
Q

How will you position a patient with Aspiration pneumonia?

A

L side lying

109
Q

What type of cough does Covid pneumonia have?

A

Dry cough

110
Q

What part of the conducting portion marks the transitional zone?

A

Terminal Bronchioles

111
Q

What is also known as wet lung disease?

A

Infant Respiratory Distress (IRD)

112
Q

What is also known as Pneumocytes?

A

Alveolar cells

113
Q

What is the functional unit of the lungs?

A

Acinus

114
Q

What is the normal volume of air?

A

400 mL of AIR

115
Q

What is the normal volume of blood?

A

500 mL of BLOOD

116
Q

What is the normal ventilation perfusion ratio?

A

0.8

117
Q

If a pt has a hx of cough for 3 months in a year continuously that could persist 2 consecutive years what could the pt have?

A

Chronic Bronchitis

118
Q

What kind of isolation unit ___ pressure room will an airborne patient be in?

A

Negative pressure room for airborne patients

119
Q

True of False.

Emphysema could be elevated to Chronic Bronchitis

A

False

120
Q

What is the X-ray finding seen in a patient with Emphysema?

A

Bullae

121
Q

In a positive pressure room who will be wearing a surgical mask?

A

Both the patient and the medical staff will be wearing a surgical mask.

122
Q

In a negative pressure room what who will be wearing an N-95 mask?

A

Medical staff will only wear N-95 mask

123
Q

What is another term for a positive pressure room?

A

Reverse isolation room

124
Q

What kind of bacteria is seen in a pt. with TB?

A

Mycobacterium tuberculosis

125
Q

What do you call the condition that has a blood supply of <75%?

A

Ischemic Attack

126
Q

True or False. Two positively charged ions cannot go together

A

True

127
Q

In every one cycle of the pump, how many Na+ ions will be pumped outside?

A

In every one cycle of the pump, 3 Na+ ions will be

pumped outside

128
Q

In every one cycle of the pump, how many __ K+ ions will be pumped back inside?

A

2 K+ ions will be pumped back inside

129
Q

In the nerve/ muscle action potential hyperpolarization phase, there is an influx of what ion?

A

Influx of Cl-

130
Q

Why is an Arrythmia considered a Chronotropic Incompetence?

A

It is considered a Chronotropic incompetence because by definition of Arrythmia there is an abnormality or irregular rhythm of the heart and one of the properties of the heart is chronotropic and under it is rhythmicity.

131
Q

On ECG there is ST elevation with a down sloping what could be the condition?

A

SUDS

* If Chronic ST elevation with a down sloping = LV Aneurysm

132
Q

On ECG you notice there is a saw tooth appearance what could the condition be?

A

Flutter

133
Q

What is the flag for atrial fibrillation?

A

Yellow to red flag

134
Q

What is Lidocaine indicated for?

A

Arrythmia

135
Q

What medication is a cardiac inotrope?

A

Epinephrine

136
Q

What drug increases contractility, promoting cardio acceleration so the patient won’t drop to flatline

A

Epinephrine

137
Q

What converts Angiotensin 1 to Angiotensin II?

A

ACE

138
Q

What alternative drug is used instead of ACE inhibitors to avoid coughing?

A

Angiotensin receptive blockers ARBs

139
Q

What is the suffix for ARBs?

A

“sartan”

140
Q

Class IV Ca Channel blockers are contraindicated for what patients?

A

Congestive Heart Failure CHF

141
Q

What is the normal levels of Albumin in the liver?

A

3.5-5.5

142
Q

What happens when a pt has <1.5 Albumin levels?

A

Malnutrition, edema and ulceration

143
Q

What kind of edema does R CHF patients have?

A

Bipedal pitting edema

144
Q

What anti-arrythmic drugs are usually used for maintenance?

A

Class II B-blockers and Class IV Ca channel blockers

145
Q

What could the patient have if there is absent Q wave on the ECG?

A

Normal

146
Q

What could the patient have if there is absent P wave on the ECG?

A

Atrial arrest

147
Q

Whis has a worse affectation zone of injury or zone of ischemia?

A

Zone of Injury

148
Q

on the ECG the pt has a pathologic q wave what zone could be affected?

A

Zone of Infarction

149
Q

What has the same normal level of Albumin?

A

Potassium

150
Q

What sympathetic receptor is present in the lungs?

A

Beta-2

151
Q

What type of cells kill RBCs?

A

Copper cells

152
Q

True or False. If there is a decrease in cortisol, there is an decrease in stress.

A

False. Cortisol hormone must be WNL any inc or dec will still result in stress.

153
Q

What represents the inferior wall of the heart?

A

Lead II, Lead III, aVF

154
Q

In a pt with L ventricular aneurysm what is seen on the ECG?

A

Chronic ST elevation with down sloping

155
Q

Enumerate the cardiac isoenzymes.

A

Myoglobin, CK-MB, AST, LDH, Troponin T and I

156
Q

If the pt has ST depression between 1mm and <2mm without any complications, what is the flag?

A

Yellow flag

157
Q

When a pt experiences an angina pectoris what is seen on the ECG?

A

ST depression
ST depression with U wave or
Inverted T wave

158
Q

What is the difference between Cushing Syndrome and Cushing’s disease?

A

Cushing’s disease: pituitary; Cushing syndrome: problem in adrenal cortex

159
Q

Where is the direction of the transcellular shift in a pt with an ECG finding of tall T wave?

A

Transcellular shifting to the R

160
Q

If a pt has > 5.5 meq/L what is the pt experiencing?

A

Hyperkalemia

161
Q

What is the most common cause of sudden death in athletes?

A

Ventricular hypertrophy

162
Q

When a pt has an elevated QRS complex what could be the condition?

A

Ventricular hypertrophy

163
Q

What type of continuous adventitious sound may be heard on a pt with Laryngospasm?

A

Ronchi

164
Q

What do you call the sound usually heard when there is retention of pulmonary secretions?

A

Crackles/ Rales

165
Q

What crackling sounds are heard over the pericardium during systole but actually is a pulmonary disease problem?

A

Crunches

166
Q

What do you call the structure that filter the air entering the nose?

A

Vibrissae

167
Q

What could happen when the larynx or muscles around it become dysfunctional?

A

Aphonia/ Dysphonia

168
Q

What condition is related to odorous perspiration?

A

Cystic fibrosis d/t affectation of sweat glands

169
Q

How often do CF patients drain secretion?

A

6x during waking hrs/ once every 2 hrs for 12 hrs

170
Q

What type of sputum consistency do Asthmatic Bronchitis patients have?

A

Thick tenacious

171
Q

What is the structure pierced for tracheostomy of endotracheal tube?

A

Cricothyroid ligament

172
Q

How many cartilages compose the trachea?

A

16 c-shaped cartilages

173
Q

Where are the two areas that have cilia?

A

Fallopian tube and tracheobronchial tree

174
Q

How do you position a patient with mycoplasma streptococcal pneumonia?

A

R side lying

175
Q

How many segmental bronchi are there on the R and on the L?

A

Segmental bronchi: 10 on the R and 8 on the L

176
Q

At the terminal bronchioles, there is a change to what type of epithelium?

A

Simple cuboidal epithelium

177
Q

There is how many generations in the trahceobronchial tree?

A

23 generations

178
Q

What is the best way to expectorate?

A

Huffing or FET

179
Q

How long is the treatment time per lung segment during postural drainage?

A

5-10 mins

180
Q

When do you perform adjuncts like percussion, vibration etc. to postural drainage?

A

If after 10 mins and still pt reports that the throat is dry even with correct auscultation and positioning.

181
Q

What cells are responsible for regulating the ABB?

A

Type 1 Alveolar cells

182
Q

What do you call the channel that interconnects bronchioles to bronchi?

A

Martin’s Canal

183
Q

How long is the maximum treatment time of postural drainage?

A

45 mins

184
Q

What do you call the supplemental oxygen given to infants with IRDs?

A

CPAP

185
Q

What is the difference between CPAP and IPBB?

A

CPAP has continuous inflation phase

IPBB has inflation and deflation phase

186
Q

What do you call the supplemental oxygen given to patients with ARDs?

A

Intermittent positive pressure breathing IPBB

187
Q

What cells are responsible for surfactant to decrease surface tension in the lungs?

A

Type 2 Alveolar cells

188
Q

Are humans capable of releasing O2? Explain if yes or no

A

Yes, during CPR the air at the anatomic dead space is what’s used to provide O2 for the pt.

189
Q

What is the FEF rate of a person with Obstructive lung disease?

A

FEF ratee: < 25%-75%

190
Q

What diseases are airborne transmissions?

A

TB, Measles and Varicella/ Chicken pox

191
Q

Specify what PPE is used for TB and COVID-19 (Delta variant).

A

N-95 mask

192
Q

What kinds of procedures may cause Pneumonia?

A

Tracheostomy, suctioning and incubation

193
Q

For pt’s with pneumonia what kind of isolation unit will he be placed at?

A

Positive pressure room or Reverse isolation room

194
Q

What condition has bigger droplets that are > 5 mm and can travel for 3ft. or less?

A

Pneumonia

195
Q

What PPE should be worn for pt’s with Pneumonia?

A

Surgical mask and/ or face shield

196
Q

What diseases have contact precautions that needs gown and gloves for PPE?

A

Herpes-Zoster, Herpes-Simplex, Open wounds and MRSA

197
Q

What type of lung disease is Tuberculosis?

A

Restrictive lung disease

198
Q

Is there a cure for TB?

A

Yes, RIPE for 6 mos.

199
Q

What is the prevention for Tuberculosis?

A

Bacillus Calmette-Guerin BCG vaccine

200
Q

What are the medications for TB?

A 
"RIPE" od for 6 months
Rifampin
Isoniazid
Pyrazinamide
Ethambutol

*Streptomycin (to increase potency of RIPE)

201
Q

Arrange the pressures from highest to lowest.

Zone 3

A

Arterial Pressure > Venous Pressure > Alveolar Pressure

202
Q

Arrange the pressures from highest to lowest.

Zone 2

A

Arterial Pressure > Alveolar Pressure > Venous Presure

203
Q

Arrange the pressures from highest to lowest.

Zone 1

A

Alveolar Pressure > Arterial Pressure > Venous Pressure

204
Q

In COVID-19 there is more ___ than ___ which is why you position the pt in prone.

A

In COVID-19 there is MORE AIR than BLOOD which is why you position the pt in prone.

205
Q

Pt’s who are intubated are placed in what position?

A

Prone pos. / SIMS (semi-prone pos.)

206
Q

What abnormality is when there is an absence of the 12th rib?

A

None, it’s normal

207
Q

Why are the first 7 ribs called True ribs?

A

It is because it’s directly attached to the sternum.

208
Q

What condition is associated with paradoxical breathing?

A

Flail chest

209
Q

How much amount can a chest drain fill up?

A

2L

210
Q

True or False. You can start doing amb training for a pt with a chest drain.

A

True

211
Q

What kind of pleural effusion refers to Chylothorax?

A

Lymph drainage

212
Q

What kind of pleural effusion refers to Pleurisy?

A

Interstitial fluid

213
Q

What kind of pleural effusion refers to Pyothorax?

A

Pus drainage

214
Q

What kind of pleural effusion refers to Empyema?

A

Pus drainage

215
Q

For a pt with chest drain what are the precautions for ROMEs?

A

Shoulder flexion <80 deg ONLY
Shoulder ER & IR in 90deg of Shoulder abduction ONLY
Horizontal abd and add at 90deg Shoulder abduction ONLY
DO NOT do full Shoulder abduction

216
Q

What is the primary mm of inspiration?

A

Diaphragm

217
Q

What conditions have pectus excavatum?

A

Marfan syndrome and Arthrogryposis multiplex congenita

218
Q

What is the innervation of the Diaphragm?

A

Phrenic Nerve: C3, C4, C5 (keeps the diaphragm alive)

219
Q

In pregnant women, which trimester can the pt experience gestational orthopnea?

A

3rd trimester

220
Q

If a pregnant woman is placed in supine pos. c lightheadedness and edema on B LE what could the pt be experiencing?

A

Vena-cava compression or Gestational supine hypotension

221
Q

How should you position a patient with Gestational supine hypotension?

A

Quarter turn to the left from supine c pillow on R butt to relieve pressure on the R vena cava

222
Q

In Rib flaring what muscles are considered weak?

A

External obliques

223
Q

What is the normal amount of IRV?

A

3000 mL

224
Q

How much of the 500 mL of Tidal volume will undergo gas exchange?

A

350 mL

225
Q

The 150 mL remaining of the TV will go where?

A

The remaining 150 mL will go to the Anatomic dead space

226
Q

Is the Alveolar dead space normal or abnormal?

A

Abnormal

227
Q

What is the normal amount of ERV?

A

1100 mL

228
Q

What pulmonary lung volume keeps the lungs inflated and preventing it from collapsing? and what it it’s normal amount?

A

Residual volume = 1200 mL

229
Q

What condition is present in a pt with crunches breath sounds?

A

Mediastinal emphysema

230
Q

What is the generation of the terminal bronchioles?

A

16th generation

231
Q

What generation is coughing most effective?

A

7th generation

232
Q

For pt’s with status asthmaticus, Ventolin meds do not work what meds should be prescribed?

A

Epinephrine

233
Q

What organs are affected with R CHF?

A

Liver, spleen and lungs

234
Q

What organs are affected with L CHF?

A

Kidneys and Brain

CardioPulmo (3 decks)

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