cardiology review
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Ductapemagic on October 2, 2009
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cardiology review
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164 terms
Terms | Definitions |
|---|---|
 A patient asks you about his risk of cardiovascular disease. He is 50-years old and has diabetes, is overweight and smokes cigarettes. You advise him that: | He can modify his risk for cardiovascular disease by losing weight and not smoking |
| Which of the following is true of the coronary arteries? | The coronary arteries begin just above the aortic valve |
| The circumflex artery is a branch of the: | Left coronary artery |
| In the event of a coronary artery blockage, the muscle of the heart can receive blood from the: | Anastomoses that provide collateral circulation |
| The right atrium receives blood from the systemic circulation and the: | Coronary veins |
| The valve between the right atrium and the right ventricle is the: | Tricuspid valve |
| Relaxation of the heart is referred to as: | Diastole |
| Stroke volume depends on preload, afterload, and: | Myocardial contractility |
| The Starling law states that: | Myocardial fibers contract more forcefully when they are stretched |
| The most important factor in determining stroke volume in a healthy heart is: | Preload |
| An increase in peripheral vascular resistance: | Decreases stroke volume |
| To increase cardiac output, you can: | Increase both heart rate and stroke volume |
| The ventricles of the heart are innervated mainly by: | Sympathetic nerve fibers |
| Parasympathetic control of the heart is provided by the: | Vagus nerve |
| The resting membrane potential is determined primarily by the difference between the intracellular potassium ion level and the | Extracellular potassium ion level |
| Depolarization takes place when: | Sodium ions rush into the cell |
| The sodium-potassium pump functions to move: | Potassium ions into the cell and sodium ions out of the cell |
| Phase I of the action potential represents the period of: | Early rapid repolarization |
| During the period between action potentials: | There is excessive sodium in the cell |
| The AV junction is formed by the AV node and the: | Bundle of His |
| The dominant pacemaker of the heart under normal conditions is the: | SA node |
| You are treating a patient who has a damaged SA node that is no longer pacing the heart. You would expect the patient's heart to: | Beat more slowly |
| Which of the following cardiac pacemakers has an intrinsic rate of 40 to 60 beats per minute? | AV junction |
| Acetylcholine affects the heart by: | Decreasing heart rate |
| The activation of myocardial tissue more than one time by the same impulse is called: | Reentry |
| You are treating a 75-year-old woman who has a history of diabetes and atherosclerosis. Her chief complaint is persistent heartburn. You suspect: | This may be a cardiovascular problem |
| Jugular vein distention in cardiac patients should be evaluated with the patient positioned: | With the head elevated 45 degrees |
| While assessing a patient you identify a carotid bruit. This leads you to believe that the patient: | Has atherosclerosis |
| An ECG can help to determine: | Whether there is ischemic cardiac muscle |
| Which of the following is a bipolar lead? | Lead II |
| In lead II ECG placement, the positive lead is located on the: | Left leg |
| Leads II and III are: | Inferior leads |
| Lead I looks at the heart from what view? | Lateral |
| A lead used for routinely monitoring dysrhythmias is: | Lead II |
| A paramedic places 10 leads: 4 on the limbs and 6 on the chest. The paramedic is preparing for viewing a: | 12-lead ECG |
| In a 12-lead ECG, leads V1 and V2 are: | Septal leads |
| When preparing for a 12-lead ECG, locate the 4th intercostal space, just to the right of the sternum and place lead: | V1 |
| Standard ECG paper is divided into 1-mm blocks and moves past the stylus of the ECG at 25 mm per second. Each small block represents: | 0.04 second |
| Each small square of graph paper represents _____ mV. | 0.1 |
| The first upward deflection on an ECG tracing is the: | P wave |
| The PR interval represents the time it takes an electrical impulse to: | Be conducted through the atria and the AV node |
| The duration of the QRS complex should be _____ second. | 0.08 to 0.10 |
| While analyzing an ECG you cannot identify a Q wave. This means: | The Q wave may not be visible in the lead you are viewing |
| The ST segment reflects the: | Early repolarization of the ventricles |
| Deep and symmetrically inverted T waves may be indicative of: | Cardiac ischemia |
| The part of the ECG tracing that is most important for detecting life-threatening arrhythmias is the: | QRS complex |
| The triplicate method of determining heart rate is: | Accurate when the heart rate is normal and greater than 50 beats per minute |
| When analyzing an ECG tracing, you notice that the rhythm is highly irregular. The best method to calculate the rate is the | Six-second count method |
| While evaluating a 22-year-old female runner who called 911 because she fell and twisted her ankle, you apply an ECG monitor. Her heart rate is 46, P waves are normal and upright, the PR interval is 0.16 second, and the QRS complex looks normal. There is a QRS complex following each P wave. The patient's ECG tracing reflects: | Sinus bradycardia |
| While evaluating a 22-year-old female runner who called 911 because she fell and twisted her ankle, you apply an ECG monitor. Her heart rate is 46, P waves are normal and upright, the PR interval is 0.16 second, and the QRS complex looks normal. There is a QRS complex following each P wave. Treatment for this patient's heart rate should include: | No treatment at this time |
| An undesirable side effect of atropine is: | Increased myocardial oxygen demand |
| Isoproterenol raises the heart rate by functioning as a: | Beta agonist |
| ECG analysis reveals that each P wave in the tracing has a different shape. The heart rate is 80 beats per minute. This is called: | Wandering pacemaker |
| Which of the following may cause sinus bradycardia? | Intrinsic sinus node disease |
| Atropine works by inhibiting: | Parasympathetic response |
| An ECG strip shows a regular rhythm with a QRS complex of 0.08, a rate of 145, a PR interval of 0.12, and one upright P wave before each QRS complex. You suspect that this rhythm is: | Sinus tachycardia |
| You are called to evaluate a 64-year-old woman who complains of palpitations, weakness, and dizziness. Her heart rate is 160 beats per minute, her blood pressure is 118/ 80 and her respiratory rate is 28. The ECG tracing shows narrow QRS complexes and no identifiable P waves. This rhythm is most likely: | SVT |
| You are called to evaluate a 64-year-old woman who complains of palpitations, weakness, and dizziness. Her heart rate is 160 beats per minute, her blood pressure is 118/ 80 and her respiratory rate is 28. The ECG tracing shows narrow QRS complexes and no identifiable P waves. The first recommended treatment for this patient is: | Valsalva maneuver |
| Which of the followinYou are called to evaluate a 64-year-old woman who complains of palpitations, weakness, and dizziness. Her heart rate is 160 beats per minute, her blood pressure is 118/ 80 and her respiratory rate is 28. The ECG tracing shows narrow QRS complexes and no identifiable P waves. Which of the following drugs is a class I (recommended) drug for this patient? | Adenosine |
| You are called to evaluate a 64-year-old woman who complains of palpitations, weakness, and dizziness. Her heart rate is 160 beats per minute, her blood pressure is 118/ 80 and her respiratory rate is 28. The ECG tracing shows narrow QRS complexes and no identifiable P waves. The patient begins to develop chest pain, and her blood pressure drops to 100/60. The treatment of choice for this patient is now: | Synchronous cardioversion |
| first synchronous cardioversion for patients in PSVT should be at: | 50 J |
| You see an irregular rhythm on the monitor with a rate of 66 to 80, a normal PR interval, and a P wave for every QRS. The rate speeds up and slows down with the patient's respiratory rate. You suspect that this rhythm is: | Sinus dysrhythmia |
| Vagal maneuvers for SVT include: | Facial immersion in ice water |
| Atrial flutter is almost always caused by: | Rapid reentry |
| You are treating a 70-year-old male patient with atrial fibrillation. The patient's ventricular heart rate is 180 beats per minute, the blood pressure is 90/60, and the patient complains of chest pain. The hallmark of atrial fibrillation is: | An irregularly irregular rhythm |
| You are treating a 70-year-old male patient with atrial fibrillation. The patient's ventricular heart rate is 180 beats per minute, the blood pressure is 90/60, and the patient complains of chest pain. You have determined that your atrial fibrillation patient is unstable and requires electrical therapy. You will perform _____ countershock with _____ joules | Synchronized; 100 |
| You are treating a 70-year-old male patient with atrial fibrillation. The patient's ventricular heart rate is 180 beats per minute, the blood pressure is 90/60, and the patient complains of chest pain. If this patient's atrial fibrillation has been present for more than 48 hours, conversion of this patient's rhythm may lead to: | Release of emboli |
| Junctional escape rhythms: | Occur when the SA node fails to fire |
| An ECG strip shows a rhythm with a rate of 45, a QRS of 0.08, and a P wave that appears after the QRS. You suspect that this dysrhythmia is most likely: | Junctional |
| The intrinsic rate for a ventricular pacemaker is _____ beats per minute. | 20 to 40 |
| Your patient has a regular bradycardic rhythm with a rate of 40, no P waves, and a QRS greater than 0.12. This is: | Ventricular escape rhythm |
| Absolute bradycardia means that: | The heart rate is less than 60 beats per minute |
| Which of the following may be a lethal treatment for a patient with a ventricular escape rhythm? | Lidocaine |
| You are treating a patient who is complaining that his heart is "skipping beats." On ECG evaluation, you see frequent PVCs that are occurring in groups. The patient's blood pressure is 100 systolic. Treatment for this patient: | Should include oxygen and lidocaine |
| The treatment of choice for a symptomatic ventricular escape rhythm is: | Pacing |
| Which of the following is true of ventricular tachycardia? | Ventricular tachycardia is triggered by a PVC |
| Patients with pulseless ventricular tachycardia should be treated as though they have: | Ventricular fibrillation |
| Synchronized cardioversion is acceptable for patients with ventricular tachycardia: | In all cases |
| The most common arrhythmia in sudden cardiac arrest is: | Ventricular fibrillation |
| Defibrillation of patients in asystole: | Is not recommended |
| Which of the following is an absolute indication for unsynchronized cardioversion? | Ventricular fibrillation |
| Demand pacemakers fire: | When the patient's rate drops below a preset number |
| You are treating a 65-year-old man who is complaining of chest pain and difficulty breathing. On ECG examination, you note that his ventricular heart rate is 56, and there are more P waves than QRS complexes. The PR interval is constant when a QRS follows a P wave. The QRS complexes are normal and narrow.You suspect this patient has what type of heart block? | Second-degree type II |
| You are treating a 65-year-old man who is complaining of chest pain and difficulty breathing. On ECG examination, you note that his ventricular heart rate is 56, and there are more P waves than QRS complexes. The PR interval is constant when a QRS follows a P wave. The QRS complexes are normal and narrow. This type of heart block is typically considered to be a: | Serious arrhythmia regardless of signs and symptoms |
| You are treating a 65-year-old man who is complaining of chest pain and difficulty breathing. On ECG examination, you note that his ventricular heart rate is 56, and there are more P waves than QRS complexes. The PR interval is constant when a QRS follows a P wave. The QRS complexes are normal and narrow. The definitive treatment for this patient is: | Transvenous pacemaker insertion |
| You are treating a 65-year-old man who is complaining of chest pain and difficulty breathing. On ECG examination, you note that his ventricular heart rate is 56, and there are more P waves than QRS complexes. The PR interval is constant when a QRS follows a P wave. The QRS complexes are normal and narrow. Prehospital care for this patient consists of: | Transcutaneous pacing |
| You are treating a 65-year-old man who is complaining of chest pain and difficulty breathing. On ECG examination, you note that his ventricular heart rate is 56, and there are more P waves than QRS complexes. The PR interval is constant when a QRS follows a P wave. The QRS complexes are normal and narrow. This type of block occurs when the impulse is not conducted through the: | AV node |
| You are treating a 65-year-old man who is complaining of chest pain and difficulty breathing. On ECG examination, you note that his ventricular heart rate is 56, and there are more P waves than QRS complexes. The PR interval is constant when a QRS follows a P wave. The QRS complexes are normal and narrow. This type of block is usually associated with: | Septal MI |
| Third-degree heart block tends to have: | Regular but independent atrial and ventricular rhythms |
| Which of the following is a class I intervention for all symptomatic bradycardias? | Transcutaneous pacing |
| How does atropine affect the ventricular rate of third-degree heart block? | Has no effect on the rate |
| Identification of bundle branch blocks is: | Helpful in identifying patients at risk for third-degree heart block |
| Which of the following is typically found on an ECG with a bundle-branch block? | A notched QRS complex (rabbit ears) |
| In a left bundle-branch block: | A Q wave is seen instead of an R wave in MCL1 |
| You are evaluating an ECG tracing that shows wide QRS complexes that were produced by supraventricular activity. On MCL1 you see a QS pattern. You suspect: | Left bundle-branch block |
| A right axis shift of the ECG is noted when the QRS deflection is: | Negative in lead I, negative or positive in lead II, and positive in lead III |
| Emergency care for a bundle-branch block is: | Aimed at the cause of the block if it is identifiable |
| On ECG, pulseless electrical activity looks like: | Any electrical activity other than ventricular fibrillation or ventricular tachycardia |
| Which of the following is a correctable cause of PEA? | Tension pneumothorax |
| You are treating a patient who is in PEA following home dialysis. Which of the following drugs may be indicated? | Sodium bicarbonate |
| Wolff-Parkinson-White syndrome is a: | Preexcitation syndrome |
| Wolff-Parkinson-White syndrome is of little clinical importance unless the patient: | Is tachycardic |
| The three characteristics of Wolff-Parkinson-White syndrome are a short PR interval, QRS widening, and a(n): | Delta wave |
| Atherosclerosis is a disease characterized by: | Progressive narrowing of the lumen of medium and large arteries |
| Prinzmetal angina occurs when: | Coronary arteries spasm |
| The first medication a paramedic should administer to a patient with angina is: | Oxygen |
| Most myocardial infarctions are caused by: | Acute thrombotic occlusion |
| The majority of acute myocardial infarctions involve the: | Left ventricle |
| An inferior-wall MI is usually caused by occlusion of the _____ artery. | Right coronary |
| Ischemia caused by unstable angina: | Responds well to treatment with antiplatelet agents |
| If the left ventricle loses 25% of its muscle mass due to myocardial infarction: | The heart can still pump effectively |
| The most common cause of death following myocardial infarction is: | Fatal dysrhythmia |
| Chest pain associated with MI: | Is constant |
| You are transporting a patient to a cardiac center after a suspected myocardial infarction. The patient's vital signs are stable. ECG shows sinus rhythm with elevated ST segments. The ST segment is elevated because the damaged muscle is: | Constantly depolarized |
| You are transporting a patient to a cardiac center after a suspected myocardial infarction. The patient's vital signs are stable. ECG shows sinus rhythm with elevated ST segments. When you analyze the ECG, ST segment elevation is determined when the ST segment is elevated: | By more than 1.0 mV in at least two leads |
| You are transporting a patient to a cardiac center after a suspected myocardial infarction. The patient's vital signs are stable. ECG shows sinus rhythm with elevated ST segments. The patient's ST segment elevation is seen in leads II, III, and aVF, leading you to suspect: | Inferior-wall MI |
| You are transporting a patient to a cardiac center after a suspected myocardial infarction. The patient's vital signs are stable. ECG shows sinus rhythm with elevated ST segments. Fibrinolytic therapy for this patient will be most effective if: | Administered within 12 hours after the onset of symptoms |
| You are transporting a patient to a cardiac center after a suspected myocardial infarction. The patient's vital signs are stable. ECG shows sinus rhythm with elevated ST segments. Fibrinolytic therapy is contraindicated for this patient if he: | Had laser eye surgery 3 weeks ago |
| A patient in left ventricular failure is expected to have: | Activation of the renin-angiotensin-aldosterone system |
| The position of comfort for a patient with left ventricular failure is usually: | Sitting with legs dependent |
| Treatment for a patient with left ventricular failure includes medications to: | Reduce afterload |
| Right ventricular failure most often results from: | Left ventricular failure |
| Which of the following is most indicative of right ventricular infarct? | Peripheral edema |
| Cardiogenic shock is defined by shock symptoms after: | Hypovolemia and dysrhythmias have been corrected |
| A drug that may improve the symptoms of cardiogenic shock patients in the field is: | Dopamine |
| Signs of cardiac tamponade include: | Muffled heart tones |
| If a patient with cardiac tamponade becomes hypotensive in the field, you should: | Administer a fluid bolus |
| Aneurysms are most commonly the result of: | Atherosclerotic disease |
| Which of the following is true of abdominal aortic aneurysm (AAA)? | AAA may be asymptomatic as long as it is stable |
| While assessing a patient, you note a pulsatile mass in the abdomen. Suddenly this mass is no longer palpable, and the patient's blood pressure begins to drop. You suspect that the: | Patient's aneurysm has ruptured |
| Dissections of the aorta are typically found: | In the ascending aorta |
| Patients usually describe the pain of an aortic dissection as: | Ripping or tearing |
| You are called to the local airport to evaluate a 40-year-old obese woman who is complaining of pain in her left lower leg. She has just completed a 12-hour flight, and the pain developed as she got off the plane. Her leg is warm, swollen, and painful. You suspect: | Deep-vein thrombosis |
| A compensatory mechanism of the heart in the presence of chronic hypertension is to: | Enlarge the muscle mass of the heart |
| The organ(s) most at risk in a hypertensive crisis include the: | Kidneys |
| You are treating a patient with blood pressure of 200 over 140. The patient initially complained of headache and nausea. During your 3-hour transport, the patient began to seize and is now unresponsive to any stimulus. You suspect the patient has: | Hypertensive encephalopathy |
| You are treating a patient with blood pressure of 200 over 140. The patient initially complained of headache and nausea. During your 3-hour transport, the patient began to seize and is now unresponsive to any stimulus. ment for this condition includes: | Labetalol |
| Most new AEDs: | Use waveforms that are more effective at lower energy settings |
| If the paddle positions are switched (if the apex paddle is applied to the sternum and the sternum paddle to the apex) during defibrillation: | Defibrillation will occur as usual |
| The initial pediatric defibrillation should occur at: | 2 J/kg |
| Second and subsequent defibrillations for pediatric patients should occur at: | .4 J/kg |
| To help reduce impedance to electrical current: | Apply 25 pounds of pressure with the paddles against the chest wall |
| If you see the outline of a small box implanted under skin in the left upper abdomen, you would suspect the patient has a(n): | Implantable cardioverter-defibrillator |
| After delivering five shocks, an implantable cardioverter-defibrillator will: | Not deliver more shocks until a slower rate is restored for 30 seconds |
| Synchronous cardioversion delivers energy: | 10 ms after the peak of the R wave |
| Pacemakers are usually set to a rate of _____ beats per minute beginning with _____ amps. | 70 to 80; 50 |
| A blood pressure reading in an adult of 180/110 is considered: | Stage 3 hypertension |
| When performing CPR on an adult, you would compress the chest to a depth of _____ inches. | 1 1/2 to 2 |
| The sound heard when the AV valves close during ventricular systole is: | S1 |
| The right coronary artery and the left anterior descending artery supply most of the blood to the: | Right atrium and ventricle |
| The circumflex branch of the left coronary artery mainly supplies blood to the: | Left atrium |
| The left anterior descending coronary artery mainly supplies blood to the: | Septum |
| Preload is defined as: | Ventricular end-diastolic volume |
| The group of nerves that innervates the atria and ventricles is known as the: | Cardiac plexus |
| The major neurotransmitter for the parasympathetic system is: | Acetylcholine |
| Norepinephrine's major effect is: | Vasoconstriction |
| Parasympathetic stimulation of the heart causes: | A decreased heart rate |
| _____ seconds is/are measured in each large box on ECG graph paper? | 0.20 |
| Each square on ECG paper is _____ mm in height and width. | 1 |
| An elevated ST segment suggests: | Injury |
| A depressed ST segment suggests: | Ischemia |
| T wave inversion suggests: | Ischemia |
| Which of the following home medicines would indicate that your patient has a strong risk factor for heart disease? | Metformin |
| After you administer nitroglycerine 0.4 mg SL to a patient with chest pain who has ST-segment elevation in leads II, III and AVF, his blood pressure drops to 78/50 mmHg. You anticipated this side effect in this patient because his ECG changes indicate damage to the: | Inferior wall which increases the dependence on preload |
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