Final Exam Flashcards
(69 cards)
1
Q
Standard GXT
A
- research or rx
- theraputic indications
- no EKG monitoring
- Ventilatory gasses
2
Q
Diagnostic GXT
A
- EKG monitoring
- BP/HR monitoring
- used for diagnostic/prognostic
- ventilatory gasses in presence of HF
3
Q
magnitude of ischemia due to lesion directly proportional to
A
- st segment depression
- # of EKG leads associated w st segment depression
- duration of st segment depression
4
Q
magnitude of ischemia due to lesion is indirectly proportional to
A
- st slope
- RPP at which st segment depression occurs
- HR max, SBP, METs achieved
5
Q
GXT post MI
A
- prognostic
- ex rx
- evaluation of medical therapy or surgical interventions
- submax testing rec after discharge
- 4-6d after acute MI
- cant do it w/o revascularization
- fx capacity <5Mets
6
Q
Functional Testing
A
- PA counceling
- EXrx
- Disability assessmet
- estimate prognosis
- return to work eval
7
Q
MET increase VS all cause mortality
A
1 MET increase = 1.3% decrease in all cause mortality
8
Q
how much weight do treadmills hold
A
350
9
Q
which protocol is more accurate in estimation of ex capacity and ventilator threshold
A
ramp
10
Q
proper ECG monitoring
A
- skin prep
- LEAD PLACEMENT
- continuous monitoring
11
Q
Echo is good for
A
- aortic stenosis
- low cardiac output
- milld mitral stenosis resulting symptoms
- severe aortic insuffieciency or mitral regurgitation
12
Q
Risk of complication hospital admission, acute mi, sudden cardiac death
A
-hospital admission <0.01 %
13
Q
CVD meds that don’t really affect ex
A
- ARBs
- ACE inhibitors
- Dieuretics
- Anticoagulants
- antiplatelet
- lipid lowering meds
14
Q
CVD meds that will affect ex
A
- Beta blockers
- Calcium channel blockers
15
Q
Beta blocker response w ex
A
-Blunted HR and BP response to ex
-faulty HR and BP
-OLOL
(selective or non selective)
16
Q
Calcium channel blockers
A
- lower HR
- used when changing electrical
- DIPINE
17
Q
ACE Inhibitors
A
- work through kidneys not heart
- PRIL
18
Q
ARBs
A
- do NOT get ACE cough
- block all actions of angiotensin 2
- SARTAN
19
Q
Dieuretics
A
- lasix is most common
- usually first med prescribed
20
Q
Anticoagulants
A
-heparin used in hospital
21
Q
Antiplatelet
A
- dont effect ex rx
- less sticky
- easier for blood to flow
22
Q
Lipid lowering drugs
A
- statins
- anyone at risk or might be at risk should be on one
- might feel sore/cramps
23
Q
Know table a1
A
put in here
24
Q
common CVD
A
- HTN
- CAD
- PAD
- atherosclerotic arterial disease
- acute coronary syndromes
- cerebrovascular disease/stroke
- MI
- myocardial ischemia
25
where does CAD occur
tunica intima
26
how many deaths per year bc of HTN
9.4 mil
27
how many deaths per year cvd
17.3 million
28
howm many deaths expected bc of cvd by 2030
23.3 million
29
plaque progression has to deal with...
lipoproteins
30
CVD risk factors
- dislipedemia
- smoking
- HTN
- DM
- sedentary
- age
- male
- family hx
31
Common cholesterol meds
- bile acid sequestriants
- fibric acid sequestriants
- statins
- nicotinic acid
- cholesterol absorption inhibitor
32
Acute coronary syndomes
- >90% due to plaque rupture and thrombus formation
| - thrombus leads to severe or complete occlusion
33
Table 7.3
put in first 2
34
Diagnosis of ACS
- presenting symptoms
- acute EKg abnormalities
- serum marker of necrosis
35
Treatment of ACS
- rapid initiation is critical
- therapy targets initiating intracoronary thrombus
- reverse ischemia and restore coronary supply and demand to normal
- treatment of STEMI is different than treatment of NSTEMI
- acute treatment may include oxygen therapy morphine and EKG monitoring
36
Acute medical management of NSTEMI
- anti ischemic therapy
| - antithrombotic therapy
37
Put in basics of table 9.6
put in
38
how many people suffer from HTN
- 1 bio worldwide
| - 60 mil americans
39
how many people w HTN are unaware
-2/3
40
HTN risk factors
- age
- gender
- obesity
- diabetes
- race/heredity/genetics
- lifestyle
41
Classifications of HTN
-normal 160 >100
42
Consequesnes of HTN
- nosebleeds/headache/dizziness
- flushin
- sweating
- blurred vision
- most are asymptomatic
43
Organ damage from HTN
- vaasculature
- heart
- cerebrovascular
44
non medical treatment for HTN
- dec weight
- ex
- diet
- sodium
- potassium
- alcohol
- smoke cess
- relaxation therapy
45
medical treatment for HTN
- dieuretics
- sympatholytic agents
- peripheral vasodialators
- ACE inhibitors
- ARBs
- antithrombotic/platelet/coagul
- lipid lowering
46
components of outpatient CR program
- ex rx
- aeorbic
- resistance
- flex
- nm training
47
FITT for cardiac patient
F- 3 d/wk pref all days
I- RPE 11-16 40-80% VO2
T- warm up/cool down 5-10 Ex 20-60
T- large musc rythmic, resistance
48
what we use to determine progression for cardiac patients
- px levels
- hr response (remember beta blockers)
- BP response
- RPE
- Err on side of safety
49
chemicals affecting HR
- epinephrine
- norepinephrine
- acetylcholine
- dopamine
50
chemicals affectng BP
- caffeine
- norepenipherine
- renin
- aldosterone
- adh
- epinepherine
- acetylcholine
51
what is HTN
>140 >90
52
vo2 factors that negatively affect
- mi
- meds
- asthsma
- chronic kidney disease
- cancer
- hiv/aids
- osteopenia
- obesity
- any disease pathology
53
measurements we take in GXT
- hr
- rpe
- bp
- dyspnea
- gas measurement
- blood lactate
- ekg
54
hypokinesis
-low movement
55
akinetic
no movement
56
diskenisis
moves wrong way
57
what is a calcium channel blocker
- impedes calcium to cell
- dec HR
- dec contractility
58
what is an ACE inhibitor
- controls the bv
| - bp dec b.c blocks angiotensin 2 which would have inc bp with symp ns
59
how does beta blocker work
-no adronergic affect
60
what does arg do
- block angiotensin 2
| - bp will be lower
61
most important factor to resistance of blood flow
- diameter
| - by 1/2 ing resistance increase rest by 16 timesi
62
positive inotropic affect
affect contractility of heart by increasing
63
negative chronotropic response
hr decreased (neg affected)
64
why don't we like beta blockers
-major effect of ex (difficult to prescribe)
65
rt sided heart failure
-lung disease
66
risks of untreated HTN
- mi
- copd
- stroke
- cad
- kidney disease
- retinopathy
- heart failure
67
how can we tell if angina is result of ischemia
-12 lead ekg st segment
68
with damage to endothelium what gets into arteries
LDL
69
risk factors for atherosclerosis
- dislipidemia
- htn
- obesity
- diet
- sedentary lifestyle
- age
- heredity
- smoking
