PCCN CARDIAC EXAM 2024 ACTUAL EXAM
COMPLETE 306 QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+
Regurgitation systolic murmurs associated with? - ANSWER..-ventricular septal
wall defect
-tricuspid regurgitation
-mitral regurgitation
Nitroglycerin drip, need what at bedside? - ANSWER..-normal saline or volume
expander
-risk for hypovolemia
Abnormal Q wave on EKG signify? - ANSWER..-complete thickness infarction
of myocardium
-partial thickness MI = non Q wave MI
Non-Q wave infarction - ANSWER..aka nontransmural MI (subendocardial)
Q wave infarction - ANSWER..aka transmural MI
Common new onset dysrhythmia with pulmonary edema? - ANSWER..a-fib
inhaled nitric oxide (NO) - ANSWER..reduces right ventricular afterload due to
vasodilation
Janeway lesions - ANSWER..nontender hemorrhagic lesions - fingers, toes, nose,
earlobes - associated with endocarditis
Osler's nodes - ANSWER..-painful nodules on finger and toe pads
-seen in endocarditis
-caused by strep viridans
Roth's spots - ANSWER..-white areas in the retina surrounded by areas of
hemorrhage
,- associated with endocarditis
Associated with endocarditis? - ANSWER..-Janeway lesion
-Osler's nodes
-Roth spots
The only definitive way to diagnose myocarditis? - ANSWER..endomyocardial
biopsy
A heart murmur associated with acute valvular regurgitation? - ANSWER..S4
radio frequency destroys myocardial tissue via? - ANSWER..heat = 50 C, cell
damage and death occur
A high CVP reading may indicate? - ANSWER..-LV, RV or biventricular failure
- tricuspid regurgitation or stenosis
-HTN
-hypervolemia
-cardiac tamponade
Decrease CVP may indicate? - ANSWER..-increased contractility
-hypovolemia
Hydralazine (Apresoline) IV, incompatible with? - ANSWER..-lasix
-phenobarbital
-aminophylline
-amplicillin
stress echocardiography test - ANSWER..uses dobutamine to stress the cardiac
tissues without requiring the patient to walk or ride
What percentage of artery's diameter becomes occluded when anginal pain starts
occurring? - ANSWER..75%
silent angina (ischemia) - ANSWER..-objective evidence of ischemia (i.e. ECG)
but pt reports no symptoms
-diabetics = high risk
,MI Zone of Injury - ANSWER..
Zone of ischemia (prenumbra) - ANSWER..Tissue that is oxygen deprived; ECG
shows T-wave inversion
zone of infarction - ANSWER..Does not heal; becomes scar tissue
Cardiac asthma - ANSWER..Wheezing in presence of left ventricular failure;
interstitial edema causes airway narrowing
Tx goal for IV nitroglycerin - ANSWER..limit drop of SBP to 30mmHg below
baseline in hypertensive patients
Pulse Pressure (PP) - ANSWER..difference between systolic and diastolic
pressure
Ejection Fraction (EF) - ANSWER..calculation of how much blood a ventricle
can eject with one contraction
Diastole phase - ANSWER..-The phase of the cardiac cycle in which the
ventricles relax
-Metabolism of heart is decreased
Mean Arterial Pressure (MAP) - ANSWER..2(Diastolic BP) + Systolic/3
Mitral valve regurgitation - ANSWER..Caused by infectious or autoimmune,
congenital malformations, dilation of the left ventricle, Marfan's syndrome. Acute
disease can be caused by rupture of the chordae tendinae from endocarditis or
rheumatic heart disease, traumatic injury or papillary muscle dysfunction. Blood
flows back in to the left atrium (regurgitation) as a result of the incompetent valve.
Left atrial diastolic pressures increase quickly, and the left atrium cannot
compensate. Cardiac output falls dramatically, causing pulmonary edema and
cardiogenic shock. Patients often requiring intra-aortic balloon pump (IABP) and
vasopressors for support until the patient is stabilized for surgical intervention.
Inodilators - ANSWER..
, Increase liver glycogenolysis - ANSWER..vasopressors: epinephrine,
norepinephrine
Pradaxa (dabigatran) - ANSWER..-Anticoagulant - lowers risk of emboi
reduces risk for stroke from A Fib
-Contraindications on heart valve replacement
aortic regurgitation - ANSWER..-(aortic insufficiency) incompetent aortic valve
that allows backward flow of blood into left ventricle during diastole
-Marfan syndrome
Marfan Syndrome - ANSWER..genetic connective tissue disorder that can cause
a ruptured aorta
Wellens Syndrome - ANSWER..Occurs with the proximal stenosis of the LAD
Wellen's syndrome is a type of angina that occurs when the LAD is stenosed
proximally. The ST segment is not elevated more than 1mm in leads V1-V3, there
is a mild T wave inversion in leads V2-V3, and Q waves are not pathologic
(greater than 25% of the total length). Because of the location of the stenosis,
surgery is emergently needed.
Prinzmetal angina is aka Variant angina -- in this type of angina, the pain occurs
at rest and is associated with a vasospasm.
Cresendo angina means that over time, it takes less to initiate the pain and the
pain lasts longer.
Stroke Volume (SV) - ANSWER..measurement of the amount of blood ejected
from a ventricle in one contraction
CVP (central venous pressure) - ANSWER..-A direct measurement of the blood
pressure in the right atrium and vena cava. CVP reflects the amount of blood
returning to the heart and the ability of the heart to pump blood from the right
heart into the pulmonary system.
COMPLETE 306 QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+
Regurgitation systolic murmurs associated with? - ANSWER..-ventricular septal
wall defect
-tricuspid regurgitation
-mitral regurgitation
Nitroglycerin drip, need what at bedside? - ANSWER..-normal saline or volume
expander
-risk for hypovolemia
Abnormal Q wave on EKG signify? - ANSWER..-complete thickness infarction
of myocardium
-partial thickness MI = non Q wave MI
Non-Q wave infarction - ANSWER..aka nontransmural MI (subendocardial)
Q wave infarction - ANSWER..aka transmural MI
Common new onset dysrhythmia with pulmonary edema? - ANSWER..a-fib
inhaled nitric oxide (NO) - ANSWER..reduces right ventricular afterload due to
vasodilation
Janeway lesions - ANSWER..nontender hemorrhagic lesions - fingers, toes, nose,
earlobes - associated with endocarditis
Osler's nodes - ANSWER..-painful nodules on finger and toe pads
-seen in endocarditis
-caused by strep viridans
Roth's spots - ANSWER..-white areas in the retina surrounded by areas of
hemorrhage
,- associated with endocarditis
Associated with endocarditis? - ANSWER..-Janeway lesion
-Osler's nodes
-Roth spots
The only definitive way to diagnose myocarditis? - ANSWER..endomyocardial
biopsy
A heart murmur associated with acute valvular regurgitation? - ANSWER..S4
radio frequency destroys myocardial tissue via? - ANSWER..heat = 50 C, cell
damage and death occur
A high CVP reading may indicate? - ANSWER..-LV, RV or biventricular failure
- tricuspid regurgitation or stenosis
-HTN
-hypervolemia
-cardiac tamponade
Decrease CVP may indicate? - ANSWER..-increased contractility
-hypovolemia
Hydralazine (Apresoline) IV, incompatible with? - ANSWER..-lasix
-phenobarbital
-aminophylline
-amplicillin
stress echocardiography test - ANSWER..uses dobutamine to stress the cardiac
tissues without requiring the patient to walk or ride
What percentage of artery's diameter becomes occluded when anginal pain starts
occurring? - ANSWER..75%
silent angina (ischemia) - ANSWER..-objective evidence of ischemia (i.e. ECG)
but pt reports no symptoms
-diabetics = high risk
,MI Zone of Injury - ANSWER..
Zone of ischemia (prenumbra) - ANSWER..Tissue that is oxygen deprived; ECG
shows T-wave inversion
zone of infarction - ANSWER..Does not heal; becomes scar tissue
Cardiac asthma - ANSWER..Wheezing in presence of left ventricular failure;
interstitial edema causes airway narrowing
Tx goal for IV nitroglycerin - ANSWER..limit drop of SBP to 30mmHg below
baseline in hypertensive patients
Pulse Pressure (PP) - ANSWER..difference between systolic and diastolic
pressure
Ejection Fraction (EF) - ANSWER..calculation of how much blood a ventricle
can eject with one contraction
Diastole phase - ANSWER..-The phase of the cardiac cycle in which the
ventricles relax
-Metabolism of heart is decreased
Mean Arterial Pressure (MAP) - ANSWER..2(Diastolic BP) + Systolic/3
Mitral valve regurgitation - ANSWER..Caused by infectious or autoimmune,
congenital malformations, dilation of the left ventricle, Marfan's syndrome. Acute
disease can be caused by rupture of the chordae tendinae from endocarditis or
rheumatic heart disease, traumatic injury or papillary muscle dysfunction. Blood
flows back in to the left atrium (regurgitation) as a result of the incompetent valve.
Left atrial diastolic pressures increase quickly, and the left atrium cannot
compensate. Cardiac output falls dramatically, causing pulmonary edema and
cardiogenic shock. Patients often requiring intra-aortic balloon pump (IABP) and
vasopressors for support until the patient is stabilized for surgical intervention.
Inodilators - ANSWER..
, Increase liver glycogenolysis - ANSWER..vasopressors: epinephrine,
norepinephrine
Pradaxa (dabigatran) - ANSWER..-Anticoagulant - lowers risk of emboi
reduces risk for stroke from A Fib
-Contraindications on heart valve replacement
aortic regurgitation - ANSWER..-(aortic insufficiency) incompetent aortic valve
that allows backward flow of blood into left ventricle during diastole
-Marfan syndrome
Marfan Syndrome - ANSWER..genetic connective tissue disorder that can cause
a ruptured aorta
Wellens Syndrome - ANSWER..Occurs with the proximal stenosis of the LAD
Wellen's syndrome is a type of angina that occurs when the LAD is stenosed
proximally. The ST segment is not elevated more than 1mm in leads V1-V3, there
is a mild T wave inversion in leads V2-V3, and Q waves are not pathologic
(greater than 25% of the total length). Because of the location of the stenosis,
surgery is emergently needed.
Prinzmetal angina is aka Variant angina -- in this type of angina, the pain occurs
at rest and is associated with a vasospasm.
Cresendo angina means that over time, it takes less to initiate the pain and the
pain lasts longer.
Stroke Volume (SV) - ANSWER..measurement of the amount of blood ejected
from a ventricle in one contraction
CVP (central venous pressure) - ANSWER..-A direct measurement of the blood
pressure in the right atrium and vena cava. CVP reflects the amount of blood
returning to the heart and the ability of the heart to pump blood from the right
heart into the pulmonary system.
