Practice Tests for Unit B & D - Anatomy & Physiology, Diagnostic Techniques - PDF

Okay, here is the converted text from the images into a structured markdown format: ### Page 1 **90.** This image shows a diagram of the three orthogonal planes of the heart. The plane labeled #2 shows a cross section of the heart with an anterior view of the atria, and a view of the ventricles...

Okay, here is the converted text from the images into a structured markdown format: ### Page 1 **90.** This image shows a diagram of the three orthogonal planes of the heart. The plane labeled #2 shows a cross section of the heart with an anterior view of the atria, and a view of the ventricles labeled 1, 2 and 3. The text underneath the diagram includes the following options: a. Four chamber b. Two chamber c. Long axis d. Short axis **91.** This image represents a parasternal M-mode echo scan from LV to AO. The scan is displayed in a graph. The Y axis is labeled ECG. On the graph are several vertical spikes labeled 1-12. What valve or structure is labeled at #4? a. Mitral valve b. Aortic valve c. Papillary muscle d. Interventricular septum **B4 - Coronary A & P** **92.** In an inferior MI the _____ and _____ are usually occluded. a. RCA, PDCA b. Proximal and distal LAD c. Diagonals, obtuse marginals d. Circumflex, obtuse marginals **93.** This is an image labeled RAO, LV GRAM. It shows a diagram of a section of the heart labeled 1-7. The LV wall labeled #6 in this RAO diagram is termed the: a. Anterior free wall b. Anterior - basal wall c. Anterior - lateral wall d. Anterior - septal wall **94.** In adult healthy resting hearts an $O_2$ saturation sample drawn from the RA will normally average: a. 45% $O_2$ saturation b. 60% $O_2$ saturation c. 75% $O_2$ saturation d. 85% $O_2$ saturation **95.** With exercise PA $O_2$ saturations _____ and the (AO-PA) arteriovenous difference _____. a. Increases, Narrows b. Increases, Widens c. Decreases, Narrows d. Decreases, Widens **96.** In a LEFT dominant coronary system, which coronary artery branch usually still arises from the RCA? a. Posterior descending coronary b. AV node artery c. Acute marginal branch d. Posterior lateral branch ### Page 2 **217.** The image shows four diagrams of different cardiovascular catheters. The diagrams are labeled 1-5. Identify catheter #5 in the diagram above. a. IMA b. Judkins c. Amplatz d. Multipurpose e. Coronary bypass **218.** Which guidewire is most kink-resistant? a. Braided stainless steel wires b. Coiled stainless steel wires c. Hypo-tube and safety ribbon wires d. Nitinol core-to-tip wires **219.** The image shows a valve and a diagram of its position labeled 1-3, and a,b,c,d. Using the handle-off coronary manifold shown in the box, to inject the coronary artery with contrast: a. Inject as shown b. Turn stopcock #2, 90 degrees clockwise c. Turn stopcock #2, 90 degrees counterclockwise d. Turn stopcock #3, 90 degrees clockwise **220.** The image shows a Tuohy-Borst rotating Y adapter labeled 3. During PCI what is normally connected to port #1 shown on this Tuohy-Borst adapter? a. Guider catheter b. Balloon inflation catheter c. Guidewire d. Pressure transducer **221.** After a diagnostic guide wire has been in the patient's arteries for 3 minutes, it should be: a. Withdrawn to check catheter waveforms for damping b. Withdrawn and wiped with heparinized gauze c. Cleaned by flushing the catheter with the wire in it d. Pulled back over the aortic arch to let heart rest **222.** Platinum is valuable in an angioplasty wire because of its: a. Low thrombogenicity b. Torque-ability c. Radiopacity d. Hypo-allergenicity e. Precious metal recycle-ability **D3 - Indications, Risks, etc.** **223.** When considering a patient for PCI, a history of hypotension, hypokalemia, and epilepsy are: a. Absolute contraindications to cardiac cath b. Contraindications to cardiac cath in female patients c. Relative contraindications to cardiac cath d. Reasons to schedule standby surgery as a backup to the cath ### Page 3 **224.** During catheterization, a patient with elevated creatinine and blood urea nitrogen (BUN) needs _____ to reduce the risk of _____. a. Ionic contrast, Ototoxicity b. Ionic contrast, Renal failure c. Low-osmolar contrast, Peripheral edema d. Low-osmolar contrast, Renal failure **225.** The average mortality risk to diagnostic heart cath is: a. 0.1% b. 0.5% c. 1.0% d. 2.0% **D4 - Cath: Protocol & Preparations** **226.** Statistically, the highest mortality to pulmonary angiography occurs in adult patients with: a. Ventricular septal defect b. Emphysema (COPD) c. Essential pulmonary hypertension d. Dilated cardiomyopathy **D5 - Vascular Access, Scrub, etc.** **227.** Pallor, hypotension, tachycardia and abdominal pain in a patient who is post-cath suggests: a. Vasovagal reaction b. Retroperitoneal hematoma c. Type II aortic aneurysm d. Arteriovenous fistula **228.** A pulsatile encapsulated hematoma in communication with a ruptured artery defines a: a. True lumen b. True aneurysm c. False aneurysm d. Fusiform aneurysm **229.** Your patient develops a pseudoaneurysm 2 days after transfemoral catheterization. How can it be most easily repaired? a. Use a Perclose vascular closure device b. Manual compression with a Syvek® patch topical dressing c. Inject procoagulant (thrombin) into the false aneurysm d. Ultrasound localization with application of a PROSTAR e. Ultrasound localization with application of Compressar clamp **230.** Following myocardial biopsy the patient develops hypotension, increasing venous pressures, tachycardia, and electrical alternans. The most likely complication is: a. Cardiac perforation b. Vasovagal discharge c. Pulmonary embolism d. Infection at the biopsy site **231.** Mr. Jones has suspected aortic stenosis. Retrograde crossing of the aortic valve was impossible. During transseptal heart catheterization several unsuccessful transseptal needle advances have been made. Now he becomes confused and lethargic. His BP is 80/40 and falling. RA pressure is 18 mmHg. Heart rate is 105 in sinus rhythm. The most likely therapy is: a. IV dopamine and nitroprusside b. Fluid administration and IV atropine c. IV epi and having Mr. Jones cough d. Emergency valve surgery e. Pericardial centesis **232.** What is the most commonly perforated chamber in bilateral heart catheterization? a. RV b. RA c. LV d. LA **233.** Three hundred cases per year is the: a. Maximum number of cases allowed for an operator due to ionizing radiation b. Minimum caseload a cath lab team must perform to maintain official competency c. Minimum caseload to pay for an average cath lab in five years d. Minimum number of PCIs a physician needs to perform to maintain competency ### Page 4 **234.** According to national guidelines PCI should only be performed by experienced operators and in hospitals with a full cardiac surgery service. One exception to this is, PCI may be performed by small community hospitals: a. In emergency STEMI b. In emergency ischemic stroke c. In emergency aortic dissection c. In acute coronary syndrome with intractable arrhythmias d. For elective low risk de novo lesions with standby ambulance **235.** During cardiac catheterization a patient develops pericardial tamponade. His BP drops dramatically and he becomes unresponsive. Your cath team should: a. Proceed with emergency IABP b. Proceed with pericardio-centesis c. Get a surgeon to perform emergency pericardial debridement d. Defer the procedure until informed consent can be obtained **236.** An ACT of 250-300 seconds is an acceptable clotting time for: a. PCI b. Pacer implant c. SwanGanz insertion d. Long term arterial line monitoring **237.** Your 55 Kg patient comes to the cath lab premedicated with 300 mg clopidogrel (Plavix) for a PCI. The physician orders 2000 units of unfractionated heparin IV. To check for the proper level of anticoagulation draw the first ACT: a. Just before the heparin is given b. 5 min after the heparin is given c. 1 hour after the heparin is given d. At end of case before pulling the sheath **238.** Which short-acting sedative is contraindicated in patients with narrow-angle glaucoma? a. Diazepam b. Midazolam c. Meperidine d. Morphine Sulfate **239.** The half-life of a 5000 unit IV heparin bolus is approximately: a. 10 minutes b. 40 minutes c. 4 hours d. 4 days **240.** A procedure utilizing the antegrade catheterization approach is: a. Aortic valvuloplasty b. Coronary angiography c. Intra-aortic balloon counterpulsation d. Temporary pacemaker **241.** Allen's maneuver: a. Helps amplify systolic murmurs b. Creates positive pressure in the lung c. Checks for collateral circulation in the hand d. Activates the cold pressor response **242.** After a radial PCI case when should you pull the sheath? a. At conclusion of the case b. When ACT falls below 160 sec c. When ACT falls below 120 sec d. After protamine administration **243.** When you attempt to pull the radial artery sheath it is tight in the vessel and painful to move. All the following will facilitate sheath removal EXCEPT: a. Inject nitroclycerine IV 20 mcg b. Give additional fentanyl IV 100 mcg c. Inject lidocaine into the sheath 20 mg. d. Inject verapamil into the sheath 2.5 mg **244.** In 6 French radial artery PCI cases how long should appropriate manual radial artery compression normally be applied to prevent radial artery hematoma and occlusion?" a. 5-10 minutes b. 10-15 minutes c. 15-20 minutes d. 20-30 minutes