Cardiology practice test

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Questions and Answers

What is the characteristic of a Premature Junctional Complex (PJC)?

Late beat/complex

Absent beat/complex

Early beat/complex (correct)

Normal beat/complex

What is the treatment for a stable bradycardic rhythm?

Oxygen, Nitro, Aspirin

Pacing (TCP)

Atropine (0.5 mg, max of 3 mg, repeat every 3-5 min) (correct)

Synchronized cardiovert

What is the characteristic of a Second Degree AV Block Type 1 (Mobitz Type 1/Wenckebach)?

PRI is always constant

Nonconducted P waves and QRS complexes

PRI grows longer and longer with each P wave before a P wave appears with a missing QRS complex (correct)

Two P waves appear for each QRS – 2:1 AV block

What is the treatment for a heart block?

Pacing (TCP) Signup and view all the answers

What is the characteristic of a right-sided heart failure?

All of the above Signup and view all the answers

What is the treatment for a stroke patient?

IV, O2, monitor Signup and view all the answers

What is the characteristic of an atrial fibrillation?

All of the above Signup and view all the answers

What is the treatment for a TIA?

None of the above Signup and view all the answers

What is the characteristic of a Multifocal Atrial Tachycardia?

Irregular rhythm with varying shaped P waves Signup and view all the answers

What is the effect of beta 1 blockers on the heart?

Decrease heart rate and contraction Signup and view all the answers

What is the function of the AV Node in the electrical conduction system of the heart?

Delays transmission of atrial activity to ventricles Signup and view all the answers

What is the primary action of alpha 1 receptors in blood pressure regulation?

Vasoconstriction Signup and view all the answers

What is the function of the Bundle of His in the electrical conduction system of the heart?

Transmits electrical signals from the AV Node to the Bundle Branches Signup and view all the answers

What is the primary action of dopamine in cardiogenic shock?

Vasoconstriction and increased cardiac output Signup and view all the answers

What is the function of the SA Node in the electrical conduction system of the heart?

Generates the heartbeat Signup and view all the answers

What is the effect of glucagon on beta blocker overdose?

Reverses beta blocker effects Signup and view all the answers

What is the primary action of nitroglycerin in the treatment of cardiogenic shock?

Vasodilator Signup and view all the answers

What is the indication for synchronized cardioversion?

Unstable tachydysrhythmias Signup and view all the answers

What is the effect of atenolol on the heart?

Decreases heart rate and contraction Signup and view all the answers

Study Notes

Anatomy and Physiology

Antidotes for beta blocker overdoses:
- Glucagon: beta 2, alpha 1 (vasoconstricts, high BP)
- Blockers end in "pril" or "lol"
Cardiac cellular action potential:
- Phase 0: depolarized, QRS complex, sodium rushes in
- Phase 1: repolarized, sodium stops leaving cell, potassium slowly enters cell
- Phase 2: repolarized, ST segment on EKG, plateau phase
- Phase 3: final phase of repolarization, potassium rushes in, sodium rushes out
- Phase 4: polarized, resting phase (negatively charged), potassium in cell
Cardiac output: stroke volume x heart rate
BP = SV x HR x CO

Commonly Prescribed Heart Medications

Antiarrhythmics:
- Digoxin: beta 1 agonist (increases contraction/HR)
- Procainamide
- Amiodarone
- Verapamil
- Cardizem (Diltiazem): calcium channel blocker
Anticoagulants:
- Enoxaparin
- Clopidogrel
- Warfarin
Angiotensin-converting enzyme inhibitors (Alpha 1):
- Captopril
- Enalapril
- Lisinopril
Beta-Blockers:
- Atenolol
- Metoprolol
- Propranolol
Lipid-Lowering agents:
- Gemfibrozil (Lopid)
- Atorvastatin (Lipitor)
- Fluvastatin (Lescol)
- Lovastatin (Mevacor)
- Pravastatin (Pravachol)
- Rosuvastatin Calcium (Crestor)
- Simvastatin (Zocor)
Diuretics:
- Furosemide (Lasix)
Vasodilators:
- Nitro
- Isosorbide (Isordil)

Cardiac Arrest

Characteristics of ventricular tachycardia:
- Heart rate 100-150
- Wide QRS
- Monomorphic or polymorphic
- Torsades de pointes: polymorphic with prolonged QT interval
Treatment of ventricular tachycardia:
- Stable: vagal maneuvers, amiodarone
- Unstable: synchronized cardiovert
- Pulseless VTach: defib shock, CPR, epi, amiodarone

Electrical Conduction System of the Heart

SA Node -> Internodal pathways -> AV Node -> Bundle of His -> Bundle Branches -> Purkinje Fibers
Internodal pathways:
- Anterior (Bachmann)
- Middle (Wenckebach)
- Posterior (Thorel)

Cardiac Rhythm Disturbance

Characteristics of a 12-lead ECG:
- Precordial leads (V1-6)
- Limb leads (I, II, III)
- Augmented leads (aVR, aVL, aVF)
Characteristics of AV junction dysrhythmias:
- Hidden or inverted P wave
- Premature Junctional Complex (PJC)
- Junctional Escape Rhythm
- Accelerated Junctional Rhythm
- Junctional Tachycardia
Identify a sinus rhythm with ectopic beats:
- Rhythm that originates from a site other than the SA node
- Premature Junctional Complex (PJC)
- PVC's

Chest Pain

Characteristics of a pulmonary embolism:
- Obstruction in one or more pulmonary arteries
- EKG findings: S1Q3T3
Treatment of a bradycardic rhythm:
- Stable: atropine
- Unstable: pacing (TCP)
Treatment of a chest pain patient:
- MONA: morphine, oxygen, nitro, aspirin

Hypotension/Hypertension from Cardiovascular Cause

Characteristics of a heart block:
- First Degree AV Block
- Second Degree AV Block Type 1 (Mobitz Type 1/Wenckebach)
- Second Degree AV Block Type 2 (Mobitz Type 2)
- Third Degree AV Block
Preexisting causes of heart failure:
- Coronary artery disease (CAD)
- Disorders of pericardium, myocardium, endocardium, or great vessels
Signs and symptoms of left-sided heart failure:
- Pulmonary edema
- Restlessness, anxiety
- Respiratory rate above normal for age
- Heart rate above normal for age
- Pulsus alternans
- Crackles
- Cough with frothy sputum
- Third heart sound (S3)
- Retractions; accessory muscle use
- Labored breathing; tripod position
- Sweating
- Inability to speak in complete sentences; limited to phrases or words
Signs and symptoms of right-sided heart failure:
- Number 1 cause: COPD
- Pedal edema
- Weight gain
- Ascites
- Anasarca
- JVD
- Liver enlargement (hepatomegaly)
- Spleen enlargement (splenomegaly)

Post-Resuscitation Care

Treatment for ROSC (return of spontaneous circulation):
- First indicator: end-tidal jumps up
- Finish cycle of CPR
- Fluid bolus
- Targeted Temperature Management: cool body to maintain temp between 89.6 and 100.4 degrees

Stroke-like Symptoms

Characteristics of a TIA:
- Transient Ischemic Attack
- Stroke that fixed itself
- Altered momentarily but not now
Pre-existing conditions for a stroke:
- High BP
- Headache
Treatment of a stroke patient:
- IV, O2, monitor
- Correct stroke facility

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Description

This quiz covers key concepts in anatomy and physiology related to cardiology, including antidotes for beta blocker overdoses and cardiac cellular action potential.