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APEX Review Qs > Unit 3.3: CV Pathophysiology > Flashcards

Unit 3.3: CV Pathophysiology Flashcards

1
Q
A
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2
Q

Review

perioperative risk factors for MI

A
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3
Q

Review

risk of perioperative MI

A
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4
Q

Review

NYHA Heart Failure classification

A
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5
Q

what degree of surgical risk is: Breast Surgery

A. High risk
B. Intermediate Risk
C. Low risk

A

C

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6
Q

what degree of surgical risk is: cataract Surgery

A. High risk
B. Intermediate Risk
C. Low risk

A

C

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7
Q

what degree of surgical risk is: endoscopic Surgery

A. High risk
B. Intermediate Risk
C. Low risk

A

C

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8
Q

what degree of surgical risk is: peripheral vascular Surgery

A. High risk
B. Intermediate Risk
C. Low risk

A

A

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9
Q

what degree of surgical risk is: orthopedic Surgery

A. High risk
B. Intermediate Risk
C. Low risk

A

B

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10
Q

what degree of surgical risk is: CEA Surgery

A. High risk
B. Intermediate Risk
C. Low risk

A

B

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11
Q

what degree of surgical risk is: intrathoracic Surgery

A. High risk
B. Intermediate Risk
C. Low risk

A

B

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12
Q

what degree of surgical risk is: emergency Surgery

A. High risk
B. Intermediate Risk
C. Low risk

A

A

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13
Q

what degree of surgical risk is: head and neck Surgery

A. High risk
B. Intermediate Risk
C. Low risk

A

B

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14
Q

what degree of surgical risk is: open aortic Surgery

A. High risk
B. Intermediate Risk
C. Low risk

A

A

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15
Q
A

30%

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16
Q
A

0.3%

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17
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A
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18
Q
A
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19
Q

Review

O2 delivery vs o2 demand

A
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20
Q

Review

O2 delivery vs o2 demand chart

A
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21
Q

Review

MYOCARDIAL ISCHEMIA: BIOMARKERS

A
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22
Q

Detection of LV ischemia: combination of leads ___, ____, and _____ has an ischemic detection rate of up to 96%

A

II, V4, V5

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23
Q

Review

treatment of ischemia

A
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24
Q
A
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25
Q
A

CK-MB

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26
Q
A
  1. V3
  2. V4
  3. V5
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27
Q

hypocapnia will

A. decrease myocardial O2 delivery
B. increase myocardial O2 demand

A

A

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28
Q

increase in wall tension will

A. decrease myocardial O2 delivery
B. increase myocardial O2 demand

A

B

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29
Q

SNS stimulation will

A. decrease myocardial O2 delivery
B. increase myocardial O2 demand

A

B

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30
Q

decreased aortic. pressure will

A. decrease myocardial O2 delivery
B. increase myocardial O2 demand

A

A

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31
Q

anemia will

A. decrease myocardial O2 delivery
B. increase myocardial O2 demand

A

A

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32
Q

hypertension will

A. decrease myocardial O2 delivery
B. increase myocardial O2 demand

A

B

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33
Q

decreased P50 will

A. decrease myocardial O2 delivery
B. increase myocardial O2 demand

A

A

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34
Q

increased contractile force will

A. decrease myocardial O2 delivery
B. increase myocardial O2 demand

A

B

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35
Q
A
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36
Q

Review

diastolic compliance

A
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37
Q

Review

A
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38
Q
A
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39
Q

myocardial ischemia

A. Increases myocardial compliance
B. decreases myocardial compliance

A

B

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40
Q

chronic aortic insufficiency

A. Increases myocardial compliance
B. decreases myocardial compliance

A

A

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41
Q

dilated cardiomyopathy

A. Increases myocardial compliance
B. decreases myocardial compliance

A

A

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42
Q

aortic stenosis

A. Increases myocardial compliance
B. decreases myocardial compliance

A

B

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43
Q

pericardial tamponade

A. Increases myocardial compliance
B. decreases myocardial compliance

A

B

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44
Q

old age

A. Increases myocardial compliance
B. decreases myocardial compliance

A

B

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45
Q

hypertrophic obstructive cardiomyopathy

A. Increases myocardial compliance
B. decreases myocardial compliance

A

B

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46
Q
A
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47
Q

Review

decreased compliance

A
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48
Q

Review

HF classification and etiology

A
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49
Q

Review

pathophysiologic changes that accompany CHF

A
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50
Q

Review

Anesthetic management of HF

A
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51
Q

Review

conditions that increase PVR

A
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52
Q

Review

treatment of RV Failure

A
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53
Q
A
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54
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A
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55
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56
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A
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57
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58
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59
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60
Q
A
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61
Q

Review

HTN diagnosis

A
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62
Q

REVIEW

Cerebral aurtoregulation

A
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63
Q

texts recommend delaying surgery if:

SBP:

DBP:

A

SBP: > 180 mmHg

DBP: > 110 mmHg

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64
Q

Hypertensive crisis is a BP of

A

180/120

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65
Q
A
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66
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A
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67
Q
A
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68
Q
A
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69
Q

Review

HTN: Secondary Causes

A
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70
Q

what is the etiology of the clinical finding:

Upper limb BP > lower limb BP

A. Cushingsd syndrome
B. Pheochromocytoma
C. Coarctation of aorta
D. Conn’s Disease

A

C

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71
Q

what is the etiology of the clinical finding:

Diaphoresis

A. Cushingsd syndrome
B. Pheochromocytoma
C. Coarctation of aorta
D. Conn’s Disease

A

B

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72
Q

what is the etiology of the clinical finding:

truncal obesity

A. Cushingsd syndrome
B. Pheochromocytoma
C. Coarctation of aorta
D. Conn’s Disease

A

A

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73
Q

what is the etiology of the clinical finding:

systolic bruit

A. Cushingsd syndrome
B. Pheochromocytoma
C. Coarctation of aorta
D. Conn’s Disease

A

C

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74
Q

what is the etiology of the clinical finding:

hypokalemia

A. Cushingsd syndrome
B. Pheochromocytoma
C. Coarctation of aorta
D. Conn’s Disease

A

D

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75
Q

what is the etiology of the clinical finding:

headache

A. Cushingsd syndrome
B. Pheochromocytoma
C. Coarctation of aorta
D. Conn’s Disease

A

B

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76
Q

what is the etiology of the clinical finding:

Moon Face

A. Cushings syndrome
B. Pheochromocytoma
C. Coarctation of aorta
D. Conn’s Disease

A

A

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77
Q

what is the etiology of the clinical finding:

alkalosis

A. Cushingsd syndrome
B. Pheochromocytoma
C. Coarctation of aorta
D. Conn’s Disease

A

D

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78
Q
A
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79
Q

Review

Drugs that target the ANS

A
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80
Q

Review

Drugs that target the Myocardium and Vascular smooth muscle

A
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81
Q

Review

Drugs that target the kidney

A
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82
Q

what drug class:

prasozin

A. Alpha 1 antagonist
B. Alpha 2 agonist
C. CCB

A

A

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83
Q

what drug class:

diltiazem

A. Alpha 1 antagonist
B. Alpha 2 agonist
C. CCB

A

C

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84
Q

what drug class:

phenoxybenzamine

A. Alpha 1 antagonist
B. Alpha 2 agonist
C. CCB

A

A

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85
Q

what drug class:

clevidipine

A. Alpha 1 antagonist
B. Alpha 2 agonist
C. CCB

A

C

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86
Q

what drug class:

clonidine

A. Alpha 1 antagonist
B. Alpha 2 agonist
C. CCB

A

B

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87
Q

what drug class:

phentolamine

A. Alpha 1 antagonist
B. Alpha 2 agonist
C. CCB

A

A

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88
Q

what drug class:

Verapamil

A. Alpha 1 antagonist
B. Alpha 2 agonist
C. CCB

A

C

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89
Q

what drug class:

dexmedetomidine

A. Alpha 1 antagonist
B. Alpha 2 agonist
C. CCB

A

B

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90
Q

what drug class:

captopril

A. ACE-I
B. ARBs
C. K sparing diuretic

A

A

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91
Q

what drug class:

enalapril

A. ACE-I
B. ARBs
C. K sparing diuretic

A

A

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92
Q

what drug class:

benazapril

A. ACE-I
B. ARBs
C. K sparing diuretic

A

A

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93
Q

what drug class:

valsartan

A. ACE-I
B. ARBs
C. K sparing diuretic

A

B

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94
Q

what drug class:

amiloride

A. ACE-I
B. ARBs
C. K sparing diuretic

A

C

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95
Q

what drug class:

triamterene

A. ACE-I
B. ARBs
C. K sparing diuretic

A

C

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96
Q

what drug class:

azilsartan

A. ACE-I
B. ARBs
C. K sparing diuretic

A

B

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97
Q

what drug class:

losartan

A. ACE-I
B. ARBs
C. K sparing diuretic

A

B

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98
Q
A
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99
Q

what are the 3 types of voltage-gated calcium channels

A
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100
Q

Review

MOA of CCBs

A

Pines Die Very Smoothly

Aka the CCB ending in “-pine” are “di”hydropyridines and act on vascular smooth muscle

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101
Q

CCB impair contractility in the following order (highest to lowest):

  • diltiazem
  • nifedipine
  • verapamil
  • nicardepine
A

verapamil > nifedipine > diltiazem > nicardpine

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102
Q

Review

CCBs and Vascular tone

A
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103
Q

Review

CCBs and heart rate

A
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104
Q

t or F: clevidipine does not impair cardiac contractility

A

F

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105
Q

sort to the drug class

verapamil

A. Dihydropyridines
B. Non-Dihydropyridines

A

B

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106
Q

sort to the drug class

diltiazem

A. Dihydropyridines
B. Non-Dihydropyridines

A

B

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107
Q

sort to the drug class

nimodipine

A. Dihydropyridines
B. Non-Dihydropyridines

A

A

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108
Q

sort to the drug class

nifedipine

A. Dihydropyridines
B. Non-Dihydropyridines

A

A

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109
Q
A
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110
Q
A
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111
Q
A
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112
Q
A
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113
Q

REVIEW

Pericarditis pathophysiology

A
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114
Q

Pericardial knock is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

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115
Q

Kussmaul’s Sign is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

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116
Q

Pulsus Paradoxus is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

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117
Q

Pericardial Friction Rub is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

118
Q

Chest pain with inspiration is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

119
Q

fever is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

120
Q

trauma is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

121
Q

tuberculosis is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

122
Q

Rheumatoid arthritis is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

123
Q

systemic lupus erythematosus is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

124
Q

previous cardiac surgery is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

125
Q

uremia is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

126
Q

dressler’s syndrome is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

127
Q
A
128
Q

select how SNS tone relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

129
Q

select how Inotropy relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

130
Q

select how Cardiac output relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

B

131
Q

select how stroke volume relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

B

132
Q

select how heart rate relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

133
Q

select how pericardial pressure relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

134
Q

select how pericardial volume relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

135
Q

select how coronary perfusion pressure relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

B

136
Q

select how LVEDV relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

B

137
Q

select how LVEDP relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

138
Q

best method of diagnosis for cardiac tamponade

A

TEE

139
Q

Review

presentation of a cardiac tamponade

A
140
Q

what is becks triad

A
  1. HOTN
  2. JVD
  3. Muffled heart tones
141
Q

define pulsus paradoxus

A

SBP decreases > 10 mmHg during inspiration

142
Q

what is kussmauls sign

A
  1. Increased CVP
  2. JVD during inspiration
143
Q
A
144
Q

Review

anesthetic management of Cardiac tamponade

A

Local ANE is preferred

145
Q

Review

hemodynamic goals for cardiac tamponade

A
146
Q

select appropriate option for treatment of a pericardial tamponade

opioids

A. Safe
B. Do not administer

A

A

147
Q

select appropriate option for treatment of a pericardial tamponade

benzodiazepines

A. Safe
B. Do not administer

A

A

148
Q

select appropriate option for treatment of a pericardial tamponade

nitrous oxide

A. Safe
B. Do not administer

A

A

149
Q

select appropriate option for treatment of a pericardial tamponade

propofol

A. Safe
B. Do not administer

A

B

150
Q

select appropriate option for treatment of a pericardial tamponade

ketamine

A. Safe
B. Do not administer

A

A

151
Q

select appropriate option for treatment of a pericardial tamponade

sevoflurane

A. Safe
B. Do not administer

A

B

152
Q

select appropriate option for treatment of a pericardial tamponade

thiopental

A. Safe
B. Do not administer

A

B

153
Q

select appropriate option for treatment of a pericardial tamponade

subarachnoid block

A. Safe
B. Do not administer

A

B

154
Q
A
155
Q
A
156
Q
A
157
Q

Review

antibiotic prophylaxis for infective endocarditis

A
158
Q

what patients should receive preop antibiotic prophylaxis due to the increased risk for infective endocarditis

A
159
Q

Does the following need antibiotic prophylaxis for infective endocarditis

mitral valve prolapse

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

B

160
Q

Does the following need antibiotic prophylaxis for infective endocarditis

upper GI endoscopy

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

B

161
Q

Does the following need antibiotic prophylaxis for infective endocarditis

unrepaired cardiac valve disease

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

B

162
Q

Does the following need antibiotic prophylaxis for infective endocarditis

TEE

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

B

163
Q

Does the following need antibiotic prophylaxis for infective endocarditis

cystoscopy

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

B

164
Q

Does the following need antibiotic prophylaxis for infective endocarditis

previous heart valve replacement

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

A

165
Q

Does the following need antibiotic prophylaxis for infective endocarditis

dental procedure with gingival manipulation

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

A

166
Q

Does the following need antibiotic prophylaxis for infective endocarditis

CABG

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

B

167
Q

Does the following need antibiotic prophylaxis for infective endocarditis

unrepaired cyanotic congenital heart disease

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

A

168
Q

Does the following need antibiotic prophylaxis for infective endocarditis

coronary stent placement

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

B

169
Q

Does the following need antibiotic prophylaxis for infective endocarditis

bronchoscopy with biopsy

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

A

170
Q

Does the following need antibiotic prophylaxis for infective endocarditis

previous infective endocarditis

A. Needs antibiotic prophylaxis
B. Doesn’t need antibiotic prophylaxis

A

A

171
Q

Review

factors that determine blood flow through the LVOT

A
172
Q

Review

ANE management obstructive hypertrophic cardiomyopathy

A
173
Q

define SAM

A
174
Q
A
175
Q
A
176
Q
A

worsens

177
Q
A

improves

178
Q
A

improves

179
Q
A

worsens

180
Q
A

improves

181
Q
A

worsens

182
Q
A

improves

183
Q
A

worsen

184
Q
A

worsens

185
Q
A

30 days

186
Q

Review

time of surgery after PCI

A
187
Q
A
188
Q
A
189
Q
A
190
Q

is centrifugal pump or roller pump preferred for CPB

A

centrifugal pump

191
Q
A

centrifugal pump

192
Q
A

roller pump

193
Q
A

centrifugal pump

194
Q
A

roller pump

195
Q
A

centrifugal pump

196
Q
A

roller pump

197
Q

what is the preferred type of oxygenator for CPB

A

membrane oxygenator

198
Q
A
199
Q
A

airlock

200
Q
A
201
Q

approriate heparinization for CPB

A

> 400 seconds for ACT

202
Q

ideal SBP for aortic cannulation prior to CPB

A

SBP 90-100 or MAP < 70 mmHg

203
Q
A
204
Q
A
205
Q
A
206
Q
A
207
Q
A
208
Q

Review

IABP indications and Contraindications

A
209
Q

Review

IABP & how it works

A
210
Q

how do we confirm IABP placement

A
  • CXR
  • fluoroscopy
  • TEE
211
Q

complications of IABP

A
  • vascular injury
  • infection at insertion site
  • thrombocytopenia
212
Q
A
213
Q
A

left subclavian artery

214
Q
A
215
Q
A

the left = balloon deflates

the right = balloon inflates

216
Q
A
217
Q
A

sepsis

218
Q
A
219
Q
A
220
Q

Review

Thoracoabdominal aortic aneurysm classification: Crawford

A

crawford = classified based on aneurysms involvement in the thoracic and abdominal aorta

221
Q
A
222
Q

Review

Thoracoabdominal aortic aneurysm classification: DeBakey and Stanford

A

DeBakey and Stanford: classified according to location of dissection

223
Q

Review

Aneurysm Key points

A
224
Q
A
225
Q
A
226
Q
A
227
Q

Review

AAA risk of rupture

A
227
Q
A
228
Q
A
229
Q
A
230
Q
A
231
Q

Review

AAA Rupture

A
232
Q
A
233
Q
A

MI

234
Q
A
235
Q
A
236
Q
A
237
Q

REVIEW

Physiologic changes associated with AoX

A
238
Q
A

decreased

239
Q
A

decreased

240
Q
A

increased

241
Q
A

increased

242
Q
A

increased

243
Q
A

increased

244
Q
A

increased

245
Q
A

increased

246
Q
A

increased

247
Q
A

decreased

248
Q
A

DECREASED

249
Q
A

increased

250
Q
A

increased

251
Q
A

decreased

252
Q
A

increased

253
Q
A

decreased

254
Q
A
255
Q

there are _____ anterior spinal artery and ______ posterior spinal arteriy

A

1

2

256
Q

Review

Anterior spinal artery syndrome

A
257
Q

SSEP monitors the ________ spinal cord

A

posterior

258
Q
A
259
Q
A
260
Q
A
260
Q
A

sensory

261
Q
A

motor

262
Q
A

sensory

262
Q
A

sensory

263
Q
A

motor

264
Q
A
265
Q

Review

amaurosis Fagux

A
266
Q

Review

Cerebral Perfusion Anatomy

A
267
Q

Review

monitors for cerebral perfusion

A
268
Q
A

false

269
Q
A

true

270
Q
A

true

271
Q
A
271
Q
A

false

272
Q
A
273
Q

subclavian steal syndrome is usually on the _________ side

A

left

274
Q

Review

Subclavian Artery Syndrome

A
275
Q
A
276
Q
A

left

277
Q
A
278
Q
A
279
Q
A
280
Q
A
281
Q
A
282
Q
A
283
Q
A
284
Q
A
285
Q
A
286
Q
A
287
Q
A
288
Q
A

APEX Review Qs (5 decks)

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