RCIS Exam 100%ACCREDITED 2023

True or False: During a left heart biopsy you should give heparin. Yes, 5000IU to avoid thrombi going to the brain What is the maximum annual Radiation exposure? 5 REM What is the therapeutic INR range for someone on warfarin/coumadin? 2.0-3.0 What is a normal INR for someone not on coumadin/warfarin? INR 0.6-1.2 When using FFR, what drug is given and how is it delivered? Adenosine causes hyperemia (Increased blood flow to the tissues. Can be delivered by either IV or IC What are the pros and cons of a mechanical aortic valve? Pros: last longer Cons: Prone to thrombus formation Why would you use Cardiac Resynchronization Therapy (CTR) pacing device (such as biventricular pacing)? How many leads does it use? Where are they placed? uses 2-3 leads placed through a vein in the RA, RV and into coronal sinus vein to pace the LV A CRT device sends small electrical impulses to both lower chambers of the heart to help them beat together in a more synchronized pattern. What are the angioplasty guidewire calibers? 0.014-0.018 inch When can you detect Myoglobin after an MI? 2-4 hours after symptom onset normal in 24-36 hours What is the diameter of the standard J wire? 0.035 What is the Warfarin ( Coumadin) antagonist? vitamin K When shooting a LIMA, the cuff should be? Isolateral (same side as LIMA) left arm What is the usual time for restenosis to occur? within 6 months What size is the red sheath? *4F-red What size is the grey sheath? 5F-grey What size is the green sheath? 6F- green What size is the orange sheath? 7F-orange What size is the blue sheath? 8F-blue What size is black sheath? 9F-black What is the name of the self expanding stent used in the carotid arteries, SVG, Iliac and femoral vessels? Wall stent Where can a wall stent be used? carotid arteries, SVG, Iliac and femoral vessels What is the loading dose of aspirin in a patient with ischemia/chest pain? 162-325 mg Should you increase or decrease burr speed when you increase from a 1.25-2.15 burr? decrease Where does the apex point in a RAO view? * RAO=apex points to the right Where does the apex point in a LAO view? *LAO= apex points to the left What medication do you give when doing FFR? How does it measure? adenosine Measure by hyperemic effect (max dilation of vessels) What medication should you give before using IVUS to avoid spasm? Always give 200 nitro before using IVUS to avoid spasm. What is the proper placement of an IABP? 1-2cm distal to left subclavian and promixal to the renals. Where do we stick for neck access for right heart? Right internal jugular vein What is the average Adult Hematocrit in %? Men 45% Women 40% What are softer guidewires used for? They Are easier/safer in a tortuous vessel What is a normal QRS complex duration? 0.08 - 0.12 sec (2 - 3 small squares) Where does a homograft valve come from? From another human heart explanted at autopsy What is atherectomy? Reduction of plaque by using rotational, laser or directional atherectomy device How does perclose work? Perclose device uses nonabsorbable suture with 2 needles to attach the suture material. What are the signs of a LBBB? LBBB( left bundle branch block) QRS 0.12 sec V5,V6 V1 negative deflection What can lidocaine be used for other than pain relief? Lidocaine also used for ventricular arrhythmias * Ca channel blocker affect directly purkinge fibers Why is it important to lower the image intensifier? *reduces pt exposure *improves image quality Where is the blood with the lowest 02 sats? coronary sinus What is a disadvantage of an Animal Aortic Valve? Does not last long because animals do not have a mechanical valve 10-20 years at most RCA RAO looks like the letter? "L" What is the average amount of pericardial fluid? 10-50ml What is a normal ACT? 75-120 sec Optimal lead thickness 0.5mm Pacemakers can be? permanent, temporary, transcutaneous, transvenous What is a normal pH level of blood? 7.35-7.45 Normal Ratio SVR to PVR? 12:1 1lb = __ kg 0.45kg How many kg in a lb? 2.2 Reopro (abciximab) & Integrilin ( eptifibatide) are: GP llb/ llla inhibitors What is the normal Hgb in women? 12-14 g/dl How is vasopressin administered? 40 units IV push replacing first or second dose of epinephrine What are the most radiosensitive tissues? lymph tissues, bone marrow, gonads, lung tissue Why does the IABP use counterpulsation? * Inflates & deflates counter to normal rhythm of the heart * decreases workload of LV * decreases oxygen consumption & decreases systolic BP * increases diastolic BP What does IVUS (intravascular Ultrasound) show? Defines anterior wall anatomy If no response to Ace inhibitors use... Angiotensin Receptor blockers ( ARB) What is attenuation? Energy from x-ray that interact with tissue & change energy level or direction and exists as scatter Drugs that are on stents * Sirolimus( rapamyclin) *paclitaxel * everolimus * zotarolimus What medication is recommended by ACLS in all pulseless conditions? * 1mg of epinephrine What enzyme peaks late, usually 2 days after MI? * troponin * delays returning to the baseline What is the heparin antagonist? protamine What is the formula for BP? BP = CO x SVR Normal Hct values 42% to 52% for men 37% to 47% for women A patient has symptomatic narrow QRS complex tachycardia. What should be the first treatment? *first vagal maneuvers, then 6mg adenosine What is the Pericardial tamponade treatment? *pericardiocentesis (use of a needle (catheter) to remove fluid) Mitral stenosis characteristics high PCWP/LA pressure high LVEDP p1-p2 Facts about Mynx closure device * 95% water and 5% PEG (freeze dried) disintegrate in 30 days. CONTINUED....