RCIS REVIEW 2023 with complete solution questions and answers

What is the normal range of potassium in the blood? 3.5-5.0 Name some antiplatelet medications? ASA, Ticlid, Plavix If a patient has a high creatinine, what should you consider? -as small amount of contrast as possible -post procedure fluid hydration 3 ml/kg How does heparin prevent clot formation? - prevents conversion of prothrombin to thrombin -combines with antithrombin to make it more effective What is the action of reopro? Inhibits IIB/IIIA receptors INR measures the levels of which drug? Coumadin Lovenox impacts what? Antithrombin and Factor Xa What might be the medication of choice for SVT? Adenosine What short acting benzodiazepine is commonly used in the cath lab for sedation? Versed What is a quick and easy way to check a patients clotting time after being given heparin? ACT How to ticlid and plavix act? they turn off receptor sites on the platelets (super-aspirin) If a patient is on NPH Insuling, what medication should not be given? Protamine What does ASA do? Prevents platelet adhesion TPA acts by? -Dissolving Fibrin -Activates plaminogen What labs look at kidney function? -BUN -Creatinine -GFR -Creatinine clearance The most accurate measure of cardiac muscle fiber damage after an MI is what? Troponin Which lab value does not evaluate the extent of an MI? Serum Creatinine Post procedure renal dysfunction is more likely to occur in patients with? -Diabetes -Pre procedure dehydration -Frequent use of NSAID -Ace inhibitors What is a pseudoaneurysm? -False Aneurysm -Often a puslatile mass near where the sheath site with a bruit is present If the transducer is positioned to low at the side of the table, the pt's pressure will read? Falsely High If you are checking the radial/ulner pulse when you press and relase one at a time this is called what kind of test? Allen's test What is the best way to calculate a patients pulse rate? Check pulse for one minute If the patients IV site is infilatrated what should you do? Shut it off Metabolic acidosis has a low level of what? Bicarb A pH less than 7.35 or greater than 7.45 is called what? Uncompensated What would be the appropriate intervention for a patient with respiratory acidosis? Increase Ventilations The primary drive to breathe comes from the patients? CO2 level Hyperventilating a patient to suctioning is done to ? Increase arterial PO2 A High CO2 will impact pH how? It will lower the pH Increased bicarb will do what to the pH? Increase pH What is the most common form of cardiac tumor? Atrial myxoma located in LA The innermost layer of an artery is what? Intima What type of intervention is best used for a CALCIFIED lesion? Rotoblador What type of balloon is best used on a calcified lesion? Cutting balloon The symptoms of increased HR, decreased BP, and shortness of breath during a biopsy indicate what? Cardiac perforation What diagnositc catheter is best used for visualizing the LAD when the patient has a dilated AO root? JL5 2.66 diameter catheter is what size catheter? 8Fr What device uses saline to dissolve and suction thrombus during acute MI? Angiojet During a rotoblador intervention, what is the most common cause of "no flow"? Distal embolization Where the needle enter for a pericardialcentesis? Sub-xiphoid process What is a possible complication of over tightening the toughy ? Unable to inflate the balloon If a patient has a heart rate of 150, assist on the IABP should be set to what? 1:2 What is the best balloon to use on an artery that has a tendency to close? Perfusion balloon Jugular vein distention can be caused by? -RV Infarct -Pulmonary HTN -TR Shortness of breath indicates right or left sided failure? Left-sided heart failure Ventricular arrythmias are most common during the injection of which coronary artery? RCA Osmolality refers to the ability of the contrast to? Pull fluid into the intravascular space The ideal contract volume to be given to the patient is ? 3ml/kg Synchronous (Demand) pacemakers have what unique ability? They sense the hearts intrinsic activity and pace only when needed In order, the first three letters of the pacemaker NBG code mean what? 1- Chamber Paced 2- Chamber Sensed 3- Chamber Triggered (Response to sensing) The purpose of bi-ventricular pacemakers is to? Synchronize the contraction of both ventricles The purpose of ICD's is to? Monitor bradycardia, tachycardia, VT, VF and convert if necessary In the terms RAO and LAO the R and the L refer to what? The position of the image intensifier What is the best view to see the LAD and Circ Bifurcation Spider View (LAO Caudal) On an EKG, what shows a "true" posterior infarct? V7-V9, V1-V2 What catheter does an internal mammary catheter resemble? JR4 If the pt. has a dilated AO root, which catheter might you need to cannulate the RCA system? JL5 In a routine PTCA, what might be some complications caused by the handling of the wire? Arterial dissection or perforation What does RAD stand for? Radiation absorbed dose The most important factor in decreasing xray exposure to a patient is to ? Decrease time of exposure What is the max dose of radiation a worker can receive a year? 5 REM What converts the x-rays to light rays? Image intensifier What is the best choice of catheter to use on an LCA with a high take-off? Amplatz To view pulmonary stenosis. where do you inject the contrast? RV Pulmonic stenosis is generally associated with what? Congenital anomalies What is the normal PRI? 0.12-0.20 What is the normal amount of blood in the pericardium? 50 cc When are the coronary arteries perfused During ventricular diastole In what condition do you get the equalization of LVEDP and RVEDP? Constrictive pericarditis Where is the most common renal stenosis located? Ostial Greatest % of peripheral stenosis occurs where? Lower extremities What will cause failure to capture of pacemaker in the RV? Lead dislodgement You have a 50 year old admitted to the cath lab, HR 200, BP 90/50, what would you do? Synchronized cardiovert Vascular resistance is most greatly influenced by? Radius of the tube (vessel) What is ACLS protocol for monophasic defib? How do you test defibrillator? Dishcharging the paddles into the dummy load (test load) If the valve of a patient has regurgitation, which cardiac output should you use? Fick What does the c wave represent? onset of ventricular contraction Where do you measure thermal dilution cardiac outputs? Inject in the RA and read in the PA What are the 4 anomalies associated with Tetrology of Fallot? -Pulmonic stenosis -VSD -RVH -Overriding AO Which valve has the smallest valve area? Aorta A PDA most likely causes? Increased pulmonary blood flow, possibly pulmonary blood edema What is a sign of right sided heart failure? JVD What is the purpos of IABP? -Increase coronary artery perfusion -Decrease afterload How is systolic ejection period measured? -Amount of time the AO valve is open. It is found between the beginning of arterial systole and the dicrotic notch What are the Gorlin's constants used to analyze mitral and aortic valve area? Mitral- 37.7 Aortic- 44.5 What is the diastolic filling period (DFP)? Amount of time the mitral valve is open When calculating a L to R shunt occuring in the RA, what formula should be used for mixed venous saturation? Flamm's Equation 3SVC+1IVC/4