Exam 1 Flashcards
(82 cards)
1
Q
SV equation
A
EDV-ESV
2
Q
Normal CO:
A
3-9
3
Q
What do these factors do to CVP:
- hypervolemia
- forced exhale
- tension pneumothorax
- HF
- pleural effusion
- decreased CO
- cardiac tampon are
- mechanical ventilation and PEEP
A
Increase
4
Q
What do these factors do to CVP:
- hypovolemia
- deep inhalation
- distributive shock
A
Decrease
5
Q
What are these the gold standard of?
- acute pulmonary edema
- severity of LVF and mitral stenosis
A
PCWP
6
Q
What does pulmonary edema with normal PCWP suggest? 2
A
ARDS or non-cardiogenic pulmonary edema (opiate poisoning)
7
Q
Normal CI:
A
2-5
8
Q
Equation for PaO2:
A
102-(age x .3)
9
Q
Equation for SVR:
A
(80)(MAP-CVP)/CO
10
Q
Increase conduction velocity
A
Dromotropic effect
11
Q
If afterload increases, what happens to CO?
A
Decreases
12
Q
Tension upon muscle fibers in heart wall is the pressure within ventricle multiplied by volume within ventricle, divided my wall thickness (pressure x radius / 2 x wall thickness)
A
LaPlace’s Law
13
Q
These cause what?
- rheumatic fever
- calcification or congenital
- bacterial endocarditis
A
Mitral stenosis
14
Q
Acute treatment for mitral regurgitation?
A
Nitroprusside (decrease afterload)
15
Q
Chronic treatment for mitral regurgitation?
A
ACE-I, hydralazine, diuretics, digoxin, anti arrhythmics
16
Q
What do you want to avoid in mitral valve prolapse?
A
Increase HR
17
Q
These cause what?
- degeneration and calcification
- early-bicuspid, late-tricuspid valve
- rheumatic, infectious endocarditis
A
Aortic valve stenosis
18
Q
Drug therapy for valvular heart disease (7)
A
- BB
- CCB
- Digitalis
- ACE-I
- Vasodilators
- Diuretics
- Inotropes
19
Q
Which disease is Afib most common with?
A
Mitral disease
20
Q
Anesthesia management with Mitral regurgitation: Preload Afterload HR Contractility
A
Maintain to slight increase
Reduce
Elevated
Maintain or increase
21
Q
Anesthesia management with aortic regurgitation: Preload Afterload HR Contractility
A
Maintain to slight increase
Reduce
Elevated
Maintain; NO DEPRESSION
22
Q
Anesthesia management for aortic stenosis: Preload Afterload HR Contractility
A
Maintain
Increase
Avoid tachycardia
Maintain
23
Q
Anesthesia management with mitral stenosis:
Preload
Afterload
HR
A
Increase
Maintain
Slower
24
Q
Anesthesia management with tricuspid regurgitation:
Use N2O?
A
NO
25
Pulsating, encapsulated hematoma in communication with the lumen of a ruptured vessel; must continue communication with artery
False or pseudoaneurysm
26
Circumferential, relatively uniform in shape aneurysm:
Fusiform
27
Pouch like with narrow neck connecting bulge to one side of arterial wall aneurysm:
Saccular
28
What do these 3 syndromes affect?
| Marfan, ehlers-danlos, loeys-dietz
Blood vessel wall integrity
29
DeBakery system:
Originates in ascending aorta, propagates at least to aortic arch and often beyond distally; pts less than 65 and most lethal form
Type 1
30
DeBakery system:
| Originates in and is confined to ascending aorta
Type 2
31
DeBakery system:
Originates in descending aorta, rarely extends proximally but will extend distally; elder pts with atherosclerosis and HTN
Type 3
32
Primary vascular action to spinal cord?
Vertebral arteries and 10 medullary arteries
33
Loss of posterior supply generally leads to loss of?
Sensory functions
34
Loss of anterior supply more often causes loss of?
Motor
35
Infants or adults tolerate longer periods of DHCA?
Infants
36
which drug augment/increase renal perfusion?
Fenoldopam
37
The higher the clamp the greater what?
Increase in preload
38
Baroreceptor reflex: high pressure zones (>60)
| 2 areas
Aortic arch and carotid sinus
39
Baroreceptor reflex: low pressures (<60)
| 3 areas
Vena cava
Pulmonary veins
Atria
40
Increase in HR due to increase in CVP
Bainbridge reflex (atrial reflex)
41
Cause of primary HTN:
Overactive RAAS
42
Cause of secondary HTN:
```
Renal and endocrine disorders
Pregnancy
OSA
Drugs
Malformed aorta
White coat HTN
```
43
How soon should discontinuation of ACE-I and ARBS be?
24-48 hrs
44
Is RBB or LBB more vulnerable?
RBB
45
Which artery supplies blood to LBB and RBB?
LAD
46
What arrhythmia can sevo cause in infants?
Bradycardia
47
What arrhythmia can des cause?
Prolong QT
48
Treatment for tachycardia?
Fix underlying disorder and BB
49
Treatment for PAC?
Rarely necessary, but limit sympathetic stimulation and BB or CCB
50
4 things if adenosine doesn’t resolve after few seconds?
Adenosine antagonist (theophylline 250mg)
Atropine
Adrenaline
CPR
51
Patients with what syndrome can you see PSVT?
Wolff Parkinson’s white
52
10 treatments for PSVT?
```
Vagal maneuver (carotid sinus massage)
Adenosine (6mg)
Verapamil (2.5-10ml)
Amiodarone
Esmolol
Phenylpherine
Digitalization (digoxin or ouabain)
Synchronized cardioversion
Electrode catheter ablation with radio frequency energy
CCBs
```
53
What 3 things should be avoided in PSVT?
Sympathetic simulation
Acid base imbalance
Electrolyte imbalance
54
What is accompanied with an arterial flutter?
AV block
55
Arterial HR in atrial flutter
250-350
56
3 treatments for atrial flutter?
BB
CCB
Synchronized DC cardioversion
57
Most common postop arrhythmia?
Afib
58
Which arrhythmia does Afib have the same treatment with?
Atrial flutter
| BB, CCB, synchronized DC cardioversion
59
What drug is recommended with long term Afib?
Warfarin (coumadin)
60
What 2 things can junctional rhythm decrease?
BP and CO
61
Treatment for junctional rhythm?
None
62
What abnormalities is common with ventricular tachycardia? (2)
Decreased serum potassium
| Low arterial oxygen tension
63
2 big treatments for VT?
Amiodarone
| Lidocaine
64
Most successful treatment for VF?
External electrical defibrillation
65
Ventricular pre-excitation causes an earlier than normal deflection of QRS complex called a delta wave
Wolf Parkinson white
66
Treats for narrow QRS WPW? (3)
Vagal maneuvers
Adenosine
Dipyridamole
67
Treatment for wide QRS WPW?
Procainamide
68
Afib with WPW, what should you avoid?
Digoxin and verapamil
69
What else is torsades de pointes known as?
Prolonged QT syndrome
70
First choice in treating long QT syndrome?
BB
71
What makes the cardiac murmurs louder in hypertrophic cardiomyopathy?
Valsalva maneuver
72
5 treatments options for LVOT?
```
BB
CCB
Anti-dysrhythmias
Septal myomectomy
IV phenylephrine
```
73
What 3 things to avoid in LVOT?
Sympathetic stimulation
Hypovolemia
Vasodilation
74
What 4 drugs to avoid in LVOT?
Pancuronium
Sux
Ephedrine
Dobutamine
75
Is there a 3rd heart sound in DCM pts?
Yes
76
ECG changes in acute pericarditis:
Accompanies onset of acute pain and is hallmark of acute pericarditis. ECG changes include diffuse concave upward ST elevation, except in leads aVR and V1. T waves are upright in leads with ST elevation and PR segment deviates opposite to P wave polarity
Stage 1
77
ECG changes in acute pericarditis:
| Several days later with return of ST segment baseline, followed by flattening of T waves
Stage 2
78
ECG changes in acute pericarditis:
| T waves become inverted but without Q wave formation
Stage 3
79
ECG changes in acute pericarditis:
ECG returns to prepercarditis baseline weeks to months after initial onset. T wave inversion may persist indefinitely in chronic inflammation observed with tuberculosis, uremia, or neoplasm
Stage 4
80
Paradoxical increase in peripheral venous dissension and pressure during inspiration.
Major mechanism is a change in shape of pericardium with resulting increase in intrapericardial pressure and obstruction to venous return to heart
Kussmaul’s sign
81
With cardiac tamponade, will kussmaul’s sign increase or decrease jugular emptying during inspiration?
Decrease
82
Do you wanna use PEEP for cardiac tamponade?
No
