FISDAP READINESS Exam Prep 2022 Question Bank

FISDAP READINESS Exam Prep 2022 Question Bank Where are Beta 1 receptors found? Heart and Kidneys Stimulation of Beta 1 receptors result in an increase of what? Heart: Inotropy, Chronotropy, Dromotropy Kidneys: Renin-Angiotensin-Aldosterone System = Vasoconstriction = Increase blood pressure Which node is located at the junction of the superior vena cava and the right atrium, is typically supplied by the Right Coronary artery, and fires at a rate of 60-100 bpm. SA Node Atrial depolarization characterized by smooth, round, upright deflection less than 0.11 secs long and less than 2.5mm tall is referred to as what on the ECG? P wave Carvedilol (Coreg) Metropolol (Lopressor) Atenolol (Tenormin) Propranolol (Inderal) Bisoprolol (Zebeta) Acebutolol (Sectral) Comolol (Brevibloc) Beta Blockers - used for blood pressure and cardiac problems Epinephrine Norepinephrine Vasopressin Dopamine Phenylephrine Dobutamine Vasopressors The middle of phase 3 to beginning of phase 4 in the cardiac cycle where cardiac cells are partially refractory and partially repolarized and certain cells can be depolarized in response to electrical stimulus. Relative Refractory Period (Partial flush of the toilet) Treatment for Beta Blocker Overdose Glucagon: 1-5mg IV/IO (1st Line Drug) Calcium Chloride: 500mg - 1g IV/IO Swelling of affected limb, pain and tenderness, inflammation/redness, warm to touch on affected limb, pain on dorsiflexion (Homan Sign) are all signs of? DVT Treatment of DVT Supportive Care, Position of Comfort, Establish IV, Cardiac Monitor, Pulse Ox, O2, Monitor vitals for embolism. Do not massage affected limb. The pressure gradient that drives coronary blood pressure. The difference between aortic diastolic pressure and left ventricular end diastolic pressure that perfuses the coronary arteries. Coronary Perfusion Tachycardia, Difficulty Breathing, Diminished Lung Sound, Pulse Quality Changes, and unequal chest rise are early signs and symptoms of? Tension Pneumothorax Air is entering the pleural space but cannot escape. Positive pressure ventilation can make it worse. Criteria for Unstable Dysrhythmia Ischemic Chest Pain ALOC Hypotension/Hypovolemia Signs of Shock Acute Heart Failure Restriction of of cardiac contraction, falling cardiac output, and shock as a result of pericardial fluid accumulation are characteristics of? Cardiac Tamponade Hypotension, SOB, Lightheadedness, Chest Pain, Syncope, Palpitations, Extremity Swelling, and Muffled heart sounds are signs and symptoms of? Cardiac Tamponade Indications for Dopamine Cardiogenic Shock Distributive Shock after fluids Hemodynamically significant Hypotension Symptomatic Brady (2nd Line drug) AHA Guidlines for Terminating CPR efforts in field(4) Arrest was not witnessed No bystander CPR was administered ROSC was not achieved after complete ALS care in the field No shocks were administered Time frame that starts at the patient contact by EMS and ends with definitive therapy of catheter passing through lesion of coronary vessel. EMS-to-Balloon-Time Time from patient entering ED to catheter passing through lesion of coronary vessel. Door-to-balloon-time Time from patient entering ED to fibrinolytic therapy administration. Door-to-needle-time Time frame for door-to-balloon <90mins Time frame for door-to-needle <30mins Principle symptom of Coronary Artery Disease or Acute Coronary Syndrome that occurs when supply of O2 is to the myocardium is insufficient to meet demand and cells become ischemic? Angina Pectoris Chest pain that occurs at rest and is caused by coronary artery vasospasm? Risk for Dysrhythmia, MI, Heart Block and Death Prinzmetal Angina (PA) Which electrolyte flows into cardiac cells to initiate depolarization? Sodium (Na+) Which electrolyte flows out of cardiac cells to to initiate repolarization? Potassium (K+) Which electrolyte plays a major role in depolarization of pacemaker cells to maintain depolarization and myocardial contractility? Calcium (Ca++) Which electrolyte stabilizes cell membrane and acts in concert with K+ and opposes actions of Ca++? Magnesium (Mg++) Hypokalemia results in? increased myocardial irritability Hyperkalemia results in? decreased automaticity/conduction Hypocalcemia results in? decreased contractility and increased irritability Hypercalcemia results in? Increased contractility Hypomagnesemia results in? decreased conduction Hypermagnesemia results in? increased myocardial irritability Four properties of the Cardiac Conduction System Excitability - cells respond to electrical impulse Conductivity - cells pass impulse to one another Automaticity - hearts ability to generate its own electrical impulse Contractility - hearts ability to contract when stimulated Affects of RCA occlusion in terms of the SA node ischemia? SA node becomes ischemic = slower firing rate (<60-100) or cease fire completely causing another automaticity foci to take over such as AV (40-60) or Purkinje (20-40). Which electrolytes are responsible for depolarization? Sodium and Calcium influx Which electrolyte is responsible for repolarization? Potassium outflow Indications for CPAP (5) Alert and able to follow commands Moderate to Severe Respiratory Distress Hyperventilation SpO2 <90% Systolic >90mmHg Contraindications for CPAP (8) Respiratory Arrest Hypoventilation ALOC Chest Trauma/Pneumo Tracheostomy GI bleed or Vomiting Inability to fit CPAP Excessive Facial Hair/Dysmorphic features During what phase of circulation do coronary arteries receive blood? Diastolic Coronary circulation begins from aorta at the? Right and Left Coronary Arteries The right coronary artery has how many branches and supplies blood to where? 9 Right Atrium, SA/AV node, and Right Ventricle Inferior Left Ventricle Left Coronary Artery is the largest and shortest coronary vessel. It divides into what and supplies blood to where? Left Anterior Descending and Circumflex Coronary arteries. Left Ventricle, Septum, and at times the AV node and atria. Epinephrine MOA (4) and Dose Beta 1 = Inotropy, Chronotropy, Dromotropy Alpha 1 = Vasoconstriction = Increased aortic diastolic pressure Beta 2 = Bronchial smooth muscle relaxation = Bronchodilation Adequately perfused kidneys produce how many mLs of urine per hour? 30-50mL Tachycardia with irregular pulse, labored breathing with diffuse crackles/rales in all lung fields, pale/cool/diaphoretic skins, and low blood pressure are signs of what type of shock? Cardiogenic What is one of the most helpful steps to formulating a field diagnosis? Considering and ruling out various conditions A sudden nervous system reaction that causes temporary generalized vasodilation leading to syncope describes what type of shock? Psychogenic Allowing full recoil of the chest in CPR enhances blood return to the heart by what mechanism? Negative intrathoracic pressure If someone has a syncopal episode and then complains of headache and inability to walk without feeling dizzy, you should suspect? Head Injury Treatment for neurogenic shock includes IV fluids, temperature management, and possibly? Atropine 0.5mg up to 3mg Suppress vagus nerve to increase cardiac output. What is the most important criteria for bystander CPR to meet prior to EMS arrival? Compressions Which system is primarily responsible for tissue perfusion? Cardiovascular The recommended fluid resuscitation for a patient in shock with no suspected TBI is? 250mL up to 4x, maintain systolic of 80-90mmHg What type of metabolism takes over when inefficient cellular metabolism produces lactic acid? Anaerobic Accumulation of lactic acid and other waste products in the blood inhibits what interaction? hemoglobin from binding with and carrying oxygen What should you do if you are working a cardiac arrest patient and the capnography spikes from <20mmHg to >40mmHg? Assess pulse for up to 10 seconds Tendency to gather or rely on information that confirms your existing views and downplays/avoids info that does not confirm your hypothesis or field differential is what kind of bias? Confirmation Bias The primary focus of running a megacode should be on? teamwork and minimal interruptions of CPR What causes increased afterload following Alpha-1 stimulation? Arteriolar constriction What senses decrease in blood flow and activates the vasomotor center in response? Baroreceptors