Flashcard Set Preview
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| 1 |
What is a normal pH level?
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7.35-7.45
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| 2 |
Read the Blood Gas
pH: 7.06
pCO2: 19
O2 Sat: 89
HCO3: 3
BE: -30
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Partially compensated Metabolic acidosis
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| 3 |
Read the Blood Gas
pH: 7.25
pCO2: 90
O2 Sat: 34
HCO3: 38
BE: +5
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Partially Compensated Respiratory Acidosis
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| 4 |
Read the Blood Gas
pH: 7.36
pCO2: 20
O2 Sat: 100
HCO3: 19
BE: -7.6
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Fully Compensated Metabolic Acidosis
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| 5 |
Read the Blood Gas
pH: 7.42
pCO2: 38
O2 Sat: 100
HCO3: 25
BE: +1
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Normal Blood Gas
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| 6 |
Read the Blood Gas
pH: 7.54
pCO2: 22
O2 Sat: 100
HCO3: 25
BE: +1
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Respiratory alkalosis
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| 7 |
Read the Blood Gas
pH: 7.45
pCO2: 24
O2 Sat: 100
HCO3: 21
BE: -4
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Fully compensated Respiratory alkalosis
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| 8 |
Read the Blood Gas
pH: 7.50
pCO2: 40
O2 Sat: 100
HCO3: 29
BE: +5
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Metabolic Alkalosis
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| 9 |
Read the Blood Gas
pH: 7.47
pCO2: 60
O2 Sat: 100
HCO3: 30
BE: +8
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Partially Compensated Metabolic Alkalosis
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| 10 |
Read the Blood Gas
pH: 7.42
pCO2: 20
O2 Sat: 100
HCO3: 22
BE: -3.7
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Fully compensated Respiratory Alkalosis
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| 11 |
Read the Blood Gas
pH: 7.79
pCO2: 40
O2 Sat: 100
HCO3: 33
BE: +12
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Metabolic Alkolosis Not compensated
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| 12 |
Read the Blood Gas
pH: 7.0
pCO2: 66
O2 Sat: 100
HCO3: 25
BE: +1.0
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Respiratory Acidosis
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| 13 |
Read the Blood Gas
pH: 7.35
pCO2: 70
O2 Sat: 100
HCO3: 30
BE: +9
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Fully Compensated Respiratory Acidosis
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| 14 |
Read the Blood Gas
pH: 7.42
pCO2: 35
O2 Sat: 100
HCO3: 25
BE: +1.0
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Normal
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| 15 |
Briefly describe the myocardium.
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Thick muscle layer of the heart that works to contract the heart
Cardiac muscle
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| 16 |
Which filaments of a sarcomere are responsible for contraction?
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Thick Myosin filaments
Thin actin filaments
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| 17 |
What ion is necessary from muscle contraction?
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Calcium
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| 18 |
What is needed for calcium to disassociate from the actin?
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ATP
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| 19 |
How many moles of ATP does Anaerobic metabolism yield?
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2 moles of ATP
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| 20 |
What will happen to the pH if there is an accumulation of lactate?
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The pH will decrease
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| 21 |
What types of things can Ischemia lead to?
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Depletion of my cardial high energy phosphates
Intracellular and extra cellular acidosis
Inhibition...
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| 22 |
How do you prevent ischemia while on CPB?
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Decrease oxygen demand
-Arrest the heart
-hypothermia
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| 23 |
A cold fibrillating heart uses (more/less) oxygen than a normal heart beating at 37 degrees...
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More.
1cc O2/100g/min at 37 C
2.0 O2/100g/min at 22 C
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| 24 |
Name 3 methods of Myocardial Preservation.
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Intermittent aortic occlusion
Ventricular fibrillation
Cardioplegia myocardial protection
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| 25 |
What is a good indicator of adequate cardioplegia delivery?
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Myocardial Temperature
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| 26 |
Which of the following is not true regarding Intermittent Aortic Occlusion?
a. ...
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b. Hypothermia is used to decrease oxygen demand
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| 27 |
Which of the following is not a goal of Cardioplegia?
a. Quiet, Motionless field
b. ...
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B. Bloodless field
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| 28 |
Where is proper placement of an antegrade cardioplegia cannula?
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Between the cross clamp and aortic valve
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| 29 |
Where is the proper placement of a retrograde cardioplegia cannula?
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In the R. heart in the coronary sinus
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| 30 |
Regarding pressure, when delivering retrograde cardioplegia what pressure range should you...
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20-40 mmHg
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| 31 |
Name two types of cardioplegia.
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Crystalloid solution
Blood cardioplegia
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| 32 |
What is an advantage of the crystalloid plegia solution?
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Decreased viscosity for better distribution
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| 33 |
What is an advantage blood cardioplegia?
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Effective buffer
Better recovery of myocardial function
Decreases edema
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| 34 |
Advantages of Cold Cardioplegia
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Reduction of MvO2
Electrical silence maintained after plegic agent is washed out
Maintains...
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| 35 |
Disadvantages of Cold Cardioplegia
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Delay in function and metabolic recovery of the heart
Reduced enzyme function
Alteration...
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| 36 |
What are some concerns regarding continuous delivery of warm cardioplegia?
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Increased blood in operative field
Increased volumes of plegia
Interuptions can lead to myocardial...
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| 37 |
Regarding cardioplegia, describe a "hot shot".
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Used to resuscitate the myocardium which will decrease reperfusion injuries
Reversal of hypothermic...
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| 38 |
Name 6 additives in cardioplegia
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Potassium
Calcium
Magnesium
Lidocaine
Glutamate/Aspertate
Nitroglycerine
Albumin, glucose,...
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| 39 |
What is the role of Potassium as an additive in cardioplegia?
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Increased extracellular K causing asystole by depolarizing the cell membrane
Lowers resting...
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| 40 |
What is the role of Calcium as an additive in cardioplegia?
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Extracellular hypocalcemia produces arrest by limiting the ionic calcium available to trigger...
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| 41 |
What roles does magnesium have as a cardioplegia additive?
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Inhibit release of Ca by sarcoplasmic reticulum
Competes with Ca at ATP activation sites
Modulates...
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| 42 |
What is the role of Lidocaine as a cardioplegia additive?
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Membrane stablization
- Decrease post arrest arrhythmias
- Prevent edema
- Blocks Na permeability...
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| 43 |
What is the role of Glutamate/Aspertate as a cardioplegia additive?
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Provide fuel for energy production
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| 44 |
What is the role of Nitroglycerine as a cardioplegia additive?
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Prevent/reduce the vasoconstrictive effects of particulate contaminants
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| 45 |
A blood gas shows a decreased pCO2 and an increased pH
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Respiratory Alkalosis
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| 46 |
A blood gas shows an increase in pCO2 and a decreased pH
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Respiratory Acidosis
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| 47 |
A gain in H or loss of HCO3
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Metabolic Acidosis
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| 48 |
A gain in HCO3 or loss of H
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Metabolic Alkalosis
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| 49 |
What percentage of the bicarb/buffer system in our bodies Hemoglobin/oxyhemoglobin?
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30%
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| 50 |
What percentage of the bicarb/buffer system in our bodies plasma proteins?
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7.4%
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