CCTC NATCO-Heart UPDATED Test Questions and CORRECT Answers

CCTC NATCO -Heart UPDATED Test Questions and CORRECT Answers Heart patients are classified according to how sick they are as determined by the following systems:✔✔✔ New York Heart Association (NYHA) Heart Failure Classification System AHA/ACC stages Per the NYHA, a Class I patient... ✔✔✔ has cardiac disease but withou t limitations of physical activity Per the NYHA, a Class II patient... ✔✔✔ has slight limitations of physical activity that will resolve with rest Per the NYHA, a Class III patient... ✔✔✔ has marked limitations of physical activity but is usually comfortable at rest Per the NYHA, a Class IV patient... ✔✔✔ has an inability to carry on any physical activity without symptoms, even at rest Per the AHA/ACC, a Stage A patient... ✔✔✔ is at risk for Heart failure but has not developed structural heart changes Per the AHA/ACC, a Stage B patient... ✔✔✔ has structural heart disease without symptoms Per the AHA/ACC, a Stage C patient... ✔✔✔ has structural abnormalities with symptoms of heart failure Per the AHA/ACC, a Stage D patient... ✔✔✔ has end -stage, refractory heart fail ure Indications for heart transplant include... ✔✔✔ End stage heart disease unresponsive to conventional therapy Ventricular arrhythmias despite medications or ablation Re-transplantation or graft failure Declining functional status - (NYHA Class 3 or 4, or CHF with poor prognosis < 2 - year survival) All other medical and surgical options exhausted Common diagnoses that could lead to heart transplant include... ✔✔✔ Cardiomyopathy Valvular Heart Disease Myocarditis Cardiac Tumors Congenital heart disease Metabolic disorders Toxins Systemic Diseases Absolute contraindications to heart transplant include... ✔✔✔ Significant peripheral vascular disease Cerebrovascular disease Active infection (except for LV AD patients) Irreversible pulmonary hypertension (4 -6 wood units or TPG >12) Significant primary lung disease Recent pulmonary embolus (within 6 wks of transplant) Irreversible end organ function or failure (renal/hepatic) Recent cancer (within 5 years) Life threatening illness - survival < 5 years Severe neuro logic injury or impairment Active AIDS Active alcohol, smoking or drugs Heart failure generally begins with the... ✔✔✔ left side, specifically the left ventricle With left sided heart failure, the patient may experience the following symptoms: ✔✔✔ Cough crackles wheezing confusion cyanosis blood tinged sputum shortness of breath exertional dyspnea orthopnea tachycardia elevated pulmonary capillary wedge pressure paroxysmal nocturnal dyspnea With right sided heart failure, the patient may experience the following symptoms: ✔✔✔ Fatigue Ascites Anorexia/GI symptoms swelling in hands/fingers Edema Increased peripheral venous pressure Enlarged liver and spleen Distended jugular veins With right sid ed heart failure, patients can also develop... ✔✔✔ pulmonary hypertension (PHTN) Cardiac diagnostic tests include... ✔✔✔ ECG Right and left heart cath (check PVRi) Echocardiogram (Low EF indicating poor function) Cardiopulmonary Stress Test - V o2 max < 14ml/k g/min (50% predicted, major limitation of activity)