IBHRE CCDS
- ANS-
What is the suggested type of antibiotics? - ANS-Beta-Lactam antibiotics, vancomycin
reserved for those with penicillin allerigies
What lead insulation material best reduces ingrowth? - ANS-.ePTFE
Which lead insulation material is most susceptible to metal ion oxidation (MIO) and
environmental stress cracking (ESC) - ANS-Poly 80A
ESC and MIO - ANS-Environmental Stress Cracking
Metal Ion Oxidation
Pros/Cons of Silicone Leads - ANS-Pros: Longevity, flexible, repairable
Cons: Tacky, thick, easily damaged
Most common cause of Ventricular Safety Pacing? - ANS-Ventricular Ectopy
Which electrode material is bad? - ANS-Elgiloy
Cardiac action potential:
0-4 - ANS-0 - depolarization (Ca+ and Na+ rush in)
1 - Na+ channels close
2 - Slow Ca+ channels
3 - fast K+ channels
4 - alert
Cardiac Tissue is (-) at rest and (+) at contraction
0 - Na channels are open
1 - K channels open and start repolarization
2 - Ca channels open and delay repolarization
3 - Ca channels close
4 - Rest
Cardiac cells are ______________ charged at rest - ANS-Negatively
,Conductor Types - ANS-DFT (Drawn Filled Tube) and DBS (Brawn Brazed Strand)
Components of DFT and DBS conductors - ANS-Silver and MP35N
Best type of capacitor - ANS-Tantalum Electrolytic
Describe the depletion Lithium Silver Vanadium Oxide battery - ANS-Predictable, 3
plateaus in discharge curve
Common battery type for ppm? ICD? - ANS-Ppm - Lithium Iodide
ICD - Lithium Silver vanadium oxide
1 Hz = ___________ bpm - ANS-60
100 bpm = _________ Hz - ANS-1.67
Battery components:
Capacitor -
Reed Switch -
Diode -
Resistor -
Rectifier - - ANS-Cap - stores electrical charge
Reed - switches ppm to Magnet mode
Diode - ensures one way flow of current
Resistor - restricts current flow
rectifier - creates all pos or all neg signals
Voltage of PPM battery? - ANS-2.8V
Voltage of ICD battery? - ANS-3.2V
Types of Sensors: Open Loop - ANS-Only takes in positive feedback; ex: piezoelectric
sensor senses movement -> increased rate until no more sensed movement
Types of sensor: closed loop - ANS-More physiologic than open loop; rate changes in
response to physiologic change -> rate stays until physiologic state indicates it needs to
slow (ex: 02 sats)
Types of Sensors: Primary - ANS-Detects changes that normal effect the sinus node (02
sats, myocardial contractilty)
, Types of sensors: Secondary - ANS-Detects internal changes that result from exercise
Types of sensors: Tertiary - ANS-Detects external changes as a result of exercise
(piezoelectric, accelerometer)
Describe acute threshold graph of steroid eluting lead VS polished platinum post implat
- ANS-Steroid: low threshold and not much change
polished platinum: bad. High threshold, acute rise, then chronic high threshold
What creates a higher current density? - ANS-Smaller pacing cathode
Anode must be atleast _____ times _______ than cathode - ANS-3x Larger
ohms law - ANS-V=IR
Most common electrolyte abnormality to cause LOC? - ANS-Hyperkalemia
Effects of Hyperkalemia - ANS-Increase in threshold, wide paced complex, latency,
peaked T wave
Effects of Hypokalemia - ANS-Irratble foci, R on T, Torsades
Equation for current drain - ANS-Time = Battery capacity / current drain
Time = AmpHour/amperes = Hours
Micro units - ANS-10^-6
BOL
ERI
EOS - ANS-Beginning of Life
Elective Replacement Indicator
End of Service
Cardiac cell charge and electrolyte membrane potential at rest - ANS-Charge: ~(-90mV)
inside of cell
Membrane: Na+ outside;
Cardiac action potentials - ANS-0 - depolarization; Rapid Na+ influx
- ANS-
What is the suggested type of antibiotics? - ANS-Beta-Lactam antibiotics, vancomycin
reserved for those with penicillin allerigies
What lead insulation material best reduces ingrowth? - ANS-.ePTFE
Which lead insulation material is most susceptible to metal ion oxidation (MIO) and
environmental stress cracking (ESC) - ANS-Poly 80A
ESC and MIO - ANS-Environmental Stress Cracking
Metal Ion Oxidation
Pros/Cons of Silicone Leads - ANS-Pros: Longevity, flexible, repairable
Cons: Tacky, thick, easily damaged
Most common cause of Ventricular Safety Pacing? - ANS-Ventricular Ectopy
Which electrode material is bad? - ANS-Elgiloy
Cardiac action potential:
0-4 - ANS-0 - depolarization (Ca+ and Na+ rush in)
1 - Na+ channels close
2 - Slow Ca+ channels
3 - fast K+ channels
4 - alert
Cardiac Tissue is (-) at rest and (+) at contraction
0 - Na channels are open
1 - K channels open and start repolarization
2 - Ca channels open and delay repolarization
3 - Ca channels close
4 - Rest
Cardiac cells are ______________ charged at rest - ANS-Negatively
,Conductor Types - ANS-DFT (Drawn Filled Tube) and DBS (Brawn Brazed Strand)
Components of DFT and DBS conductors - ANS-Silver and MP35N
Best type of capacitor - ANS-Tantalum Electrolytic
Describe the depletion Lithium Silver Vanadium Oxide battery - ANS-Predictable, 3
plateaus in discharge curve
Common battery type for ppm? ICD? - ANS-Ppm - Lithium Iodide
ICD - Lithium Silver vanadium oxide
1 Hz = ___________ bpm - ANS-60
100 bpm = _________ Hz - ANS-1.67
Battery components:
Capacitor -
Reed Switch -
Diode -
Resistor -
Rectifier - - ANS-Cap - stores electrical charge
Reed - switches ppm to Magnet mode
Diode - ensures one way flow of current
Resistor - restricts current flow
rectifier - creates all pos or all neg signals
Voltage of PPM battery? - ANS-2.8V
Voltage of ICD battery? - ANS-3.2V
Types of Sensors: Open Loop - ANS-Only takes in positive feedback; ex: piezoelectric
sensor senses movement -> increased rate until no more sensed movement
Types of sensor: closed loop - ANS-More physiologic than open loop; rate changes in
response to physiologic change -> rate stays until physiologic state indicates it needs to
slow (ex: 02 sats)
Types of Sensors: Primary - ANS-Detects changes that normal effect the sinus node (02
sats, myocardial contractilty)
, Types of sensors: Secondary - ANS-Detects internal changes that result from exercise
Types of sensors: Tertiary - ANS-Detects external changes as a result of exercise
(piezoelectric, accelerometer)
Describe acute threshold graph of steroid eluting lead VS polished platinum post implat
- ANS-Steroid: low threshold and not much change
polished platinum: bad. High threshold, acute rise, then chronic high threshold
What creates a higher current density? - ANS-Smaller pacing cathode
Anode must be atleast _____ times _______ than cathode - ANS-3x Larger
ohms law - ANS-V=IR
Most common electrolyte abnormality to cause LOC? - ANS-Hyperkalemia
Effects of Hyperkalemia - ANS-Increase in threshold, wide paced complex, latency,
peaked T wave
Effects of Hypokalemia - ANS-Irratble foci, R on T, Torsades
Equation for current drain - ANS-Time = Battery capacity / current drain
Time = AmpHour/amperes = Hours
Micro units - ANS-10^-6
BOL
ERI
EOS - ANS-Beginning of Life
Elective Replacement Indicator
End of Service
Cardiac cell charge and electrolyte membrane potential at rest - ANS-Charge: ~(-90mV)
inside of cell
Membrane: Na+ outside;
Cardiac action potentials - ANS-0 - depolarization; Rapid Na+ influx
