Cardiology Flashcards
(138 cards)
1
Q
IDENTIFY THE AREA OF INJURY OR INFARCTION:
_____ is represented by inverted T Waves.
A
Cardiac Ischemia
2
Q
IDENTIFY THE AREA OF INJURY OR INFARCTION:
_____/_____ is represented by elevated “ST” Segment.
A
AMI/STEMI (cardiac injury)
3
Q
IDENTIFY THE AREA OF INJURY OR INFARCTION:
_____ is represented by deep “Q” waves.
A
Cardiac Necroses (MI or previous infarction)
4
Q
IDENTIFY THE AREA OF INJURY OR INFARCTION:
Deep Q Waves is _____.
A
Cardiac Necrosis
MI or previous myocardial infarction
5
Q
IDENTIFY THE AREA OF INJURY OR INFARCTION:
Inverted “T” waves is _____. aka ST depression.
A
Ischemia
6
Q
IDENTIFY THE AREA OF INJURY OR INFARCTION:
ST Elevation is injury leading to _____.
A
Infarction (STEMI or AMI)
7
Q
IDENTIFY THE AREA OF INJURY OR INFARCTION:
Peak “T” wave can mean _____.
A
Hyperkalemia (dialysis patient)
8
Q
The P Wave represents _____.
A
Atrial Depolarization
9
Q
How long is the PR Interval?
A
.12-.20 or 3-5 small boxes
10
Q
In regards to PR Interval anything greater than _____ or _____ means a block.
A
.20 or 5 small boxes.
11
Q
In regards to PR Intervals, blood is filling the _____ at this time.
A
Ventricles
12
Q
What is the speed of paper?
A
25 mm/sec
13
Q
Each small box on a EKG strip is _____ mm/sec.
A
.04 mm/sec
14
Q
Normal width of QRS:
A
2-3 small boxes
Or
.08-.12 milliseconds
15
Q
What is happening if the QRS is too wide?
A
It is related to slower spread of ventricular depolarization
16
Q
Why could a QRS be wide?
A
Due to SVT with block, BBB, V-Tach, Hypertrophy
17
Q
_____: Sudden onset; pain ripping or tearing sensation; pain radiating to neck, back, shoulders or abdomen; Stridor or hoarseness; two different BP’s; dysphagia.
Could show SS’s of hypovolemic shock after rupture.
Treatment: surgical; maintain BP w/ morphine; DONT increase BP
A
Thoracic Aortic Aneurysm
18
Q
_____: Lower abdominal pain on the left side; palpable abdominal pulse; lower back of flank pain; equal or absent distal pulses.
Pain may be constant or intermittent.
Treatment: transport quickly but drive carefully
A
AAA
(Abdominal Aortic Aneurism?)
19
Q
Type of Risk Factor for Cardiac Patient:
_____: blood pressure, diet, exercise, stress and sugar.
A
Modifiable Risk Factors (Changeable)
20
Q
Type of Risk Factor for Cardiac Patient:
_____: age, race, sex, heredity (biggest factor)
A
Not-Modifiable
21
Q
Normal Rate for SA Node:
A
60-100
22
Q
Normal rate for AV Node:
A
40-60
23
Q
Normal Rate for Purkinje Fibers:
A
20-40
24
Q
Rate for accelerated Junctional:
A
60-100
25
Drugs for blood pressure and heart rate control: (7)
Atropine, Adenosine, Amiodarone, Epi, Lidocaine, Mag, -olol drugs.
26
IV Bolus ___ to ___ normal saline.
1 to 2 Liter
27
Norepinephrine (levophed) ___ to___ mcg/kg/min to achieve a minimum SBP of >___.
.1 to .5 mcg/kg/min
90
28
Epinephrine ___ to ___ mcg/min IV infusion until SBP >___.
2 to 10 mcg/min IV
90
29
Dopamine ___ to ___ mcg/kg/min IV until SBP >___.
5 to 20 mcg/kg/min
90
30
_____: dyspnea, Rales, tachycardia, decreased BP, increased respirations, diaphoreses, arrhythmias; increased blood volume in lungs and liver due to pump failure.
Treatment- consider dopamine to increase BP; 2-20mcg/kg/min.
Cardiogenic Shock
31
ATROPINE:
Dose-
Sympathetic or Parasympathetic agent
Works on Atrium or Ventricles
Treats what heart condition
What does it do to the body
- 1 mg max of 3 doses
- Parasympathetic agent
- Works on Atrium
- Treats bradycardia
- Reverses vagal tone
32
DOPAMINE
Dose
Sympathetic or Parasympathetic agent
Works on Atrium or Ventricles
Treats what heart condition
What does it do to the body
- 5-20 mcg/kg drip
- Parasympathetic agent
- Causes more forceful Ventricular contractions
- Rate and force of Ventricles
- Peripheral Vasoconstriction
33
EPINEPHRINE:
Dose
Sympathetic or Parasympathetic agent
Works on Atrium or Ventricles
Treats what heart condition
What does it do to the body
- 2-10 mcg/min IV
- Parasympathetic Agent
- Both
- Increases heart rate
- Alpha effects/vasopressor/vasoconstricts
34
_____: is a broad term for the condition in which the arteries narrow and harden, leading to poor circulation of blood throughout the body.
Arteriosclerosis
35
_____: the thickening or hardening of the arteries caused by a buildup of plaque in the inner lining of an artery.
Atherosclerosis
36
_____ risk factors may include high cholesterol and triglyceride levels, high blood pressure, smoking, diabetes, obesity, physical activity and eating saturated fats.
Atherosclerosis
37
_____ goes away with nitro or when hard work stops.
Stable Angina
38
_____ is not helped by nitro; happens rapidly with no physical work.
Unstable Angina
39
ST Elevation = _____
STEMI
40
Inverted P Wave means _____.
Junctional
41
_____ drugs effect the force of cardiac contraction.
Inotropic
42
_____ drugs affect the heart rate.
Chronotropic
43
_____ drugs affect conduction velocity/speed through the conducting tissues of the heart.
Dromotropic
44
What to do with unstable A Flutter, A Fib, SVT, V-Tach or Torsades with a pulse?
Synch Cardiovert
45
What to do with V-Fib or V-Tach with no pulse?
Defibrilate
46
Loss of oxygen, blood and sugar in the heart stimulates _____ and will cause _____ which does what to extremities.
Release of epinephrine
Alpha-constriction/vasoconstriction
Steals blood/oxygen from the extremities
47
Parasympathetic or Sympathetic?
_____: innervates through SA node and will cause bradycardia.
Parasympathetic
48
_____ is the volume of blood pumped out of the left ventricle of the heart during each systolic cardia contraction.
Stroke Volume
49
The average stroke volume of a 70 kg make is _____ mL.
70 mL
50
Not all of the blood that fills the heart by the end of diastole (_____) can be ejected from the heart during systole.
End-Diastolic Volume - EDV
51
The volume left in the heart at the end of systole is _____.
End-Systolic Volume (ESV)
52
_____= EDV - ESV
Stroke Volume
53
_____ is the blood volume the heart pumps through the system in circulation over a period measured in liters per minute.
Cardiac Output
54
CO = ___ x ___
SV x HR
55
Typically after a heart attack, how long does it take a life threatening arrhythmia to appear?
24-48 hours
56
Public education relating to cardiovascular disease (CVD) focuses on _____ and not responding to it.
Prevention
57
BP = ___ x ___ x ___
SV x HR x Peripheral Vascular Resistance (PVR)
58
Ventricles (Purkinje Fibers) rate: *for tests
15-40 bpm
59
Signs and Symptoms of _____/_____:
Dyspnea, Rales, tachycardia, chronic atrial arrhythmias, pink frothy sputum, orthopnea, increased BP.
Treatment: O2, Nitro, Morphine, CPAP
CHF/Left side heart failure
60
Treatment of chest pain: (4)
O2, Nitro, Aspirin, Morphine
61
_____: the initial stretching of the cardiac myocytes prior to contraction.
Preload
62
_____: the amount of pressure that the heart needs to exert to eject the blood during ventricular contraction.
After load
63
_____ or _____ are normally prescribed to people with a history of hypertension.
Beta blockers or ACE inhibitors
64
Ca Channel Blocker and nothing else is _____ or _____.
Hypertension or AFIB.
65
_____ drip is the cousin of dopamine but doesn’t have the Chronotropic effects.
Dobutamine
66
Chronotropic Effects of Dopamine:
Increased HR
67
Patient has SVT or V-Tach and they are unstable - go directly to _____.
Cardioversion
68
Hyperkalemia presents as what on a monitor?
Tall peak T wave.
69
Tall peaked T wave can cause _____.
Torsades
70
Hyperkalemia is caused by _____.
Renal Failure
71
In Hyperkalemia, what is the importance of water?
It attracts salt
72
When ROSC is achieved, look at ___-___ degrees C/F for cooling therapy.
32-36 C
89.6-98.6F
73
Electrolyte imbalances from N/V/D need to be looked at during _____.
H/T’s
74
_____ have a-typical heart attacks (don’t have cardiac type chest pain).
- Maybe no chest pain
- Jaw pain
- Weak/nauseated
Women (especially post menopause)
75
If a person needs defibrillation, what is a considering factor for the survival of this patient?
Sooner you defib the better chance they have of living.
76
_____ is pressure being pushed throughout the body.
Systolic
77
_____ is the pressure in the arteries when the hear is at rest.
Diastolic
78
_____ and _____ are the two most common underlying and potentially reversible causes of PEA.
Hypovolemia and Hypoxia
79
H&T’s: (5&4)
Hypovolemia
Hypoxia
Hydrogen Ion (acidosis)
Hypo/Hyperkalemia
Hypothermia
Tension Pneumo
Tamponade
Toxin
Thrombosis pulmonary/coronary
80
ST Depression = _____
Ischemia
81
ST Elevation = Damage/Injury leading to _____.
Myocardial Infaction
82
_____ states that the force or tension developed in a muscle fiber depends on the extent to which the fiber is stretched.
Starlings Law
83
_____: the bigger the hose the more water but the less pressure.
Poiseuille’s Law (Pipe Law)
84
Decreased pre load means _____.
Less after load.
85
_____ is angina that is lasting longer and pain is getting worse.
Unstable Angina
86
If the rhythm is Sinus Tach, what do you treat?
The underlying reason. (Is it asthma, COPD, etc)
87
Max heart rate formula:
220 - Age
88
How to treat Supraventricular Tachycardia (SVT):
If it’s sinus then why is the heart overcompensating; treat the patient (why did they call?); consider medications after determining cause of the rhythm.
89
Torsades De Pointes results from _____.
Hypomagnesemia
90
What medication would you administer for Torsades?
Mag
91
Wide QRS complex: dysrythmia is from the _____.
Ventricles
92
Narrow QRS complex: dysrhthmia is from _____.
Above the ventricles (Supraventricular tachycardia)
93
_____ & _____ check H’s and T’s.
Asystole and PEA
94
PVC Terminology
_____ if similar in configurations-originating from the same place.
Unification
95
PVC Terminology
_____ if there are multiple PVC configurations originating from different places.
Multifocal
96
PVC Terminology
If you have _____ your heart doesn’t beat in a normal pattern. After every routine beat, you have a beat that comes too early, or what’s know as a premature ventricular contraction (PVC).
Bigeminy
97
_____ is made of parietal and visceral layers with pericardial fluid in between; it forms the pericardial sac to reduce friction.
Pericardium
98
Atrioventricular valves: (2)
Tricuspid and bicuspid valve
99
Semilunar Valves: (2)
Pulmonic and Aortic Valves
100
_____: tenons that hold valves closed to prevent regurgitation into the atrium.
Cordae Tendanae
101
_____ side: Preload; low pressure system.
Right Side
102
_____ side: after load; high pressure system.
Left side
103
_____: pressure in filled ventricle at the end of diastole. (End of diastolic volume)
Preload
104
_____: Resistance the ventricles must contract against.
After load
105
_____ arteries originate in the aorta and fill on diastole.
Coronary Arteries
106
_____: Amount of blood pumped out by left ventricle in one beat. (70 mL)
Stroke Volume
107
Systole: _____ of the myocardium.
Contraction
108
Diastole: _____ of the myocardium.
Relaxation
109
Sodium Potassium Pump:
Impulse hits myocyte, calcium channels open, _____ rushes out, _____ rushes in.
Polarity Changes and cell _____.
_____ period.
_____ rushes out, and _____ starts moving into intracellular space.
Polarity changes and cell _____.
_____ period.
Potassium out; sodium in
Depolarizes
Absolute Refractory
Sodium out; potassium in
Repolarizes
Relative Refractory
110
Sympathetic nervous system communicates with the heart through the _____.
Cardiac plexus
111
Parasympathetic nervous communicates with the heart through the _____.
Vagus Nerve
112
_____: catecholamines
Adrenergic Agonists
113
Anticholinergics are _____.
Sympatholytics
Parasympatholytics
Sympathomimetics
Parasympathomimetics
Parasympatholytics
114
Cholinergics are _____.
Sympatholytics
Parasympatholytics
Sympathomimetics
Parasympathomimetics
Parasympathomimetics
115
Class I - _____ blockers
Class II - _____ blockers
Class III - _____ blockers
Class IV - _____ blockers
Class V - _____
Sodium Channel Blockers
Beta Blockers
Potassium Blockers
Calcium Channel Blockers
Miscellaneous
116
Chronotropy = _____
Heart rate
117
Inotropy = _____
Heart Contraction
118
Dromotropic = _____
Nerve impulse conduction
119
_____ cells have automaticity, synchronicity, contractility, conductivity, irritability and excitably.
Cardiac
120
_____: electrical impulse gets trapped in internodal pathways. Can cause SVT.
Reentry Phenomena
121
Sodium _____ of the myocardium.
Depolarization
122
Potassium _____ of the myocardium.
Repolarization
123
_____ is responsible for myocardial depolarization/contraction.
Calcium
124
_____: murmur in vessel indication blockage from plaque.
Cardiac Bruits
125
_____: more negatively charged anions inside cell than positively charged anions.
Resting Potential
126
_____: influx of sodium and positive change in membrane polarity.
Action Potential
127
Cardiac enzyme _____ increases during myocardial infarction.
Troponin
128
Gold standard time = _____ minutes
60
129
_____ sided heart failure.
SS: Pending respiratory failure, cardiac wheezing, dyspnea, tripoding, Rales, hypertension.
Treatment: CPAP, nitro, lasix, PEEP 10+ cmH2O
History: medication non compliance, paroxysmal nocturnal dyspnea, orthopnea
Left Sided Heart Failure
130
_____ sided heart failure.
SS: Peripheral/sacral edema, jugular vein distension, ascites, hypotension.
Treatment: Fluid resuscitation, vasoconstrictors.
History: Pulmonary hypertension
Right sided heart failure
131
Cardiogenic shock - push _____ or _____.
Dopamine or levophed
132
_____: infection in the lining of the heart.
No history/risk factors.
ST elevation in all leads.
SS sharp pain, position chest pain.
history of cold, pneumonia or infection.
Pericarditis
133
_____: peripheral pulse quality alternating from weak to strong.
Pulsus Alternans
134
_____: build up of fluid in the pericardial sac.
Pericardial Tamponade
135
_____: muffled heart tones, jugular vein distention, narrowing pulse pressure.
Becks Triad
136
_____: communication between 2+ blood vessels.
Anastomosis
137
_____: ventricles eject 2/3rds of the blood it contains.
Ejection fraction
138
MEDS to GIVE:
A-Fib/A-Flutter/SVT (Really Fast Atrial Contraction):
Calcium Channel Blockers (ZEMs)
Beta Blockers (LOLs)
Sodium Channel Blockers (Caines) - Lidocaine
