Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fall'20 Advanced Principles II > Valves > Flashcards

Valves Flashcards

1
Q

What is mitral valve prolapse

A

Prolapse of one or both mitral valve leaflets into the left atrium during systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What disorder can accompany MVP

A

Mitral regurgitation- it can be with or without it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What type of murmur is associated with mvp

A

Systolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name the most common form of valvular heart disease

A

MVP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MVP can be associated with what conditions

A 
Marfan
Rheumatic carditis
Myocarditis
Thyrotoxicosis
SLE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What symptoms do MVP patients have

A 
Anxiety
Orthostatic symptoms
Palpitations
Dyspnea
Fatigue
Atypical chest pain
Cardiac dysrhthmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Patients experiencing cardiac dysrhythmias respond well to which drugs

A

Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

In MVP what is done to decrease the degree of mvp

A

Keep left ventricle large-decrease ventricular emptying and increase ventricular volume via HTN-vasoconstriction- myocardial depression and volume resuscitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

True or false

Most patients with mvp have normal left ventricular function and tolerate all forms of general and regional anesthesia

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Should ketamine be used in mvp

A

No- poor choice due to its ability to stimulate the sympathetic nervous system and enhance left ventricular emptying causing increase in prolapse and regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name the two factors associated with the development of aortic stenosis

A

Calcified aortic stenosis- from aging

Bicuspid aortic valve - most common congenital valvular abnormality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If a patient has BAV what age does stenosis develop

A

Often develops earlier in life age 30-50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What other complication is associated with BAV- leading to what higher risk

A

Dilatation of the aortic root and or ascending aorta- giving them a higher risk of aortic dissection and rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why do patients with aortic stenosis develop angina in the absence of coronary disease

A

The concentric hypertrophy creates increase in myocardial oxygen requirements and the stenosis valves create increase in myocardial work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the classical symptoms of critical aortic stenosis

A

SAD
syncope
Angina pectoris
Dyspnea on exertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is it important to listen for systolic murmurs in older patients scheduled for surgery

A

Many patients with aortic stenosis are asymptomatic

17
Q

Auscultation in a patient with AS reveals what type of murmur

A

Systolic murmur

Heard best in the aortic area

18
Q

The systolic murmur in AS may mimic what.?

A

Mimic carotid bruit-echo to confirm but remember these patient frequently have concomitant carotid artery disease- so this finding could deserve special attention

19
Q

In the elderly symptomatic patients with AS-what lab finding may be concerning and why

A

Elevated levels of bnp may suggest clinical decompensation- an elevated bnp has been associated with a decreased 1 year survival after AVR

20
Q

Can coronary revascularization occur at the same time as avr

A

Yes

21
Q

Tavr is contraindicated in patients with ____why

A

BAV owing to concerns of malfunction and malposition because of the abnormal valve anatomy

22
Q

In patients with AS what symptoms can occur if hypotension develops

A

Myocardial ischemia and further deterioration in left ventricular function and cardiac output.
Hypotension treatment is mandatory to prevent cardio genie shock and or cardiac arrest

23
Q

What anesthesia is avoided in AS

A

General is preferred over epidural or spinal as regional can lead to significant hypotension- avoid ketamine due to tachycardia
Opioid induction may be useful if left ventricular function is compromised

24
Q

Patients with AS can be maintained with what combination of drugs during anesthesia

A

Nitrous oxide + volatile anesthetic + opioids or with opioids alone

25
Q

In a patient with AS and marked left ventricular dysfunction- how should anesthesia be maintained

A

Nitrous oxide + opioids or opioids alone in high doses is recommended

26
Q

Patients with AS should be treated with what drug when hypotensive

A

Phenylephrine

27
Q

Patient with AS DEVELOPS A JUNCTIONAL RHYTHM OR BRADYCARDIA- what three meds must you consider

A

Atropine-ephedrine- glycopyrrolate

28
Q

Patient with as develops SVT- how do you terminate it

A

Promptly with cardioversion

29
Q

AS patients have a propensity to develop ventricular dysrhythmias- what must you have available

A

Lidocaine- amiodarone and defibrillator

30
Q

In patients with AS- what is it important to remember about pulmonary occlusive pressure reading

A

It may overestimate left ventricular end diastolic volume because of the decreased compliance of the hypertrophied left ventricle

31
Q

What is the result of ACUTE aortic regurgitation

A

The ventricle has not had time to compensate- leading to coronary ischemia rapid deterioration in left ventricular function and heart failure

32
Q

When do symptoms appear for aortic and mitral regurgitation

A

When left ventricular dysfunction is present

Fall'20 Advanced Principles II (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions