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Exam (elaborations)

FISDAP READINESS Exam Prep Questions and Answers

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Where are Beta 1 receptors found? - ANSWER Heart and Kidneys Stimulation of Beta 1 receptors result in an increase of what? - ANSWER 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. - ANSWER 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? - ANSWER P wave Carvedilol (Coreg) Metropolol (Lopressor) Atenolol (Tenormin) Propranolol (Inderal) Bisoprolol (Zebeta) Acebutolol (Sectral) Comolol (Brevibloc) - ANSWER Beta Blockers - used for blood pressure and cardiac problems Epinephrine Norepinephrine Vasopressin Dopamine Phenylephrine Dobutamine - ANSWER 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. - ANSWER Relative Refractory Period (Partial flush of the toilet) Treatment for Beta Blocker Overdose - ANSWER 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? - ANSWER DVT Treatment of DVT - ANSWER 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. - ANSWER Coronary Perfusion Tachycardia, Difficulty Breathing, Diminished Lung Sound, Pulse Quality Changes, and unequal chest rise are early signs and symptoms of? - ANSWER Tension Pneumothorax Air is entering the pleural space but cannot escape. Positive pressure ventilation can make it worse. Criteria for Unstable Dysrhythmia - ANSWER 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? - ANSWER Cardiac Tamponade Hypotension, SOB, Lightheadedness, Chest Pain, Syncope, Palpitations, Extremity Swelling, and Muffled heart sounds are signs and symptoms of? - ANSWER Cardiac Tamponade Indications for Dopamine - ANSWER Cardiogenic Shock Distributive Shock after fluids Hemodynamically significant Hypotension Symptomatic Brady (2nd Line drug) AHA Guidlines for Terminating CPR efforts in field(4) - ANSWER 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. - ANSWER EMS-to-Balloon-Time Time from patient entering ED to catheter passing through lesion of coronary vessel. - ANSWER Door-to-balloon-time Time from patient entering ED to fibrinolytic therapy administration. - ANSWER Door-to-needle-time Time frame for door-to-balloon - ANSWER <90mins Time frame for door-to-needle - ANSWER <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? - ANSWER Angina Pectoris Chest pain that occurs at rest and is caused by coronary artery vasospasm? Risk for Dysrhythmia, MI, Heart Block and Death - ANSWER Prinzmetal Angina (PA) Which electrolyte flows into cardiac cells to initiate depolarization? - ANSWER Sodium (Na+) Which electrolyte flows out of cardiac cells to to initiate repolarization? - ANSWER Potassium (K+) Which electrolyte plays a major role in depolarization of pacemaker cells to maintain depolarization and myocardial contractility? - ANSWER Calcium (Ca++) Which electrolyte stabilizes cell membrane and acts in concert with K+ and opposes actions of Ca++? - ANSWER Magnesium (Mg++) Hypokalemia results in? - ANSWER increased myocardial irritability Hyperkalemia results in? - ANSWER decreased automaticity/conduction Hypocalcemia results in? - ANSWER decreased contractility and increased irritability Hypercalcemia results in? - ANSWER Increased contractility Hypomagnesemia results in? - ANSWER decreased conduction Hypermagnesemia results in? - ANSWER increased myocardial irritability Four properties of the Cardiac Conduction System - ANSWER 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? - ANSWER 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? - ANSWER Sodium and Calcium influx Which electrolyte is responsible for repolarization? - ANSWER Potassium outflow Indications for CPAP (5) - ANSWER Alert and able to follow commands Moderate to Severe Respiratory Distress Hyperventilation SpO2 <90% Systolic >90mmHg Contraindications for CPAP (8) - ANSWER 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? - ANSWER Diastolic Coronary circulation begins from aorta at the? - ANSWER Right and Left Coronary Arteries The right coronary artery has how many branches and supplies blood to where? - ANSWER 9 Right Atrium, SA/AV node, and Right Ventricle Inferior Left Ventricle

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