Cardiac Diseases and Rehabilitation Flashcards
(204 cards)
1
Q
The powerful contributor of cardiovascular morbidity and mortality
A
Hypertension
2
Q
JNC 8: SBP <120 & DBP <80 mmHg
A
Normal
3
Q
JNC 8: >60 years old
A
SBP <150 & DBP <90 mmHg
4
Q
JNC 8: Stage 1
A
SBP 130-139 & DBP 80-89 mmHg
5
Q
JNC 8: <60 years old and > 18 yeards old with CKD or DM
A
SBP <140 & DBP <90
6
Q
JNC 8: SBP 120-129 & DBP <80 mmHg
A
Elevated
7
Q
JNC 8: Hypertensive Crisis
A
SBP >180 & DBP >120
8
Q
JNC 8: SBP >140 & DBP >90 mmHg
A
Stage 2
9
Q
Three factors of Acute Coronary Syndrome
A
Atherosclerosis, Thrombosis, and Vasospasm
10
Q
Narrowing of blood vessels due to fatty plaque formation
A
Atherosclerosis
11
Q
Theories behind Atherosclerosis
A
Intimal Injury
12
Q
Blood vessel with the highest resistance
A
Arterioles
13
Q
Blood vessel with the highest compliance
A
Vein
14
Q
Narrowing of arteries due to hardening of the vessel
A
Arteriosclerosis
15
Q
What layer of the blood vessel is thick in arteries?
A
Tunica Media
16
Q
What layer of the blood vessel contains endothelial cells?
A
Tunica Intima
17
Q
The obstruction due to intimal injury that creates clot formation in the blood vessel
A
Thrombosis
18
Q
What component of a cigarette is a systemic vasoconstrictor?
A
Nicotine Factor
19
Q
Blood vessel with the highest cross-sectional area
A
Capillaries
20
Q
Six modifiable factors of CAD
A
Physical inactivity, tobacco smoking, increase serum cholesterol, increase BP, DM, and Obesity
21
Q
Four non-modifiable factors of CAD
A
Age, Male, Family history, and Race
22
Q
What race has a high risk for CAD?
A
African-American
23
Q
The three common manifestations of CAD
A
Angina, Ischemia and Infarction
24
Q
“Pre-infarction or Crescendo Angina”
A
Unstable Angina
25
Angina occurs during activity
Stable Angina
26
A cardiac-related chest pain
Angina
27
"Variant Angina"
Prizmental Angina
28
A potent vasodilator medicine usually given to patient's with angina
Nitroglycerin
29
Angina occurs at rest
Unstable Angina
30
Angina due to vasospasm of coronary arteries
Prizmental Angina
31
"New acute MI"
Myocardial Injury
32
The most common cause of myocardial infarction
Thrombosis
33
The total occlusion of an artery
Myocardial Infarction
34
In patients experiencing MI, how long does chest pain lasts?
20 mins to 2 hours
35
Zone of MI: (+) ST elevation
Infarction and Injury
36
What is the ultimate complication of MI?
Cardiogenic shock
37
Zone of MI: (+) ST depression
Ischemia
38
How much urine output a patient undergoing is cardiogenic shock have?
<30ml/hr
39
What specific artery is the intra-aortic balloon pump inserted?
Subclavian artery
40
Zone of MI: (+) Abn Q-wave
Infarction
41
Five usual distribution of cardiac pain
(L) UE (shoulder, arm, and FA), Jaw, (R) Chest, Epigastric pain, and Back (in between shoulder blades and scapula)
42
What nerve distribution usually the cardiac pain referred to?
Ulnar distribution
43
Fist of the chest
(+) Levine Sign
44
ECG: start of ST segment
J point
45
ECG: (+) Large acute MI
STEMI
46
The golden hour of laboratory findings of MI
15-32 hours
47
Four cardiac enzymes tested in laboratory exams for MI
CKMB, Troponin I, Myoglobin, and LDH
48
ECG: (+) Small MI
NSTEMI
49
Cardiac Enzyme: CKMB 5-10%
(+) MI CKMB
50
Cardiac Enzyme: Myoglobin (+) MI
200-500 μg/ml
51
Cardiac Enzyme: 100-225 μg/ml
Normal LDH
52
Cardiac Enzyme: peak 24-36 hours
Troponin I
53
Cardiac Enzyme: >5-10 μg/ml
(+) MI Troponin I
54
Cardiac Enzyme: <100 μg/ml
Normal Myoglobin
55
Cardiac Enzyme: peak 14-36 hours
CKMB
56
Cardiac Enzyme: Normal CKMB
0.3%
57
Cardiac Enzyme: Normal Troponin I
0-0.2 μg/ml
58
Cardiac Enzyme: LDH (+) MI
300-750 μg/ml
59
PTCA healing time
2 weeks
60
Most common donor vessel used in CABG
Saphenous Vein
61
What are the two arteries inserted by catheter in PTCA?
Femoral and Radial artery
62
Most effective donor vessel used in CABG
Internal mammary artery
63
Triceps strengthening is postponed until when?
4 weeks post-op
64
What activities are contraindicated after CABG?
STS or Supine to Long sitting
65
The three donor vessels in CABG
Saphenous Vein, Internal mammary artery, and Radial artery
66
Impaired cardiac pump
Heart Failure
67
Percentage of ejected blood
Ejection Fraction
68
The clinical syndrome caused by the accumulation of fluid in the pericardial space, resulting in the reduced ventricular filling.
Cardiac Tamponade
69
What kind of dysfunction has a compromised ventricular contraction?
Systolic Dysfunction
70
The normal range of Ejection Fraction
55-78%
71
True or False: There is an increased ejection fraction in diastolic dysfunction
False (no change)
72
How much ejections fraction decreases in systolic dysfunction?
40%
73
What kind of dysfunction has a compromised ventricular filling & relaxation?
Diastolic Dysfunction
74
Right or Left Heart Failure: Jugular Vein Distention
Right
75
Right or Left Heart Failure: Ortopnea & Trapopnea
Left
76
Right or Left Heart Failure: SOB
Left
77
SOP in an upright position
Platypnea
78
Right or Left Heart Failure: Ascites
Right
79
Right or Left Heart Failure: Bipedal Edema
Right
80
Right or Left Heart Failure: Pulmonary Edema
Left
81
SOP in a supine position
Orthopnea
82
Right or Left Heart Failure: Cerebral Hypoxia
Left
83
Right or Left Heart Failure: Cyanosis
Right
84
SOP in a side-lying position
Trapopnea
85
Right or Left Heart Failure: Muscle Fatigue
Both
86
Right or Left Heart Failure: Weight Gain
Right
87
Right or Left Heart Failure: Cough
Left
88
Right or Left Heart Failure: Muscle Weakness
Left
89
What heart sound is present in patients with CHF?
S3
90
NYHA: Marked Limitation
Class III
91
NYHA: Ordinary activity presents symptoms
Class II
92
NYHA: (+) Cardiac disease with no limitation of activity
Class I
93
NYHA: Symptoms presents at rest
Class IV
94
NYHA: Less ordinary activity presents symptoms
Class III
95
NYHA: 1.5 METs
Class IV
96
NYHA: 3-4 cal/min
Class II
97
NYHA: Class I METs
6 METs
98
NYHA: Class IV power
1-2 cal/min
99
NYHA: 4.5 METs
Class II
100
NYHA: Class I power
4-6 cal/min
101
NYHA: 2-3 cal/min
Class III
102
NYHA: Class III METs
3.0 METs
103
Four manifestations in NYHA
Fatigue, Palpitation, Dyspnea, and Angina
104
Cardiac neurohormones send signals to the kidney to decrease fluid volume
Atrial and Brain Natriuretic Peptide
105
What is a diuretic drug that decreases fluid volume?
Furosemide
106
Narrowing of heart valve
Stenosis
107
Backflow due to the incomplete valve closure
Regurgitation
108
Enlarged valve cusps
Prolapse
109
Most common valve involved in prolapse
Mitral Valve
110
Disturbance in electrical activity that leads to absent rhythm
Arrhythmia
111
A beat from a site other than SA node
Ectopic Beats
112
Beats from the ventricles create an irregular rhythm
Ventricular Ectopy
113
Quivering of atria
Atrial Fibrillation
114
Run of 4 or more PVCs
Ventricular Tachycardia
115
Quivering of ventricles
Ventricular Fibrillation
116
ECG: (-) P-wave and (+) QRS widening
Ventricular Ectopy
117
ECG: (+) P wave - non-sinus
Atrial Fibrillation
118
Two types of Ectopic Beats
PACs and PVCs
119
(+) Decrease Atrial Kick
Atrial Fibrillation
120
Symptom: no palpable pulse
Ventricular Tachycardia
121
The normal range of Atrial Kick
15-20%
122
"Irregularly Irregular"
Atrial Fibrillation
123
Firing from any location above the ventricle
Supraventricular Ectopic Beats
124
A lethal electrical conduction abnormality that can lead to cardiac arrest
Ventricular Tachycardia
125
(+) 150-250 bpm
Supraventricular Tachycardia
126
What are the two PT management that you can provide in a patient with Supraventricular Ectopic Beats?
Activate Baroreceptors by Carotid massage and Breathing technique such as holding breath
127
AV block: (+) prolonged PR interval only
First Degree AV block
128
AV block: (+) mismatch of the atrium and ventricular contraction
Third Degree AV block
129
AV block: (+) Prolonged PR interval + drop a beat
Mobitz I AV block
130
AV block: Normal PR interval + drop a beat
Mobitz II AV block
131
"Not a true arrhythmia"
Bundle Branch Block
132
"Wenckebach"
Mobitz I AV block
133
What is the ECG finding that presents a Bundle Branch Block?
Widen QRS
134
Bening Bundle Branch Block
Right Bundle Branch Block
135
Pathological Bundle Branch Block
Left Bundle Branch Block
136
How long before an artificial pacemaker gets replaced?
5-10 years
137
Infection of the inner lining of the heart
Endocarditis
138
Wall inflammation that presents an MI like symptoms (Sharp shooting pain for days)
Pericarditis
139
A rare wall inflammation condition
Myocarditis
140
Three things to watch out for in patients with wall inflammation?
HR, SOB, and Fever
141
The dilation of the arterial wall
Aneurysm
142
Four most common sites of Aneurysm
Thoracic Aorta, Femoral Artery, Popliteal Artery and Abdominal Artery
143
Two risk factors of Aneurysm
Ehlers-Danlos Syndrome and Marfan Syndrome
144
One way to detect an aneurysm
Pulsating sensations at the abdomen
145
Most common artery affected with Aneurysm
Abdominal Artery
146
Most common congenital defect
Ventricular septal defect
147
Septal defect due to the patent foramen ovale
Atrial septal defect
148
A congenital heart defect where the blood that travels from the aortal will go back to the pulmonary artery.
Patent Ductus Arteriosus
149
Four presenting conditions of Tetralogy of Fallot
Pulmonary stenosis, (R) ventricular hypertrophy, ventricular septal defect, and an overriding aorta.
150
A presenting sign of babies with TOF where a cry elicits for cyanosis on their body
Tet spells
151
Right to Left or Left to Right shunt: Atrial Septal Defect
Left to Right
152
Right to Left or Left to Right shunt: Patent Ductus Arterious
Left to Right
153
Right to Left or Left to Right shunt: Tetralogy of Fallot
Right to Left
154
Right to Left or Left to Right shunt: Ventricular Septal Defect
Left to Right
155
A condition caused by the reversal of shunting (left to right shunts lead to the right to left shunt due to the overfilling of (R) side of the heart
Eisenmenger Syndrome
156
The ability of the individual to do work or perform an exercise
Aerobic capacity
157
The formula for Rate Pressure Product
RPP = HR x SBP
158
Unit of Aerobic Capacity
VO2max
159
True or False: VO2max = MET
True
160
The normal range of RPP
25-35 mmHg x bpm/10*3
161
Karvonen's Formula
THR = RHR + 60-70% (MHR - RHR)
162
Blood volume per heartbeat
Stroke Volume
163
Blood volume per minute
Cardiac Output
164
Five factors to consider before doing aerobic training
Aerobic Capacity, HR, SV, CO and MVO2
165
An increase of what will lead to an increase of MVO2?
Workload
166
Four determinants of exercise
Frequency, Intensity, Time and Type of Exercise (FITT)
167
Minimum time for aerobic exercise
20-30 minutes
168
The frequency for moderate-intensity exercise
3x/wk
169
Components of Intensity in exercise
Max HR and THR
170
The frequency for low-intensity exercise
5x/wk
171
What benefits of exercise should increase?
VO2 max, CO, and SV
172
What factors should decrease after constant aerobic training?
HR at rest, MVO2, Peripheral Resistance
173
True or False: Maximum HR doesn't change after exercise
True
174
Three factors that increase MVO2
Cold weather, after eating, after smoking
175
METS: 5
Sex with wife
176
METS: Office Work
1.3-2.3
177
RPE: weak
2
178
METS: 1.5
Eating
179
METS: 5.7
2 step climb
180
RPE: 5
very strong
181
RPE: 7
very very light
182
METS: 4
Bed Pan
183
METS: 7.4
Running
184
METS: 1.4-2.0
Standing
185
RPE: very very hard
19
186
METS: Walking 3mph
4.3
187
RPE: 3
Moderate
188
RPE: 11
Fairly Light
189
METS: Ascending Stairs
9
190
METS: Wheelchair and drive
2.8
191
METS: Walking 1mph
2.3
192
RPE: 13
Somewhat Hard
193
METS: 3.5
Shower
194
METS: sitting
1.2-1.6
195
Cardiac Rehab Phase: MET 1-2, RPE 11
Phase 1
196
Cardiac Rehab Phase: 70-85% HR max
Phase 2
197
Cardiac Rehab Phase: 3-4x/wk
Phase2
198
Cardiac Rehab Phase: Maintenance
Phase 3
199
Phase I Level: Increase ambulation by frequency and time
Level 4-6
200
Phase I Level: ICU
Level 1
201
Phase I Level: Increase ambulation
Level 3
202
Phase I Level: Bed Side
Level 2
203
Phase I Level: 2-2.5 METs
Phase 3-6
204
Phase I Level: 1.5-2 METs
Phase 2
