Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiopulmonary > Diagnostic Tests > Flashcards

Diagnostic Tests Flashcards

1
Q

Holter Monitor

A
  • Patient Activated monitor:
    – Hit button when feel Sx
  • Indication: pt with syncope, dizziness, intermittent symptoms
  • Pt keeps a 24 hr diary
    – 1-3 days duration
  • Diagnosis and manage symptomatic arrhythmias
    – Rest and with Ex
  • ECG for entire length of time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is a resting ECG different from a 12 lead exercise ECG?

A

The Right and Left Foot are in different places.
Resting ECG: On actual eet
Exercise: On the ribs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What abnormalities might someone see on a resting ECG?

A
  • Identify Ischemia
    – ST depression
  • Identify injury
  • MI
  • Arrhythmias
    – Afib; SVT; Vtach; Vfib
    – Aflutter; AV blocks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a GXT?

A
  • Incremental exercise test
  • Treadmill or bike/cycle
  • 12 lead ECG
  • HR, BP, RPE monitored at each stage
  • Maximal or Symptom limited
  • Sub-max
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the GXT used for?

A
  • Evaluate cardiac symptoms
  • Evaluate effects of medical / surgical intervention
  • Evaluate arrhythmias & hemodynamic response to ex
  • Determine Exercise prescription
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is done in an electrophysiological study?

A
  • Catheter inserted groin, up to the heart
  • Electrical signals are sent to the heart; evaluate the SA node and the conduction pathways
  • Dysrhythmia may be induced
    – Meds given to stop & evaluate effectiveness of the meds
  • Mapping to locate the spot where a dysrhythmia starts
    – If found an ablation (freezing or radiofrequency) can be done
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is an ablation indicated?

A
  • SVT, A fib and A flutter
  • Goal is to remove ectopic foci (scar tissue doesn’t allow signal)
  • Radiofrequency ablation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What tests can be done to test for ischemia?

A
  • Resting ECG
  • Exercise ECG (stress test)
  • Angiography
  • Radioactive Nuclide Perfusion testing
  • Pharmacological stress testing
  • MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can cause ischemia?

A

Vasospasm or artherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is an angiogram and what does it look at?

A
  • A long thin flexible catheter is inserted through femoral artery up to heart (Sometimes brachial artery is used)
  • Goal: establish or confirm Dx of CAD
  • X-rays are taken of heart chambers and coronary arteries
  • Data on R coronary, L main, LAD & Circumflex circulation
  • Radio-opaque contrast material is injected into heart chamber or coronary arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a Thallium Stress Test?

A
  • Use isotope Thallium to evaluate coronary artery perfusion (blood flow)
  • EKG and treadmill
  • Two phases: Pre and during exercise (isotope injected near peak)
  • Evaluate perfusion of the heart = IPE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A Thallium Stress Test is performed, an area of the heart perfused at rest but not during exercise (IPE), what does that tell you

IPE: Immediate post exercise

A

It is transient ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A Thallium Stress Test is performed, no areas of the heart perfused at rest nor during exercise (IPE). What does that mean?

A

MI with scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the alternative test to Thallium Stress Test for those that cannot exercise? What does it do?

A

Persantine-Thallium Stress Test

Persantine helps to expand the coronary arteries (similar to exercise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is the Thallium Stress Test and GXT Stress Test different?

A

Thallium is similar but also uses additional information by using the isotope Thallium to evaluate coronary blood flow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is an echocardiography?

A
  • Noninvasive
  • Ultrasound of heart through the intercostal space
  • Looks at the size, struture and function of the heart, chambers and valves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a Transesophageal Echo and how is it different than ultrasound?

A
  • Thin flexible tube (special tip) inserted down throat. Anethetic applied to inhibit gag reflex. Tip sends out an ultrasound wave
  • It is different because of location and you get a much clearer image
18
Q

What is a stress echo?

A
  • Echo and Treadmill Stress Test
  • Echo done at rest and again at peak heart rate
  • Looking at wall motion, chamber size, wall thickness and valves
19
Q

What is a Dobutamine Stress Echo?

A
  • Evaluate heart movement, valves and chambers for those who can’t exercise on treadmill
  • Dobutamine – medication to increase HR and BP similar to ex
20
Q

What is a carotid ultrasound measure?

A

Diameter and velocity

21
Q

Tilt Table Test

A
  • Done with pt’s with syncope
  • Point is to cause symptoms they were having before
  • Increase to 80 degrees
  • If they can get to 80 degrees will be given glyceryl trinitrate to drop BP and more likely to have symptoms
22
Q

Oximetry - Values

A
  • Normal 98-100%
  • If drops below 90% with exercise – evaluate situation
  • PaO2 >80 mm Hg ~ SpO2 >93 - 95%
  • PaO2 <60 mm Hg ~ SpO2 <88 - 90%

NEED TO KNOW; REALIZE RELATIONSHIP BETWEEN PRESSURE AND O2 SAT

23
Q

What is a PCI?

A
  • Percutaneous Coronary Innervention
  • Performed when stenotic lesion is not too large (~>70%) occluded
  • Catheterization; Change tip on catheter with balloon and inflate the balloon where the obstruction is to try to push the atherosclerosis along the line of flow
24
Q

How common is restenosis after a PCI?

A

Within the first 6 months:
* Restenosis of 32-42% with no Stent
* Restenosis less than 10% with Stent

25
Q

What is a post surgery restriction with PCI patients?

A
  • Can’t bend at the hip for 6-8 hours post procedure
  • Due to a whole in the artery; Arteries have such a high pressure proper clotting takes longer.
26
Q

What is an Atherectomy

A
  • Percutaneous innervention
  • Cut out plaque
  • Break off plaque and suck it up
27
Q

What is a stent and what is it used for?

A
  • Tiny spring like device
  • Placed at stenotic lesion following angioplasty
28
Q

What does CABG stand for? What is it done for?

A
  • Coronary Artery Bypass Graft
  • Bypass a stenosis
  • Graft comes from saphenous vein (leg) or internal mammary artery
  • Attach on aorta and distal to stenosis
29
Q

CABG Surgery Techniques (3)

A
  • Traditional: Heart-Lung Machine; Heart is stopped
  • Minimally invasive direct coronary bypass (MIDCAB); Tiny incision NO cutting of ribs
  • Off-Pump Coronary Artery Bypass (OPCAB); heart is beating, no machine, cut and stitch
30
Q

What happens to the hearts electrical system with a heart transplant?

A
  • Herat is denervated and lacks autonomic control
  • Wihtout sympathetic control results in HR to be 100-115 bpm being controlled by AV Node
  • Only way to stimulate the HR is from catecholamines (This is why a long warm up and cool down is crucial)
31
Q

What are the types of heart transplants?

A
  • Orthotropic and Heterotopic
  • Orthotopic: Old heart out, new donor heart in
  • Heterotopic: Sick heart stays and donor heart is connected if there is enough space
32
Q

What does an assistive device do for the heart?

A

Improves the ability of the ventrical to eject blood

Ex: Ventricular Assist Device: Improves the function of L ventricle

33
Q

What is an Intra-Aortic Balloon Counterpulsation?

A
  • Hemodynamically unstable patients
    – Acute conditions post surgery
  • Augment diastolic BP
  • Increase coronary blood flow
  • Balloon inflates – early diastole
  • Keep hip angle less than 70 degrees
  • In bed activities
34
Q

What stage of a heart beat are the coronaries fed?

A

During diastole!

35
Q

Carotid Endarerectomy

A

Catheter up through carotid to cut and suck plaque

36
Q

Emboli Capture Device for Angioplasty

A

Large Veins to catch large clots

37
Q

How can you test for Heart Valve Integrity?

A

Echocardiography
Contrast echo
Cathiterization

38
Q

What are some Vascular Diagnostic Tests

A
  1. ABI
  2. Ex ABI
    - Dec ABI by .2 or more
    - Decrease SBP by 20% or more
  3. Segmental limb pressure
39
Q

Chest Radiographs are ____ sensitive for diagnosis of ____

A
  1. NOT
  2. COPD

Can see disease progression if taken at different stages of disease
May be able to see thoracic hyperinflation with flattening diapraham???

40
Q

What is a distinguishing characterisitc of COPD on plain films?

A

Increased AP diameter of the chest, and increased retrosternal airspace, as seen in green arrow

41
Q

What is a V/Q scan? What values are important?

A
  • Ventiltion/Purfusion Scan; Performed seperately or together
  • Ventilation scan (V): scanning the lungs while having the person inhale radioactive gas.
  • Perfusion scan: performed by injecting radioactive albumin into the vein. The lungs are scanned to detect the location of the radioactive particles as blood flows through the lungs

Normal: 0.8-0.9
<0.8 blocked on pulmonary side
>0.9 blocked on vesicle side (Ex: PE)

NEED TO KNOW VALUES

Cardiopulmonary (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions