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Cardiopulmonary > Week 2 > Flashcards

Week 2 Flashcards

1
Q

risk factors for CHD

A

increasing age
family hx of CVD
gender (specifically male)
uncontrolled hypertension
elevated total cholesterol
uncontrolled diabetes
smoking
physical inactivity
obesity
poorly controlled DM
postmenopausal
uncontrolled stress
poor diet
alcohol use

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2
Q

cholesterol is essential component for

A

cell walls/cell fluidity
precursor molecule for vitamin D, steroid hormones

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3
Q

what level of cholesterol is desirable

A

<200 mg/dL

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4
Q

for effective transport, cholesterol requires a carrier molecule–

A

a lipoprotein

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5
Q

a lipid panel includes

A

the amount of total cholesterol, HDL, LDL, and trigylcerides present in the blood

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6
Q

high density lipoproteins (HDL)

A

“good cholesterol”
mobilized to be used for energy

exercise increases HDL concentrations

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7
Q

low density lipoproteins (LDL)

A

“bad cholesterol”
can invade the tunica interna of BV and remain there, forming an atheroma

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8
Q

increased LDLs=

A

increased plaque formation and increased risk for CV disease

LESS IS BETTER

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9
Q

VLDL cholesterol

A

difficult to measure
estimated as a percentage of your triglyceride value

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10
Q

high levels of VLDL cholesterol have been associated with the development of

A

plaque deposits on artery walls

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11
Q

lipoprotein A

A

high levels associated with atherosclerosis
independent risk factor for CAD and CHD

forms fatty plaques

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12
Q

cholesterol ratios– a lower ratio means there is

A

a lower risk of heart disease

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13
Q

cholesterol ratio is recommended to be

A

5 or less

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14
Q

high levels of triglycerides in the blood stream have been linked to

A

atherosclerosis and therefore heart disease/stroke

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15
Q

CIS fatty acids

A

unsaturated
GOOD for health
naturally occuring

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16
Q

TRANS fatty acids

A

unsaturated
BAD for health
uncommon in nature

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17
Q

triglycerides are managed by

A

medications (statins) and lifestyle changes

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18
Q

diabetes is a disease of

A

hyperglycemia

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19
Q

patients with DM commonly exhibit

A

LV diastolic dysfunction

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20
Q

structural abnormalities that are characteristic of a diabetic heart

A

fibrosis
cardiac hypertrophy
impaired coronary microvascular perfusion
mitochondria dysfunction
impaired calcium handling

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21
Q

CPK-MB

A

most specific of the three types of CPK for myocardial injury

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22
Q

CPK-MM

A

most conclusive for skeletal muscle damage

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23
Q

CPK-BB

A

most conclusive for brain tissue injury

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24
Q

aspartate aminotransferase

A

AST
liver enzyme

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25
Q

lactate dehydrogenase

A

LDH
found in nearly every cell

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26
Q

TnC

A

binds to calcium

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27
Q

TnI

A

inhibits interaction between actin and myosin

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28
Q

TnT

A

links troponin complex to tropomyosin

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29
Q

troponin I peak

A

12-24 hours

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30
Q

troponin T peak

A

10-24 hours

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31
Q

myoglobin peak

A

3-15 hours after injury

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32
Q

how early can myoglobin be detected

A

as early as 2 hours after injury

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33
Q

atrial natriuretic peptide is secreted in response to

A

atrial distention (increased atrial volume)

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34
Q

ANP limits ___ and results in _____

A

limits activation of the RAAS system
results in vasodilation and diuresis leading to decreased preload/afterload and decreased workload on the heart

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35
Q

ANP serum levels increase with

A

increasing severity of heart failure

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36
Q

brain natriuretic peptide (BNP) is released in response to

A

excessive ventricular distention

caused by blood volume expansion and reduced GFR

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37
Q

BNP is the gold standard measurement of

A

HEART FAILURE

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38
Q

_____ levels of BNP are bad

A

HIGH

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39
Q

stage 1 of HF

A

no limitation of physical activity
activity does not cause undue breathlessness, fatigue, or palpitations

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40
Q

stage 2 HF

A

slight limitation of physical activity
comfortable at rest but ordinary physical activity results in undue breathlessness, fatigue, or palpitations

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41
Q

stage 3 HF

A

marked limitation of physical activity.
comfortable at rest but less than ordinary physical activity results in due breathlessness, fatigue, or palpitations

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42
Q

stage 4 HF

A

unable to carry on any physical activity without discomfort
symptoms at rest can be present
if any physical activity is undertaken, discomfort is increased

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43
Q

c reactive protein is produced in

A

the liver

44
Q

CRP is increased during inflammatory states like

A

atherosclerosis, CHF, cancer, infection, or liver dysfunction

45
Q

serum creatinine is filtered by

A

the kidneys

46
Q

elevated serum creatinine may be an independent predictor of

A

cardiovascular mortality

47
Q

indication:
rhythm abnormalities

A

tests:
holter monitor
12 lead ECG
exercise ECG
EPS mapping

48
Q

indication:
ischemia

A

tests:
resting ECG
exercise ECG
pharmacologic stress testing
cardiac MRI
cardiac catheterization
contract echocardiogram
PET

49
Q

indication:
valve integrity

A

echocardiography
contrast echocardiography
cardiac catheterization

50
Q

indication:
ventricular size and EF

A

tests:
chest xray
echocardiography

51
Q

indication:
cardiac muscle and pump function

A

tests:
echocardiography
ventriculography
MUGA

52
Q

indication:
acute myocardial infarction

A

tests:
cardiac enzymes and markers
resting ecg

53
Q

indication:
vascular diagnostic testing

A

tests:
ankle brachial index
segmental limb pressures
pulse volume recordings
arterial duplex ultrasonography
exercise studies

54
Q

holter monitor is ordered to

A

detect and assess arrhythmias

also evaluates the effectiveness of antiarrhythmic therapy

55
Q

echocardiogram

A

ultrasound images of the heart

56
Q

echocardiogram provides

A

real time images of the beating heart and
information about blood flow

56
Q

abnormalities seen on an echocardiogram

A
  • size of ventricular cavity
  • thickness and integrity of septa
  • function of valves
  • motions of individual segments of ventricular walls
  • volumes of the L ventricle
  • assessment of heart performance
  • estimate stroke volume and EF
  • analyze motion of valves and heart muscle
57
Q

Surface or transthoracic echocardiography

A

the echo transducer is moved on the skin over the heart
basic model (pic in last slide)

58
Q

Transesophageal Echocardiography

A

the echo transducer is swallowed
very clear images of heart structures and valves

59
Q

Stress Echocardiography

A

Imaging is done while the patient during or after (or both) exercising

60
Q

positron emission tomography (PET)

A

very expensive
uses radioactively labeled glucose

61
Q

what does a PET scan measure

A

cardiac metabolism and blood flow of the heart

62
Q

what does a PET scan detect

A

cardiac tissue viability, but not quality of movement nor anatomy

63
Q

single photon emission computed tomography

A

detects and quantifies myocardial perfusion defects//contraction defects

64
Q

radionuclide perfusion imaging

A

nuclear stress test
provides information on myocardial perfusion, viability, global and regional L ventricular systolic function

65
Q

radionuclide perfusion imaging is used to

A
  1. assess ongoing chest pain
  2. dx CAD
  3. look for post MI heart muscle damage
  4. assess blood flow to areas of the heart that have undergone revascularization procedures
  5. look for scar tissue in the heart from other diseases
66
Q

barriers to MRI

A

pacemaker
artificial joint
metallic devices

67
Q

magnetic resonance angiography

A

a type of MRI that looks specifically at the body’s blood vessels

68
Q

what is magnetic resonance angiography used for

A

arterial aneurysm
aortic dissection
carotid artery disease

69
Q

left heart catheterization implication

A
  • the femoral artery
  • bed rest for 6-8 hours with involved LE straight
  • knee immobilizer to minimize hip flexion
  • monitor for groin hematomas and pain
70
Q

right heart catheterization implication

A
  • used to dx right ventricular, atrial, and pulmonary artery impairments
  • the incision site is generally via the external jugular vein and there are no activity restrictions
71
Q

computer tomography

A

machine takes 2D pictures and a computer assembles these slices to create a detailed iamge

72
Q

CAT angiography

A

imaging test that looks at the arteries that supply blood to your heart

73
Q

CAT angiography is used to dx

A
  • aneurysms
  • blockages
  • blood clots
  • congenital abnormalities of the cardiovascular system
  • disorganized blood vessels (vascular malformations)
  • vessel rupture or tears
74
Q

cardiac calcium scan

A

uses special xray equipment to produce pictures of the coronary arteries to determine if they are blocked or narrowed by the buildup of plaque

75
Q

cardiac calcium scan
when calcium is present…

A

the higher the score and the higher the risk of heart disease

76
Q

cardiac calcium scan
score of 0

A

no plaque

77
Q

cardiac calcium scan
score of 1-10

A

small amount of plaque

78
Q

cardiac calcium scan
score of 11-100

A

some plaque

79
Q

cardiac calcium scan
score of 101-400

A

moderate amount of plaque

80
Q

cardiac calcium scan
score of over 400

A

large amounts of plaque

81
Q

doppler ultrasound shows

A
  • DVT
  • blockages in arteries
  • check blood flow in your veins, arteries, and heart
  • locate aneurysms
82
Q

MUGA scan
multigated acquisition scan

A

creates a video of the blood moving through the ventricles and out to systemic circulation to determine whether they are pumping properly and if blood is moving through them properly

inflow and outflow tracts

83
Q

MUGA scan shows any abnormalities in

A

the size of the chambers and in the movement of blood through the heart to allow for calculation of EF

84
Q

AEs of vasodilators

A

headache
dizziness
hypotension
**especially with sublingual forms

85
Q

sublingual nitrogylcerin tablets

A

acts in 1-3 minutes
helps avoid the first pass effect

86
Q

drugs that increase myocardial oxygen supply

A

thrombolytic agents
antiplatelet agents
anti coagulants
calcium-channel blockers

87
Q

AEs of anti-clotting drugs

A

bruising
bleeding

88
Q

pradaxa vs warfarin

A

pradaxa– less monitoring involved

warfarin– INR monitoring

89
Q

positive iontropes

A

drugs that increase myocardial contractility

90
Q

negative iontropes

A

drugs that decrease contractility

91
Q

diuretics do what to preload

A

decrease

92
Q

sodium channel blockers

A

decreases AP frequency

93
Q

calcium channel blockers

A

good for arrhythmias and BP issues

94
Q

AEs of cardiac arrhythmias

A

can cause/trigger different forms of arrhythmia

95
Q

AEs of beta blockers

A

can cause fatigue, weakness, decreased libido

patients in BB respond differently during exercise

96
Q

AEs of all antihypertensive drugs

A

can cause a drop in blood pressure resulting in orthostatic hypotension, dizziness, fainting, and falls

97
Q

AEs of calcium channel blockers

A

can cause swollen ankles, arrhythmia, and MI in older adults

98
Q

AEs of ACE inhibitors

A

can cause persistent dry cough
manifests as an allergy

99
Q

AEs of diuretics

A

can cause electrolyte imbalance resulting in confusion, dizziness, unreasonably fatigue, and dehydration

100
Q

what numbers qualify for postural hypotension

A

Decrease in SBP >20 mmHg or decrease in DBP of 10 mmHG

101
Q

mechanism of statins

A

inhibit LDL synthesis
increase LDL catabolism

102
Q

side effects of statins

A

constipation, diarrhea, gas heartburn, stomach pain, dizziness, headache, nausea, myopathy,

***rhabdomylosis, renal dysfunction, neuropathy, liver failure

103
Q

classical symptoms of hyperglycemia

A

polyuria
polydipsia
polyphagia

104
Q

AEs of diabetes mellitus medications

A

hypoglycemia, coma, death

105
Q
A

Cardiopulmonary (6 decks)

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