BKAT STUDY GUIDE WITH QUESTIONS AND
ANSWERS
What to do first if patient has chest pain. - answerRest!
ECG changes in an acute MI - answerST elevation in 2 or more contiguous leads. Ischemia d/t full
thickness loss of muscle. EMERGENCY.
Inferior leads - answerII, III, aVF. RCA occlusion.
Septal leads - answerV1 & V2.
Anterior leads - answerV1 - V4. LAD lesion.
Lateral leads - answerV5, V6, I, and aVL. Circumflex lesion.
Cardiac enzymes - answerTroponins, CK-MB, and CK
Changes in CK - answerRise: 3-6 hours
Peak: 24 hours
Normal: 3-4 days
Changes in CK-MB - answerReleased after myocardial necrosis. Specific for myocardial damage.
Rise: 3-12 hours
Peak: 24 hours
Normal: 2-3 days
Troponin I - answerProtein found in cardiac muscle. High sensitivity.
Rise: 3-12 hours
Peak: 24 hours
Normal: 5-10 days
Troponin T - answerProtein found in cardiac muscle. High sensitivity.
Rise: 3-12 hours
Peak: 12-48 hours
Normal: 5-14 days
Common conditions that cause a murmur - answerAortic dissection, aortic regurgitation (both
acute & chronic), mitral valve regurgitation (both acute & chronic), mitral valve stenosis
Drugs to decrease afterload/SVR/PVR - answer(Arterial Dilators) Nitroprusside, nitroglycerin,
, amrinone, alpha (Regitine) & Ca channel blockers
Drugs to increased afterload/SVR/PVR - answer(Vasopressors) Epinepherine, norepinepherine,
dopamine, neosynephrine
Drugs to decrease contractility/SVI - answerBeta blockers (atenolol, metoprolol, propranolol,
labetolol, esmolol) and Ca channel blockers
Drugs to increase contractility/SVI - answerPositive inotropes, dobutamine, dopamine, milrinone,
and digoxin
Drugs to decrease preload/CVP/PAWP - answerVenous Dilators - Nitroglycerin, nitroprusside,
amrinone, alpha & Ca channel blockers
Diuretics - Furosemide, bumex, mannitol
Drugs to increase preload/CVP/PAWP - answerVolume - Colloid, crystalloids, blood, hetastarch
Dysrhythmia control - antirhythmics, pacemaker, AICD
Complications when using thrombolytics - answerAllergic reaction, bleeding/hemorrhage, stroke
Failure to capture - answerPacer delivers a stimulus at the appropriate time but no depolarization
occurs. No P or QRS wave after pacer spike.
Failure to fire/pace - answerNo pacer spikes seen
Failure to sense - answerPacemaker does not detects heart's intrinsic activity or interprets
noncardiac activity as intrinsic activity. Spikes in inappropriate times.
Normal PR - answer0.12 - 0.20
Normal QRS - answer0.04-0.10
Normal QT - answerLess than 0.48. Varies by age, HR, and gender.
Vasopressors - answerEpinepherine, norepinepherine, dopamine, phenylephrine/neosynephrine,
vasopressin/pitressin, milrinone/Primacor, dobutamine/Dobutrex
Indication for dopamine/Intropin - answerActs on SNS to increased HR and BP. Indicated for
hypotension, low CO, decreased renal blood flow. Use if patient is bradycardic.
Doses of dopamine - answerLow: 0.5-2 mcg/kg/min (dopaminergic)
Intermediate: 2-10 mcg/kg/min (beta receptors, increases CO)
High: over 10 mcg/kg/min (alpha receptors, vasoconstrict)
SE of dopamine - answerWatch volume and starting BP. Use central line. Inactivated by sodium
bicarb. Can cause acidosis. SE: ectopic beats, tachycardia, tissue necrosis d/t extravasation
Treatment of dopamine extravasation - answerPhentaolmine 5-10 mg and possibly nitropaste to
vasodilate
Indication for norepinepherine/Levophed - answerIndicated for diastolic hypotension (specifically
ANSWERS
What to do first if patient has chest pain. - answerRest!
ECG changes in an acute MI - answerST elevation in 2 or more contiguous leads. Ischemia d/t full
thickness loss of muscle. EMERGENCY.
Inferior leads - answerII, III, aVF. RCA occlusion.
Septal leads - answerV1 & V2.
Anterior leads - answerV1 - V4. LAD lesion.
Lateral leads - answerV5, V6, I, and aVL. Circumflex lesion.
Cardiac enzymes - answerTroponins, CK-MB, and CK
Changes in CK - answerRise: 3-6 hours
Peak: 24 hours
Normal: 3-4 days
Changes in CK-MB - answerReleased after myocardial necrosis. Specific for myocardial damage.
Rise: 3-12 hours
Peak: 24 hours
Normal: 2-3 days
Troponin I - answerProtein found in cardiac muscle. High sensitivity.
Rise: 3-12 hours
Peak: 24 hours
Normal: 5-10 days
Troponin T - answerProtein found in cardiac muscle. High sensitivity.
Rise: 3-12 hours
Peak: 12-48 hours
Normal: 5-14 days
Common conditions that cause a murmur - answerAortic dissection, aortic regurgitation (both
acute & chronic), mitral valve regurgitation (both acute & chronic), mitral valve stenosis
Drugs to decrease afterload/SVR/PVR - answer(Arterial Dilators) Nitroprusside, nitroglycerin,
, amrinone, alpha (Regitine) & Ca channel blockers
Drugs to increased afterload/SVR/PVR - answer(Vasopressors) Epinepherine, norepinepherine,
dopamine, neosynephrine
Drugs to decrease contractility/SVI - answerBeta blockers (atenolol, metoprolol, propranolol,
labetolol, esmolol) and Ca channel blockers
Drugs to increase contractility/SVI - answerPositive inotropes, dobutamine, dopamine, milrinone,
and digoxin
Drugs to decrease preload/CVP/PAWP - answerVenous Dilators - Nitroglycerin, nitroprusside,
amrinone, alpha & Ca channel blockers
Diuretics - Furosemide, bumex, mannitol
Drugs to increase preload/CVP/PAWP - answerVolume - Colloid, crystalloids, blood, hetastarch
Dysrhythmia control - antirhythmics, pacemaker, AICD
Complications when using thrombolytics - answerAllergic reaction, bleeding/hemorrhage, stroke
Failure to capture - answerPacer delivers a stimulus at the appropriate time but no depolarization
occurs. No P or QRS wave after pacer spike.
Failure to fire/pace - answerNo pacer spikes seen
Failure to sense - answerPacemaker does not detects heart's intrinsic activity or interprets
noncardiac activity as intrinsic activity. Spikes in inappropriate times.
Normal PR - answer0.12 - 0.20
Normal QRS - answer0.04-0.10
Normal QT - answerLess than 0.48. Varies by age, HR, and gender.
Vasopressors - answerEpinepherine, norepinepherine, dopamine, phenylephrine/neosynephrine,
vasopressin/pitressin, milrinone/Primacor, dobutamine/Dobutrex
Indication for dopamine/Intropin - answerActs on SNS to increased HR and BP. Indicated for
hypotension, low CO, decreased renal blood flow. Use if patient is bradycardic.
Doses of dopamine - answerLow: 0.5-2 mcg/kg/min (dopaminergic)
Intermediate: 2-10 mcg/kg/min (beta receptors, increases CO)
High: over 10 mcg/kg/min (alpha receptors, vasoconstrict)
SE of dopamine - answerWatch volume and starting BP. Use central line. Inactivated by sodium
bicarb. Can cause acidosis. SE: ectopic beats, tachycardia, tissue necrosis d/t extravasation
Treatment of dopamine extravasation - answerPhentaolmine 5-10 mg and possibly nitropaste to
vasodilate
Indication for norepinepherine/Levophed - answerIndicated for diastolic hypotension (specifically
