Unit 3.3: CV Pathophysiology Flashcards by Mik Corinne

Q

A

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Review

perioperative risk factors for MI

A

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Review

risk of perioperative MI

A

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Q

Review

NYHA Heart Failure classification

A

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Q

what degree of surgical risk is: Breast Surgery

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

A

C

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Q

what degree of surgical risk is: cataract Surgery

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

A

C

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Q

what degree of surgical risk is: endoscopic Surgery

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

A

C

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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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Q

what degree of surgical risk is: orthopedic Surgery

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

A

B

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Q

what degree of surgical risk is: CEA Surgery

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

A

B

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Q

what degree of surgical risk is: intrathoracic Surgery

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

A

B

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Q

what degree of surgical risk is: emergency Surgery

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

A

A

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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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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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Q

A

30%

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Q

A

0.3%

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A

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A

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Review

O2 delivery vs o2 demand

A

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Q

Review

O2 delivery vs o2 demand chart

A

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Q

Review

MYOCARDIAL ISCHEMIA: BIOMARKERS

A

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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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Q

Review

treatment of ischemia

A

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A

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Q

A

CK-MB

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Q

A

V3
V4
V5

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Q

hypocapnia will

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

A

A

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Q

increase in wall tension will

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

A

B

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Q

SNS stimulation will

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

A

B

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Q

decreased aortic. pressure will

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

A

A

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Q

anemia will

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

A

A

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Q

hypertension will

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

A

B

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Q

decreased P50 will

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

A

A

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Q

increased contractile force will

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

A

B

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A

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Q

Review

diastolic compliance

A

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Review

A

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A

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Q

myocardial ischemia

A. Increases myocardial compliance
B. decreases myocardial compliance

A

B

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Q

chronic aortic insufficiency

A. Increases myocardial compliance
B. decreases myocardial compliance

A

A

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Q

dilated cardiomyopathy

A. Increases myocardial compliance
B. decreases myocardial compliance

A

A

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Q

aortic stenosis

A. Increases myocardial compliance
B. decreases myocardial compliance

A

B

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Q

pericardial tamponade

A. Increases myocardial compliance
B. decreases myocardial compliance

A

B

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Q

old age

A. Increases myocardial compliance
B. decreases myocardial compliance

A

B

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Q

hypertrophic obstructive cardiomyopathy

A. Increases myocardial compliance
B. decreases myocardial compliance

A

B

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Q

A

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Q

Review

decreased compliance

A

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Q

Review

HF classification and etiology

A

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Review

pathophysiologic changes that accompany CHF

A

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Q

Review

Anesthetic management of HF

A

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Q

Review

conditions that increase PVR

A

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Q

Review

treatment of RV Failure

A

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A

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A

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A

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A

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A

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A

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A

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A

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Q

Review

HTN diagnosis

A

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Q

REVIEW

Cerebral aurtoregulation

A

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Q

texts recommend delaying surgery if:

SBP:

DBP:

A

SBP: > 180 mmHg

DBP: > 110 mmHg

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Q

Hypertensive crisis is a BP of

A

180/120

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A

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A

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A

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Q

Review

HTN: Secondary Causes

A

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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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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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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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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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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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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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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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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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Q

A

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Q

Review

Drugs that target the ANS

A

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Q

Review

Drugs that target the Myocardium and Vascular smooth muscle

A

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Q

Review

Drugs that target the kidney

A

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Q

what drug class:

prasozin

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

A

A

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Q

what drug class:

diltiazem

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

A

C

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Q

what drug class:

phenoxybenzamine

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

A

A

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Q

what drug class:

clevidipine

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

A

C

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Q

what drug class:

clonidine

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

A

B

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Q

what drug class:

phentolamine

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

A

A

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Q

what drug class:

Verapamil

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

A

C

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Q

what drug class:

dexmedetomidine

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

A

B

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Q

what drug class:

captopril

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

A

A

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Q

what drug class:

enalapril

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

A

A

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Q

what drug class:

benazapril

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

A

A

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Q

what drug class:

valsartan

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

A

B

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Q

what drug class:

amiloride

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

A

C

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Q

what drug class:

triamterene

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

A

C

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Q

what drug class:

azilsartan

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

A

B

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Q

what drug class:

losartan

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

A

B

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Q

A

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Q

what are the 3 types of voltage-gated calcium channels

A

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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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Q

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

diltiazem
nifedipine
verapamil
nicardepine

A

verapamil > nifedipine > diltiazem > nicardpine

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Q

Review

CCBs and Vascular tone

A

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Q

Review

CCBs and heart rate

A

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Q

t or F: clevidipine does not impair cardiac contractility

A

F

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Q

sort to the drug class

verapamil

A. Dihydropyridines
B. Non-Dihydropyridines

A

B

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Q

sort to the drug class

diltiazem

A. Dihydropyridines
B. Non-Dihydropyridines

A

B

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Q

sort to the drug class

nimodipine

A. Dihydropyridines
B. Non-Dihydropyridines

A

A

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Q

sort to the drug class

nifedipine

A. Dihydropyridines
B. Non-Dihydropyridines

A

A

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A

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A

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A

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A

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Q

REVIEW

Pericarditis pathophysiology

A

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Q

Pericardial knock is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

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Q

Kussmaul’s Sign is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

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Q

Pulsus Paradoxus is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

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Q

Pericardial Friction Rub is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

Q

Chest pain with inspiration is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

Q

fever is a sign/symptom of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

Q

trauma is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

Q

tuberculosis is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

Q

Rheumatoid arthritis is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

Q

systemic lupus erythematosus is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

Q

previous cardiac surgery is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

Q

uremia is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

A

Q

dressler’s syndrome is an etiology of

A. Constrictive pericarditis
B. Acute pericarditis

A

B

Q

A

Q

select how SNS tone relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

Q

select how Inotropy relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

Q

select how Cardiac output relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

B

Q

select how stroke volume relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

B

Q

select how heart rate relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

Q

select how pericardial pressure relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

Q

select how pericardial volume relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

Q

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

A. Increases
B. Decreases

A

B

Q

select how LVEDV relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

B

Q

select how LVEDP relates to the pathophysiology of pericardial tamponade

A. Increases
B. Decreases

A

A

Q

best method of diagnosis for cardiac tamponade

A

TEE

Q

Review

presentation of a cardiac tamponade

A

Q

what is becks triad

A

HOTN
JVD
Muffled heart tones

Q

define pulsus paradoxus

A

SBP decreases > 10 mmHg during inspiration

Q

what is kussmauls sign

A

Increased CVP
JVD during inspiration

Q

A

Q

Review

anesthetic management of Cardiac tamponade

A

Local ANE is preferred

Q

Review

hemodynamic goals for cardiac tamponade

A

Q

select appropriate option for treatment of a pericardial tamponade

opioids

A. Safe
B. Do not administer

A

A

Q

select appropriate option for treatment of a pericardial tamponade

benzodiazepines

A. Safe
B. Do not administer

A

A

Q

select appropriate option for treatment of a pericardial tamponade

nitrous oxide

A. Safe
B. Do not administer

A

A

Q

select appropriate option for treatment of a pericardial tamponade

propofol

A. Safe
B. Do not administer

A

B

Q

select appropriate option for treatment of a pericardial tamponade

ketamine

A. Safe
B. Do not administer

A

A

Q

select appropriate option for treatment of a pericardial tamponade

sevoflurane

A. Safe
B. Do not administer

A

B

Q

select appropriate option for treatment of a pericardial tamponade

thiopental

A. Safe
B. Do not administer

A

B

Q

select appropriate option for treatment of a pericardial tamponade

subarachnoid block

A. Safe
B. Do not administer

A

B

Q

A

Q

A

Q

A

Q

Review

antibiotic prophylaxis for infective endocarditis

A

Q

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

A

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

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

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

Q

Does the following need antibiotic prophylaxis for infective endocarditis

TEE

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

A

B

Q

Does the following need antibiotic prophylaxis for infective endocarditis

cystoscopy

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

A

B

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

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

Q

Does the following need antibiotic prophylaxis for infective endocarditis

CABG

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

A

B

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

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

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

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

Q

Review

factors that determine blood flow through the LVOT

A

Q

Review

ANE management obstructive hypertrophic cardiomyopathy

A

Q

define SAM

A

Q

A

Q

A

Q

A

worsens

Q

A

improves

Q

A

improves

Q

A

worsens

Q

A

improves

Q

A

worsens

Q

A

improves

Q

A

worsen

Q

A

worsens

Q

A

30 days

Q

Review

time of surgery after PCI

A

Q

A

Q

A

Q

A

Q

is centrifugal pump or roller pump preferred for CPB

A

centrifugal pump

Q

A

centrifugal pump

Q

A

roller pump

Q

A

centrifugal pump

Q

A

roller pump

Q

A

centrifugal pump

Q

A

roller pump

Q

what is the preferred type of oxygenator for CPB

A

membrane oxygenator

Q

A

Q

A

airlock

Q

A

Q

approriate heparinization for CPB

A

> 400 seconds for ACT

Q

ideal SBP for aortic cannulation prior to CPB

A

SBP 90-100 or MAP < 70 mmHg

Q

A

Q

A

Q

A

Q

A

Q

A

Q

Review

IABP indications and Contraindications

A

Q

Review

IABP & how it works

A

Q

how do we confirm IABP placement

A

CXR
fluoroscopy
TEE

Q

complications of IABP

A

vascular injury
infection at insertion site
thrombocytopenia

Q

A

Q

A

left subclavian artery

Q

A

Q

A

the left = balloon deflates

the right = balloon inflates

Q

A

Q

A

sepsis

Q

A

Q

A

Q

Review

Thoracoabdominal aortic aneurysm classification: Crawford

A

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

Q

A

Q

Review

Thoracoabdominal aortic aneurysm classification: DeBakey and Stanford

A

DeBakey and Stanford: classified according to location of dissection

Q

Review

Aneurysm Key points

A

Q

A

Q

A

Q

A

Q

Review

AAA risk of rupture

A

Q

A

Q

A

Q

A

Q

A

Q

Review

AAA Rupture

A

Q

A

Q

A

MI

Q

A

Q

A

Q

A

Q

REVIEW

Physiologic changes associated with AoX

A

Q

A

decreased

Q

A

decreased

Q

A

increased

Q

A

increased

Q

A

increased

Q

A

increased

Q

A

increased

Q

A

increased

Q

A

increased

Q

A

decreased

Q

A

DECREASED

Q

A

increased

Q

A

increased

Q

A

decreased

Q

A

increased

Q

A

decreased

Q

A

Q

there are _____ anterior spinal artery and ______ posterior spinal arteriy

A

1

2

Q

Review

Anterior spinal artery syndrome

A

Q

SSEP monitors the ________ spinal cord

A

posterior

Q

A

Q

A

Q

A

Q

A

sensory

Q

A

motor

Q

A

sensory

Q

A

sensory

Q

A

motor

Q

A

Q

Review

amaurosis Fagux

A

Q

Review

Cerebral Perfusion Anatomy

A

Q

Review

monitors for cerebral perfusion

A

Q

A

false

Q

A

true

Q

A

true

Q

A

Q

A

false

Q

A

Q

subclavian steal syndrome is usually on the _________ side

A

left

Q

Review

Subclavian Artery Syndrome

A

Q

A

Q

A

left

Q

A

Q

A

Q

A

Q

A

Q

A

Q

A

Q

A

Q

A

Q

A

Q

A

Q

A

Q

A