Cardiovascular & Respiratory System
69 important questions on Cardiovascular & Respiratory System
What are symptoms of left-sided heart failure?
- Backflow to the lungs
- Difficulty of breathing
- Orthopnea (difficulty breathing lying flat)
- Paroxysmal nocturnal dyspnea
- Bibasilar crackles
- Non-productive cough
- Pink frothy sputum
- Decreased cardiac output
What causes inflammatory heart disease?
- Infectious agents: viruses, bacteria, fungi, parasites
- Toxic materials: environment, water, food, air, gases, smoke, pollution
What are the layers affected in infectious cardiac disorders?
- Endocardium: Inner layer
- Myocardium: Muscle layer
- Pericardium: Outermost layer
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How do you check for cardiac responsiveness?
- Check for responsiveness
- Ask for help
- Activate Emergency Medical Services (EMS)
- Get Automated External Defibrillator (AED)
How is stable angina managed?
What are the signs of endocarditis?
- Heart valves become incompetent
- Vegetation, infective emboli
- Murmurs
- Skin: petechiae, nodules
What does the ECG rhythm indicate?
- Ventricular Tachycardia
- Rapid impulse > 100 bpm
- P wave is absent
- Poor cardiac output
What is the CPR sequence?
- Compression
- Airway
- Breathing (C-A-B)
What are the symptoms of myocarditis?
- Decrease in muscle contraction
- Chest pain with fatigue
- Cardiac dysrhythmia
What is shown in the ECG for supraventricular tachycardia?
- P wave: Abnormal
- QRS: Normal
- PR Interval: Not measurable
How is stable Ventricular Tachycardia managed?
- Administer Amiodarone
- Administer Lidocaine
What is the purpose of administering Epinephrine in cardiac arrest?
- To create impulse
- Administer to revive the heart
What are the stages of myocardial infarction (MI)?
- Ischemia: decreased oxygen, pain
- Injury: damage
- Infarct: necrosis
What are the symptoms of pericarditis?
- Inflammation of pericardium
- Pain when inhaling or lying supine
- Pleural friction rub
What is the typical impulse rate at the atria in atrial flutter?
What are the management strategies for supraventricular tachycardia?
- Vagal Maneuver
- Adenosine
- Beta-blockers
- Calcium channel blockers
- Cardioversion
What is the management for unstable Ventricular Tachycardia?
- Use Cardioversion
- Deliver high-energy shock
What are the CPR guidelines for infants?
What are the diagnostics for myocardial infarction (MI)?
- Troponin: 3 hours after attack
- CK-MB: 18 hours after attack
- Myoglobin: 24 hours
What medications manage infectious cardiac disorders?
- Penicillin
- Corticosteroids
- Vancomycin
What are the two modes of a pacemaker?
- Fixed (Asynchronous): Impulse at constant rate
- Demand (Synchronous): Impulse when heart rate decreases
What are common characteristics of the P wave and QRS in atrial flutter?
- P wave: Abnormal
- QRS: Normal
What are the risk factors for supraventricular tachycardia?
- Exercise
- Caffeine
- Fear
- Common in pediatrics
What should be done for pulseless and unconscious patients with Ventricular Tachycardia?
- Start defibrillation at 200 joules
- Then 300 joules
- Finally, 360 joules
What is the compression rate for untrained personnel during CPR?
- 100-120 compressions/min
- Push hard and fast
How is myocardial infarction (MI) managed?
- M: Morphine
- O: Oxygen
- N: Nitroglycerin
- A: Aspirin
What is cardiac tamponade?
- Blood/fluid fills space between sac and heart muscle
- Increase in pericardial fluid leads to effusion
What steps are involved in naming an ECG?
- Check 5 parameters.
- Check origin of firing.
- Check rate and rhythm.
What should be monitored daily for a pacemaker diary?
- Count heart rate daily
- List down activities performed
What are complications associated with atrial flutter?
- Complication: Stroke
- Blood stasis: Clot
How is a vagal maneuver used in supraventricular tachycardia?
- Carotid sinus massage
- Slows heart rate
- Stimulates vagus nerve
What happens in the first 3-5 mins of decreased cardiac output?
- Fatal decrease in cardiac output
- Reduced brain perfusion
- Blood not reaching the brain
What drugs are Sodium Channel Blockers in Group I-A?
- Disopyramide (Norpace)
- Procainamide (Pronestyl)
- Quinidine (Quinaglute)
What are the complications of myocardial infarction (MI)?
- Cardiac dysrhythmia
- Cardiogenic shock (B.C.O.)
- Heart failure
What are signs and symptoms of cardiac tamponade?
- Muffled heart sound
- Jugular vein distention
- Pulsus paradoxus: systolic BP decrease 10mmHg on inhalation
What is the role of the SA Node in the heart?
- Initiates electrical impulses
- Known as the "physiologic pacemaker"
- Controls heart rate: 60-100 bpm
What does a normal sinus rhythm look like in terms of P wave, QRS, PR Interval, Rate, and Rhythm?
- P wave: Normal
- QRS: Normal
- PR Interval: Normal
- Rate: 60-100 bpm
- Rhythm: Regular
Name two malfunctions of a pacemaker.
- Dizziness and altered LOC
- Dislodgement: Displacement
What is the role of Sodium Channel Blockers in atrial flutter management?
- Management: Sodium Channel Blockers
- Purpose: Stops the heart temporarily to restore rhythm
What are the ventricular rhythm abnormalities?
- Extra abnormal heartbeats
- Occur in ventricle chambers
How is management handled for cardiac output decrease and V-fib?
- Defibrillation
- Perform CPR
- Use Epinephrine
Which drugs are classified as Group II Beta-adrenergic blockers?
- Carvedilol
- Metoprolol
- Propranolol
How is cardiac tamponade managed?
- Pericardiocentesis
- Aspiration of fluid in pericardial space
- Position: 45-60 degree angle
What does the AV Node do in heart conduction?
- Acts as a "secondary pacemaker"
- Regulates impulses: 40-60 bpm
- Connects atria to ventricles
Describe the characteristics of sinus bradycardia.
- P wave: Normal
- QRS: Normal
- PR Interval: Normal
- Rate:
What symptoms indicate a pacemaker dislodgement?
- Hiccups
- Spasms of the diaphragm
What are the mentioned risk factors for atrial rhythms?
- Infection
- Stress
- Electrolyte imbalance
- Noxious stimuli
How many PVCs indicate possible ventricular tachycardia?
Which medications prevent recurrence of V-fib?
What are the uses of Amiodarone (Cordarone)?
- Blue discoloration of skin
- Use sunscreen
- Prevents the recurrence of v-fib
What is done post-procedure for cardiac tamponade?
- Monitor vital signs every 15 mins for 1 hour
- Assess heart and lung sounds
- Record fluid amount
- ECG for heart rhythm
- Semi-Fowler’s position
Describe the function of the Bundle of His.
- Transmits impulses from AV Node
- Sends signals to ventricle muscles
- Facilitates synchronized contractions
What can cause sinus bradycardia?
- Anti-arrhythmic drugs
- Sleep
- Hypothyroidism
- Vagal stimulation (e.g. training, exertion)
- Common in elderly & athletes
How long is the battery life for a pacemaker?
- Lithium: 10 years
- Nuclear: 20 years
What is the purpose of cardioversion in atrial flutter?
What are the management strategies for ventricular arrhythmias?
- Beta-blockers
- Calcium channel blockers
- Sodium channel blocker (Lidocaine)
- Notify the doctor
What should be avoided with Group IV Calcium Channel Blockers?
What is represented by the P Wave in an ECG?
- Indicates atrial depolarization
- Reflects electrical activity in atria
What management options are available for sinus bradycardia?
- Alter medication (beta-blockers, calcium channel blockers).
- Drugs: Atropine, Dopamine, Epinephrine.
- Transcutaneous pacing.
- Artificial pacemaker.
What to avoid with a pacemaker according to guidelines?
- Avoid high magnetic fields (MRI)
- Avoid high voltage equipment
- Avoid contact sports
What medications are used as anticoagulants in atrial flutter management?
- Tissue Plasminogen Activator (TPA)
- Aspirin
- Warfarin
What are the risk factors for ventricular arrhythmias?
- Irritated/stressed ventricles
- Medications
- Cocaine
- Electrolyte imbalance
- Ischemia
What does the QRS Complex indicate on an ECG?
- Represents ventricular depolarization
- Shows electrical activity in ventricles
What are some causes of sinus tachycardia?
- Dehydration
- Anemia
- Shock
- Hyperthyroidism
Explain the importance of the PR Interval in an ECG.
- Measures time from atrial to ventricular activation
- Indicates AV conduction time
What beta-blockers are used for managing sinus tachycardia?
How is heart rate evaluated using an ECG?
- Examine the R-R interval
- Calculate beats per minute (bpm)
What calcium channel blockers can be used?
- Diltiazem
- Verapamil
- Nifedipine
- Amlodipine
What is assessed for heart rhythm on an ECG?
- Check consistency of R-R intervals
- Determine if rhythm is regular or irregular
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