FINALS Flashcards

1
Q

What represents ventricular repolarization in an ECG?

A

T-wave

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2
Q

Where is the V1 electrode placed in a standard ECG?

A

Fourth intercostal space just to the right of the sternum

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3
Q

Which lead does not record the electrical activity of the heart in the lateral area?

A

Lead III

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4
Q

What percentage of cross-sectional diameter reduction can cause angina?

A

70%

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5
Q

What condition has no regularity shape of the QRS complex because all electrical
activity is disorganized and there are no P waves or PR intervals present?

A

Ventricular Fibrillation

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5
Q

Where is the V4 electrode placed in a standard ECG?

A

Fifth intercostal space in the mid-clavicular line

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6
Q

Which finding is associated with a PR interval > 0.22 seconds?

A

First-degree AV block

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7
Q

What represents atrial depolarization in an ECG?

A

P-wave

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8
Q

Where is the RA electrode placed in a standard ECG?

A

On the right arm, avoiding thick muscle

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9
Q

Which condition has a ventricular rate usually between 150 and 250 beats per
minute, with variable ventricular complex?

A

Irregular Wide Complex Tachycardia

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10
Q

What is the most common cause of injury to the intimal walls of the artery?

A

Hypertension

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11
Q

What is the most common cause of injury to the intimal walls of the artery?

A

Hypertension

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12
Q

What condition has a ventricular rate less than 60bpm, but usually more than
40bpm, with a consistent PR interval between 0.12 and 0.20 seconds in duration?

A

SInus Bradycardia

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13
Q

Which enzyme peaks at 24-36 hours following a major myocardial injury?

A

Creatine kinase-myocradial band

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14
Q

Which lead uses the positive electrode on the left leg and a combination of the
right arm and left arm electrodes as the negative pole?

A

Lead II

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15
Q

Is high blood pressure, with a systolic blood pressure of 130
mmHg or higher, and/or a diastolic blood pressure of 80 mmHg or higher?

A

Hypertension

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16
Q

is the pressure in the arteries when the heart contracts

A

Systolic Blood Pressure

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17
Q

is the pressure in the arteries when the heart is relaxed between beats

A

Diastolic Blood Pressure

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18
Q

is swelling in the legs, ankles, and feet due to the accumulation of
fluid in the tissues

A

Peripheral Edema

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19
Q

is the accumulation of fluid in the lungs, which can cause difficulty breathing,coughing and other respiratorty symptoms.

A

Pulmonary Edema

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20
Q

is a complication of untreated streptococcal pharyngitis (strep
throat) that can cause damage to the heart valves and lead to rheumatic heart disease.

A

Rheumatic Heart Fever

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21
Q

is a congenital heart defect that consists of four abnormalities: a
ventricular septal defect (a hole between the right and left ventricles), pulmonary
stenosis (narrowing of the pulmonary valve and artery), right ventricular hypertrophy
(enlargement of the right ventricle), and an overriding aorta (the aorta is shifted to the
right and receives blood from both the right and left ventricles).

A

Tertalogy of Fallot

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22
Q

can lead to cardiac muscle disease through a process called hypertensive
heart disease. When blood pressure is consistently elevated, it causes the heart to work
harder to pump blood against the increased resistance in the blood vessels. Over time,
this increased workload can cause the heart muscle to thicken and become stiff, a
condition called left ventricular hypertrophy (LVH). LVH can lead to a variety of
complications, including diastolic dysfunction, systolic dysfunction, and other
conditions that can lead to heart failure, arrhythmias, and other complications.

A

Hypertension

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23
Q

What are the two hallmark symptoms of right-sided heart failure?

A

Peripheral Edema, Jugular Venous Distension

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24
A score of _ on the modified Berg Scale indicates that the person is able to perform activities with moderate difficulty, but can continue with activity
7
25
is a bulge or weakening in the wall of an artery, which can develop in various locations throughout the body.
Aneurysm
26
it can cause internal bleeding and life-threatening complications
Aneurysm Ruptures
27
is the most common form of heart disease. It is the result of atheromatous changes in the vessels supplying the heart.
Coronary Artery Disease
28
is used to describe a range of clinical disorders from asymptomatic atherosclerosis and stable angina to acute coronary syndrome
Coronary Artery DIsease
29
A stenosis of >50% of diameter or >75% cross-section diameter reduction can lead to?
Angina
30
Thrombus formation after plaque disruption can lead to
Acute Coronary syndrome
31
Symptoms of CAD are not experienced until the lumen is at least how many percent occluded.
70%
32
Most myocardial infarctions occurred in the______ and _______?
Right coronary artery and Left anterior descending artery
33
the new terminology for ischemic heart disease or CAD.
Acute coronary syndrome
34
It involves a spectrum of entities ranging from the least involved condition on the spectrum (unstable angina) to the worst involved condition (sudden cardiac death).
Acute Coronary Syndrome
35
cardiac-related chest pain, is due to ischemia.
Angina
36
is a temporary condition due to the imbalance between the myocardial oxygen supply and demand.
Ischemia
37
It is chest pain that increases in severity, frequency, and duration and is refractory to treatment.
Unstable angina
38
when angina occurs during exercise or activity. Chest pain is experienced at a certain intensity of exercise when the myocardial oxygen demand exceeds the blood supply to the myocardium and is alleviated by decreasing the MVO2.
stable angina
39
caused by a vasospasm of coronary arteries in the absence of occlusive disease.
Variant or Prinzmetal angina
40
preferred long-term pharmacological choice for variant angina
Calcium Channel Blockers
41
results from interruption of myocardial blood flow and resultant ischaemia and is a leading cause of death worldwide
Myocardial infraction
42
can occur in those with poor visceral sensation (diabetics, post-cardiothoracic surgery) and may manifest with other symptoms of myocardial compromise, e.g. breathlessness
Silent ischaemia
43
is a complex clinical syndrome that results from either functional or structural impairment of ventricles resulting in symptomatic left ventricle (LV) dysfunction.
Congestive Heart Failure
44
It can result from disorders of the pericardium, myocardium, endocardium, heart valves, great vessels, or some metabolic abnormalities
Congestive Heart Failure
45
is the first presentation of heart failure or a sudden onset of heart failure
Acute CHF
46
is when heart failure is recurrent or episodic
Transient CHF
47
is heart failure that is persistent, worsening, or decompensate (to lose ability to function).
Chronic CHF
48
This is the most common form of heart failure, gradually pushing up the pressure in the left atrium and pulmonary vascular system. The resulting pulmonary hypertension may force fluid into the alveoli creating pulmonary edema.
Left Ventricular Failure
49
This generally occurs secondary to cardiopulmonary disorders such as pulmonary hypertension, right ventricle infarction, congenital heart disease, pulmonary embolism or COPD.
Right Ventricular Failure
50
occurs from direct insult to the RV caused by conditions that increase PA pressure.
Right-sided heart failure
51
Symptoms can be reflective of both left and right-sided heart failure, including shortness of breath and swelling due to a build-up of fluid
Biventricular heart failure
52
Increased peripheral arterial pressure contributes to increased afterload and pathological hypertrophy of the left ventricle.
Hypertension
53
Acute injury to myocardial tissue damages ventricular contractility causing systolic dysfunction. Scar formation seen in infracted tissue alters relaxation and may lead to diastolic dysfunction.
Coronary Artery Disease
54
Normal electrical conduction through the heart allows for normal mechanical contraction of the ventricles. Altered electrical conduction alters the mechanical activity of the ventricles exacerbating heart failure.
Cardiac Dysrhythmias
55
Cardiac valve pathology (stenosis or regurgitation) causes structural changes to the chamber behind the valve resulting in cardiac muscle dysfunction and failure.
Valve Abnormalities
56
Damage to the myocardial cells from various pathological processes alters the systolic and/or diastolic function of the ventricles
Cardiomyopathies
57
Inflammation of the pericardium
Pericarditis
58
An abnormal dilatation in the arterial wall, vein or the heart
Aneurysm
59
three common sites of aneurysm
Thoracic, Peripheral and Abdominal
60
a bluish color of the skin, nail beds, and possibly lips and tongue, may be present when arterial oxygen saturation is 85% or less.
Cyanosis
61
the absence of a pink, rosy color, may indicate a decrease in CO.
Pallor
62
(excess sweating, cool clammy skin) should also be noted because it may indicate excessive effort or inadequate cardiovascular response
Diaphoresis
63
these drugs help relax and widen the blood vessels, reducing blood pressure.
ACE Inhibitors
64
Lisinopril, Enalapril, Captopril, Ramipril are all examples of what type of cardiovascular drug
ACE inhibitors
65
what do ACE inhibitor drugs end in?
-pril
66
they reduce the effects of adrenaline and related hormones, which typically increase heart rate and constrict blood vessels. They slow down the heart rate and lower blood pressure.
Beta Blockers
67
Metoprolol, Propranolol, Atenolol, Carvedilol are all examples of what type of cardiovascular drugs?
Beta blockers
68
What do Beta blockers end in?
-olol
69
prevent calcium from entering the cells of the heart and blood vessels. This action relaxes and widens the blood vessels, allowing for better blood flow and reducing the workload on the heart. They also help lower blood pressure.
Calcium Channel Blockers
70
Amlodipine, Nifedipine, Verapamil, Diltiazem are all examples of what type of cardiovascular drug?
Calcium Channel Blockers
71
what are the two endings of Calcium channel blockers?
-pine and -zem
72
act on specific kidney receptors to balance potassium and sodium levels in the body.
Diuretics
73
Hydrochlorothiazide, Furosemide, Spironolactone, Chlorthalidone are all examples of what cardiovascular durg ?
Diuretics
74
What are the two endings of Diuretics?
-ide and -ctone
75
Hearts Location *3 pinpoints
Centrally, Substernally and tilted to the Left
76
one third of the heart is located on the
right side
77
two-thirds of the heart is located on the
left side of the midline
78
the base of the heart is located
below the third rib as it approaches the sternum
79
the base of the heart is directed superiorly to the ____ of _____ and _______
right of midline and posterior
80
the pointed apex of the heart projects to the ______ of the ______ and _________
to the left of the midline and anterior
81
the outer layer of the wall of the heart and is formed by the visceral layer of the serous pericardium.
Epicardium
82
the muscular middle layer of the wall of the heart and has excitable tissue and the conducting system. It is composed of three discernable layers of muscle that are seen predominantly in the left ventricle and inter-ventricular septum alone.
Myocardium
83
The three layers of the myocardium
-Subepicardial layer -Middle concentric layer -Subendocardial layer
84
the innermost layer of the heart is formed of the endothelium and subendothelial connective tissue
Endocardium
85
Receives oxygenated blood from the lungs via the left and right pulmonary veins.
Left atrium
86
what veins enter the heart as two pairs of veins inserting posteriorly and laterally into the left atrium.
pulmonary
87
the smallest pulmonary veins are called
thebesian
88
what veins drain deoxygenated blood from the atrial myocardium directly into the left atrium.
thebesian
89
is found midline, posterior to the right atrium and superior to the left ventricle.
left atrium
90
the walls of the atrial appendage are
pectinate
91
the walls of the left atrium are
smooth
92
the left atrium discharges into the left ventricle through the ______ valve
mitral valve
93
Region of the right atrium: smooth-walled
posterior
94
other name for posterior part of the right atrium
sinus venarum
95
Region of the right atrium:which is lined by horizontal, parallel ridges of muscle bundles that resemble the teeth of a comb
Anterior part
96
other name for the anterior part of the right atrium
pectinate muscle
97
receives both the superior and inferior venae cavae and the coronary sinus. It also contains the fossa ovalis, the sinoatrial node and the atrioventricular node. *septum
Atrial septum
98
location of the atrial septum
Right atrium
99
where in the right atrium is the tricuspid valve attached to *septum
membranous septum
100
It pumps blood throughout the body via the aorta.
Left ventricle
101
The ______________ septum appears from within the left ventricle to bulge into the right ventricle; this creates a barrel-shaped left ventricle.
interventricular septum
102
It pumps blood to the lungs through the pulmonary trunk and arteries.
Right Ventricle
103
Part of the right ventricle: extends from tricuspid annulus to the insertions of the papillary muscles.
The inlet
104
this septum separates the left and right ventricular outflow tracts and is located just inferior to both semilunar valves
infundibular septum
105
consists of three semilunar cusps with free edges projecting upward into the lumen of the pulmonary trunk thus prevents the backflow of blood as it is pumped from the right ventricle to the pulmonary artery.
pulmonary valve
106
prevents the backflow of blood as it is pumped from the right atrium to the right ventricle.
tricuspid valve
107
thus prevents the backflow of blood as it is pumped from the left ventricle to the aorta.
aortic valve
108
It prevents the backflow of blood as it is pumped from the left atrium to the left ventricle and are continuous with each other at the commissures.
Mitral valve
109
other name for mitral valve
bicuspid valve
110
The left atrium via the anterior interventricular branch is supplied by the
Left Coronary Artery
111
The right coronary artery supplies the right atrium via which branch
atrial branch
112
Venous drainage of the heart: is a wide venous channel that runs from left to right in the posterior part of the coronary groove. It receives the great cardiac vein at its left end and the middle cardiac vein and small cardiac veins at its right end.
Coronary sinus
113
Venous drainage of the heart: is the main tributary of the coronary sinus and it drains the areas of the heart supplied by the LCA.
great cardiac vein
114
Venous drainage of the heart: begin over the anterior surface of the right ventricle, cross over the coronary groove, and usually end directly in the right atrium; sometimes they enter the small cardiac vein.
anterior cardiac veins
115
Nerve Supply: decreases heart rate, reduces force of contraction and constricts the coronary arteries.
Parasympathetic preganglionic fibers
116
Nerve supply: increases heart rate and increases the force of contraction.
Sympathetic fibers
117
Nerve Supply: from the heart, a part of the cardiac plexus pass through the cardiac plexus and return to the central nervous system in the cardiac nerves from the sympathetic trunk and in the vagal cardiac branches.
Visceral afferents fibers
118
Conduction System of the Heart: an excitation signal (an action potential) is created by the
Sinoatrial (SA) Node
119
Conduction System of the Heart: delays action potential signal
Atrioventricular (AV) node
120
Conduction System of the Heart: spreads the wave impulses along the ventricles,causing them to contract. *2 items
Bundle of HIS and Purkinje fibers
121
Conduction System of the Heart: is a collection of specialised cells (pacemaker cells), and is located in the upper wall of the right atrium, at the junction where the superior vena cava enters.
Sinoatrial (SA) node
122
Conduction System of the Heart: conducts the impulse to the Purkinje fibres of the right ventricle
Right bundle branch
123
Conduction System of the Heart: conducts the impulse to the Purkinje fibres of the left ventricle.
Left bundle branch
124
Conduction System of the Heart: are a network of specialised cells. They are abundant with glycogen and have extensive gap junctions.
Purkinje Fibers
125
Heart Sounds: "lub",closure of AV valves
s1
126
Heart sounds: "dub",closure of SL valves
s2
127
Heart sounds: "dub",closure of SL valves
s2
128
Heart sounds: occurs soon after s2
s3
129
Heart sounds: occurs just before s1
s4
130
– Refers to the amount of time required for refill after compression of a nailbed, and indicates perfusion status.
Capillary Refills
131
Auscultation: 2(R) ICS
Aortic
132
Auscultation: 2(L) ICS
Pulmonic
133
Auscultation: 5(L) ICS
Mitral
134
Auscultation: 4(L) ICS
Tricuspid
135
Palpation: 3(L) ICS
Aortic
136
Palpation: 3(L) CC
Pulmonic
137
Palpation: 4(L) CC
Mitral
138
Palpation: 4(R) ICS
Tricuspid
138
Palpation: 4(R) ICS
Tricuspid
139
Electrode Name: On the right arm, avoiding thick muscle.
RA
140
Electrode Name: In the same location where RA was placed, but on the left arm.
LA
141
Electrode Name: In the fourth intercostal space (between ribs 4 and 5) just to the right of the sternum (breastbone)
V1
142
Electrode Name: In the fourth intercostal space (between ribs 4 and 5) just to the left of the sternum.
V2
143
Electrode Name: Between leads V2 and V4.
V3
144
Electrode name: In the fifth intercostal space (between ribs 5 and 6) in the mid- clavicular line.
V4
145
Electrode Name: Horizontally even with V4, in the left anterior axillary line.
V5
146
Electrode Name: Horizontally even with V4 and V5 in the mid-axillary line.
V6
147
Limb Leads: is the voltage between the (positive) left arm (LA) electrode and right arm (RA)
Lead I
148
Limb Leads: is the voltage between the (positive) left leg (LL) electrode and the right arm (RA)
Lead II
149
Limb Leads: is the voltage between the (positive) left leg (LL) electrode and the left arm (LA)
Lead III
150
They are derived from the same three electrodes as leads I, II, and III, but they use Goldberger's central terminal as their negative pole.
Augmented Limb Leads
151
is a combination of inputs from two limb electrodes, with a different combination for each augmented lead.
Goldberger's Central Terminal
152
Augmented Limb Leads: -has the positive electrode on the right arm. -The negative pole is a combination of the left arm electrode and the left leg electrode
Lead augmented vector right (aVR)
153
Augmented Limb Leads: -has the positive electrode on the left arm. -The negative pole is a combination of the right arm electrode and the left leg electrode
Lead agumented vector left (aVL)
154
Augmented Limb Leads: -has the positive electrode on the left leg. -The negative pole is a combination of the right arm electrode and the left arm electrode.
Lead Augmented vector foot (aVF)
155
represents ventricular depolarization
The QRS complex
156
represents ventricular repolarization.
The T wave
157
represents papillary muscle repolarization
The U wave
158
ECG – Rhythm: has the characteristics heart rate of 50–100 beats/minute,P-wave before every QRS complex and positive in lead II and also a constant PR interval.
Sinus Rhythm
159
ECG-Rhythm: Causes are second and third degree AV block, sinoatrial block and arrest termed sinus node dysfunction (SND) bradycardia and sick sinus syndrome (SSS) if symptomatic.
Bradycardia
160
ECG-Rhythm: Causes are sinus tachycardia, inappropriate sinus tachycardia, sinoatrial re-entry tachycardia, atrial fibrillation, atrial flutter, atrial tachycardia, and multifocal atrial tachycardia. Tachyarrhythmia with narrow QRS complexes rarely cause circulatory compromise.
Tachycardia with narrow QRS complexes
161
ECG-Rhythm: The main cause is ventricular tachycardia and it can be life-threatening. QRS complexes become wide due to abnormal ventricular depolarization but 10% of wide complex tachycardia starts from the atria.
Tachycardia with wide QRS complexes
162
Rate: The rate appears rapid, but the disorganized electrical activity prevents the heart from pumping. P wave: There are no P waves present. PR interval: There are no PR intervals present. QRS complex : The ventricle complex varies
Ventricular Fibrillation
163
Rate: The atrial rate cannot be determined, Ventricular rate is usually between 150 and 250 beats per minute P Wave: QRS complexes are not preceded by P waves. There are occasionally P waves in the strip, but they are not associated with the ventricular rhythm. PR interval: it is not measured since this is a ventricular rhythm. QRS complex: it measures more than 0.12 seconds. The QRS will usually be wide and bizarre. It is usually difficult to see a separation between the QRS complex and the T Wave.
Ventricular Tachycardia
164
Rate: the atrial rate cannot be determined. Ventricular rate is usually between 150 and 250 beats per minute. P Wave: there are no P waves present. PR interval: there are no PR interval present. QRS complex: the ventricle complex varies.
Irregular Wide Complex Tachycardia
165
Rate: there is no rate. P wave: there is no P waves present PR interval: PR interval is unable to be measure due to no P waves being present. QRS Complex: there are no QRS complexes present.
Pulseless Electrical Activity and Asystole
166
Rate: the rate is less than 60bpm, but usually more than 40bpm P wave: there is one P wave in front of every QRS. The P waves appear uniform PR interval: measures between 0.12 and 0.20 seconds in duration. PR interval is consistent. QRS complex: measures less than 0.12 seconds.
Sinus Bradycardia
167
Rate the rate is over 100bpm but usually less than 170bpm P wave: there is one P wave in front of every QRS. The P wave appear uniform. PR interval: measures between 0.12-0.20 seconds in duration. PR interval is consistent. QRS complex: Measures less than 0.12 seconds.
Sinus Tachycardia
168
Rate: The atrial rate is normally between 250 to 350. Ventricular rate depends on conduction through the AV node to the ventricles. P wave: The P waves will be well defined and have a “sawtooth” pattern to them. PR interval: Due to the unusual configuration of P waves, the interval is not measured with atrial flutter QRS complex: QRS measures less than 0.12 seconds
Atrial Flutter
169
Normal Range: Central Venous Pressure (CVP)
0-8mmHg
170
Right-sided heart catheterization Normal Range: Right atrial (mean)
0-8mmHg
171
Right-sided heart catheterization Normal Range: Pulmonary Artery Systolic
20-25mmHg
172
Right-sided heart catheterization Normal Range: Pulmonary Artery Diastolic
6-12mmHg
173
Right-sided heart catheterization Normal Range: Pulmonary Artery Mean
9-19mmHg
174
Right-sided heart catheterization Normal Range: Pulmonary Capillary Wedge Pressure (PCWP)
6-12mmHg
175
Left-sided heart catheterization Normal Range: Left ventricular end-diastolic pressure
5-12mmHg
176
Left-sided heart catheterization Normal Range: Left ventricular peak systolic pressure
90-140mmHg
177
Left-sided heart catheterization Normal Range: Systemic arterial pressure systolic
110-120mmHg
178
Left-sided heart catheterization Normal Range: Systemic arterial pressure diastolic
70-80mmHg
179
Left-sided heart catheterization Normal Range: Systemic arterial pressure mean
82-102mmHg
180
Left-sided heart catheterization Normal Range: Cardiac Output (CO)
4-5L/min
181
Left-sided heart catheterization Normal Range: Cardiac index (CO ^ body index)
2.5-3.5 L/min
182
Left-sided heart catheterization Normal Range: Stroke volume
55-100 mL/beat
183
Left-sided heart catheterization Normal Range: Systemic vascular resistance
800-1200 dynes/sec/cm-5
184
Laboratory Tests and Reference Values: Hgb (male)
13-18
185
Laboratory Tests and Reference Values: Hgb (female)
12-16
186
Laboratory Tests and Reference Values: HCT (%) male
37-49
187
Laboratory Tests and Reference Values: HCT (%) female
36-46
188
METS: Lying
1.0
189
METS: Sitting
1.2-1.6
190
METS: Sitting c writing
1.9-2.2
191
METS: standing
1.4-2.0
192
METS: (+)wash/shave
2.5-2.6
193
METS: (+) dress/undress
2.3-3.3
194
METS: walking 1mph
2.3
195
METS: Walking 2mph
3.1
196
METS: Walking 3mph
4.3
197
METS: Run
7.4
198
METS: Wheelchair/Drive
2.8
199
METS: Stair descend
5.2
200
METS: Ascending stairs
9
201
METS: 2 Step climb
5.7
202
METS: Eating
1.5
203
METS: Wash face
2.0
204
METS: Shower
3.5
205
METS: Bedpan
4.0
206
METS: Sex c wife
5.0
207
METS: Extramarital Sex
8.0
208
METS: Light Housework
1.7-3.0
209
METS: Heavy Housework
3.0-6.0
210
METS: Office work
1.3-2.3
211
METS: Backpacking (45lbs)
6-11
212
METS: Baseball
4-6
213
METS: Basketball
5-12
214
METS: Cycling 5mph
2-3
215
METS: Cycling 8mph
4-5
216
First pharmacological intervention for angina
Sublingual Nitroglycerin
217
CK-MB and LDH peak levels
14-36 hours
218
Troponin and Myoglobin peak levels
24-36 hours
219
Normal values for Cardiac Output
5-6 Liters/min
220
Where is P-wave positive in? *determine the 3 leads
Lead II,III and avF
221
Persistent mild-severe chest pain that lasts four hours or days; relieved by learning forward
Pericarditis
222
3 zones of myocardial infarction
Zone 1- Zone of Ischemia Zone 2- Zone of Injury Zone 3- Zone Farction
223
Referred Pain for M.I
(L) jaw, (L) shoulder, (L) Arm and (R) side of chest
224
What is normal HR range
60-100
225
Right sided heart failure symptoms are usually...
systemic
226
Left sided heart failure symptoms are usually...
pulmonary
227
Difficulty breathing in supine
Orthopnea
228
DIfficulty breathing in sidelying
Troponea
229
1 MET is equivalent to how many mL of O2 per kilogram of BW/min
3.5mL of O2/kg of bW/min
230
What is the other name for irregular wide complex tachycardia
Torsades De Pointes