Chest Pain Causes Quiz
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Questions and Answers

What is the primary goal when diagnosing chest pain in the prehospital setting?

  • To rule out life-threatening conditions first (correct)
  • To identify the least critical cause
  • To determine the exact cause of the pain
  • To provide immediate treatment for cardiac ischemia

    • Which of the following is NOT a cardiovascular cause of chest pain?

  • Thoracic dissection of the aorta
  • Cholecystitis (correct)
  • Cardiac ischemia
  • Pericarditis

    • What is the term for a spectrum of coronary artery disease processes?

  • Myocardial infarction
  • Acute coronary syndrome (correct)
  • Cardiac ischemia
  • Angina pectoris

    • Which of the following is a musculoskeletal cause of chest pain?

    <p>Chest wall syndrome</p> Signup and view all the answers

    What is the term for inflammation of the pericardium?

    <p>Pericarditis</p> Signup and view all the answers

    Which of the following is NOT a respiratory cause of chest pain?

    <p>Cholecystitis</p> Signup and view all the answers

    What is the primary contributor to decreased oxygen supply in myocardial ischemia?

    <p>Impairment of oxygen delivery</p> Signup and view all the answers

    What is the term used to describe the clinical spectrum of myocardial ischemia, injury, and infarction?

    <p>Acute Ischemic Coronary Syndrome</p> Signup and view all the answers

    What is the main factor that leads to thrombus formation in coronary artery disease?

    <p>Atherosclerotic plaque disruption</p> Signup and view all the answers

    What is the definition of stable angina?

    <p>Transient, episodic chest discomfort resulting from myocardial ischemia</p> Signup and view all the answers

    What is the term used to describe the process of the body developing collateral circulation to compensate for decreased blood flow?

    <p>Collateral circulation</p> Signup and view all the answers

    What is the term used to describe the formation of hard, thick plaques in the coronary arteries?

    <p>Atherosclerosis</p> Signup and view all the answers

    What is the main factor that contributes to increased oxygen demand in the myocardium?

    <p>All of the above</p> Signup and view all the answers

    What is the term used to describe the diagnosis of Acute Myocardial Infarction?

    <p>ECG findings and elevated biomarkers</p> Signup and view all the answers

    What is the term used to describe the clinical entity of chest discomfort resulting from myocardial ischemia?

    <p>Angina Pectoris</p> Signup and view all the answers

    What is the term used to describe the irreversible injury of the myocardium?

    <p>Myocardial Necrosis</p> Signup and view all the answers

    What is the primary effect of atherosclerosis on the coronary arteries?

    <p>Decreases blood flow</p> Signup and view all the answers

    What proportion of patients with vasospastic angina also have atherosclerotic coronary artery disease?

    <p>Two-thirds</p> Signup and view all the answers

    What is the term for angina that occurs at rest and may not respond readily to treatment?

    <p>Unstable angina</p> Signup and view all the answers

    What is the typical duration of an angina episode?

    <p>3-5 minutes</p> Signup and view all the answers

    What is the primary difference between stable and unstable angina?

    <p>Response to treatment</p> Signup and view all the answers

    What is the significance of weak or absent peripheral pulses in an angina patient?

    <p>Potential or pending shock</p> Signup and view all the answers

    What should be done immediately in an angina patient with weak or absent peripheral pulses?

    <p>Treat for shock</p> Signup and view all the answers

    What is the significance of ST segment elevation on an ECG in a patient with Prinzmetal's angina?

    <p>Myocardial tissue ischemia</p> Signup and view all the answers

    What is the primary purpose of obtaining an ECG tracing in an angina patient?

    <p>To determine the severity of ischemia</p> Signup and view all the answers

    Why is it important to transmit the ECG tracing to the receiving medical facility?

    <p>To provide additional diagnostic detail</p> Signup and view all the answers

    What is the primary reason for rapid transport of a patient with suspected myocardial infarction?

    <p>To prevent further complications from delayed medical treatment</p> Signup and view all the answers

    Which of the following is a common precipitating event for myocardial infarction?

    <p>Formation of a thrombus in a coronary artery</p> Signup and view all the answers

    What is the term for the death of a portion of the heart muscle due to prolonged deprivation of oxygenated arterial blood?

    <p>Myocardial infarction</p> Signup and view all the answers

    Which of the following is a characteristic of a transmural infarction?

    <p>Destroys the entire thickness of the myocardium</p> Signup and view all the answers

    What is the significance of the J point in the ECG?

    <p>It marks the junction between the QRS complex and the ST segment</p> Signup and view all the answers

    What is the term for a myocardial infarction that involves the entire thickness of the myocardium and is associated with Q wave changes on the ECG?

    <p>ST-segment-elevation myocardial infarction</p> Signup and view all the answers

    Which of the following is a consequence of occlusion of the coronary artery?

    <p>Ischemia</p> Signup and view all the answers

    What is the significance of ST-segment elevation with a downward concavity in the ECG?

    <p>It is associated with acute coronary syndrome</p> Signup and view all the answers

    What can occur if the patient's underlying disease process is worsening?

    <p>Immediate transport</p> Signup and view all the answers

    What is the term for an infarction that involves only the subendocardial layer?

    <p>Subendocardial infarction</p> Signup and view all the answers

    Why is it important to administer nitroglycerin sublingually?

    <p>To dilate coronary arteries</p> Signup and view all the answers

    Which of the following is a characteristic of a non-ST-segment-elevation myocardial infarction?

    <p>It involves only the subendocardial layer</p> Signup and view all the answers

    What should be considered for chest pain that does not respond to nitrates or calcium channel blockers?

    <p>Morphine sulfate or fentanyl</p> Signup and view all the answers

    What is a common ECG finding in the patient with angina?

    <p>ST segment depression</p> Signup and view all the answers

    Why is it important to establish an IV line?

    <p>To administer medication and fluids</p> Signup and view all the answers

    What should be done if the patient refuses transport after their chest pain is relieved?

    <p>Document patient refusal and strongly encourage immediate evaluation</p> Signup and view all the answers

    What can occur if the patient has taken nitroglycerin?

    <p>Hypotension</p> Signup and view all the answers

    Why is it important to place the patient at rest in a position of physical and emotional comfort?

    <p>To decrease myocardial oxygen demand</p> Signup and view all the answers

    What can indicate that the patient's underlying disease process is worsening?

    <p>Absence of relief after receiving oxygen and/or nitrates</p> Signup and view all the answers

    Why is it important to measure any ST segment changes?

    <p>To communicate to the receiving facility</p> Signup and view all the answers

    What is the main purpose of administering radiographic contrast dye during PCI?

    <p>To visualize the coronary arteries and their anatomy</p> Signup and view all the answers

    What is the primary reason for performing coronary artery bypass grafting (CABG) over PCI?

    <p>The patient has disease that is extensive or not amenable to PCI techniques</p> Signup and view all the answers

    What is the purpose of placing a stent during PCI?

    <p>To keep the artery open after angioplasty</p> Signup and view all the answers

    What is the trend in coronary artery bypass grafting (CABG) procedures?

    <p>Performing more procedures off pump with the heart still beating</p> Signup and view all the answers

    Which of the following patients is not a candidate for CABG?

    <p>A patient with mild coronary artery disease</p> Signup and view all the answers

    What is the benefit of performing endoscopic bypass grafts?

    <p>Markedly decreasing the pain and recovery time</p> Signup and view all the answers

    What is the usual cause of occlusion in myocardial infarction?

    <p>Plaque that has broken loose</p> Signup and view all the answers

    What is the term for the ring of tissue surrounding the area of infarcted myocardium?

    <p>Ischemic tissue</p> Signup and view all the answers

    What is the most common complication of myocardial infarction?

    <p>Arrhythmias</p> Signup and view all the answers

    What is the primary strategy in managing a myocardial infarction?

    <p>Pain relief</p> Signup and view all the answers

    What is the most common chief complaint in myocardial infarction?

    <p>Chest pain</p> Signup and view all the answers

    What is the typical duration of chest pain in myocardial infarction?

    <p>More than 30 minutes</p> Signup and view all the answers

    What is the sensation often described by patients experiencing myocardial infarction?

    <p>Feeling of impending doom</p> Signup and view all the answers

    What is the result of the destruction of a portion of the myocardial muscle mass?

    <p>Heart failure</p> Signup and view all the answers

    What is the term for the heart's inability to meet the body's oxygen demands?

    <p>Inadequate tissue perfusion</p> Signup and view all the answers

    What is the importance of rapid and safe transport in managing myocardial infarction?

    <p>To facilitate reperfusion</p> Signup and view all the answers

    What is the primary concern of patients experiencing chest pain for the first time?

    <p>Fear of death</p> Signup and view all the answers

    What is a characteristic of a patient who has suffered an MI before?

    <p>They are less concerned about the current pain</p> Signup and view all the answers

    What is the significance of a patient's blood pressure during an MI?

    <p>It can be elevated, normal, or lower than normal</p> Signup and view all the answers

    What is the purpose of examining the ST segment in a 12-lead ECG?

    <p>To examine the ST segment for height, depth, and overall contour</p> Signup and view all the answers

    What is the significance of a pathological Q wave?

    <p>It indicates infarcted tissue or extensive transient ischemia</p> Signup and view all the answers

    What is the most serious threat to patients before they arrive at the emergency department?

    <p>Cardiac arrhythmias</p> Signup and view all the answers

    What is the purpose of reperfusion therapy?

    <p>To stop further injury and reperfuse ischemic tissue</p> Signup and view all the answers

    What is the window of time in which a fibrinolytic can be given and be effective?

    <p>6 hours from the onset of symptoms</p> Signup and view all the answers

    What is the purpose of percutaneous coronary intervention (PCI)?

    <p>To take the patient to the lab for diagnosis and treatment</p> Signup and view all the answers

    What is a complication of giving fibrinolytics?

    <p>Hemorrhage, allergic reactions, and reperfusion arrhythmias</p> Signup and view all the answers

    What is the primary purpose of ascertaining the exact time of symptom onset in a patient with suspected myocardial infarction?

    <p>To determine the patient's eligibility for fibrinolytic therapy</p> Signup and view all the answers

    What should the EMS provider assume if they are unsure whether a patient meets local criteria for fibrinolytic therapy?

    <p>That the patient meets the criteria</p> Signup and view all the answers

    Why is it essential to weigh treating the patient's pain against rapid transport?

    <p>To balance the need for pain relief with the urgency of reperfusion</p> Signup and view all the answers

    What is the primary goal of using a checklist similar to those used in emergency departments?

    <p>To reduce the wait time for patients who meet the clinical criteria for fibrinolytic therapy</p> Signup and view all the answers

    What information should the emergency physician or staff relay to the EMS provider?

    <p>The time of the pain's onset, ST segment elevation, and location of ischemia and infarction on the 12-lead ECG</p> Signup and view all the answers

    Why is it important to consider the patient's anxiety and apprehension when managing myocardial infarction?

    <p>To reduce the patient's anxiety and apprehension during transport</p> Signup and view all the answers

    What is the primary effect of increased peripheral vascular resistance on stroke volume?

    <p>It decreases stroke volume</p> Signup and view all the answers

    What is the primary consequence of the myocardial muscle being stretched too far?

    <p>It cannot contract properly</p> Signup and view all the answers

    In congestive heart failure, what is the typical presentation of edema?

    <p>Pulmonary, peripheral, and ascites</p> Signup and view all the answers

    What is the estimated number of new cases of congestive heart failure diagnosed each year in the United States?

    <p>550,000</p> Signup and view all the answers

    What is the primary mortality outcome in 50% of congestive heart failure patients within 5 years?

    <p>Pulmonary edema and respiratory failure</p> Signup and view all the answers

    What is the primary assessment priority when evaluating a patient with suspected congestive heart failure?

    <p>Evaluating the patient's skin color and breathing</p> Signup and view all the answers

    What is the primary symptom reported by patients with pulmonary edema?

    <p>Shortness of breath and coughing</p> Signup and view all the answers

    What is the primary concern when managing a patient with congestive heart failure and respiratory failure?

    <p>Oxygenation and ventilation</p> Signup and view all the answers

    What is the primary medication class used to decrease afterload in congestive heart failure patients?

    <p>ACE inhibitors</p> Signup and view all the answers

    What is the primary reason for assessing a patient's chief complaint and medical history in congestive heart failure?

    <p>To evaluate the patient's symptoms and disease progression</p> Signup and view all the answers

    What is the primary reason for administering oxygen to a patient suspected of MI?

    <p>To correct hypoxia and decrease myocardial oxygen demand</p> Signup and view all the answers

    What should be considered when establishing IV access in a patient suspected of MI?

    <p>Avoiding multiple attempts to minimize the risk of fibrinolytic therapy</p> Signup and view all the answers

    What medication is typically indicated for patients suspected of MI to relieve chest pain?

    <p>Nitroglycerin</p> Signup and view all the answers

    What is the significance of monitoring the ECG constantly in a patient suspected of MI?

    <p>To detect life-threatening arrhythmias</p> Signup and view all the answers

    What should be done if a patient suspected of MI refuses transport after chest pain relief?

    <p>Convince the patient to be transported to the hospital</p> Signup and view all the answers

    What indicates myocardial damage in a patient suspected of MI?

    <p>Increase in creatine kinase (CK) levels</p> Signup and view all the answers

    What is the purpose of rapid transport in a patient suspected of MI?

    <p>To reduce the door-to-balloon time</p> Signup and view all the answers

    What is the significance of the ST segment in a 12-lead ECG?

    <p>It diagnoses myocardial ischemia or infarction</p> Signup and view all the answers

    What should be done when a patient suspected of MI has hypotension?

    <p>Transport the patient rapidly to the hospital</p> Signup and view all the answers

    What is the primary concern when a patient suspected of MI refuses transport?

    <p>The patient's risk of myocardial damage or death</p> Signup and view all the answers

    What is the primary consideration when applying CPAP to a patient?

    <p>Using the lowest effective pressure</p> Signup and view all the answers

    What is a contraindication for CPAP?

    <p>Suspected pneumothorax</p> Signup and view all the answers

    What should be done every 5 minutes when administering CPAP?

    <p>Check and document vital signs</p> Signup and view all the answers

    What is an important consideration when using CPAP in patients with a DNR order?

    <p>CPAP can be used on patients with a DNR order</p> Signup and view all the answers

    Why is it important to monitor the patient for gastric distension when using CPAP?

    <p>It can cause vomiting</p> Signup and view all the answers

    What is the primary purpose of administering medications when using CPAP?

    <p>To treat underlying conditions</p> Signup and view all the answers

    What is the primary reason for measuring CK-MB levels in patients with suspected myocardial infarction?

    <p>To determine the extent of cardiac damage</p> Signup and view all the answers

    What is the advantage of using high-sensitivity troponin (hs-cTnC) assays in diagnosing myocardial infarction?

    <p>They can detect much lower concentrations of the troponin protein</p> Signup and view all the answers

    What is the significance of a reversal of the ratio of LDH isoenzymes in diagnosing myocardial infarction?

    <p>It is a specific indicator of cardiac injury</p> Signup and view all the answers

    What is the primary advantage of using myoglobin levels in diagnosing myocardial infarction?

    <p>It is a rapid indicator of cardiac damage</p> Signup and view all the answers

    What is the primary purpose of obtaining cardiac enzyme levels in patients with chest pain?

    <p>To diagnose myocardial infarction</p> Signup and view all the answers

    What is the significance of elevated CK-MB levels in patients with suspected myocardial infarction?

    <p>It indicates cardiac damage</p> Signup and view all the answers

    What is the primary advantage of using troponin I levels in diagnosing myocardial infarction?

    <p>It is a specific indicator of cardiac injury</p> Signup and view all the answers

    What is the primary reason for using cardiac enzymes in conjunction with ECG findings and other diagnostic testing in diagnosing myocardial infarction?

    <p>To increase the specificity of the diagnosis</p> Signup and view all the answers

    What is the significance of a peak level of CK-MB at 24 hours after myocardial infarction?

    <p>It indicates the time of onset of myocardial infarction</p> Signup and view all the answers

    What is the primary purpose of using LDH levels in diagnosing myocardial infarction?

    <p>To diagnose cardiac damage</p> Signup and view all the answers

    What is the primary consequence of left ventricular failure?

    <p>Back pressure of blood into the pulmonary circulation</p> Signup and view all the answers

    Which of the following is a common cause of right ventricular failure?

    <p>Left ventricular failure</p> Signup and view all the answers

    What is the term that describes the ability of heart failure patients to compensate, at least for a time?

    <p>Starling's law of the heart</p> Signup and view all the answers

    What is the result of pulmonary capillary pressure becoming too high in left ventricular failure?

    <p>Forced blood plasma into the alveoli</p> Signup and view all the answers

    What is the primary effect of coronary artery disease on the heart?

    <p>Impaired heart's mechanical performance</p> Signup and view all the answers

    What is the primary cause of systolic left ventricular failure?

    <p>Inability of the left ventricle to contract completely</p> Signup and view all the answers

    What is the consequence of right ventricular failure?

    <p>Back pressure of blood into the systemic venous circulation</p> Signup and view all the answers

    What is the primary cause of diastolic left ventricular failure?

    <p>Inability of the left ventricle to relax completely</p> Signup and view all the answers

    What is the term used to describe heart failure due to pulmonary disease?

    <p>Cor pulmonale</p> Signup and view all the answers

    What is the primary cause of pulmonary edema in left ventricular failure?

    <p>Increased pulmonary capillary pressure</p> Signup and view all the answers

    What is the most common symptom of CHF, which worsens with activity?

    <p>Labored breathing</p> Signup and view all the answers

    What is the significance of a patient using multiple pillows to sleep?

    <p>More severe PND</p> Signup and view all the answers

    What is the likely finding in a patient with severe pulmonary edema?

    <p>Rhonchi and wheezes</p> Signup and view all the answers

    What is the purpose of seating a patient with feet dangling in CHF?

    <p>To decrease preload</p> Signup and view all the answers

    What is the effect of nitroglycerin on CHF patients?

    <p>Decreases peripheral edema</p> Signup and view all the answers

    What is the significance of pulsus paradoxus in CHF?

    <p>Compression of great vessels or ventricles</p> Signup and view all the answers

    What is the purpose of administering oxygen in CHF patients with pulmonary edema?

    <p>To correct hypoxia</p> Signup and view all the answers

    What is the complication of pulmonary edema that can quickly lead to death?

    <p>Respiratory failure</p> Signup and view all the answers

    What is the characteristic of a patient with severe pulmonary edema?

    <p>Tachypnea</p> Signup and view all the answers

    What is the significance of wheezes in CHF patients?

    <p>Sign of cardiac asthma</p> Signup and view all the answers

    What is the primary goal of CPAP therapy in patients with acute CHF?

    <p>To force excess fluid out of the alveoli and back into the pulmonary capillaries</p> Signup and view all the answers

    Why is morphine no longer a recommended medication for acute CHF?

    <p>It worsens CHF outcomes</p> Signup and view all the answers

    What is the primary effect of CPAP/BiPAP on the left ventricle in patients with acute CHF?

    <p>It decreases the left ventricle's workload</p> Signup and view all the answers

    What is the difference between CPAP and PEEP?

    <p>CPAP is applied during the entire respiratory cycle, while PEEP is applied only during expiration</p> Signup and view all the answers

    Why is it important to limit fluids in patients with acute CHF?

    <p>To prevent excessive fluid buildup in the lungs</p> Signup and view all the answers

    What is the primary benefit of using ACE inhibitors in the treatment of acute CHF?

    <p>They reduce afterload</p> Signup and view all the answers

    What is the primary effect of CPAP/BiPAP on pulmonary gas exchange in patients with acute CHF?

    <p>It improves pulmonary gas exchange by forcing excess fluid out of the alveoli</p> Signup and view all the answers

    What is the primary concern when using CPAP/BiPAP at high pressures?

    <p>The risk of barotrauma increases</p> Signup and view all the answers

    What is the primary benefit of using albuterol in the treatment of acute CHF?

    <p>It is an adrenergic bronchodilator</p> Signup and view all the answers

    Why is it important to establish IV access in patients with acute CHF?

    <p>To administer medications</p> Signup and view all the answers

    What is the primary purpose of a Left Ventricular Assist Device (LVAD)?

    <p>To aid patients whose physical condition precludes them from a heart transplant</p> Signup and view all the answers

    What is the normal mean arterial pressure (MAP) for a patient with a Left Ventricular Assist Device (LVAD)?

    <p>60–80 mmHg</p> Signup and view all the answers

    What is unique about the flow technology used in Left Ventricular Assist Devices (LVADs)?

    <p>The flow is continuous</p> Signup and view all the answers

    How many power connections are required to power the controller and pump of a Left Ventricular Assist Device (LVAD)?

    <p>Two</p> Signup and view all the answers

    What is the purpose of the tube that passes through the skin in a Left Ventricular Assist Device (LVAD) system?

    <p>To connect the pump to the external controller and power source</p> Signup and view all the answers

    What can be challenging to obtain in patients with a Left Ventricular Assist Device (LVAD)?

    <p>Pulse oximetry readings</p> Signup and view all the answers

    What is the typical presentation of a patient with cardiac tamponade?

    <p>Dyspnea and orthopnea</p> Signup and view all the answers

    What should be done when transporting a patient with an LVAD?

    <p>Bring two batteries and the backup controller</p> Signup and view all the answers

    What is the primary goal of management in cardiac tamponade?

    <p>Supportive treatment and maintaining perfusion</p> Signup and view all the answers

    What is the significance of jugular vein distension in cardiac tamponade?

    <p>It indicates an increase in venous pressure</p> Signup and view all the answers

    What is the characteristic of the ECG in cardiac tamponade?

    <p>It shows a decrease in QRS and T wave voltages</p> Signup and view all the answers

    What is the significance of pulsus paradoxus in cardiac tamponade?

    <p>It indicates a decrease in systolic pressure</p> Signup and view all the answers

    What is the underlying cause of cardiac tamponade?

    <p>Pericardial effusion of air, pus, serum, blood, or any combination of these</p> Signup and view all the answers

    What is the significance of a muffled heart sound in cardiac tamponade?

    <p>It indicates a pericardial effusion</p> Signup and view all the answers

    What is the primary concern when managing a patient with an LVAD?

    <p>Monitoring for signs of cardiac tamponade</p> Signup and view all the answers

    What should be done when the VAD alarm is sounding?

    <p>Check the connections and make sure batteries are charged</p> Signup and view all the answers

    What is the primary purpose of performing pericardiocentesis in a patient with cardiac tamponade?

    <p>To aspirate fluid from the pericardium</p> Signup and view all the answers

    What is the most common cause of hypertensive emergency?

    <p>Medication noncompliance</p> Signup and view all the answers

    What is the blood pressure threshold for diagnosing preeclampsia?

    <p>140/90 mmHg</p> Signup and view all the answers

    What is the primary consequence of untreated preeclampsia?

    <p>Eclampsia and death</p> Signup and view all the answers

    What is the approximate prevalence of hypertension in the United States?

    <p>100 million</p> Signup and view all the answers

    What is the primary reason for rapid transport in a patient with cardiac tamponade?

    <p>To perform pericardiocentesis</p> Signup and view all the answers

    What is the primary difference between a hypertensive emergency and a hypertensive urgency?

    <p>Presence of end-organ damage</p> Signup and view all the answers

    What is the primary complication of hypertensive encephalopathy?

    <p>Stroke</p> Signup and view all the answers

    What is the primary cause of death in patients with preeclampsia?

    <p>Eclampsia</p> Signup and view all the answers

    What is the primary concern when a patient with cardiac tamponade refuses transport?

    <p>Delayed treatment</p> Signup and view all the answers

    What is the primary mechanism by which the body tries to compensate in cardiogenic shock?

    <p>Increasing contractile force, or improving preload, or reducing peripheral resistance</p> Signup and view all the answers

    What is the most common presentation of cardiogenic shock in geriatric patients?

    <p>As an end-stage event with significant underlying disease(s)</p> Signup and view all the answers

    What is the usual heart rhythm in cardiogenic shock?

    <p>Sinus tachycardia</p> Signup and view all the answers

    What is the primary cause of high mortality rate in geriatric patients with cardiogenic shock?

    <p>Multiple end-organ damage reaches the point that life cannot be sustained</p> Signup and view all the answers

    What is the significance of radial pulses in cardiogenic shock?

    <p>They are initially present but later disappear</p> Signup and view all the answers

    What is the primary reason for assessing the patient's past medical history in cardiogenic shock?

    <p>To identify any recent trauma or hypovolemic cause</p> Signup and view all the answers

    What is the primary respiratory finding in cardiogenic shock?

    <p>All of the above</p> Signup and view all the answers

    What is the primary indication of cardiogenic shock in the early stages?

    <p>Cold extremities, weak pulses, and low blood pressure</p> Signup and view all the answers

    What is the primary significance of the patient's medication history in cardiogenic shock?

    <p>It indicates the patient's underlying disease processes</p> Signup and view all the answers

    What is the primary consequence of preload, afterload, and contractility failing to meet vital organ demands in cardiogenic shock?

    <p>Unconsciousness and eventually death</p> Signup and view all the answers

    What is the primary problem during the electrical phase of cardiac arrest?

    <p>Disordered electrical conduction</p> Signup and view all the answers

    At what time interval after cardiac arrest does the circulatory phase begin?

    <p>4 minutes</p> Signup and view all the answers

    What is the result of anaerobic metabolism in the myocardial cells during the circulatory phase?

    <p>Marked decrease in energy production</p> Signup and view all the answers

    Why is immediate defibrillation during the circulatory phase detrimental?

    <p>The heart is not prepared for a shock</p> Signup and view all the answers

    What is the primary benefit of administering epinephrine during the circulatory phase?

    <p>Prepares the myocardium for a shock</p> Signup and view all the answers

    What is the characteristic of the metabolic phase of cardiac arrest?

    <p>Severe hypoxia and severe acidosis</p> Signup and view all the answers

    What is the result of the failure of the sodium-potassium pump in the metabolic phase?

    <p>Cellular swelling</p> Signup and view all the answers

    What is the consequence of the loss of the barrier between the GI tract and the rest of the body in the metabolic phase?

    <p>Bacteria can enter the body</p> Signup and view all the answers

    What is the benefit of providing at least 90 seconds of CPR before defibrillation during the circulatory phase?

    <p>Increases survival rates</p> Signup and view all the answers

    What is the primary difference between the electrical and circulatory phases of cardiac arrest?

    <p>The heart is prepared for a shock in the electrical phase but not in the circulatory phase</p> Signup and view all the answers

    What is the primary characteristic of a hypertensive emergency?

    <p>Target-organ changes such as confusion, seizures, or ECG changes</p> Signup and view all the answers

    What is the indication for treating a hypertensive patient with supportive care and reassurance only?

    <p>Hypertensive urgency with symptoms such as chest pain, headache, or shortness of breath</p> Signup and view all the answers

    What is the typical presentation of a hypertensive patient?

    <p>Chief complaint of headache accompanied by nausea and/or vomiting, blurred vision, shortness of breath, chest pain, epistaxis, and vertigo</p> Signup and view all the answers

    What is the possible cause of hypertension in a patient who has been noncompliant with their medication regimen?

    <p>All of the above</p> Signup and view all the answers

    What is the definition of hypertension?

    <p>Systolic pressure greater than 160 mmHg and diastolic pressure greater than 90 mmHg</p> Signup and view all the answers

    What is the significance of a strong and bounding pulse in a hypertensive patient?

    <p>Is a common presentation of hypertension</p> Signup and view all the answers

    What is the primary concern when evaluating a patient with hypertension?

    <p>Evaluating the patient's airway, breathing, and circulation</p> Signup and view all the answers

    What is the term for shock that occurs when left ventricular function is compromised and the heart cannot meet the body's metabolic demands?

    <p>Cardiogenic shock</p> Signup and view all the answers

    What is the purpose of placing a saline lock in a hypertensive patient?

    <p>To establish an IV for medication administration</p> Signup and view all the answers

    What is the recommendation for transporting a pregnant patient with hypertension?

    <p>Transport on the left side to reduce pressure on the vena cava</p> Signup and view all the answers

    What is the primary reason for the patient's need for emergent revascularization and reperfusion?

    <p>To treat the underlying cardiac problem</p> Signup and view all the answers

    What is the most critical factor in prehospital care for cardiogenic shock patients?

    <p>Rapidly transporting the patient to a facility with interventional cardiology capabilities</p> Signup and view all the answers

    What is the mechanism of death in sudden death from coronary artery disease?

    <p>Lethal arrhythmia</p> Signup and view all the answers

    During the electrical phase of cardiac arrest, what is available to the myocardial cells?

    <p>Adequate oxygen</p> Signup and view all the answers

    What is the purpose of understanding the pathophysiology of cardiac arrest and sudden death?

    <p>To understand current treatment regimens for cardiac arrest</p> Signup and view all the answers

    What is the primary difference between the electrical phase and the circulatory phase of cardiac arrest?

    <p>The duration of cardiac arrest</p> Signup and view all the answers

    What is the significance of the three phases of cardiac arrest?

    <p>They guide the type of prehospital intervention required</p> Signup and view all the answers

    What is the primary cause of cardiac arrest and sudden death?

    <p>Atherosclerotic disease</p> Signup and view all the answers

    What is the result of cardiac arrest?

    <p>Systemic circulatory failure</p> Signup and view all the answers

    What is the significance of the patient's position in managing cardiogenic shock?

    <p>It influences the patient's comfort and hemodynamic stability</p> Signup and view all the answers

    What is the primary effect of endotoxins and cytokines released by Gram-negative bacteria on the heart?

    <p>Suppressed myocardial function</p> Signup and view all the answers

    What is the primary goal of resuscitative measures during the metabolic phase?

    <p>To control injurious factors during reperfusion</p> Signup and view all the answers

    What is the characteristic ECG abnormality associated with Brugada syndrome?

    <p>Right bundle branch block with ST segment elevation</p> Signup and view all the answers

    What is the primary benefit of administering antiendotoxin antibodies in septic shock?

    <p>To minimize the detrimental effects of endotoxins</p> Signup and view all the answers

    What is the typical age range for arrhythmias to occur in patients with Brugada syndrome?

    <p>30-40 years</p> Signup and view all the answers

    What is the primary cause of cardiac arrest in patients with Long QT syndrome?

    <p>Polymorphic ventricular tachycardia</p> Signup and view all the answers

    What is the primary effect of hypothermia on cardiac function?

    <p>Reduced metabolic demand</p> Signup and view all the answers

    What is the primary benefit of administering anti-inflammatory agents in septic shock?

    <p>To reduce inflammation</p> Signup and view all the answers

    What is the primary benefit of using metabolically focused therapies in the metabolic phase?

    <p>To correct electrolyte problems</p> Signup and view all the answers

    What is the primary inheritance pattern of Brugada syndrome?

    <p>Autosomal dominant with incomplete penetrance</p> Signup and view all the answers

    What is the typical demographic affected by commotio cordis?

    <p>Young, otherwise healthy male athletes</p> Signup and view all the answers

    What is the correct sequence of actions when responding to a cardiac arrest patient?

    <p>Initiate CPR, place ECG leads, and then confirm asystole in two or more leads</p> Signup and view all the answers

    What is the primary goal when evaluating the downtime of a cardiac arrest patient?

    <p>To determine the total downtime from the beginning of the arrest to delivery to the emergency department</p> Signup and view all the answers

    What is the significance of ventricular fibrillation in commotio cordis?

    <p>It is triggered by chest wall impact only over the heart</p> Signup and view all the answers

    What is the primary purpose of asking certain questions when evaluating a cardiac arrest patient?

    <p>To focus on events prior to the arrest</p> Signup and view all the answers

    What is the effective treatment for commotio cordis?

    <p>CPR and early defibrillation</p> Signup and view all the answers

    What is the primary goal of resuscitation in a patient experiencing cardiac arrest?

    <p>To obtain return of spontaneous circulation</p> Signup and view all the answers

    What is the revised mnemonic for the preferred sequence of primary assessment and management of an emergency patient in cardiac arrest?

    <p>CAB (circulation, airway, breathing)</p> Signup and view all the answers

    When should a shock be delivered during CPR?

    <p>After checking the rhythm</p> Signup and view all the answers

    What is the significance of field termination of resuscitation (TOR) in patients unlikely to survive?

    <p>It reserves EMS resources for patients who truly have the possibility of benefiting from EMS care</p> Signup and view all the answers

    What is the significance of postarrest care in cardiac arrest management?

    <p>It is almost as important as prearrest care</p> Signup and view all the answers

    What is the primary reason for administering high-concentration oxygen during CPR?

    <p>To supply oxygen to the patient</p> Signup and view all the answers

    When should epinephrine be administered during CPR?

    <p>During the next CPR interval</p> Signup and view all the answers

    What is the primary difference between return of spontaneous circulation (ROSC) and survival?

    <p>ROSC refers to the patient's spontaneous pulse and breathing, while survival refers to the patient's survival to be discharged from the hospital</p> Signup and view all the answers

    What is the primary consideration for field termination of resuscitation (TOR) in patients unlikely to survive?

    <p>The absence of ROSC, a shockable rhythm, and reversible causes</p> Signup and view all the answers

    What is the primary benefit of continued resuscitation measures in patients who achieve ROSC?

    <p>It increases the patient's chance of survival</p> Signup and view all the answers

    What is the ideal range of systolic blood pressure in the postarrest patient?

    <p>80 to 100 mmHg</p> Signup and view all the answers

    What is the primary benefit of induced therapeutic hypothermia in cardiac arrest survivors?

    <p>Minimizes the effects of hypoxic injury and oxidative stress</p> Signup and view all the answers

    At what temperature is the patient typically cooled during induced therapeutic hypothermia?

    <p>32° to 36° C</p> Signup and view all the answers

    What is the purpose of extracorporeal membrane oxygenation (ECMO) in postcardiac arrest patients?

    <p>To support life and take strain off the heart and lungs until the patient's own organs have recovered</p> Signup and view all the answers

    What is the term used to describe the use of ECMO in arrested patients?

    <p>Extracorporeal cardiopulmonary resuscitation (ECPR)</p> Signup and view all the answers

    What is the primary underlying factor in many cardiovascular emergencies?

    <p>Atherosclerosis</p> Signup and view all the answers

    What is the decision not to attempt resuscitation based on?

    <p>Certainty that the patient will not survive</p> Signup and view all the answers

    What is the purpose of using chilled IV fluids and ice packs in induced therapeutic hypothermia?

    <p>To cool the patient to a temperature of 32° to 36° C</p> Signup and view all the answers

    What is the primary benefit of transporting patients with an ROSC to a designated facility?

    <p>To initiate induced therapeutic hypothermia as part of the bundle of postresuscitation care strategies</p> Signup and view all the answers

    What is the term used to describe the formation of hard, thick plaques in the coronary arteries?

    <p>Atherosclerosis</p> Signup and view all the answers

    What is the significance of bruits audible over the affected carotid artery in a patient with a vascular emergency?

    <p>It is a sign of peripheral arterial atherosclerotic disease.</p> Signup and view all the answers

    What is the primary goal of management in a patient with a vascular emergency?

    <p>To provide supportive care and arrange for rapid transport.</p> Signup and view all the answers

    Why should the patient be placed in a position of comfort during a vascular emergency?

    <p>To reduce anxiety and discomfort.</p> Signup and view all the answers

    What is an indication for rapid transport with lights and sirens in a patient with a vascular emergency?

    <p>The patient's symptoms are not relieved by medication.</p> Signup and view all the answers

    What should be done before administering any medication to a patient with a vascular emergency?

    <p>Ask the patient or family members about medication allergies.</p> Signup and view all the answers

    What is the consequence of a patient refusing transport in a vascular emergency?

    <p>The patient is likely to experience serious complications without further medical attention.</p> Signup and view all the answers

    What is the primary mechanism by which atherosclerosis damages the tunica media?

    <p>Injury response to fat deposition under the tunica intima</p> Signup and view all the answers

    What is the most common location of an abdominal aortic aneurysm?

    <p>Below the renal arteries and above the bifurcation of the common iliac arteries</p> Signup and view all the answers

    What is the primary cause of infectious aneurysms?

    <p>Syphilis</p> Signup and view all the answers

    What is the term for the dilation of a vessel?

    <p>Aneurysm</p> Signup and view all the answers

    What is the primary consequence of untreated dissecting aortic aneurysm?

    <p>Rupture of the aortic wall</p> Signup and view all the answers

    What is the estimated incidence of abdominal aortic aneurysm in men versus women?

    <p>10 times more common in men</p> Signup and view all the answers

    What is the primary cause of degenerative changes in the smooth muscle and elastic tissue of the aortic media?

    <p>Cystic medial necrosis</p> Signup and view all the answers

    What is the primary location of dissecting aortic aneurysms?

    <p>Ascending aorta</p> Signup and view all the answers

    What is the primary consequence of atherosclerosis on the vessel's intimal surface?

    <p>Destruction of the vessel's elasticity</p> Signup and view all the answers

    What is the primary condition that can cause disability and death due to a blood clot forming in a vein and then dislodging and traveling in the blood?

    <p>Venous thromboembolism</p> Signup and view all the answers

    What is the most common cause of acute arterial occlusion?

    <p>Emboli</p> Signup and view all the answers

    What is the term used to describe the formation of a blood clot in a deep vein?

    <p>Deep vein thrombosis</p> Signup and view all the answers

    What is the consequence of a pulmonary embolism blocking the blood flow through a vessel?

    <p>The right heart must pump against increased resistance</p> Signup and view all the answers

    What is the term used to describe the inflammation of blood vessels?

    <p>Vasculitis</p> Signup and view all the answers

    What is the best strategy for VTE?

    <p>Prevention</p> Signup and view all the answers

    What is the common symptom of a patient with DVT?

    <p>Gradually increasing pain or tenderness in the calf</p> Signup and view all the answers

    What is the term used to describe the discomfort behind the knee associated with DVT?

    <p>Homan’s sign</p> Signup and view all the answers

    What can occur if the patient has a genetic predisposition for clot formation?

    <p>Increased risk of clot formation</p> Signup and view all the answers

    What is the term used to describe the progressive degenerative disease of the midsize and large arteries?

    <p>Peripheral arterial atherosclerotic disease</p> Signup and view all the answers

    What is the consequence of a blocked vessel in the lung?

    <p>The area of the lung supplied by the occluded vessel stops functioning</p> Signup and view all the answers

    What is the characteristic of pain in patients with peripheral arterial disease?

    <p>It is present even at rest</p> Signup and view all the answers

    What is the significance of absent pulses in a patient with vascular emergency?

    <p>It is a sign of occlusion distal to the affected area</p> Signup and view all the answers

    What is the consequence of untreated occlusion of any vessel?

    <p>It can cause severe disability or death</p> Signup and view all the answers

    What is the purpose of checking the five Ps in a patient with vascular emergency?

    <p>To check for signs of ischemia</p> Signup and view all the answers

    What is the typical presentation of a patient with peripheral arterial disease?

    <p>Cold, numb, and painful extremity</p> Signup and view all the answers

    What is the significance of a sudden onset of pain in a patient with vascular emergency?

    <p>It is a sign of acute occlusion</p> Signup and view all the answers

    What is the purpose of assessing the patient's chief complaint and medical history in vascular emergency?

    <p>To determine the contributing history of the patient</p> Signup and view all the answers

    What is the consequence of pulmonary occlusion?

    <p>It can cause severe disability or death</p> Signup and view all the answers

    What is the significance of unequal bilateral blood pressures in a patient with vascular emergency?

    <p>It is a sign of high thoracic aneurysm</p> Signup and view all the answers

    What is the purpose of the OPQRST acronym in a patient with vascular emergency?

    <p>To elicit the patient's description of symptoms and pain</p> Signup and view all the answers

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