Cardiology practice test

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

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