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CCP > Exam 2 Review > Flashcards

Exam 2 Review Flashcards

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1
Q

S1 heart tones indicate:

A

Closure of the Mitral and Tricuspid (AV) Valves

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2
Q

Which of the following is the least accurate cardiac enzyme indicating an MI?

Troponin T
Myoglobin
CPK-MB
BNP

A

Myoglobin

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3
Q

An elevated BNP indicates:

AMI
Heart Failure
Pulmonary HTN
Unstable Angina

A

Heart Failure

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4
Q

What sign indicates Chest Pain?

Murphy’s sign
Cullen’s sign
Obturator Sign
Lavine’s sign

A

Lavine’s sign

(Murphy’s: Cholycystitis, Cullen’s: pancreatitis, Obturator: Appendicitis)

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5
Q

Which of the following is a P2Y12 inhibitor

Amlodipine
Losartan
Hydralazine
Ticagrelor

A

Ticagrelor

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6
Q

Which of the following is NOT a GP IIb/IIIa inhibitor?

Reopro
Integrilin
Clopidogrel
Aggrastat

A

Clopidogrel

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7
Q

Which agent is a potent vasodilator that acts equally on venous and arterial smooth muscle?

Nitroprusside
Nitroglycerin
Hydralazine
Labetalol

A

Nitroprusside

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8
Q

This dihydropyridine calcium channel blocker is commonly used to treat HTN in head bleeds:

Nitroprusside
Nicardipine
Diltiazem
Hydralazine

A

Nicardipine

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9
Q

Which of the following is NOT an organic nitrate?

Cleviprex
Isordil
Apresaline
Nipride

A

Cleviprex

(Apresaline: Hydralazine)

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10
Q

Which dyhydropyradine is a potent vasodilator that is metabolized by tissue? (AKA no renal or hepatic dose is required)

Cardene
Apresoline
Clevidipine
Diltiazem

A

Clevidipine

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11
Q

What class of drug is methyldopa?

Alpha 1 antagonist
Alpha 2 agonist
Organic Nitrate
Phosphodiesterase inhibitor

A

Alpha 2 agonist

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12
Q

What drug prevents hydrolysis of cAMP and thus prolongs the action of protein kinase?

Methyldopa
Milrinone
Cleviprex
Flolan

A

Milrinone (Phosphodiesterase inhibitor)

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13
Q

Which inodilator is used in right-sided heart failure?

Dobutamine
Primacor
Nipride
Cleviprex

A

Primacor (Milrinone)

(Dobutamine is left-sided)

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14
Q

Which of the following is a 5-HT3 Serotonin Receptor Antagonist?

Zofran
Phenergan
Haldol
Inapsine

A

Zofran

(Phenerhan: H1 antagonist)

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15
Q

In the clotting cascade, which factor is the start of the common pathway?

VII
IV
X
XII

A

X

(VII start the external pathway)
(XII starts the internal)

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16
Q

Which agent blocks thromboxane A2 (TXA2) synthesis from arachidonic acid in platelets?

ASA
Reopro
Heparin
Plavix

A

ASA

(Reopro: GP IIb/IIIa inhibitor, Plavix: P2Y12)

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17
Q

GP IIb/IIIa inhibitors:

A

abciximab (abcixifiban) (ReoPro)
eptifibatide (Integrilin)
tirofiban (Aggrastat)

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18
Q

What drug binds to antithrombin III and accelerates activity, inhibiting thrombin and factor Xa?

ASA
Plavix
Lovenox
Factor X

A

Lovenox (enoxaprin)

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19
Q

What stage of acetaminophen overdose does death occur?

I
II
III
IV

A

Stage III

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20
Q

What is the antidote for acetaminophen overdose?

Methyl Blue
Indomathacine
Dexamethasone
N-Acetylcysteine

A

N-acetylcysteine (Bucamyst)

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21
Q

All of the following are opioid receptors EXCEPT:

Mu
Gamma
Delta
Sigma

A

Gamma

(Mu, Kappa, Sigma, Delta)

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22
Q

What anticonvulsant is used for prophylactic tx of SAH?

Midazolam
Lorazepam
Phenobarbital
Levetiracetam

A

Levetiracetam (Keppra)

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23
Q

What drug is used in the tx of GI bleeds?

Sandostatin
Methylprednisolone
Dexamethasone
Keppra

A

Sandostatin (octreotide)

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24
Q

Identify a balloon port, CVP, PA, and infusion port:

A

Balloon port is SHORT and RED, and has a locking mechanism
CVP is BLUE, lumen is PROXIMAL (30cm from tip)
PA port is YELLOW, lumen is DISTAL (at the tip)
Infusion port is WHITE/CLEAR and usually longer, lumen is PROXIMAL (30cm from tip)

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25
Which port is essential to monitor the waveform in case of PAC malposition?
The PA distal port (YELLOW)
26
Which port is transduced with a normal value of 0-6mmHG?
CVP port (Blue) The most proximal opening (30cm from tip)
27
Identify different types of aortic dissections: Type I Type II Type III
Type I: Root, Ascending, Arch, Descending Type II: Ascending Only Type III: Descending aorta and extends distally
28
What hemodynamic parameter is equivalent to LVEDP? CVP PCWP PAP RAP
PCWP (CVP=RVEDP/RAP)
29
Which of the following does not factor into oxygen delivery (DO2)? SaO2 BSI Cardiac Index (CI) PaO2
PaO2 (Equation: Cardiac Index: CO/BSI)
30
The phlebostatic axis aligns to what anatomical structure? Right Atrium Left Ventricle Aortic Arch Right nipple line
Right Atrium
31
What are the two transducer points?
Phlebostatic axis (Right Atrium) Tragus (Formen of Munro)
32
What does the area under the arterial waveform represent? SBP LVEDP MAP CO
MAP
33
Which type of central line has the highest risk for a DVT? Jugular Subcarotid Brachial Femoral
Femoral (Subcarotid is MADE UP)
34
Which of the following is the parameter for a reduced EF? <40% <50% <65% <25%
Reduced: <40% (Preserved: >50%, Midrange: 40-50%)
35
Which hemodynamic parameter reflects left ventricular afterload? PVR SVR MAP PCWP
SVR
36
Which of the following will reduce right ventricular afterload? Nitroglycerin Nipride Propofol Nitric Oxide
Nitric Oxide
37
Which of the following is best if you want to give a vasopressor? Dopamine Milrinone Epinephrine Phenylephrine
Phenylephrine (Pure Alpha)
38
Which of the following will you find a high cardiac output and high SvO2? Sepsis HF Anemia Hypoxemia
Sepsis
39
Which of the following is an advantage of IABP therapy? Increases afterload Promotes pulsatile flow Increases myocardial oxygen consumption Promotes pulsatile flow
Promotes pulsatile flow (Decreases afterload; Decrease myocardial oxygen demand; Increases coronary artery perfusion)
40
What trigger should you use with a IABP in cardiac arrest? Pressure ECG Either Turn the IABP off
Pressure
41
Be familiar with timing errors and associated waveforms
Early inflation Late inflation Early deflation Late deflation Should be inflating ON the dicrotic notch Late deflation is the worst thing an IABP can do
42
Be familiar with the elements of an IABP waveform:
Unassisted systolic Unassisted diastolic Assisted Systolic Assisted diastolic Dicrotic notch
43
You are pacing a patient in VVI mode. What does the second letter represent? Chamber Sensed Chamber Paced Pacemaker response to sensing Programmed Function
Chamber sensed (Paced, Sensed, Response) (VVI is a transvenous setting)
44
Which of the following would be a pacer setting for a patient with a transvenous pacer? DDD DDI DAI VVI
VVI Anything that starts with D is Dual-pacing Anything sensing the atria is Dual-pacing MUST be epicardial
45
What pathogen is the most common cause of community acquired pneumonia? S. Pneumoniae S. Aureus H. Influenza Klebsiella
S. Pneumoniae
46
Which of the following is NOT a treatment for community acquired pneumonia? Cefepime Ceftriaxone Levofloxacin Ampicillin-sulbactam
Cefepime
47
Which antibiotic is used for treatment of chemical pneumonitis? Clindamycin Amoxicillin Flagyl No ABX used
No ABX used
48
What test is used to diagnose TB? Acid Fast Gram stain Sputum Stain PCR
Acid Fast Mycobacterium: No cell wall for gram staining
49
What pathogen is the most common cause of meningitis in adults? S. Pneumoniae H. Influenzae E. Coli L. Monocytogenes
S. Pneumoniae
50
What is the IV antiviral that treats severe influenza? Peramivir Zanamivir Oseltamivir Baloxavir
Peramivir The rest are PO
51
Which of the following is not a Human Herpes Virus? Epstein-Barr Varicella Zoster CMV Noravirus
Noravirus
52
What type of pathogen causes malaria? Virus Bacteria Protozoa Amoeba
Protozoa
53
What is the first line treatment of C. Diff in the intubated ICU Patient? Vancomycin Metronidazole Cefepime PCN
Metronidazole (Flagyl) Vancomycin PO can be used, but not for the intubated PT.
54
You have an afebrile patient with abdominal pain and rice water diarrhea. What is the first line treatment? Doxycycline Azithromycin Ceftriazxone Vancomycin
Doxycycline (Cholera)
55
What type of pathogen causes C. Diff? Gram positive cocci Gram negative cocci Gram negative rod Gram positive rod
Gram positive anaerobic rod
56
A CVA pt has a left-sided tongue deviation. What cranial nerve is involved? XII X VII IX
XII
57
What dermatome is found at the nipple line? T4 T10 L1 C8
T4
58
Which of the following is a sign of meningeal irritation? Psoas Kehr’s Chvosek’s Brudzinski’s
Brudzinski’s (Hip/Knee flexion 2/2 raising head) Kernig’s (increased pain/resistance to straightening knee from hip/knee flexion) (Kehr’s: diaphragmatic irritation , Psoas: Appendicitis , Chvosek’s: Hypocalcemia)
59
What is the end-goal therapy for SBP in subarachnoid hemorrhage?
140mmHG 180mmHG in ischemic/thrombolytic strokes
60
What anatomical landmark aligns with the tragus? Foremen of Munro Cerebral aqueduct 3rd Ventricle Hypothalamus
Foramen of Munro
61
What area of the brain is responsible for word formation? Wernicke’s Broca’s Parietal Occipital
Broca’s
62
What is the most common cause of a SAH? Trauma Berry’s Aneurysm Basal artery dissection Severe HTN
Berry’s aneurysm (Medical) (2nd most common cause: ADM)
63
How many nerve roots extend from the cervical vertebrae? 7 6 8 10
8
64
A patient has a MAP OF 88 AND ICP OF 23. What is the CPP?
MAP - ICP = CCP CPP is 65
65
OB patient has 4 living children with 1 born at 32 weeks and no abortions. What is her OB history? P3104G5 P4004G5 P2114G5 P3104G4
PfpalG (P: full-term, pre-term, abortions, living children; G: total pregnancies) P3104G5
66
The umbilical cord has: 2 arteries and 1 vein 2 veins and 1 artery 2 veins and 2 arteries 1 vein and 1 artery
2 arteries and 1 vein :)
67
The uterine fundus of a pregnant pt is at the umbilicus. How many weeks gestation is she? 10 weeks 20 weeks 15 weeks 23 weeks
20 weeks (McDonald’s rule: fundus leaves the pelvic cavity ~14 weeks)
68
What condition found in TOCO monitoring requires emergent C-section? Variable decelerations Early decelerations Late decelerations Atony
Late decelerations
69
OB patient with severe abdominal pain and dark red vaginal bleeding. you suspect: Abruptio placenta Placenta Previa Uterine rupture Ectopic pregnancy
Abruptio Placenta (Sever pain, dark red blood) (Placenta previa: Painless, bright red blood; Uterine rupture: no bleeding; Ectopic pregnancy: appendicitis-like pain, possibly bleeding)
70
Pre-eclampsia is defined as a SBP >140, plus: Pulmonary edema Peripheral edema Seizures Proteinuria
Proteinuria (Peripheral edema is a common finding in OB patients; non-specific)
71
What calcium channel blocker is used to treat pre-eclampsia? Labetalol Hydralazine Cardene Nifedipine
Nifedipine (Calcium channel blocker) 1st line Labetalol is a beta-blocker Cardene is second line Hydralazine acts as an organic nitrate
72
What drug is used to treat post-partum hemorrhage? Mag sulfate Terbutaline Apresaline Oxytocin
Oxytocin (Pitosin) Will cause uterine contractions. Do not administer until after delivery of placenta
73
How to recognize different blocks on ECG
74
Which drug is a benzodiazepine antagonist? Phenytoin Luminal Romazicon Levetiracetam
Romazicon (flumazenil)
75
Localize MIs on 12-lead ECG
I SEE ALL LEADS Inferior: II, III, aVF Septal: V1, V2 Anterior: V3, V4 Low-Lateral: V5, V6 High-Lateral: I, aVL
76
Identify suspect artery through MI localization on ECG
77
Recognize electrolyte abnormalities on ECG
78
Strep pneumoniae
Most common cause of CAP (40% of cases) Gram + Lobar Pattern on Cxr Associated w/ rigors and sputum production Emerging drug resistance TX: ceftriaxone -or- ampicillin-sulbactam + azithromycin or levofloxacin (PCN allergy: levofloxacin and aztreonam)
79
Haemophilus Influenza
2nd most common cause of CAP Gram -ve coccobacillary Anaerobe Nasal flora Usually lobar Sputum production Thx: Ceftriaxone -or- ampicillin-sulbactam + azithromycin or levofloxacin (PCN allergy: levofloxacin and aztreonam)
80
Atypical Pneumonia
Mycoplasma Gm +/Chlamidophila Gm - Walking Pna (often mild, no hypoxia) Tx: Azithromycin or Levofloxacin
81
Legionella
Presents as acute pneumonias, but minimal sputum + HA and confusion, Abd on, Nausea, Diarrhea, LFTs Mortality 15-50% Tx: Azithromycin
82
Chemical pneumonitis
Inflammation immediately following aspiration Tx: O2, removal of aspirate. NO Abx needed
83
Aspiration Pneumonia
Mostly Gm - anaerobes Favors RLL on Cxr Several days from aspiration event to pneumonia Tx: clindamycin -or- metronidazole + amoxicillin
84
HAP/VAP
Hospital-acquired Pna/Ventilator-acquired Pna Watch for development ~48hours after admission or ~2-3 days after intubation Complex treatment: follow algorithm
85
HAP/VAP tx algorithm
1. Stability 2. Previous Abx (w/in 90 days) 3. Pseudomonas Risk 4. MRSA risk
86
Treatment of TB
4-drug regimen: INH, rifampin, pyrazinimide, ethambutol
87
CLABSI
Pulmonary artery catheters- highest infection rate (3.7%) Remove: Severe Sepisis, endocarditis, thrombophlebitis, bacteremia >72 hours Salvage: always remove line in S. Aureus, Pseudomonas, fungi, mycobacteria, or polymicrobial infection Empiric therapy: Vancomycin, add Cefepime for pseudomonas/Gram -ve coverage/neutropenia. Continue for 10 days after 1st negative culture.
88
CAUTI
Tx: IV imipenem and vancomycin for sepsis/drug resistance Ceftriaxone, Pipercillin/Tazobactam, or ciprofloxacin for less severe hospitalized PT. Switch to PO therapy after clinical improvement
89
Bacterial Meningitis Tx
Varies by age/source, but generally involves vancomycin + 3rd gen cephalosporin.
90
Cranial nerves
I- Olfactory II- Optic III- Oculomotor IV- Trochlear V- Trigeminal VI- Abducens VII- Facial VIII- Vestibulocochlear IX- Glossopharyngeal X- Vagus XI- Accessory XII- Hypoglossal
91
Dermatomes T4 & T10
T4- Nipple line T10- Umbilicus

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