CSCS CERTIFICATION EXAM WITH COMPLETE
SOLUTIONS 100% VERIFIED!!
What does the RCA perfuse? - ANSWER Inferior wall, RA, SA Node, AV node, RV,
Posterior portion of the septum, Posterior wall, Bundle of His
What does the LMA perfuse? - ANSWER Bifurcates into the: LAD (Left Anterior
Descending), Left Circumflex Artery
What does the LAD perfuse? - ANSWER Septal & Anterior Wall, Front & apex of LV,
Interventricular septum, anterior pap muscle, most of the R & L bundle branches,
Bundle of His
What is the most commonly occluded artery? - ANSWER LMA
What does the Left Circumflex perfuse? - ANSWER Lateral Wall, LA, Back of LV,
Posterior wall in 10% of pop
Ramus artery - ANSWER 20% of population has it. Tertiary left main; runs along the LV,
between the LAD & circumflex
SVR - ANSWER Systemic Vascular Resistance- the resistance the LV has to overcome
to eject. (Afterload)
PVR - ANSWER Peripheral vascular resistance: the resistance the RV has to overcome
to eject
S1 - RESULT Closure of the MV and TV; Systole; 1/3 of the cardiac cycle "Lub"
,S2 - RESULT Closure of the pulmonic and aortic valve; Diastole; 2/3 of the cardiac
cycle; DUB
S3 - RESULT Auscultated in fluid overload; when preload is elevated; KENTUCKY
S3 is normal in which popoulation(s)? - RESULT Normal in kids, high CO like pregnancy
(3rd trimester)
S4 - ANSWER Atrial gallop (pre-systolic); sound caused by vibration of atria ejecting
into non compliant ventricle; Tennessee
Causes of S4 - ANSWER Ischemia, HTN, pulmonary stenosis, CAD, AS, LV Hypertrophy
When are Split Heart sounds heard best? - ANSWER Inspiration
Split S1 - ANSWER MV closes b/f tricuspid
Causes of Split S1 - ANSWER RBBB, PVCs, Ventricular Paced rhythms
Split S2 - ANSWER Aortic closes b/f pulmonic valve
Causes of Split S2 - ANSWER Overfilled RV, ASD
Indications for ACE Inhibitors - ANSWER CHF/Systolic Failure, AMI (EF <40%), Anterior
wall MI, HTN, Diabetic Renal Nephropathy
-prils Angiotensin Converting Enzyme
Effects of ACE Inhibitors - ANSWER Vasodilation, decrease preload & afterload,
,prevention of myocardial remodeling, reduce progress of diabetic nephropathy
What do you want to watch for in ACE inhibitor administration? - ANSWER
Hypotension, hyperk, cough/angioedema, renal function
Cardioselective B-Blockers - ANSWER Blocks B1--> Bisoprolol, metoprolol SR,
Atenolol, Esmolol, Acebutolol, Nebivolol
Alpha & Beta Blocking Medications - ANSWER Labetalol, Carvedilol (Coreg)
Non-selective Beta Blocking Medications - ANSWER Blocks B1 + B2; Propanolol,
Timolol, Nadolol, Sotalol
Indications for Beta Blockers - ANSWER HTN, Secondary prevention of MI (metoprolol
+ carvedilol), Cardiac arrhythmias, angina, Afib, CHF/Systolic HF
Effects of B Blockers - ANSWER Decreases HR/BP, negative inotrope by decreasing
myocardial workload, decreases preload, blocks stress catecholamines (epi + NE),
decreases morbidity/mortality, decreases arrhythmias
What should you monitor for in B blocker administration? - ANSWER Low HR, Low BP,
AV Blocks, HF, signs of shock, bronchospasm; cocaine use
B blocker reversal agent - ANSWER Glucagon
How do Angiotensin Receptor Blockers work? - ANSWER They block AT1 receptors
that hormones act on which are found in the heart, blood vessels, and kidneys. Block
Angiotensin 2 to help lower BP
Examples of ARBS - ANSWER "sartans"; Losartan, valsartan, candesartan,
olmesartan, telmisartan
, Indications for ARBs - ANSWER HTN, CHF/Systolic failure, diabetic renal nephropathy,
intolerance of ACE inhibotors
Effects of ARBs - ANSWER Vasodilation, decreases preload and afterload, reduces
secretion of vasopressin.
Watch out for these s/sx of ARBs - ANSWER Hypotension, HyperK, HA, caution in MI;
second line drug use for pts that cant tolerate ACE inhibitors
Examples of Aldosterone Blockers - ANSWER Spironolactone and eplerenone
Indications of Aldosterone Blockers - ANSWER Adjunctive therapy in HF
S/sx of Aldosterone Blockers - ANSWER Diuresis, Blocks Na reabsorption, decreases
preload and afterload, In combo with other diuretics, decreases Cardiac workload, k
sparing diuretic
What to watch out for with aldosterone blockers - ANSWER HyperK especially when
used with ACE or Arbs
Calcium Channel Blockers- ANSWER Dihydropyridines: Amlodipine, nimodipine,
nicardipine, nifedipine, felodipine (very little impact on contractility or HR)
Benzothiazepine: Diltiazem (control of HR)
Phenylalkylamine: Verapamil (control of HR)
Uses of CCBs- ANSWER HTN, Decreases HR, SVT, Afib/aflutter, Angina (prinzmetals for
vasospasm), hypertrophic CM, Prevent cerebral artery vasospasm (nimodipine)
Effect of CCBs- ANSWER Causes arteriovenous dilation/decreased afterload, The
force of the myocardiadic contraction decrease it is negatively chronotrope and
SOLUTIONS 100% VERIFIED!!
What does the RCA perfuse? - ANSWER Inferior wall, RA, SA Node, AV node, RV,
Posterior portion of the septum, Posterior wall, Bundle of His
What does the LMA perfuse? - ANSWER Bifurcates into the: LAD (Left Anterior
Descending), Left Circumflex Artery
What does the LAD perfuse? - ANSWER Septal & Anterior Wall, Front & apex of LV,
Interventricular septum, anterior pap muscle, most of the R & L bundle branches,
Bundle of His
What is the most commonly occluded artery? - ANSWER LMA
What does the Left Circumflex perfuse? - ANSWER Lateral Wall, LA, Back of LV,
Posterior wall in 10% of pop
Ramus artery - ANSWER 20% of population has it. Tertiary left main; runs along the LV,
between the LAD & circumflex
SVR - ANSWER Systemic Vascular Resistance- the resistance the LV has to overcome
to eject. (Afterload)
PVR - ANSWER Peripheral vascular resistance: the resistance the RV has to overcome
to eject
S1 - RESULT Closure of the MV and TV; Systole; 1/3 of the cardiac cycle "Lub"
,S2 - RESULT Closure of the pulmonic and aortic valve; Diastole; 2/3 of the cardiac
cycle; DUB
S3 - RESULT Auscultated in fluid overload; when preload is elevated; KENTUCKY
S3 is normal in which popoulation(s)? - RESULT Normal in kids, high CO like pregnancy
(3rd trimester)
S4 - ANSWER Atrial gallop (pre-systolic); sound caused by vibration of atria ejecting
into non compliant ventricle; Tennessee
Causes of S4 - ANSWER Ischemia, HTN, pulmonary stenosis, CAD, AS, LV Hypertrophy
When are Split Heart sounds heard best? - ANSWER Inspiration
Split S1 - ANSWER MV closes b/f tricuspid
Causes of Split S1 - ANSWER RBBB, PVCs, Ventricular Paced rhythms
Split S2 - ANSWER Aortic closes b/f pulmonic valve
Causes of Split S2 - ANSWER Overfilled RV, ASD
Indications for ACE Inhibitors - ANSWER CHF/Systolic Failure, AMI (EF <40%), Anterior
wall MI, HTN, Diabetic Renal Nephropathy
-prils Angiotensin Converting Enzyme
Effects of ACE Inhibitors - ANSWER Vasodilation, decrease preload & afterload,
,prevention of myocardial remodeling, reduce progress of diabetic nephropathy
What do you want to watch for in ACE inhibitor administration? - ANSWER
Hypotension, hyperk, cough/angioedema, renal function
Cardioselective B-Blockers - ANSWER Blocks B1--> Bisoprolol, metoprolol SR,
Atenolol, Esmolol, Acebutolol, Nebivolol
Alpha & Beta Blocking Medications - ANSWER Labetalol, Carvedilol (Coreg)
Non-selective Beta Blocking Medications - ANSWER Blocks B1 + B2; Propanolol,
Timolol, Nadolol, Sotalol
Indications for Beta Blockers - ANSWER HTN, Secondary prevention of MI (metoprolol
+ carvedilol), Cardiac arrhythmias, angina, Afib, CHF/Systolic HF
Effects of B Blockers - ANSWER Decreases HR/BP, negative inotrope by decreasing
myocardial workload, decreases preload, blocks stress catecholamines (epi + NE),
decreases morbidity/mortality, decreases arrhythmias
What should you monitor for in B blocker administration? - ANSWER Low HR, Low BP,
AV Blocks, HF, signs of shock, bronchospasm; cocaine use
B blocker reversal agent - ANSWER Glucagon
How do Angiotensin Receptor Blockers work? - ANSWER They block AT1 receptors
that hormones act on which are found in the heart, blood vessels, and kidneys. Block
Angiotensin 2 to help lower BP
Examples of ARBS - ANSWER "sartans"; Losartan, valsartan, candesartan,
olmesartan, telmisartan
, Indications for ARBs - ANSWER HTN, CHF/Systolic failure, diabetic renal nephropathy,
intolerance of ACE inhibotors
Effects of ARBs - ANSWER Vasodilation, decreases preload and afterload, reduces
secretion of vasopressin.
Watch out for these s/sx of ARBs - ANSWER Hypotension, HyperK, HA, caution in MI;
second line drug use for pts that cant tolerate ACE inhibitors
Examples of Aldosterone Blockers - ANSWER Spironolactone and eplerenone
Indications of Aldosterone Blockers - ANSWER Adjunctive therapy in HF
S/sx of Aldosterone Blockers - ANSWER Diuresis, Blocks Na reabsorption, decreases
preload and afterload, In combo with other diuretics, decreases Cardiac workload, k
sparing diuretic
What to watch out for with aldosterone blockers - ANSWER HyperK especially when
used with ACE or Arbs
Calcium Channel Blockers- ANSWER Dihydropyridines: Amlodipine, nimodipine,
nicardipine, nifedipine, felodipine (very little impact on contractility or HR)
Benzothiazepine: Diltiazem (control of HR)
Phenylalkylamine: Verapamil (control of HR)
Uses of CCBs- ANSWER HTN, Decreases HR, SVT, Afib/aflutter, Angina (prinzmetals for
vasospasm), hypertrophic CM, Prevent cerebral artery vasospasm (nimodipine)
Effect of CCBs- ANSWER Causes arteriovenous dilation/decreased afterload, The
force of the myocardiadic contraction decrease it is negatively chronotrope and
