Know It! Pt.2 Flashcards by Anyssa Palma

LV angiogram is also known as what three other words ?

1.Ventriculography
2. Selective angiography
3. Angiocardiography

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Ventriculography is a.k.a?

Angiography

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What is the best Cath Lab technique for LV function?

Using an LV angiogram

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What 5 things can angiography measure in the LV and blood vessels?

-vessel narrowing
-Regurgitation
-Shunts
-EF

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What is the fick method?

A method used to measure O2 consumption in the Cath Lab

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How does the fick method measure O2 consumption in the Cath Lab?

O2 consumption /divided by the difference in O2 content between arterial and pulmonary systems

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What’s oximetry?

Measuress O2 saturation in various chambers and can detect shunts by O2 changes

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How is a shunt size calculated?

By the difference between the pulmonary and systemic blood flow

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Pulmonary capillary wedge pressure comes from what kind of catheter?

Swan-Ganz

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AS is usually asymptomatic until what aortic valve area?

<1cm

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What is a normal aortic valve area?

3-4cm

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What’s a moderate mild and severe aortic valve area?

3-4normal
Mild- >1.5
Mod - 1.5-1 five
Severe - <1

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In the Cath Lab, they can determine aortic stenosis by placing catheters where?

1 in the LV and 1 in the aorta with two separate sensors

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What is the key difference between fundamental imaging and harmonic imaging?

Fundamental imaging- send and receives at the same frequency

Harmonic Imaging - transmits one frequency and receives at the 2nd harmonic (twice the transmit frequency)

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What results in thicker valve leaflets ?

A) High Gain
B) fundamental Imaging
C) low wall filter
D) harmonic Imaging

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With Echo contrast agents bubbles are ____than red blood cells

Smaller

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Echo contrast agents cross the ____ circuit

Pulmonary

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When should an echo contrast be used for left ventricular opacification?

A) all segments can be seen
B) when 1 segment cannot be seen
C) when two more segments cannot be seen
D) none of the above

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Apical swirling of echo contrast is can be caused by what 2 things

A high MI
Amount of contrast injected is too low

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Attenuation of contrast being pushed all the way to the Apex can be caused by what two things?

Too much contrast was injected
Contrast was injected too fast

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Should you use extension cords for electrical safety when scanning patients?

No this is not safe

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You should inspect your ultrasound systems?
A) monthly
B) routinely
C) monthly
D) every 2 years

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During an EKG, what should be grounded the patient or the machine?

The machine

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In what year did Congress Pass HIPAA?

1996

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What does HIPAA stand for?

Health insurance, portability, and accountability act

Sonographers should do peer to peer reviews. How often for quality?

Two times a month

Whose responsibility Is it to obtain the informed consent prior to a TEE?

The physician

Can sonographers interpret exams to the patient?

When moving the patient in the wheelchair, make sure the ___ engaged and the foot rests are ___

Brakes; retracted

Always keep a urinary drainage bag ___ the ____

Below; bladder Or else if it’s above the bladder urine can collect and regur back into the bladder

What is the difference between sterilization and disinfection?

Sterilization eliminates, all agents, good and bad Disinfection eliminates only those organisms that can cause disease

What is an opportunistic infection?

Bad bacteria that was being controlled multiplies and causes harm to the host

What is the preferred principle for sterilization?

Heat and pressure

What kind of sterilization method is an auto clave?

Heat sterilization

Auto cleaves use_____ to heat up

Steam

At what temperature is an autoclave heated to?

121°C or 250°F

What pressure is a autoclave at?

15 PSI or 103 kPa

How long should an auto clave run for effective sterilization?

15 minutes

Can chemicals also be used for sterilization?

Yes

Although the sterilization is the most effective way to destroy agents. Why is it not always appropriate?

Because the degree of heat can destroy objects such as a fiber optics, electronics and plastics

What is Ethylene oxide?

A gas used to sterilize objects that cannot survive past 60°C like a plastics, fiber optics and electric

What is another option of sterilization if he sterilization is too harsh for certain objects?

Ethylene oxide gas

Aseptic means?

Without organisms

What is meant by a aseptic technique?

A practice that reduces post procedure infections by decreasing the likelihood that organisms will enter during clinical procedures Aseptic technique is just ensuring a sterile field during procedures

The sterile field should be draped starting from the area ___ to the person and then ____ outwards

Closest; extended

Is it OK to allow sterile personnel to reach across unsterile areas or hand them under sterile objects?

Chest compressions should be how many inches deep?

2inch

PIM stands for?

Potentially infected material

What is the first thing you should do when cleaning up a blood spill?

Mark the area so that others do not enter that area until cleanup is complete

What are the percentages and parts of a good true disinfectant?

10% bleach solution One part bleach, nine parts water

When cleaning up a blood spill, he should soak the area for at least ___minutes with the ____% disinfectant solution

20minutes; 10% bleach

When cleaning up a blood spill at least ___ minutes for the disinfectant to completed the decontamination

20minutes

True or false -goggles cannot be disinfected and reused. They must be thrown away.

False

___% of AV calcific/degenerative stenosis starts off as____?

50%; Bicuspid AV

How common in bicuspid congenital valve?

1-2%

What’s a secondary finding of AS?

LVH

AS can be caused by ____valvuar & ____valvuar obstructions?

Supra and sub valvuar

AS causes ? A) LV dilation B) Diastolic pressure overload increase C) LA dilation D) systolic pressure overload increase

AS causes ____ pressure overload which leads to ____

Systolic; LVH

AS causes increased ____ pressure in the LV. This ends up causing increased ___ pressure in the ___

Squeezing; diastolic; LA

What’s it called when there is valvular thickening but no hemodymanic gradient?

Aortic sclerosis

What are symptoms of AS?

- syncope -sudden death -angina - Dyspena

AS murmur is?

Harsh systolic ejection murmur RSB crescendo -descendo

AS murmur had a decreased or absent ?

A2 meaning a valve doesn’t move

With AS what can occur in the carotids?

Delayed or decreased carotid upstroke due to sentosed AV with a bruit/thrill

With AS there’s post stenotic ____ of the aorta

Dilation

Mild, mid, severe AV jet velocity ?

Mild- 2.6-2.9m/sec Mod- 3.0-4.0 m/sec Severe - > or equal to 4m/sec

Mild, mid & severe Mean gradient for AS?

Mild - < 20mmhg Mod- 20-40mmhg Severe - > or equal to 4mmhg

What’s the calculation for the AV dimensionless index?

LVOT VTI / AV VTI

What’s the mild, mod & severe dimensionless index for the AV?

Mild- > 0.50 Mod- 0.50-0.25 Severe - <0.25

A patient had AS. The jet velocity is 2.7m/sec and how do you calculate the Mean gradient?

You use the jet velocity and put it into the bernouli equation P= 4v^2

Pt. With a bicuspid AV will have a possible ____ on m-mode

Eccentric closure

___% of people with a Bicuspid AV will have a ____ AV midline closure on m-mode

25% ; normal

Bicuspid AV will show a ____ doming (tethering) in PLAX

Systolic

How will a bicuspid AV look like in PSAX?

Football shaped

If a pt. Has a bicuspid AV what 3 things should we additionally look for?

Aortic coarctation Post stenotic dilation of the aorta LVH

What’s the best view to diagnosis a bicuspid AV? A) short axis diastole B) short axis systole C) Long axis diastole D) long axis systole

Another name for doming is?

Tethering

What is a normal descending aorta jet velocity that we take in the suprasternal view?

1 m/sec

What’s a common system of aortic coarctation?

Systemic HTN

Subvalvular aortic issues is a ___ membrane or ridge in the ____ under the ___

Congenital ; LVOT ; AV

Subvalvular aortic issues cause early ___ ____of the AV

Systolic Closure

Subvalvar aortic issues can cause have left ventricular pathology?

LVH

What’s the best echo view to see aortic subvalvuar issues?

Ap5

Often aortic Subvalvular issues are repaired with surgery but about ___% will grow back afterwards

15%

What is Aortic Supravalvuar issues?

Discrete narrowing of the Aortic root or ascending aorta above the AV

Aortic subvalvuar and supravalvuar issues cause what LV issue

LVH

Because supravalvuar aortic issues may occur in the ascending aorta past the AV. We should use the ___ probe and scan in multiple windows.

PEDOFF

With Subvalvular or supravalvuar aortic issues there will be increased ____ & ____at the site of obstruction

Velocity and turbulence

Use ___ or ___ flow Doppler to locate level of obstruction with subvalvuar or supravalvuar aortic issues

PW or color

Mean gradient and cath lab gradients correlate better than? A) peak instantaneous B) peak to peak C) highest gradient

B) peak to peak

What is Takayusu Arteritis is also called?

Aortic arch syndrome

Takaysau arteritis occurs more in ____ from ___

Young women ; Asia

Takaysau arteritis is ___ of the ____ and ____ ___ of unknown etiology

Fibrosis ; aorta ; descending aorta

Takaysasu arteritis is? A) narrowing of the aorta B) Fibrosis of the aorta C) Regur of the aorta D) PDA

A pt. Has AS. The jet velocity is 5m/sec & BP is 110/84. With this information how do you calculate the LV peak pressure?

You use the Bernoulli equation first to convert the 5msec. Then you add that to the systolic BP. Correct answer is 210mmhg

What is the continuity equation? And what’s it describe?

It’s describes that FLOW 2 is = to FLOW 1

What is better peak velocities of AI or VTI with mod-severe AI

VTI is always better than peak velocities

when using the continuity equation when would the severity of aortic stenosis be underestimated?

If you measure the LVOT too large

When the LVOT cannot be accurately measured or in the setting of LV dysfunction, what calculation may help evaluate the severity of AS?

Dimensionless index

What is the calculation for the dimensionless index?

LVOT VTI / CW VTI AS

What pressure is obtained during echo dopplers?

Peak or peak instantaneous

What is usually higher Cath Lab gradients or Echo gradient?

Echo gradients are usually higher

What kind of gradients do Cath Lab use? A) peak peak B) peak instantaneous B) mean ingredient

Know It! Pt.2 Flashcards

(104 cards)