What is an adequate Exercise ECG test for noninvasive cardiac testing?
Patient can exercise to at least 85% of their target HR, which is defined as 220 minus patient age
What do we substitute heparin for in patients experiencing HIT?
direct thrombin inhibitors suchas bivalirudin, lepirudin, or argatroban
What are the mediators responsible for that are released during the aggregation phase?
Platelet aggregation to form a primary unstable clot
4 Complications associated with CVP line placement
- Nerve injury
- Cardiac Tamponade
Describe the clinical presentation of mitral regurgitation?
- Systolic murmur heard best at the apex
- Holsystolic timing
- High pitched radiating to the axilla
What is LMWH effective at treating?
VTE prophylaxis is more compared to unfractioned heparin
What is the single greatest threat in sickle cell patients?
Acute chest syndrome
Where do we see more depolarization towards in right ventricular hypertrophy?
Toward the right, seen on V1
Describe Disseminated Intravascular Cogulopathy
Systemic activation of the coagulation system simultaneously leads to thrombus formation and exhaustion of platelets and coagulation factors
Describe remodeling as it occurs in heart failure (3 points)
- Heart changes shape, size and function to try to preserve CO
- Overtime this defense mechanism fails
- Will eventually cause myocardial dysfunction
Is valine or glutamate nonpolar (water insoluble)?
Valine is non-polar
3 Vasoconstrictors associated with the clotting cascades?
- Thromboxane A2
- Adenosine diphopshpate
Describe the right side of the heart compared to the left side of the heart
Right heart is thinner, more compliant and weaker than the left heart
What doe chemoreceptors respond to?
Changes in pH (decreased) and blood oxygen tension
Comorbidities associated with left ventricular hypertrophy?
Aortic stenosis, chronic hypertension (increased afterload)
How much pressure do we add to help with atelectasis in patients placed under general anesthesia?
How long does vitamin k take to reverse coumadin anticoagulation?
6 to 8 hours
Heart rate and rhythm goal with mitral regurg?
High HR (90-100BPM) and NSR as the faster HR reduces regurgitant volume
What is the opening size and pressure gradient in moderate mitral stenosis?
1.1 to 1.4 cm^2 and 6-10 mmHg
Describe MET 1
Eating, working at a computer, or dressing
How is the amount of regurgitant blood flow associated with aortic regurg?
Bradycardia due to increased diastolic time, Elevated SVR and Bigger/Larger Opening
What is the typical hemoglobin level in patients with sickle cell disease?
5 to 8 g/dL
What is the name, source and vitamin k dependency of factor V?
- Name: Proaccelerin
- Source: Liver
- Vit. K Dependent: No
What is the role of calcium in platelet structure?
Plays a role in the coagulation cascade
Examples and effects of dihydropyridine CCB's
- suffix = dipine
- Targets vasculature smooth muscle mostly
- Reduction in vascular iCa+2 levels causes vasodilation
- Reduction in SVR (afterload)
What does PT measure?
Extrinsic and common pathway
When does primary hemostasis begin?
After vascular contraction causing tamponade if the injury is not resolved
3 Etiologies of Systolic Heart Failure?
- Myocardial ischemia
- Valve insufficiency/regurgitation
- Dilated cardiomyopathy
Walk through the path Nitric Oxide takes to cause muscle relaxation
- Nitric oxide synthetise acts on L-arginine to become nitric oxide
- Nitric oxide diffuses into the muscle cells and activates soluble guanylate cyclase
- This produces cycline guanosine monophosphate, a second messenger, which causes muscle relaxation
What does it mean to have myocardial infarct (transmural) mean?