IBHRE

Question 1

Name the correct medical suffix
1. Surgical repair
2. Surgical removal or incision
3. Surgical tap
4. Surgical opening between organs

Answer 1

1. Surgical repair -plasty
2. Surgical removal -ectomy
3. Surgical tap -centesis
4. Surgicla opening -ostomy

Question 2

Name the correct medical suffix
1. Blood condition
2. Formation
3. Enlargement
4. Disease condition
5. Deficiency
6. Inflammation

Answer 2

1. Blood condition -emia
2. Formation -poiesis
3. Enlargement -meglay
4. Disease condition -pathy
5. Deficiency -penia
6. Inflammation -itis

Question 3

Moist respirations are associated with ____ and may be termed ___

Answer 3

pulmonary edema; rales

Question 4

Tachypnea means _____

Answer 4

rapid respiratory rate

Question 5

ST depression is associated with _____ in many instances.

Answer 5

Coronary Artery Disease (CAD)

Question 6

____ reflects the potential error caused by false-negative test results in patients with disease

____ reflects the potential error caused by false-positive test results in normal patients

Answer 6

Sensitivity; Specificity

Question 7

Normal AH interval?

Answer 7

60-140 ms

Question 8

Normal HV interval?

Answer 8

30-55 ms

Question 9

Normal PR interval?

Answer 9

120-200 ms

Question 10

Normal QRS interval?

Answer 10

70-100 ms

greater than 120 ms pathogenic

Question 11

Surface ECG leads are usually filtered at:

Answer 11

0.1 to 100 Hz

Question 12

Normal EGM filter setting for bipolar EP catheters are:

Answer 12

30-300 Hz

Question 13

What is the standard equipment sizes of micropuncture introducer sets?
Needle/Wire

Answer 13

21-gauge needle; .018 inch wire

Question 14

The pouch like structures above the aortic valve from which the coronary arteries arise?

Answer 14

Sinus of Valsalva

Question 15

The coronary artery that normally supplies the AV node?

Answer 15

Distal RCA

Question 16

Which branch of the LCA is nearest the backbone in most oblique X-ray views?

Answer 16

Circumflex

note: the LAD and LV apex are nearest the sternum

Question 17

LCA blood flow occurs during the ______ phase of the cardiac cycle because ________

Answer 17

Diastolic; diastole releases the compressed endocardial capillaries

Question 18

The coronary return accounts for about ____ of all the cardiac venous return.

Answer 18

5-10% of CO

Question 19

When one of the three fascicles becomes blocked it is termed:

Answer 19

Hemiblock

note: when 2 fascicles are blocked it is called bi-fascicular block

RBBB is only a hemiblock

Question 20

The two primary cardiac responses associated with a parasympathetic neural discharge are _____ heart rate and ____ AV conduction.

Answer 20

Reduced HR; reduced AV conduction

Question 21

The aortic dicrotic notch marks the beginning of:

Answer 21

LV diastole

note: “isometric relaxation”. Sudden reversal of flow in the Ao which “bounces” off the closed Ao valve.

Question 22

The phases of diastolic filling are:

Answer 22

1. Rapid inflow (“suction cup effect, 60%)
2. Diastasis (slow inflow, 25%)
3. Atrial kick (active filling, 15-20%)

Question 23

A patient goes from NSR to atrial fibrillation but the heart rate stays the same. The resulting CO is expected to:

Answer 23

Decrease by 15-20% due to loss of atrial kick

Question 24

The systolic BP associated with a PVC _____ in pressure, and the following return sinus beat will ____ in pressure.

Answer 24

PVC BP decreases; Post PVC BP increases

note: compensatory pause associated with PVC allows for more LV filling and a stronger EF according to Starlings Law (i.e. stretched muscle fibers = stronger contractile force)

Question 25

Closure of the AV valves produces the ______ heart sound?

Answer 25

First heart sound -S1

Question 26

The second heart sound (-S2) is caused by closure of what 2 valves?

Answer 26

Aortic and Pulmonic

Question 27

Equation for EF? What is considered normal?

Answer 27

Stroke Volume / End Diastolic Volume

Normal is 70-85%

Question 28

What do inotropic medications do?

Answer 28

Modify contractile force

i.e. Digitalis

Question 29

How would Digitalis or catecholamine effect the Starling curve of a patient in CHF experiencing dyspnea?

Answer 29

Increase the contractile state. This moves up the CO and down the wedge pressure.

Decreases dyspnea.

Question 30

How would volume expansion or increased salt intake effect the Starling curve of a patient in CHF experiencing dyspnea?

Answer 30

Increases preload. May slightly increase CO but increases the wedge pressure above the acute pulmonary edema point.

note: increased preload, increased salt intake, veno-constriction, and/or continued IV infusions

Question 31

How would no therapy (decompensation) effect the Starling curve of a patient in CHF experiencing dyspnea?

Answer 31

Move the patient down to a lower CO. Also, wedge pressure increase.

decreased contractility and deterioration

Question 32

How would a diuretic or restricted sodium diet effect the Starling curve of a patient in CHF experiencing dyspnea?

Answer 32

Will lover the CO and wedge pressure of the patient.

patient will breathe better but may feel more tired

decrease preload, veno-dilator to pool blood away from the main circulating volume

Question 33

End-diastolic filling or stretching of the ventricle is termed:

Answer 33

Preload

Question 34

What is afterload?

Answer 34

Systemic vascular resistance

i.e. the amount of resistance that the heart must overcome to open the aortic valve

hypertension leads to increased afterload which leads to ventricular hypertrophy which leads to hypertrophic congestive heart failure

Question 35

During bouts of SVT some patients experience the need for frequent urination due to:

Answer 35

Atrial Naturic Hormone (ANP)

Question 36

Heart failure is an abnormal state of cardiac function which fails to meet the needs of metabolizing tissues or can only meet them with:

Answer 36

Increased venous pressure

Question 37

Congestive heart failure patients retain excessive amounts of:

Answer 37

Sodium

note: reduced CO in CHF makes the kidneys retain Na+

this leads to fluid retention and increased blood volume (increase preload)

ACE inhibitors break the Renin-Aldosterone cycle and prevent sodium retention

Question 38

The most common symptom found in patients with Congestive Left Heart Failure is:

Answer 38

Shortness of Breath (SOB)

Question 39

A CHF patient must sit up to get his breath. This is termed:

Answer 39

Orthopnea