Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

ARCHIVED: Assessment > Exam 2: Cardiac > Flashcards

Exam 2: Cardiac Flashcards

(69 cards)

Start Studying
1
Q

Clinical predictors of minor CV risk:

A 
Uncontrolled HTN (>160/>100)
EKG: LBBB, L/R hypertrophy, non-sinus rhythm
Low functional capacity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clinical predictors of moderate CV risk:

A 
CAD
Mild and stable angina
MI > 1 month ago with Q waves
Compensated LVF/CHF
DMI/DMII
Chronic renal insufficiency (Cr > 2.0)
Stroke/TIA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Clinical predictors of major CV risk:

A

Unstable coronary syndrome
Unstable angina
Acute or recent MI (

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

Incidences of periop infarction by previous MI timeframe:

A

> 6 mo: 6%
3-6 mo: 10%
Within 3 mo: 30%

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

Mortality rate for periop re-infarction:

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ACC/AHA guidelines recommend waiting this long after MI for elective surgery:

A

4-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

High-risk surgeries:

A

Intraperitoneal
Intrathoracic
Aortic surgery or other major vascular surgery
Emergent major operations (especially elderly)
Prolonged procedures with large fluid shifts/blood loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Intermediate risk surgeries:

A 
Carotid endarterectomy
Peripheral vascular surgery
Head & neck
Neurologic/orthopedic
Endovascular aneurysm repair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Low risk surgeries:

A 
Endoscopic procedures
Superficial procedures
Biopsies
Cataracts
Breast surgery
GYN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Gold standard exam for coronary anatomy:

A

Coronary angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Goal of cardiac history is to elicit:

A

Severity
Progression of condition
Functional limitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Examples of 1-4 MET activities:

A

ADL’s, eating, dressing, walking around house, dishwashing

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

1 MET = ____

A

3.5 mL of O2/kg/min

Basal metabolic rate

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

Examples of 4-10 MET activities:

A

Climbing stairs, walk in neighborhood, heavy housework, golf, bowl, dance

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

Examples of > 10 MET activities:

A

Strenuous sports i.e. swimming, tennis, running, football, basketball, stress test

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

Angina is a sign of:

A

Imbalance between myocardial O2 supply and demand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Angina may be experienced in patients with ______ & ______ despite normal coronaries.

A

Aortic stenosis

Prinzmetal angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Non-coronary condition that can cause angina-like pain and be relieved by NTG:

A

Esophageal spasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Prinzmetal angina is:

A

Vasospastic angina that occurs at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Patients with Prinzmetal angina have ↑ risk of:

A

Reynaud’s

Migraines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tx for Prinzmetal angina:

A

Nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Five things to know about a patient’s pacemaker/ICD:

A 
The indication 
The underlying rhythm/rate
The type (demand, fixed, RF)
The chamber paced
The chamber sensed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pacemaker/ICD should be evaluated within:

A

3-6 months prior to surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Effect of magnet on pacemaker/ICD:

A

Converts to a fixed asynchronous rate

EXCEPT tachyarrythmia ICDs - need to be turned off manually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Safety with cautery and pacemakers/ICDs:
Grounding pads as far away as possible from device Use bipolar, not monopolar cautery Have external pacing available Monitor blood flow (pulse ox, a-line) not just EKG
26
Treat HTN when greater than:
160 systolic | 90 diastolic
27
Worse in the OR: hypo or hypertension?
Hypotension
28
Labs for long-standing severe or uncontrolled HTN:
EKG BUN/Cr Chemistry *if* on diuretics
29
β-blockers and surgery:
If on, continue - discontinuation may ↑ CV morbidity Start β-blockers on high risk patients having vascular surgery or having 3+ risk factors If starting, start DAYS before surgery, NOT day of!
30
S/s of heart failure:
``` Orthopnea Nocturnal coughing Fatigue Peripheral edema 3rd/4th heart sound Resting tachycardia Rales JVD Ascites ```
31
EKG sign of heart failure:
LVH ↑ R wave in I, aVF, V4-6 ↑ S wave in III, aVR, V1-3
32
Labs for heart failure:
EKG Chemistry BUN/Cr BNP (want
33
Cardiac medications to hold pre-op:
ACEIs ARBs (Hold for one day)
34
Greatest-risk valvular disorder:
Severe aortic stenosis | If symptomatic, postpone surgery!
35
Diastolic murmurs are always:
Pathologic and requiring investigation
36
Medication considerations for prosthetic heart valves:
May need anticoag bridge and/or endocarditis prophylaxis
37
Arrhythmias associated with periop risk:
SVT | Ventricular arrythmias
38
Arrythmia strongly associated with CAD:
LBBB
39
Postpone surgery for these rhythms:
``` Uncontrolled atrial fibrillation Ventricular tachycardia New-onset atrial fibrillation Symptomatic bradycardia High-grade or 3rd degree HB ```
40
Statins and surgery:
Continue them and start vascular surgery patients on them
41
Aspirin and surgery:
Weigh risks/benefits, esp. patients at high risk (CAD/CVD) If holding - hold 7-10 days prior to surgery Do not D/C ASA in patients with DES until 12 months of dual therapy, or bare metal stents until 1 month dual therapy, and in general try not to d/c it at all in stented pts
42
Anticoagulants and surgery:
D/c coumadin 3-5 days prior (aim for INR
43
CXR can show us r/t heart function:
Cardiomegaly Pulmonary vascular congestion/pulmonary edema (CHF) Pleural effusions
44
Order CXR preop for anyone who is:
75y/o + CHF history Symptomatic CV disease
45
Definite EKG for patients who:
Are having vascular surgery | CAD/PAD/CVD and intermediate risk procedure
46
Maybe EKG for patients who:
1+ risk factor having intermediate risk surgery
47
Review EKGs for:
Acute or prior MI Rhythm/conduction disturbance Cardiomegaly/VH Electrolyte imbalances
48
On EKG, hypocalcemia causes:
Prolonged QT
49
On EKG, hypercalcemia causes:
Shortened QT
50
On EKG, hypokalemia causes:
Flat or inverted T waves
51
On EKG, hyperkalemia causes:
Peaked T waves
52
Inferior EKG leads and associated artery:
II, III, aVF | Right coronary artery
53
Lateral wall EKG leads and associated artery:
I, aVL, V5-6 | Circumflex branch of LCA
54
Anterior wall EKG leads and associated artery:
I, aVL, V1-4 | Left coronary artery
55
Anteroseptal EKG leads and associated artery:
V1-4 | Left anterior descending
56
Sufficient stress criteria for stress testing:
5+ minutes at HR > 120
57
Positive ECG criteria during stress testing:
ST segment depression >2.5 mm especially early in test (first 3 minutes) Serious ventricular arrhythmias Prolonged duration of ST depression in post recovery period
58
Positive non-ECG responses during stress testing:
↑ in BP or HR at time of ST-depression Hypotension (ominous) Achieved HR of
59
Drugs used to elicit stress in pharmacologic stress testing:
Dipyridamole or adenosine (vasodilators)
60
Interpreting "cold" spots in pharmacologic stress testing:
Only during stress: ischemia | Constant perfusion deficit: old MI/scarring
61
When to request stress testing:
Active cardiac condition 3+ risk factors, poor functional capacity, vascular surgery Maybe for less if it will change management
62
Drug used to elicit stress in stress echocardiography:
Dobutamine
63
Abnormal result in stress echo:
New regional wall motion abnormalities or worsening of existing regional wall motion abnormalities during an infusion of dobutamine
64
When to order a pre-op echo:
Current/prior heart failure Dyspnea of unknown origin Possible aortic stenosis Re-do if past echo > 1 year old
65
When to order pre-op cath:
Stable angina with: - L main CAD - 3-vessel disease - 2-vessel disease including proximal LAD and EF
66
Time to wait after PCI interventions before surgery:
Balloon angioplasty: 14+ days Bare-metal stent: 30-45+ days DES: 365+ days (so anticoag can be stopped)
67
High-risk conditions for SBE:
Prosthetic heart valves Hx of infective endocarditis Unrepaired cyanogenic congenital heart disease Post defect repair with prosthetic material for 6 mo Repaired defect with residual defect Transplant recipients with valve disease
68
SBE prophylaxis indicated in high-risk patients when:
Dental procedures involving gums/oral mucosa/periapical teeth area Invasive/incising/biopsy respiratory tract procedures
69
Drugs used for SBE prophylaxis:
Ampicillin 2gm IV Ancef (Cefazolin) 1gm IV Ceftriaxone (Rocephin) 1gm IV PCN allergy: clindamycin 600mg IV

ARCHIVED: Assessment (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions