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Cardio-Pulmonary > Cardiovascular Diagnostic Test/Procedures > Flashcards

Cardiovascular Diagnostic Test/Procedures Flashcards

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1
Q

rhythm abnormalities indicate what testing

A

holter monitor
12 lead / exercise ECG

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2
Q

ischemia indicates what testing

A

resting/exercise ECG
pharmacologic stress testing
PET scan
MRI

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3
Q

valve integrity is tested via

A

echocardiography
contrast echo
cardiac catheterization

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4
Q

ventricle size and EF is tested via

A

chest x-ray
angiogram imaging
echocardiography

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5
Q

cardiac muscle pumping is tested via

A

echocardiography
ventriculography
MUGA

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6
Q

acute MI is tested via

A

cardiac enzyme markers
resting ECG

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7
Q

vascular diagnostic testing is done via

A

ABI
segmental limb pressures

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8
Q

what biomarkers indicate cardiac injury

A

CPK-MB
troponin
myoglobin
carbonic anhydrase III
cardiac myosin light chains

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9
Q

explain difference between CPK-MB,MM, and BB

A

MB = myocardial injury
MM = skeletal muscle injury
BB = brain tissue injury

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10
Q

abnormal CPK-MB level

A

serum level >3%

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11
Q

abnormal troponin I value
- time associated

A

> 0.1 ng/mL

onset of rise = 4-6 hrs
time of peak = 12-24 hrs
return to normal = 4-7 days

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12
Q

abnormal troponin T value
- time associated

A

> 0.2 ng/mL

onset of rise = 3 to 4 hrs
peak = 10-24 hrs
return to normal = 10-14 days

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13
Q

abnormal creatine phosphokinase value

A

> 75 mU/mL

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14
Q

abnormal myoglobin value

A

> 100 ng/mL overall
- male = >96 ng/mL
- female = >65 ng/mL

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15
Q

what is CRP? what is the importance of it?

A

an acute-phase reactant to inflammation
- can be used to assess cardiovascular disease risk

higher levels are associated with lower survival rates in those with CAD

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16
Q

explain CRP values and risk for CVD development

A

<1 mg/L = low risk
1-3 mg/L = average risk
3 mg/L = high risk

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17
Q

explain BNP’s production / role

A

from cardiac ventricles (especially left) during pressure or volume overload

  • dilates arteries and veins
  • neurohumoral modulator in decreasing vasoconstricting / sodium-retaining hormones
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18
Q

BNP is important because

A

has been associated with increased risk for CV mortality, HF and CVA

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19
Q

what are abnormal hemoglobin ranges for males and females

A

males = < 14-18
females = <12-16

in (g/100mL)

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20
Q

what does low levels of hemoglobin result in

A

anemia
- lack of oxygen carrying capacity and low levels of oxygen available to the tissues

will put more stress on the myocardium as a result, due to need to get blood out

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21
Q

values for hematocrit in males and females

A

males = < 42g/100 mL
females = <37g/100 mL

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22
Q

what does an elevated hematocrit mean

A

blood flow is more viscous than normal
- can mean blood flow is also being impeded

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23
Q

what is used to measure coagulation of blood

A

prothrombin time
partial thromboplastin

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24
Q

what electrolytes are the most important to monitor

A

Na+
K+
CO2

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25
what are normal sodium serum levels? what are abnormalities associated?
136-145 mmol/L hyponatremia = <136 hypernatremia = >145
26
what are s/s with sodium levels being off
nausea vomiting headaches seizures
27
value of serum potassium? s/s of abnormalities below and above
3.5-5 mEq/L lower = life-threatening arrythmia higher = myocardium contractility issue
28
s/s associated with low levels of CO2
alkalotic state muscle weakness dizziness
29
normal range of blood urea nitrogen
BUN 8-23 mg/dL
30
elevated vs depressed BUN levels
elevated = uremia or urea retention decreased = starvation, dehydration, possible liver disease
31
what laboratory values are found in HF? what do those indicate
increased BUN increased LDH increased BNP normal CPK-MB increased creatinine levels -- indicate renal dysfunction
32
what lab values are representative of renal function
BUN creatinine
33
normal creatinine levels
<1.5 mg/dL >1.5 mg/dL
34
what creatinine level indicates renal insufficiency/failure
>4.0 mg/dL
35
what is the gold standard measure for heart failure
B-type natriuretic peptide - both compensated and uncompensated
36
what is the value of BNP that is normal vs abnormal? what does that indicate
normal = <100 pg/mL >700 pg/mL = acute cardiac decompensation 100-700 pg/mL = chronic compensation
37
indication for exercise stress testing
chest pain suggestive of coronary disease evaluation of atypical chest pain prognosis and severity of CAD effects of medical/surgical therapy arrhythmic evaluation hypertension w/activity evaluation functional capacity assessment exercise prescription screening
38
what differentiates max vs submax testing
point of stoppage - submax = achievement of predetermined end point (certain % of predicted HRmax or attainment of certain work load) max = end point of predicted HRmax
39
what are intermittent vs continuous exercise tests
intermittent = progressive workloads with short rest periods (decreases effect of peripheral fatigue) continuous = incrementally progressive workloads until the test is terminated
40
low level exercise testing is most commonly done after
acute MI or CABG -- can be used prior to discharge
41
what can low level exercise testing be helpful for
prediction of subsequent course post-MI, even identifying high risk patients
42
what low level exercise tests are commonly done
5 meter walk test of gait speed test
43
what is indicated if ST-depression and angina are produced during low-level exercise testing vs angina alone
increased risk of death after MI -- if done during the early period angina alone = subsequent CABG
44
post myocardial injury, what does low-level exercise testing provide
treatment strategies for angina = arrythmia hypertension
45
arrhythmia post myocardial injury during low level exercise can indicate what
therapeutic management before discharge
46
low-level exercise testing contraindications
unstable angina / angina at rest severe heart failure - presence of S3 and rales serious arryhthmias at rest second/third degree heart block disabling MSK abnormalities valvular heart disease BP >180/105
47
what low-level exercise protocols are commonly used in the hosptial?
modified Naughton modified Sheffield - Bruce progressive workload from 2-6 METs
48
explain main disadvantage of bicycle vs treadmill exercise testing
bicycle is not a common activity like walking - pts will develop muscular fatigue faster because they are using muscle groups that are "untrained"
49
Bruce vs Balke protocols
Bruce = speed increases, but incline stays the same. Begins at 10% -- typically causes test to be finished between 6-12 minutes typically Balke - speed remains, but incline increases allows for steady state to be attained at each level, therefore more accurate O2 consumption is recorded (more so with athletes)
50
incidence of sudden death is increased if _____ and _____ occur during exercise testing
inability to exceed 130mmHg SBP increased frequency/severity of arrhythmias
51
low risk for developing CAD in women is predicted by what variables during exercise testing
test longer than 6 min maxHR > 150 bpm ST recovery less than 1 min
52
what is HR recovery defined as? what does it help predict
difference between maxHR and HR at rest 1 minute later - likelihood of mortality
53
what gasses are observed during exercise testing
oxygen consumption co2 production
54
what does cardiopulmonary testing with ventilatory gasses provide information regarding
cardiac performance functional limitation exercise limitation
55
what is the dyspnea index value
Minute Ventilation / Max Voluntary Ventilation = > 50%
56
what occurs when VE/MVV = >70%
respiratory muscle fatigue will occur in minutes
57
dyspnea due to pulmonary disease during exertion will cause these things to occur
rapid/shallow breathing reduction in peak ventilation reduction in tidal volume VO2 and CO2 max decrease
58
dyspnea due to HF during exertion will cause
dyspnea index will remain normal - anaerobic threshold is achieved much earlier with a lower than maximal ventilation and maximal CO2 production
59
when is pharmacologic stress testing indicated
if any contraindications for exercise testing are met
60
what is pharmacologic stress testing
injection of pharmacologic agent that induces physiological stress on the body
61
what are the most common agents used during pharm stress testing
adenosine dipyridamole dobutamine regadenoson
62
What does adenosine and dipyridamole induce
coronary vasodilation
63
dobutamine induces what response
adrenergic stimulant -- increased myocardial oxygen demand with the purpose of assessing that oxygen supply can produce some nasty side effects, need B-blockers to regress them
64
indications for cardiac catheterizaton
cardiac arrest primary v-fib intolerance to medical therapy for angina SBP <100 mmHg during exercise >35% decrease in exercise duration significant ST depression LVent EF <35% without ischemia
65
how is cardiac catheterization done
brachial artery or femoral artery passed into great vessels and into chambers pressures in chambers across valves and CO are measured radiopaque contrast is injected and followed to assess arteries / myocardium
66
ABIs are attained by assessing which arteries? what values are normal?
dorsalis pedis or post tib to brachial artery <0.9 is abnormal
67
what do segmental limb pressures assess
localizing stenoses or occlusions - thigh, calf, ankle or trans metatarsal region
68
arterial duplex US is a more diagnostic test than _______ for __________
segmental limb pressures for stenoses and occlusions
69
rubor dependency test is for
LE arterial circulation leg elevated 35-45 degrees assessment for color change at top, then leg placed in dependent position normal = rapid pink flush abnormal = deep red color after 30 sec

Cardio-Pulmonary (22 decks)

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