Cardiopulm

Question 1

bainbridge reflex

Answer 1

increased venous return leads to increased HR through inhibiting vagus

Question 2

what is normal blood volume?

Answer 2

4.5-5.0L

Question 3

thrombocytopenia vs. thromobocythemia

Answer 3

decreased number of platelets vs too many; increased risk of bleeding vs. increased risk of thrombus: normal = 150-450; <20 AROM/ADLs only, 20-30 light exercise only, 30-50 moderate exercise

Question 4

leukocytosis

Answer 4

abnormally high white blood cells - can indicate infection or leukemia

Question 5

netrophils

Answer 5

protect against infection by ingesting bacteria/debris

Question 6

tricuspid vs. mitral valve

Answer 6

R AV valve (try again) vs. L AV valve (my turn)

Question 7

Conduction of the heart

Answer 7

SA node > AV node (junction of R/L atrium)> bundle of His >purkinje fibers

Question 8

in what order is the fastest/slowest conductors of the heart

Answer 8

SA = 60-100bpm(pacemaker) > AV node = 40-60bpm > Purkinje 20-40bpm

Question 9

normal ejection fractions

Answer 9

> 55%, the lower it is the more impaired the LV

Question 10

hyperkalemia

Answer 10

increased concentration of K+ in blood - widens the PR interval and QRS

Question 11

hypokalemia

Answer 11

decreased K+ causes flattened T waves, prolonged PR and QT intervals - arrhythmias, ventricular fibrillation

Question 12

Hypercalcemia

Answer 12

increased calcium concentration - increases hearts actions

Question 13

hypocalcemia

Answer 13

depresses hearts actions

Question 14

hyper vs hypomagnesemia

Answer 14

hyper = calcium blocker, can lead to arrhythmias or cardiac arrest; hypo = ventricular arrhythmias, coronary artery vasospasm, and sudden death

Question 15

Grading scale for pulse (0-4+)

Answer 15

0 = no pulse, not palpable; 1+ = diminished; 2+ = easily palpable; 3+ = full pulse/increased strength; 4+ = bounding pulse

Question 16

Normal heart rate: adults, peds, infants

Answer 16

adults = 60-100bpm; peds = 60-140bpm; infants; 90-164bpm

Question 17

Postural tachycardia syndrome (POTS)

Answer 17

Sustained heart rate increased of >30 bpm within 10min of standing

Question 18

Auscultation landmarks: AorticV valve, Pulmonic valve, tricupsid valve, mitral valve

Answer 18

AorticV = 2nd R intercostal space; PV = 2nd L intercostal space; Tricupsid = 4th L intercostal space; Mitral = 5th L intercostal space midclavicular line

Question 19

Heart sounds: S1 vs. S2

Answer 19

S1 = lub - closure of mitral & tricupid = systole; S2 = dub - closure of aortic & pulmonary = end of systole (beginning of diastole) - diastole falls between S2 and S1

Question 20

thrill

Answer 20

abnormal tremor accompanied by a vascular or cardiac murmur - can feel on palpation

Question 21

S3 vs. S4 sounds

Answer 21

S3 = soon after S2 during ventricular filling = indicative of LV heart failure (heart bumping against the chest wall); S4 = before S1 with ventricular filling - indicative of coronary artery disease (CAD), MI, or aortic stenosis

Question 22

EEG Cardiac cycle - go!

Answer 22

P wave = atrial depolarization; P-R interval = SA node> purjikne fibers; QRS complex = ventricular depolarization; ST segment = ventricular repolarization; (QT interval = electrical systole)

Question 23

How to calculate HR on a strip

Answer 23

count number of intervals between QRS complex in 6 sec strip

Question 24

Premature ventricular contraction (PVC)

Answer 24

premature beat from the ventricle > EKG: no p wave, wide & bizzare QRS complex followed by a pause; bad = more than 6/minute

Question 25

Ventricular tachycardia

Answer 25

Run of 3 or more PVCs in a row at a rapid rate of 150-200bpm; usually as a result of ventricular ischemia; nonsustained = stops in 30sec, sustained = doesn't stop in 30 sec

Question 26

Ventricular fibrillation

Answer 26

dude you got no pulse; no QRS complex

Question 27

Atrial arrhythmia

Answer 27

P waves abnormal due to ectopic foci on the atria; atrial tachycardia = 140-250bpm; atrial flutter =250-350bpm; fibrillation >300bpm

Question 28

how much ST segment elevation is considered abnormal

Answer 28

>1mm

Question 29

Digitalis & affect on ST segment

Answer 29

depresses ST, flattens T & shortens QT

Question 30

beta blocker

Answer 30

decreases HR, blunts heart rate response to exercise; i.e Indera, lopressor

Question 31

Nitrates

Answer 31

increase heart rate

Question 32

anti-arrhythmic agents

Answer 32

prolong QRS and QT intervals

Question 33

Orthostatic hypotension

Answer 33

drop in systolic >20, diastolic >10

Question 34

Pediatric BP

Answer 34

<2yo: 106-110/59-63; 3-5yo: 113-116/67-74

Question 35

Respiratory rate: adult, ped, infant

Answer 35

12-20; ped = 20-30; infant = 30-40 | in general; ped BP and RR is 10 more than adult

Question 36

Stages of hypertension

Answer 36

normal 120/80; pre: 120-139/80-89; stage 1: 140-159/90-99; stage 2: >160/>100; crisis: >180/>110; increases by 20's for systolic & 10's for diastolic

Question 37

Anginal scale

Answer 37

1+ to 4+; 1+ = light, 2+ = moderate/bothersome; 3+; severe/uncomfortable; 4+ = most severe pain ever

Question 38

Dyspnea Borg scale (NOT Borg RPE)

Answer 38

0-10; 3= moderate, severe starting at 5-6

Question 39

Scale for Edema

Answer 39

1+ to 4+; 1+ = 30sec or more

Question 40

Ankle Brachial Index Values

Answer 40

1.0-1.3 = normal; 0.80.99 = mild blockage; 0.4-0.79 = moderate blockage; <0.4 = severe PAD may have claudication ; >1.3 = non compliant arteries

Question 41

Hemoglobin numbers (M/F)

Answer 41

M=13-18; F = 12-16

Question 42

Hematocrit

Answer 42

M=45-52%; F = 37-48%

Question 43

ACE inhibitors

Answer 43

decrease Na rentetion and peripheral vasoconstriction to decrease BP; captopril, enalopril, lisinopril

Question 44

calcium channel blocking agents

Answer 44

inhibit flow of calcium ions, decrease HR, decrease contractility, dilate coronary arteries and reduce BP, control arthymmias

Question 45

compression depth CPR adults, peds, infants

Answer 45

adults = >2in; peds = 1/3AP depth ~2in/5cm; infants = at least 1/3 AP depth, ~1.5in/4cm

Question 46

compression: ventilation ratio for CPR

Answer 46

30:2, ventilate until visible chest rise

Question 47

Phase of Korotkoff sounds correspond to what?

Answer 47

Phase I = SBP (clear tapping); Phase V = diastolic (sound disappears)

Question 48

crackles are heard with which type of lung disease?

Answer 48

restrictive - atelectasis, pneumonia, brochietasis