RCIS Review 2023 with complete solution questions and answers

What heart sound is caused by the rapid filling of the ventricle? 3rd An Austin Flint murmur is characterized by... (AS,AR,MS, or MR) AR Diamond-shaped ejection murmur radiating toward the neck is associated with (AS,AR,MS, or MR) AS What are some drugs that cause a chronotropic response Isoproterenol and Atropine What drugs are given prior to angioplasty to avoid coronary spasm? Ca Channel Blockers (ie. Verapamil) What converts one form of energy into another? Transducer What is indicative of lactic acid in excessive amounts in the Coronary Sinus? Coronary Ischemia What are lipid lowering drugs? Statins (ie. Pravastatin, Lovastatin) What type of exercise causes pressure work, increase BP and not CO Isometric What group of drugs reduces afterload? Nitrates What volume of fluid is transported through the lymphatics? 1-2 ml/min What is indicative of a blockage of any one of hte 3 major conduction fascicles? Hemiblock What is the function of the endocrine portion of the pancreas? Produces Bile What is a common result of right heart failure? Neck vein distension The inferior wall of the LV is supplied by what coronary artery? RCA The normal mean PA pressure? 10-20 mmHG EF equation utlizing volume EF= SV / EDV SV = EDV-ESV Another word for contractility inotropic Lead II ECG, RCA injection causes ST.... depression and bradycardia Sterilization of most plastic materials is best acheived... Ethylene Oxide (gas) Most complete, practical, efficient, and inexpensive method to sterilize metal instruments.... Steam Heat Standard adult dosage of Atropine IV 0.5 mg Q 5 mins, max 2 mg DCCV may be dangerous in the presence of what drug? Digitalis Anxiety produced hyperventilation will produce... increase pH and decrease pCO2 Stimulation of cholinergic autonomic receptor sites primariliy results in... cardiac depression What is an antagonist to Warfarin Vitamin K The tissure that grows over implanted valves and stents.. endothelium What is a venous problem associated with varicosities? An incompetency of the valves of the veins Fixed CO, the mean Arterial BP is determined by Afterload In MS there is a __________ obstruction between what two chambers diastolic, LA and LV Compared to myocardial cells SA node cell are prone to a faster ____________ because of their steeper phase _____ automaticity, 4 Splitting of the S2 during inspiration is due to a delay in PV closures Reducing a patients contact with microorganisms and eliminating all pathogens Aspesis What is the shelf life of double cloth sterilized items 21-30 days Most lethal frequency of electrical current 60 Hz Diuretics effect for CHF Decrease preload Retention of sodium and H2O by the kidney due to insufficent CO is... Forward CHF What are the worm like muscle strands within the RV trabecular carnae HR equation HR = 60 sec / (R-R Interval) An arterial pulse which is felt as two distinct impulses during systole is termed... pulsus bisferiens The chief effect of atropine is increased heart rate A false aneurysm is composed of... pericardium, hematoma, and clot The elastic arteries filter and smooth out the pulsatile pressure within the Aorta. This effect is termed the... Windkessel or compliance effect Surgical repair of obstructive atherosclerotic lesions in the carotid arteries usually involves: carotid endarterectomy The modern device that replaces the image intensifier tube and converts x-rays into visible light is the ... flat panel detector Arterial lines should be connected to a continuous flush device which at 300 mmHg infusion will deliver approximately... 3-5 ml flush/hour ICE uses __________ as an injectable contrast agent to view shunts or distinguish the right heart from the left heart chambers agitated saline The RAO view of the RCA normally looks like.... L The angiography that best diagnoses a VSD LV gram in LAO view Valvular regurgitation can be diagnosed with angiography_______ to the valve distal Which defect would most benefit from PA banding VSD To convert a temporary demand pacer to asynchronous mode, what control should be adjusted.. Decrease sensitivity Emergency coronary stenting may be necessary in the case of Spiral dissection Consequence of renal artery stenosis Increased Renin production Hypertension Lowest blood O2 sat in the heart Coronary Sinus The interval when ventricular pressures rise to a level to open the semilunar valves Isovolumetric contraction Qp/Qs of 0.5 Right to Left Shunt Pericarditis causes ST elevation in what leads? In most leads Broad RSR' is indicative of what? RBBB Angiography view for LV function and MV competency? RAO Hakki formula for Valve Area VA = CO / Peak-Peak Gradient Mortality rate of PTCA Twice that of diagnostic cath (0.3%) PTFE covered stents contain distensible micro-porous Teflon membrane The effects of IABP counterpulsation on preload and afterload Decreases both Venous capacitance is normally _____ times greater than arterial capacitance 20 Blood flow will change from laminar to turbulant at a Reynolds numbers of Over What occurs at the 2nd Heart Sound Aortic and Pulmonic Valves Close Percent of ventricular filling that results from atrial contraction 15-25% Absolute refractory period of the heart occurs when the heart is not responsive to stimuli Patient with normal situs will have a PA chest radiograph showing abdominal contents... Left side stomach bubble study and Right side hepatic shadow Angiography view of the LV long axis 30 degree RAO To convert a temporary demand pacer to asynch mode decrease sensitivity Medication that best facilitates DCCV of Afib Ibutilide Morphine effects on venous capacitance and PVR increase venous capacitance decrease PVR Elderly individuals typically have _____ arterial wall compliance resulting in ____ systolic pressure decrease arterial wall compliance increase systolic pressure Normal adult resting PVR 1 hybrid resistance (Wood) units What does the output phosphor do? Convert electrons to light Best view to image the diagonal - LAD bifurication 30 LAO, 20 Cranial Beta blockers block Adrenalin Diaphragmatic surface of the LV Inferior wall Nitroglycerine tablets deteriorate when exposed to air, especially in the presence of light During a heart cath on patients with HOCM what medication would not provoke an Intra-ventricular pressure gradient Beta blockers In an inferious MI what coronaries are occluded RCA, PDCA An upright R wave on the ECG, describes a ventricular _______ stimulus moving ______ a positive skin ECG electrode Depolarization; Toward What is the normal angiographic appearance of a perforation Staining of the pericardium Ventricular myopathy associated with amyloidosis Restrictive cardiomyopathy Bronchial veins empty into.... PV Tunica media is composed of .... Smooth Muscle Vessels in the vascular system that create the greatest pressure drop... systemic arterioles Which law states that wall tension is a product of transluminal pressure and radius of the vessel LaPlace's Law Greatest LCA blood flow occrus during ventricular Diastole As the frequency of ultrasound increases Resolution increases Cardiac enzyme that peaks late, usually 3-4 days after myocardial infarction LDH Ion transfer across myocardial cell membrane throughout systeol Potassium seeps out Fibrous skeleton of the heart or annuli fibrosi loacted at around the heart valves Constrictive cardiac pathology seen in acute cardiac tamponade shows reduced... RV diastolic filling Most positive asurance that a pack is sterile is by checking Biological indicators Usual effect of high dose dopamine administration... Peripheral vasoconstriction The SA node lies at the junction of the SVC and RA To planimeter an AS gradient Move the Femoral AO tracing to the left so AO diastole intersects LV upslope Coronary driving pressure... AO diastolic RA mean Degree of blackness on an area of x-ray film... Density Method of disinfection only and not a safe method of serilization Boiling water Calcium blockers .... vasoconstrict or vasodilate Vasodilate Alpha 1 receptors are found in Vascular smooth muscle The Femoral Artery arises from... External Iliac artery Image a LA myxoma by... pulmonary artery angiography Elevated blood angiotension II levels cause arteriolar vasoconstriction TIAs occur most commonly in people with chronic Afib MS Mean BP directly reflects LV afterload Amaurosis Fugax Temporary episode of blindness in on eeye or partial blindness LV Gram RAO walls Inferior Basal, Mid inferior, Apical inferior, Apical Anterior, Mid Anterior, Anterior Basal LV Gram LAO Walls Basal Septal, Mid Septal, Apical Septal, Apical Lateral, Mid Lateral, Basal Lateral. Fentanyl Reversal and Dosage Nalaxone 0.4mg-2mg Q 203 min Most important safety equipment with laser catheter Safety eye wear How fast should a laser catheter be advanced? 1mm/sec Anesethsiology scale 9 or 10 means? PT is stable Angioseal? bio-absorbable intra-arterial anchor and collagen seal Perclose/Prostar XL non bio-degradable polypropylene suture Star Close Disc-shaped nitinal clip Complications with femoral approach Low: below bifurcation, pseudoaneurysm, hematoma, arteriovenous High: Inferior epigastric or above inguinal ligament- retroperitoneal hemorrhage Pseudoaneurysm Dilated artery or blood vessel due to injury resulting in blood leaking and pooling outside artery wall non pulsating True aneurysm artery or vessel is enlarged, not resulting from injury and blood flows normally Hematoma Localised collection of blood outside blood vessel, usually within tissue causing bruises greater 10mm on the skin Arteriovenous Fistula Abnormal connection or passageway between an artery and a vein Retroperitoneal hemorrhage Occurs when blood pools in retroperitoneal space, located in the lower back. Medication used with IVUS? Heparin. Must use an antiocoagulant when using an interventional equipment How distal is interventional wire positioned in the coronary? As distal as possible Max dose of REM in any one year? 5 REM What is the cumulative dose over a lifetime of REM? 1 REM per year of age ALARP As Low As Reasonably Possible How much greater protection does lead glass offer in comparison to regular glass? Glasses containing 0.5mm of lead offer 4 times the protection regular eyeglasses Hypokinesis A diminished but not absent motion on part of the LV wall Akinesis Total lack of motion portion of LV wall Dyskinesis Paradoxical systolic motion or expansion of one part of the LV wall Half life of Heparin 1-1.5 hrs Coumadin, you test? PT Heparin , you test? PTT Unfractionated sodium heparin Low molecular weight= Enoxaprin (lovenox) Direct thrombin inhibitors Bivalrudin (angiomax) Irreversible cyclooxygenase Inhibitors Aspirin ADP receptor inhib Clopidogrel (Plavix) Dual Antiplatelet Therapy DAPT Aspirin+plavix Glycoprotein11B/111A inhib Eptifibatide(integrilin), Abciximab(reopro), Tirofibin(aggrastat) What class of patient used ventricular support devices? Class IV IABP indications cardiogenic shock, MI with mechanical defects, LV failure, MR due to pap muscle dysfunction, ventricular septal rupture. IABP Contraindications AO valve insufficiency, AO aneurysm, Dissection, Severe peripheral vascular disease, coagulopathy, irreversible brain damage, chronic end stage heart disease, when pt is not awaiting transplant. Pts with diabetes on NPH insulin cannot receive what medication? PROTAMINE, subject to severe reactions. What is a mullins sheath used for? Transseptal Versed Reversal Romazicon 0.2mg IV over 15seconds