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Principles II > Review for Test 1 > Flashcards

Review for Test 1 Flashcards

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1
Q

Side effects of radiation: Brain

A

-Fatigue
-Hair loss
-N/V
-Skin changes
-Headache
-Blurry Vision

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2
Q

Side effects of radiation: Breast

A

-fatigue
-hair loss
-skin changes
-edema
-tenderness

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3
Q

Side effects of radiation: Chest

A

-fatigue
-hair loss
-dysphagia
-cough
-SOB

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4
Q

Side effects of radiation: Head/Neck

A

-fatigue
-hair loss
-mouth changes
-taste changes
-dysphagia
-hypothyroidism

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5
Q

Side effects of radiation: Pelvis

A

-fatigue
-diarrhea
-N/V
-Sexual problems
-infertility
-urinary changes

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6
Q

Side effects of radiation: Rectum

A

-fatigue
-diarrhea
-sexual problems
-infertility
-urinary changes

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7
Q

Side effects of radiation: Abdomen

A

-fatigue
-diarrhea
-N/V
-skin changes
-urinary changes

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8
Q

T1:

A

-magnetic vector relaxes
-fat appears brighter, water appears dark
-good gray/white matter contrast-anatomy

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9
Q

T2:

A

-axial spin relaxes
-fat is darker than water
-identifies tissue edema easily-pathology

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10
Q

Estimation of Burn Injuries for Infants:

A

-head: 21%
-abdomen: 13%
-back: 13%
-each arm: 10%
-each leg: 13.5%
-buttocks: 5%
-genital area: 1%

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11
Q

CO “ebb state”:

A

-CO reduced by 60%
-hypovolemia due to permeability
-reduced response to catecholamines
-increased SVR
-myocardial ischemia d/t decreased coronary flow
-ensure appropriate fluid resuscitation

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12
Q

CO “Flow phase”:

A

-72-96 hours post-burn
-hyper-dynamic: increased CO and tachycardia
-increased myocardial O2 consumption
-increased possibility of ischemia
-decreased SVR
-this is when it’s good to give beta blockers!!

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13
Q

Carboxyhemoglobin levels: 1-3%:

A

normal nonsmoker

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14
Q

Carboxyhemoglobin levels: 4-9%:

A

smokers

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15
Q

Carboxyhemoglobin levels: 15-20%:

A

overt signs of toxicity: HA, N/V

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16
Q

Carboxyhemoglobin levels: 20-25%:

A

signs of severe toxicity: seizures, acute renal failure, myocardial ischemia

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17
Q

Carboxyhemoglobin levels: >25%:

A

unconsciousness and death

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18
Q

Reciprocal Changes for Inferior (2, 3, AVF):

A

1, AVL

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19
Q

Reciprocal Changes for Anterior (V3 and V4):

A

2, 3, AVF

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20
Q

Reciprocal Changes for Lateral (V5, V6, 1, AVL):

A

2, 3, AVF

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21
Q

Inferior MI:

A

Yes to fluids, NO to nitrates

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22
Q

Anterior MI:

A

Yes to nitrates, NO to fluid!

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23
Q

Right Atrial Hypertrophy:

A

-first part of P wave is LARGER in V1
-height of QRS >2.5mm in any limb lead

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24
Q

Left Atrial Hypertrophy:

A

-terminal part of P wave is LARGER in V1
-occurs with mitral stenosis and systemic HTN

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25
Right Ventricular Hypertrophy:
-RV wall is VERY thick, more depolarization towards V1 -QRS in V1 are positive, R waves get smaller
26
Left Ventricular Hypertrophy:
-large S wave in V1, LARGER R wave in V5 -depth of V1 and height of V5= 35 mm
27
Ischemia:
-inverted T waves, symmetrical
28
Injury:
-ST elevation
29
Infarct:
-Q waves indicate necrosis -1 mm wide or 1/3 QRS tall in 2 related leads
30
Which type of electrode setup uses less energy?
-bipolar
31
Pacemaker Code 1:
-chamber paced -either O for none, Atrium, Ventricle, or dual
32
Pacemaker Code 2:
-chamber sensed -either O, A, V, or D
33
Pacemaker Code 3:
-Response to sensing -either O, T for triggered, I for inhibited, or D for dual
34
Pacemaker Code 4:
-Rate Modulation -either O or R for rate modulation (think artifact)
35
Pacemaker Code 5:
-Multisite pacing -either O, A, V, or D
36
What is the MOST common response to sensing (code 3)?
-Dual (triggered and inhibited)
37
A wave:
-atrial contraction, occurs after P wave -increases atrial pressure -provides atrial kick
38
C wave:
-interrupts decreasing atrial pressure, end of atrial involvement -isovolumetric contraction of the ventricle -tricupsid valve closed and ventricle bulges toward the atria -follows the R wave
39
X descent:
-decrease in atrial pressure from the A wave through ventricular systole -called systolic collapse -sometimes called X and X^1
40
V wave:
-venous filling of the atrium -during late systole, tricuspid valve remains closed -peaks just after the T wave
41
Y descent:
-tricuspid valve opens, initial blood flow into the ventricle -called diastolic collapse
42
Abnormal CVP waveforms-atrial fibrillation:
-absence of A wave -longer C wave
43
Abnormal CVP waveforms- tricuspid regurg:
-no X descent b/c of incompetent valve
44
Abnormal CVP waveforms-tricuspid stenosis:
-tall A wave b/c of back pressure and inability to contract -y descent is masked
45
Guidelines for PAC depth:
-110 cm length, marked at 10 cm intervals -RA: 20-25 cm -RV: 30-35 cm -PA: 40-45 mm -Wedge: 45-55 cm
46
Abnormal PAC Waveform- Mitral Regurg:
-Tall V wave -C wave fused with V wave -no X descent -no specificity or sensitivity to severity of MR due to LA compliance changes and volume change
47
Abnormal PAC Waveform- Mitral Stenosis:
-slurred, early y descent -A wave may be absent due to frequent association with a fib -with mitral valve surgery, often have to cardiovert
48
Abnormal PAC Waveform- Acute LV MI:
-Tall A waves due to noncompliant LV -LV systolic dysfunction increases LVEDV and LVEDP -PAWP increases
49
Mixed Venous Oximetry Equation:
SvO2= SaO2-VO2/(Q x 1.34 x Hgb) -SVO2: mixed venous Hgb saturation -SaO2: arterial Hgb saturation -VO2: oxygen consumption -Q: CO -1.34: oxygen carrying capacity of hgb
50
What is true if hgb, arterial saturation, and oxygen consumption stay the same?
-Mixed venous oximetry is an indirect indicator of CO -so if CO falls, mixed venous value will fall too
51
Average mixed venous sat:
75
52
Average PVR and SVR:
-PVR: 80 -SVR: 1200
53
With bolus thermodilution, what does it mean if the temp changes alot?
-the CO is probably low -change of 13% in temp is significant
54
Thermodilution inaccuracies: (measured at right heart, assumed left heart)
-intracardiac shunts -tricuspid/pulmonic regurg -mishandling of injectate -fluctuations in temperature (following bypass) -rapid fluid infusion-cool meds or blood?
55
Pulse Contour Inaccuracies:
-atrial fibrillation -site of arterial puncture -quality of arterial trace-affected by pressors -requires frequent re-calibration-ideally calibrated initially with a known CO
56
Echo-M mode:
-narrow beams to measure tissue planes -ex: ventricular wall mass
57
Echo-2D:
-real time motion, shows function
58
Echo-Doppler:
-can determine speed and direction, color!
59
Focus Method with Echo:
-5 key views -anterior structure is at top of image, closest to transducer -windows: parasternal (3-5 ICS), apical @ PMI, Subcostal (below xiphoid)
60
Parasternal long axis:
-great overall view, measures LA, LV, and Ao root
61
Parasternal short axis:
-LV function and volume assessment
62
Apical 4 chamber:
-RV and LV size, TV and MV function, and descending Ao
63
Subcostal 4 chamber:
-4 chambers, pericardial effusion often next to right heart
64
Subcostal IVC:
-diameter, collapsibility (especially in spontaneous respiration)
65
TEE: what's it good for?
-rescue tool -assessment of valve function -posterior structures are now closer to transducer, at top of image! opposite of TTE setup
66
Contraindications to TEE:
-esophageal varices -laparoscopic banding of the esophagus

Principles II (3 decks)

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