SEM Flashcards
(234 cards)
1
Q
Specify the Heart block that is associated with Wenckebach.
A
2nd degree Type 1 Mobitz
2
Q
Provide the formula for Stroke Volume (SV).
A
SV = EDV-ESV
3
Q
What is the heart’s natural pacemaker?
A
SA node
4
Q
What is the best determinant for intensity of exercises in pulmonary pt’s?
A
Dyspnea
5
Q
What heart sound refers to the closure of SL valves?
A
S2 (dub)
6
Q
A pt has a low BP and high HR. What is the pt experiencing?
A
Orthostatic Hypotension
7
Q
How much mL is in a normal EDV?
A
120 mL EDV
8
Q
Termination of exercise. How much increase in mmHg from resting BP to stop exercise?
A
20-10mmHg
20 sbp - 10 dbp
9
Q
Termination of exercise. How much decrease in mmHg from resting BP to stop exercise?
A
10-5 mmHg
10 sbp - 5 dbp
10
Q
Which side of the body is the cardiac pacemaker placed?
A
Non-dominant side
11
Q
What condition refers to “multiple P on P phenomenon”?
A
3rd Degree Heart Block
12
Q
What type of population are affected with Ventricular hypertrophy?
A
Athletes (especially olympians)
13
Q
What is immediately done in a pt. with Ventricular Fibrillation?
A
CPR and then Defibrillator
14
Q
Specify the condition with “double P on P phenomenon”?
A
2nd degree Type 2 Mobitz
15
Q
What is the proper mmHg release in taking a pt’s BP?
A
Deflation is 2-3 mmHg/sec drop in taking BP
16
Q
What is the greatest treatable risk factor?
A
Hypertension
17
Q
What condition is associated with a positive finding of chronic valve murmurs?
A
Rheumatic Heart Disease RHD
18
Q
What is the % HR max of pt’s with comorbidities?
A
40-60% HR max
19
Q
Provide the formula for Cardio Output CO.
A
CO = HR x SV
20
Q
What cardiac condition is associated with Brugada syndrome?
A
Sudden Unexplained Death Syndrome SUDS
21
Q
What heart sound automatically corresponds to an abnormal pathology?
A
S4 heart sound
22
Q
What kind of shunt is a cyanotic VSD?
A
L shunt
23
Q
Enumerate the 4 manifestations of Tetralogy of Fallot TOF.
A
- Pulmonary artery stenosis
- RV hypertrophy
- Ventricular septal defect (L shunt)
- Overriding of the aorta
24
Q
What invasive surgery may be done to pt’s with a thrombus?
A
Coronary Artery Bypass Graft surgery
25
What do you call the object that maintains the shape of a vessel after deflating a ballon?
Cardiac stent
26
What are the semilunar valves?
Aortic valve and Pulmonary valve
27
What heart sound is associated with congestive heart failure CHF?
S3
28
What technique is used to check the pulmonary arterial pressure?
Swan-Ganz catheter
29
Hypotension in the midst of tachycardia
Orthostatic Hypotension
30
Drug of choice given to patients with CHF
Digoxin
31
Antidote to digitalis toxicity
Digibind
32
What supplies the 40% of the SA node?
Left Circumflex artery
33
Provide the formula for Bohr Effect.
Co2 + Hgb –> O2
34
What are the only veins that carry highly
| oxygenated blood?
Pulmonary veins
35
Where does the Bohr Effect take place?
Peripheral/systemic capillaries
36
What are the only arteries that carry deoxygenated blood?
R & L pulmonary arteries
37
What is the systemic pump?
L ventricle
38
Provide the formula for Haldane Effect.
O2 + Hgb –> CO2
39
What is the most prone for CAD?
LAD
40
If there is an impending heart disease or MI or angina pectoris, where will the referred pain be?
Simultaneous B shoulder referred pain
41
What are the physiologic properties of the heart?
Chronotropic, Bathmotropic, Dromotropic and Inotropic
42
What artery besides the R coronary artery also supplies the Right ventricle?
LAD
43
What condition can be seen with Levine's sign?
Myocardial Infarction
44
What is the definition of Stroke Volume?
The amount of blood ejected by the heart per second/per cardiac cycle
45
Provide the formula for Ejection fraction (EF)
SV / LV EDV = x 100
46
What is the normal value of Stroke Volume?
70 mL
47
What do you call the structure in an adult heart that was previously called in a fetal heart 'Foramen ovale'?
Fossa ovalis
48
What do you call the structure in an adult heart that was previously called in a fetal heart 'Ductus arteriosus'?
Ligamentum arteriosum
49
What is the most common cause of blue babies?
Tetralogy of Fallot
50
What are the mainstays for an MI Myocardial Infarction?
Aspirin, nitroglycerin and O2 (ANO)
51
What conditions refers to the exchange places aorta becomes RV while pulmonary a.
becomes part of LV?
Transposition of Great vessels
52
What is the first drug to be given to a pt. with heart attack?
Oxygen
53
What condition refers to the aorta and pulmonary a. become one in the same trunk without normal separation?
Truncus Arteriosus
54
What are the 4 defects associated with Tricuspid valve atresia?
Defective tricuspid valve, ASD, VSD and very small RV
55
R ventricular hypertrophy may lead to ________
R ventricular hypertrophy may lead to cor pulmonale
56
What position should an irritable blue baby of 10 months?
Supine knee to chest < 1 y.o
57
What situation is the given pathway referring to VC, RA, RV, pulmo. artery (blocked) goes back to RV?
Pulmonary artery stenosis
58
What position should an irritable blue baby of 13 months?
Side lying knee to chest > 1 y.o`
59
A hole in between two atrias of the R atrium and the L atrium
Astrial sepal defect ASD
60
Enumerate the 4 acyanotic CHD.
Atrial sepal defect (ASD), Patent ductus arteriosus (PDA), Coarctation of the Aorta, VSD (R shunt)
61
What heart sound can be heard with rapid ventricular filling?
S3
62
What do you call when the F. ovale is open and the Ductus art. Is closed the blood can still reach the lungs?
Astrial sepal defect ASD
63
The F. ovale is open and the Ductus art. Is closed the blood can still reach the lungs via ___
L Atrium
64
What possible conditions with a (+) S4 heart sound?
```
MI
Aortic Stenosis
CAD
HTN
Pulmo Dse.
CABG
```
65
What heart sound refers to atrial gallop or abnormal atrial systole?
S4 heart sound
66
In what phase can you hear the S2 heart sound?
Diastole
67
What BP ranges do you consider normal in a 12 yo.?
SBP: 95-135mmHg
DBP: 53-88 mmHg
68
What BP ranges do you consider to be preyhypertension?
SBP: 120-139
DBP: 80-89 mmHg
69
What is the formula for the number of seconds to take a BP?
Pulse pressure divided by 2 mmHg and 3 mmHg
70
What are the phases of Korotkoff sounds?
```
Tapping
Swishing, murmur
Crisp, louder
Muffling
Disappear
```
71
What phase of the cardiac cycle is when all of the AV valves and SL valves are closed?
Phase 2 (Isovolumetric contraction) and Phase 4 (Isovolumetric relaxation)
72
In the cardiac auscultation where can you hear the murmurs and mitral stenosis?
Erb's point 3rd ICs on the L
73
Amount of blood ejected by the ventricle per cycle per second or per beat
Stroke Volume
74
What is the best determinant for exercise for pulmonary patients like Covid 19?
Dyspnea scale
75
Provide the formula for BP.
CO x TPR
76
Where does the conduction of 1st degree Heart Block patients end?
Conducts until the Bundle of HIS
77
What refers to ventricular repolarization on ECG?
T wave
78
What basis do you use for termination of exercise?
Blood pressure
79
What basis do you use for the adjustment of exercise intensity?
Determinants of exercise like dyspnea etc.
80
What is the pathway for the conduction of the heart?
SA Node → AV Node → AV Bundle of HIS → (R) and (L)
| branches of Bundle of HIS → Purkinje Fibers → Ventricles
81
What refers to atrial depolarization on ECG?
P wave
82
What is the normal conduction of the heart?
0.12 -0.20 secs
83
On ECG what determines the conduction of the heart?
PR interval
84
What heart condition refers to "regularly irregular"?
3rd Degree Heart Block (HB)
85
What dromotropic incompetence refers to P on P phenomenon – QRS complex is gone
2nd Degree Heart Block (HB) Type 1 Mobitz
86
Where does physiologic delay happen to allow ventricular filling?
AV Node
87
What conditions has a flecked sputum?
Pneumoconiosis / Coal Miner's Disease
88
What is the most common cause of Bronchiectasis in children?
Cystic Fibrosis
89
What condition has a purple sputum?
Neoplasm (bronchogenic carcinoma)
90
What condition has a gray sputum?
Emphysema
91
What condition has a rusty sputum?
Pneumonia
92
What is the consistency of a sputum that is "very viscous, white, foul smelling"?
Fetid consistency
93
What condition has a fetid consistency?
Cystic Fibrosis
94
Viscous sputum blocks the pathways may cause permanent dilatation of the bronchioles; may lead to what condition?
Bronchiectasis
95
What adventitious or abnormal lung sound will you hear in a patient with L CHF?
Bibasilar rales
96
What condition has s/sx such as dyspnea, wheeze, productive cough?
Asthmatic Bronchitis
97
At what level is Liver?
T7-T10
98
What type of pneumonia is most commonly seen on the R lung?
Aspiration pneumonia
99
What bronchus is longer, narrow and oblique?
L bronchus
100
What cartilage of the larynx represents the Adam's Apple?
Thyroid cartilage
101
What is the most effective mechanical way of secretion clearance?
Suctioning
102
How long should suctioning take?
10-15 secs
103
Why does the trachea have c-shaped cartilages?
At the posterior part it accommodates the esophagus alimentary upper GIT
104
What is the bifurcation of the trachea?
Carina
105
______ lung disease is in a way restrictive also.
Infectious lung disease is in a way restrictive also.
106
What diseases are commonly seen on the L Bronchus
Bacterial, viral, streptococcal pneumonia, mycoplasma and coronavirus
107
What is the best position for COVID-19 patients to improve oxygenation?
Prone
108
How will you position a patient with Aspiration pneumonia?
L side lying
109
What type of cough does Covid pneumonia have?
Dry cough
110
What part of the conducting portion marks the transitional zone?
Terminal Bronchioles
111
What is also known as wet lung disease?
Infant Respiratory Distress (IRD)
112
What is also known as Pneumocytes?
Alveolar cells
113
What is the functional unit of the lungs?
Acinus
114
What is the normal volume of air?
400 mL of AIR
115
What is the normal volume of blood?
500 mL of BLOOD
116
What is the normal ventilation perfusion ratio?
0.8
117
If a pt has a hx of cough for 3 months in a year continuously that could persist 2 consecutive years what could the pt have?
Chronic Bronchitis
118
What kind of isolation unit ___ pressure room will an airborne patient be in?
Negative pressure room for airborne patients
119
True of False.
| Emphysema could be elevated to Chronic Bronchitis
False
120
What is the X-ray finding seen in a patient with Emphysema?
Bullae
121
In a positive pressure room who will be wearing a surgical mask?
Both the patient and the medical staff will be wearing a surgical mask.
122
In a negative pressure room what who will be wearing an N-95 mask?
Medical staff will only wear N-95 mask
123
What is another term for a positive pressure room?
Reverse isolation room
124
What kind of bacteria is seen in a pt. with TB?
Mycobacterium tuberculosis
125
What do you call the condition that has a blood supply of <75%?
Ischemic Attack
126
True or False. Two positively charged ions cannot go together
True
127
In every one cycle of the pump, how many Na+ ions will be pumped outside?
In every one cycle of the pump, 3 Na+ ions will be
| pumped outside
128
In every one cycle of the pump, how many __ K+ ions will be pumped back inside?
2 K+ ions will be pumped back inside
129
In the nerve/ muscle action potential hyperpolarization phase, there is an influx of what ion?
Influx of Cl-
130
Why is an Arrythmia considered a Chronotropic Incompetence?
It is considered a Chronotropic incompetence because by definition of Arrythmia there is an abnormality or irregular rhythm of the heart and one of the properties of the heart is chronotropic and under it is rhythmicity.
131
On ECG there is ST elevation with a down sloping what could be the condition?
SUDS
| * If Chronic ST elevation with a down sloping = LV Aneurysm
132
On ECG you notice there is a saw tooth appearance what could the condition be?
Flutter
133
What is the flag for atrial fibrillation?
Yellow to red flag
134
What is Lidocaine indicated for?
Arrythmia
135
What medication is a cardiac inotrope?
Epinephrine
136
What drug increases contractility, promoting cardio acceleration so the patient won’t drop to flatline
Epinephrine
137
What converts Angiotensin 1 to Angiotensin II?
ACE
138
What alternative drug is used instead of ACE inhibitors to avoid coughing?
Angiotensin receptive blockers ARBs
139
What is the suffix for ARBs?
"sartan"
140
Class IV Ca Channel blockers are contraindicated for what patients?
Congestive Heart Failure CHF
141
What is the normal levels of Albumin in the liver?
3.5-5.5
142
What happens when a pt has <1.5 Albumin levels?
Malnutrition, edema and ulceration
143
What kind of edema does R CHF patients have?
Bipedal pitting edema
144
What anti-arrythmic drugs are usually used for maintenance?
Class II B-blockers and Class IV Ca channel blockers
145
What could the patient have if there is absent Q wave on the ECG?
Normal
146
What could the patient have if there is absent P wave on the ECG?
Atrial arrest
147
Whis has a worse affectation zone of injury or zone of ischemia?
Zone of Injury
148
on the ECG the pt has a pathologic q wave what zone could be affected?
Zone of Infarction
149
What has the same normal level of Albumin?
Potassium
150
What sympathetic receptor is present in the lungs?
Beta-2
151
What type of cells kill RBCs?
Copper cells
152
True or False. If there is a decrease in cortisol, there is an decrease in stress.
False. Cortisol hormone must be WNL any inc or dec will still result in stress.
153
What represents the inferior wall of the heart?
Lead II, Lead III, aVF
154
In a pt with L ventricular aneurysm what is seen on the ECG?
Chronic ST elevation with down sloping
155
Enumerate the cardiac isoenzymes.
Myoglobin, CK-MB, AST, LDH, Troponin T and I
156
If the pt has ST depression between 1mm and <2mm without any complications, what is the flag?
Yellow flag
157
When a pt experiences an angina pectoris what is seen on the ECG?
ST depression
ST depression with U wave or
Inverted T wave
158
What is the difference between Cushing Syndrome and Cushing's disease?
Cushing’s disease: pituitary; Cushing syndrome: problem in adrenal cortex
159
Where is the direction of the transcellular shift in a pt with an ECG finding of tall T wave?
Transcellular shifting to the R
160
If a pt has > 5.5 meq/L what is the pt experiencing?
Hyperkalemia
161
What is the most common cause of sudden death in athletes?
Ventricular hypertrophy
162
When a pt has an elevated QRS complex what could be the condition?
Ventricular hypertrophy
163
What type of continuous adventitious sound may be heard on a pt with Laryngospasm?
Ronchi
164
What do you call the sound usually heard when there is retention of pulmonary secretions?
Crackles/ Rales
165
What crackling sounds are heard over the pericardium during systole but actually is a pulmonary disease problem?
Crunches
166
What do you call the structure that filter the air entering the nose?
Vibrissae
167
What could happen when the larynx or muscles around it become dysfunctional?
Aphonia/ Dysphonia
168
What condition is related to odorous perspiration?
Cystic fibrosis d/t affectation of sweat glands
169
How often do CF patients drain secretion?
6x during waking hrs/ once every 2 hrs for 12 hrs
170
What type of sputum consistency do Asthmatic Bronchitis patients have?
Thick tenacious
171
What is the structure pierced for tracheostomy of endotracheal tube?
Cricothyroid ligament
172
How many cartilages compose the trachea?
16 c-shaped cartilages
173
Where are the two areas that have cilia?
Fallopian tube and tracheobronchial tree
174
How do you position a patient with mycoplasma streptococcal pneumonia?
R side lying
175
How many segmental bronchi are there on the R and on the L?
Segmental bronchi: 10 on the R and 8 on the L
176
At the terminal bronchioles, there is a change to what type of epithelium?
Simple cuboidal epithelium
177
There is how many generations in the trahceobronchial tree?
23 generations
178
What is the best way to expectorate?
Huffing or FET
179
How long is the treatment time per lung segment during postural drainage?
5-10 mins
180
When do you perform adjuncts like percussion, vibration etc. to postural drainage?
If after 10 mins and still pt reports that the throat is dry even with correct auscultation and positioning.
181
What cells are responsible for regulating the ABB?
Type 1 Alveolar cells
182
What do you call the channel that interconnects bronchioles to bronchi?
Martin's Canal
183
How long is the maximum treatment time of postural drainage?
45 mins
184
What do you call the supplemental oxygen given to infants with IRDs?
CPAP
185
What is the difference between CPAP and IPBB?
CPAP has continuous inflation phase
| IPBB has inflation and deflation phase
186
What do you call the supplemental oxygen given to patients with ARDs?
Intermittent positive pressure breathing IPBB
187
What cells are responsible for surfactant to decrease surface tension in the lungs?
Type 2 Alveolar cells
188
Are humans capable of releasing O2? Explain if yes or no
Yes, during CPR the air at the anatomic dead space is what's used to provide O2 for the pt.
189
What is the FEF rate of a person with Obstructive lung disease?
FEF ratee: < 25%-75%
190
What diseases are airborne transmissions?
TB, Measles and Varicella/ Chicken pox
191
Specify what PPE is used for TB and COVID-19 (Delta variant).
N-95 mask
192
What kinds of procedures may cause Pneumonia?
Tracheostomy, suctioning and incubation
193
For pt's with pneumonia what kind of isolation unit will he be placed at?
Positive pressure room or Reverse isolation room
194
What condition has bigger droplets that are > 5 mm and can travel for 3ft. or less?
Pneumonia
195
What PPE should be worn for pt's with Pneumonia?
Surgical mask and/ or face shield
196
What diseases have contact precautions that needs gown and gloves for PPE?
Herpes-Zoster, Herpes-Simplex, Open wounds and MRSA
197
What type of lung disease is Tuberculosis?
Restrictive lung disease
198
Is there a cure for TB?
Yes, RIPE for 6 mos.
199
What is the prevention for Tuberculosis?
Bacillus Calmette-Guerin BCG vaccine
200
What are the medications for TB?
```
"RIPE" od for 6 months
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
```
*Streptomycin (to increase potency of RIPE)
201
Arrange the pressures from highest to lowest.
Zone 3
Arterial Pressure > Venous Pressure > Alveolar Pressure
202
Arrange the pressures from highest to lowest.
Zone 2
Arterial Pressure > Alveolar Pressure > Venous Presure
203
Arrange the pressures from highest to lowest.
Zone 1
Alveolar Pressure > Arterial Pressure > Venous Pressure
204
In COVID-19 there is more ___ than ___ which is why you position the pt in prone.
In COVID-19 there is MORE AIR than BLOOD which is why you position the pt in prone.
205
Pt's who are intubated are placed in what position?
Prone pos. / SIMS (semi-prone pos.)
206
What abnormality is when there is an absence of the 12th rib?
None, it's normal
207
Why are the first 7 ribs called True ribs?
It is because it's directly attached to the sternum.
208
What condition is associated with paradoxical breathing?
Flail chest
209
How much amount can a chest drain fill up?
2L
210
True or False. You can start doing amb training for a pt with a chest drain.
True
211
What kind of pleural effusion refers to Chylothorax?
Lymph drainage
212
What kind of pleural effusion refers to Pleurisy?
Interstitial fluid
213
What kind of pleural effusion refers to Pyothorax?
Pus drainage
214
What kind of pleural effusion refers to Empyema?
Pus drainage
215
For a pt with chest drain what are the precautions for ROMEs?
Shoulder flexion <80 deg ONLY
Shoulder ER & IR in 90deg of Shoulder abduction ONLY
Horizontal abd and add at 90deg Shoulder abduction ONLY
DO NOT do full Shoulder abduction
216
What is the primary mm of inspiration?
Diaphragm
217
What conditions have pectus excavatum?
Marfan syndrome and Arthrogryposis multiplex congenita
218
What is the innervation of the Diaphragm?
Phrenic Nerve: C3, C4, C5 (keeps the diaphragm alive)
219
In pregnant women, which trimester can the pt experience gestational orthopnea?
3rd trimester
220
If a pregnant woman is placed in supine pos. c lightheadedness and edema on B LE what could the pt be experiencing?
Vena-cava compression or Gestational supine hypotension
221
How should you position a patient with Gestational supine hypotension?
Quarter turn to the left from supine c pillow on R butt to relieve pressure on the R vena cava
222
In Rib flaring what muscles are considered weak?
External obliques
223
What is the normal amount of IRV?
3000 mL
224
How much of the 500 mL of Tidal volume will undergo gas exchange?
350 mL
225
The 150 mL remaining of the TV will go where?
The remaining 150 mL will go to the Anatomic dead space
226
Is the Alveolar dead space normal or abnormal?
Abnormal
227
What is the normal amount of ERV?
1100 mL
228
What pulmonary lung volume keeps the lungs inflated and preventing it from collapsing? and what it it's normal amount?
Residual volume = 1200 mL
229
What condition is present in a pt with crunches breath sounds?
Mediastinal emphysema
230
What is the generation of the terminal bronchioles?
16th generation
231
What generation is coughing most effective?
7th generation
232
For pt's with status asthmaticus, Ventolin meds do not work what meds should be prescribed?
Epinephrine
233
What organs are affected with R CHF?
Liver, spleen and lungs
234
What organs are affected with L CHF?
Kidneys and Brain
