Principles Of Cardiology III- Test I

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Principles Of Cardiology III- Test I - Quiz

A review of the material for Principles III test 1. Reviewing cardiac material.


Questions and Answers
  • 1. 

    Blood flow to the coronary arteries decreases during which phase of the cardiac cycle?

    • A.

      Systole

    • B.

      Bradycardia

    • C.

      Diastole

    • D.

      None of above, blood flow to coronary arteries is constant

    Correct Answer
    A. Systole
    Explanation
    During systole, the heart muscle contracts and pumps blood out of the chambers and into the arteries. This contraction causes a temporary decrease in blood flow to the coronary arteries, which supply oxygen and nutrients to the heart muscle itself. This is because the contraction of the heart muscle compresses the coronary arteries, reducing the amount of blood that can flow through them. Therefore, the correct answer is systole.

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  • 2. 

    What effect will tachycardia have on coronary artery perfusion?

    • A.

      Perfusion will increase due to an increase in cardiac output.

    • B.

      Perfusion will decrease do a decrease in filling times.

    • C.

      Perfusion remains the same because the decrease in diastolic filling time and increase in CO roughly balance each other out.

    Correct Answer
    B. Perfusion will decrease do a decrease in filling times.
    Explanation
    Tachycardia refers to an abnormally fast heart rate. When the heart beats faster, the filling time of the ventricles decreases. This means that there is less time for the ventricles to fill with blood during diastole. As a result, the amount of blood pumped out of the heart with each beat (stroke volume) decreases. Since perfusion refers to the delivery of blood to tissues, a decrease in stroke volume leads to a decrease in coronary artery perfusion. Therefore, tachycardia will have a negative effect on coronary artery perfusion.

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  • 3. 

    Which of the following reflects an appropriate resting potential of the heart?

    • A.

      -20 mv

    • B.

      -40 mv

    • C.

      -80 mv

    • D.

      +5 mv

    Correct Answer
    C. -80 mv
    Explanation
    The correct answer is -80 mv. Resting potential refers to the electrical charge difference between the inside and outside of a cell when it is at rest. In the case of the heart, a resting potential of -80 mv indicates that the inside of the heart cell is more negatively charged compared to the outside. This negative charge is essential for maintaining the normal electrical activity of the heart and allows it to contract and pump blood effectively.

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  • 4. 

    Depolarization of cardiac cells results in increased _____ and decreased _____.

    • A.

      Calcium, Chloride

    • B.

      Potassium, Sodium

    • C.

      Magnesium, Potassium

    • D.

      Sodium, Potassium

    Correct Answer
    D. Sodium, Potassium
    Explanation
    During depolarization of cardiac cells, the sodium channels open, allowing sodium ions to enter the cell. This influx of sodium ions leads to an increase in the intracellular concentration of sodium. At the same time, the potassium channels also open, allowing potassium ions to exit the cell. This efflux of potassium ions leads to a decrease in the intracellular concentration of potassium. Therefore, the correct answer is Sodium, Potassium.

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  • 5. 

    During what phase of the cardiac action potential do L-type calcium channels open?

    • A.

      Plateau

    • B.

      Repolarization

    • C.

      Depolarization

    • D.

      Holy Action Potentials, Batman!!

    Correct Answer
    A. Plateau
    Explanation
    During the plateau phase of the cardiac action potential, L-type calcium channels open. This allows calcium ions to enter the cardiac cells, leading to a sustained depolarization of the cell membrane. This phase is characterized by a prolonged period of membrane potential, which helps in the contraction of the cardiac muscle and ensures efficient pumping of blood.

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  • 6. 

    What occurs during repolarization?

    • A.

      Voltage dependent increase in sodium and potassium

    • B.

      Potassium increases and slow calcium channels close.

    • C.

      Sodium increases and potassium decreases

    • D.

      Slow calcium channels open and calcium increases

    Correct Answer
    B. Potassium increases and slow calcium channels close.
    Explanation
    During repolarization, the potassium ions inside the cell increase while the slow calcium channels close. This process allows the cell to return to its resting state by restoring the original electrical charge across the cell membrane. The increase in potassium ions helps to bring the membrane potential back to its negative value, while the closure of slow calcium channels prevents further calcium influx, which is responsible for depolarization.

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  • 7. 

    Sympathetic stimulation of the SA node results in release of ________ from nerve endings, which binds to Beta 1 adrenergic receptors on pacemaker cell membranes.

    • A.

      Acetycholine

    • B.

      Ephedrine

    • C.

      Norepinephrine

    • D.

      CAMP

    Correct Answer
    C. Norepinephrine
    Explanation
    Sympathetic stimulation of the SA node triggers the release of norepinephrine from nerve endings. Norepinephrine then binds to Beta 1 adrenergic receptors on pacemaker cell membranes. This binding activates a signaling cascade that leads to an increase in heart rate and contractility. Acetylcholine, on the other hand, is released during parasympathetic stimulation and has the opposite effect, slowing down the heart rate. Ephedrine is a sympathomimetic drug that stimulates the release of norepinephrine, but it is not directly released from nerve endings. cAMP is a secondary messenger involved in the signaling pathway activated by norepinephrine binding to the Beta 1 adrenergic receptors.

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  • 8. 

    Look at the above ECG. Occlusion of which coronary artery most likely resulted in this ECG?    

    • A.

      Right Coronary Artery

    • B.

      Acute Marginal

    • C.

      Circumflex

    • D.

      Left Anterior Descending

    Correct Answer
    D. Left Anterior Descending
    Explanation
    Based on the given ECG, the most likely occlusion is in the Left Anterior Descending (LAD) coronary artery. The ECG shows ST-segment elevation in leads V1-V6, which is characteristic of an anterior wall myocardial infarction. The LAD supplies blood to the anterior wall of the left ventricle, which explains the changes seen in the ECG.

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  • 9. 

    Look at the above ECG. Occlusion of which coronary artery most likely resulted in the above ECG?      

    • A.

      Right Coronary Artery

    • B.

      Acute Marginal

    • C.

      Circumflex

    • D.

      Left Anterior Descending

    Correct Answer
    A. Right Coronary Artery
    Explanation
    Based on the given ECG, the most likely occlusion is in the Right Coronary Artery. This is because the ECG shows ST-segment elevation in leads II, III, and aVF, which are typically affected by a right coronary artery occlusion.

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  • 10. 

    Occlusion of the circumflex artery will result in what type of MI?

    • A.

      Inferior wall MI

    • B.

      Lateral wall MI

    • C.

      Anterior wall MI

    • D.

      Posterior wall MI

    Correct Answer
    B. Lateral wall MI
    Explanation
    Occlusion of the circumflex artery will result in a lateral wall MI. The circumflex artery is one of the main branches of the left coronary artery and supplies blood to the lateral wall of the left ventricle. When this artery becomes blocked, it causes a lack of blood flow to the lateral wall, leading to myocardial infarction in that area. Symptoms of a lateral wall MI may include chest pain, shortness of breath, and changes in the ECG readings.

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  • 11. 

    Approximately what percentage of pts with HTN and a normal ECG have undiagnosed significant CAD?

    • A.

      17%

    • B.

      21%

    • C.

      14%

    • D.

      26%

    Correct Answer
    C. 14%
    Explanation
    Approximately 14% of patients with hypertension and a normal ECG have undiagnosed significant CAD. This means that out of all the patients with high blood pressure and a normal electrocardiogram, around 14% of them have significant coronary artery disease that has not been detected or diagnosed.

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  • 12. 

    During anesthetic management of a pt with HTN, you should seek to keep the intra-op BP within _____ of your baseline BP.

    • A.

      You should seek to reduce BP to normal range.

    • B.

      10%

    • C.

      5%

    • D.

      20%

    Correct Answer
    D. 20%
    Explanation
    During anesthetic management of a patient with hypertension, it is important to keep the intraoperative blood pressure within 20% of the baseline blood pressure. This means that the blood pressure should not deviate more than 20% from the patient's normal or baseline blood pressure. This is crucial to ensure that the patient's blood pressure remains stable and within a safe range during the procedure.

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  • 13. 

    Which of the following pts has minor cardiac clinical predictors?

    • A.

      Ms. A, an 85 yr old pt with PMH: stroke

    • B.

      Mrs. B, a 67 yr old female PMH: a-fib, severe mitral stenosis

    • C.

      Mr. C, a 52 yr old male. PMH: Diabetes and periph neuropathy

    • D.

      None of above

    Correct Answer
    A. Ms. A, an 85 yr old pt with PMH: stroke
    Explanation
    Ms. A, an 85-year-old patient with a history of stroke, has minor cardiac clinical predictors. This suggests that her previous stroke may have affected her cardiovascular health and could be indicative of underlying cardiac issues. While the other patients have their own medical histories, Ms. A's history of stroke is specifically mentioned as a minor cardiac clinical predictor.

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  • 14. 

    Which of the following pts has intermediate cardiac clinical predictors?

    • A.

      Ms. A, an 85 yr old pt with PMH: stroke

    • B.

      Mrs. B, a 67 yr old female PMH: a-fib, severe mitral stenosis

    • C.

      Mr. C, a 52 yr old male. PMH: Diabetes and periph neuropathy

    • D.

      None of above

    Correct Answer
    C. Mr. C, a 52 yr old male. PMH: Diabetes and periph neuropathy
    Explanation
    The correct answer is Mr. C, a 52 yr old male with a history of diabetes and peripheral neuropathy. Intermediate cardiac clinical predictors refer to conditions or factors that are associated with an increased risk of cardiac events or complications. In this case, diabetes and peripheral neuropathy are both conditions that can contribute to cardiovascular problems. While Ms. A and Mrs. B have their own medical histories, they do not have conditions that directly relate to cardiac risk. Therefore, Mr. C is the only patient among the options provided who has intermediate cardiac clinical predictors.

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  • 15. 

    Which of the following pts has major cardiac clinical predictors?

    • A.

      Ms. A, an 85 yr old pt with PMH: stroke

    • B.

      Mrs. B, a 67 yr old female PMH: a-fib, severe mitral stenosis

    • C.

      Mr. C, a 52 yr old male. PMH: Diabetes and periph neuropathy

    • D.

      None of above

    Correct Answer
    B. Mrs. B, a 67 yr old female PMH: a-fib, severe mitral stenosis
    Explanation
    Mrs. B is the correct answer because she has major cardiac clinical predictors, specifically a history of atrial fibrillation and severe mitral stenosis. These conditions indicate significant cardiac dysfunction and increase the risk of cardiovascular events. The other patients do not have major cardiac clinical predictors mentioned in their medical history.

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  • 16. 

    Which of the following patients would you want to get a stress test prior to surgery (assuming it is not already done)?

    • A.

      Patient with PMH of HTN, undergoing emergent repair of AAA

    • B.

      Patient with PMH: Diabetes, neuropathy, who has METS= 6 and a normal baseline ECG. Recently diagnosed thyroid CA undergoing thyroidectomy.

    • C.

      Patient with PMH of HTN (currently well controlled), MI 4 yrs ago, METS=3, COPD, undergoing TURP.

    • D.

      Patient with PMH angina (minor), HTN, DM. Undergoing carotid endarterectomy.

    Correct Answer
    C. Patient with PMH of HTN (currently well controlled), MI 4 yrs ago, METS=3, COPD, undergoing TURP.
    Explanation
    The patient with a history of hypertension (currently well controlled), a myocardial infarction four years ago, a METS score of 3, and chronic obstructive pulmonary disease (COPD) undergoing transurethral resection of the prostate (TURP) would require a stress test prior to surgery. This patient has a history of cardiovascular disease (MI) and a low exercise capacity (METS=3), which puts them at a higher risk for perioperative cardiac events. The stress test would help assess their cardiovascular fitness and determine if any further interventions or precautions are needed before the surgery.

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  • 17. 

    Which of the following procedures is considered high cardiac risk?

    • A.

      Carotid Endartectomy

    • B.

      Mediastinoscopy

    • C.

      Left breast Mastectomy

    • D.

      Fem-pop bypass

    Correct Answer
    D. Fem-pop bypass
    Explanation
    Fem-pop bypass is considered a high cardiac risk procedure because it involves bypassing a blocked or narrowed artery in the leg using a graft. This procedure requires the heart to pump blood through the graft, which puts additional strain on the heart. It is typically performed on patients with severe peripheral artery disease and significant cardiovascular risk factors. Carotid endarterectomy, mediastinoscopy, and left breast mastectomy are not specifically related to cardiac risk.

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  • 18. 

    Which of the following procedures carries an intermediate cardiac risk?

    • A.

      Thyroidectomy

    • B.

      Repair of AAA

    • C.

      Whipple procedure

    • D.

      ERCP

    Correct Answer
    A. Thyroidectomy
    Explanation
    Thyroidectomy carries an intermediate cardiac risk because it involves the removal of the thyroid gland, which is located near the heart. During the procedure, there is a risk of damage to the nearby blood vessels and nerves, which can potentially lead to cardiac complications. Additionally, the surgery itself can cause stress on the cardiovascular system, increasing the risk of cardiac events such as arrhythmias or heart attack. Therefore, patients undergoing thyroidectomy should be closely monitored for any cardiac issues during and after the procedure.

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  • 19. 

    Mr. Avery’s BP is currently 134/80. What is his MAP?

    • A.

      107

    • B.

      98

    • C.

      80

    • D.

      76

    Correct Answer
    B. 98
    Explanation
    The mean arterial pressure (MAP) is calculated by adding twice the diastolic blood pressure (DBP) to the systolic blood pressure (SBP) and dividing the sum by 3. In this case, the DBP is 80 and the SBP is 134. Adding twice the DBP (80 x 2 = 160) to the SBP (134) gives a sum of 294. Dividing 294 by 3 gives a MAP of 98.

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  • 20. 

    What is the Cardiac output for Mrs. Wiffenbach? Her BP is currently 141/78, HR 74, SV 84 mls, BSA 2 m2, CVP 4.

    • A.

      3.1 L/min

    • B.

      9.9 L/min

    • C.

      6.2 L/min

    • D.

      2.7 L/min

    Correct Answer
    C. 6.2 L/min
  • 21. 

    What is the cardiac index for Mrs. Duvar? BP 116/64, HR 58, SV 100, BSA 2 m2, CVP 6.

    • A.

      5.8 L/min/m2

    • B.

      9.4 L/min/m2

    • C.

      3.1 L/min/m2

    • D.

      2.9 L/min/m2

    Correct Answer
    D. 2.9 L/min/m2
    Explanation
    The cardiac index is a measure of cardiac output adjusted for body surface area. It is calculated by dividing the cardiac output by the body surface area. In this case, the cardiac output can be calculated by multiplying the stroke volume (SV) by the heart rate (HR). The given values are BP 116/64, HR 58, SV 100, BSA 2 m2, and CVP 6. Using these values, the cardiac output can be calculated as 100 * 58 = 5800 ml/min. Dividing this by the body surface area of 2 m2 gives a cardiac index of 5800/2 = 2900 ml/min/m2, which is equivalent to 2.9 L/min/m2.

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  • 22. 

    What is the SVR for Mr. Gosser? BP  152/80, HR 92, CO 6.9 L min, CI 3.3 L/min/m2, BSA 2.1/m2, CVP 4, SV 75 ml.

    • A.

      1159 dynes

    • B.

      2425 dynes

    • C.

      881 dynes

    • D.

      1563 dynes

    Correct Answer
    A. 1159 dynes
  • 23. 

    Which anesthetic causes the greatest amount of myocardial depression?

    • A.

      Sevoflurane

    • B.

      Halothane

    • C.

      Desflurane

    • D.

      Isoflurane

    Correct Answer
    B. Halothane
    Explanation
    Halothane is the correct answer because it causes the greatest amount of myocardial depression compared to the other anesthetics listed. Myocardial depression refers to a decrease in the contractility of the heart muscle, leading to a decrease in the pumping ability of the heart. Halothane is known to have a more pronounced negative inotropic effect on the heart, meaning it reduces the force of contraction. This can be problematic in patients with compromised cardiac function or those undergoing cardiac surgery, as it can further impair heart function. Sevoflurane, Desflurane, and Isoflurane also have some myocardial depressant effects, but to a lesser extent than Halothane.

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  • 24. 

                            Which of the following BP’s represents stage 1 hypertension?

    • A.

      162/100

    • B.

      138/86

    • C.

      142/90

    • D.

      180/112

    Correct Answer
    C. 142/90
    Explanation
    Stage 1 hypertension is defined as having a systolic blood pressure (the top number) between 130-139 mmHg or a diastolic blood pressure (the bottom number) between 80-89 mmHg. Among the given options, the blood pressure reading of 142/90 falls within this range, making it the correct answer for stage 1 hypertension.

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  • 25. 

    Which of the following BP’s represents Stage 2 hypertension?

    • A.

      135/82

    • B.

      154/92

    • C.

      201/112

    • D.

      178/100

    Correct Answer
    D. 178/100
    Explanation
    Stage 2 hypertension is defined as a systolic blood pressure (the top number) of 140 mmHg or higher, or a diastolic blood pressure (the bottom number) of 90 mmHg or higher. Among the given options, the BP reading of 178/100 is the only one that meets this criteria, making it the correct answer for Stage 2 hypertension.

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  • 26. 

    Which of the following BP’s represents Stage 3 hypertension?

    • A.

      184/110

    • B.

      176/102

    • C.

      132/88

    • D.

      147/92

    Correct Answer
    A. 184/110
    Explanation
    Stage 3 hypertension is defined as a blood pressure reading of 180/110 mmHg or higher. Therefore, the correct answer is 184/110 as it falls within this range and represents Stage 3 hypertension.

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  • 27. 

    At what stage of hypertension would a patient begin to experience renal dysfunction?

    • A.

      Stage 4

    • B.

      Stage 3

    • C.

      Stage 2

    • D.

      Stage 1

    Correct Answer
    B. Stage 3
    Explanation
    Stage 3 hypertension is characterized by a systolic blood pressure of 180 mmHg or higher, or a diastolic blood pressure of 110 mmHg or higher. At this stage, the blood pressure is severely elevated, which can lead to damage to the blood vessels in the kidneys. This damage can result in renal dysfunction, such as decreased kidney function or the development of chronic kidney disease. Therefore, it is at stage 3 of hypertension that a patient would begin to experience renal dysfunction.

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  • 28. 

    At what stage of hypertension would a patient experience encephalopathy?

    • A.

      Stage 3

    • B.

      Stage 1

    • C.

      Stage 4

    • D.

      Stage 2

    Correct Answer
    C. Stage 4
    Explanation
    Encephalopathy is a condition characterized by brain dysfunction, which can occur as a result of severe hypertension. Stage 4 hypertension is the most severe stage, where blood pressure is extremely high and can cause damage to various organs including the brain. Therefore, it is at this stage that a patient is most likely to experience encephalopathy.

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  • 29. 

    If a patient has a Right sided Dominant heart it means what?

    • A.

      The right atria provides the majority of force required to perfuse Left coronary artery and circumflex artery during diastole

    • B.

      Patient is experiencing Left sided heart failure, thus making the pt right sided dominant

    • C.

      The coronary veins drain into the right atrium

    • D.

      Patients posterior descending artery is supplied by the right coronary artery

    Correct Answer
    D. Patients posterior descending artery is supplied by the right coronary artery
  • 30. 

    Many patients with hypertension display an accentuated _______ response to induction and an exaggerated ______ response to intubation.

    • A.

      Hypotensive, hypertensive

    • B.

      Hypertensive, hypertensive

    • C.

      Hypertensive, hypotensive

    • D.

      Hypotensive, hypotensive

    Correct Answer
    A. Hypotensive, hypertensive
    Explanation
    Many patients with hypertension display an accentuated hypotensive response to induction, meaning their blood pressure drops significantly during the process. However, they also exhibit an exaggerated hypertensive response to intubation, where their blood pressure increases significantly. This suggests that these patients have a tendency to experience low blood pressure during induction and high blood pressure during intubation.

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  • 31. 

    You are the SRNA for Mr. Bad-day, a few minutes into his surgery you notice ST-segment elevation on the ECG. His BP is currently 164/98, What should you do first?

    • A.

      Send an ABG

    • B.

      Check lead placement and verify ST segment changes

    • C.

      Increase tidal volume and FiO2

    • D.

      Give Esmolol and increase depth of anesthesia.

    Correct Answer
    B. Check lead placement and verify ST segment changes
    Explanation
    The correct answer is to check lead placement and verify ST segment changes. This is because ST-segment elevation on the ECG can indicate myocardial ischemia or infarction, which is a serious condition that requires immediate attention. Checking the lead placement ensures that the ECG readings are accurate, while verifying the ST segment changes helps to confirm if there is indeed myocardial ischemia or infarction occurring. This information is crucial for determining the appropriate course of action and providing the necessary interventions to address the patient's condition.

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  • 32. 

    You are SRNA for Mrs. Xaio today. During the procedure, you notice ST elevation on her ECG. Her BP is currently 118/ 72 with HR 116. You verified the ST segment changes already, what should you do now?

    • A.

      Give Esmolol to treat tachycardia

    • B.

      Inform the surgeon of problems and consider stooping surgery

    • C.

      Ensure adequate oxygenation and ventilation

    • D.

      Deepen the anesthesia as pt may be too light

    Correct Answer
    C. Ensure adequate oxygenation and ventilation
    Explanation
    The presence of ST elevation on the ECG indicates myocardial ischemia or a heart attack. It is crucial to ensure adequate oxygenation and ventilation to optimize oxygen delivery to the heart and prevent further damage. This can be achieved by providing supplemental oxygen and ensuring proper ventilation. Giving Esmolol to treat tachycardia may help control the heart rate, but it does not address the underlying issue of myocardial ischemia. Informing the surgeon and considering stopping the surgery may be necessary, but ensuring adequate oxygenation and ventilation should be the immediate priority. Deepening the anesthesia may not be the appropriate action as it does not directly address the myocardial ischemia.

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  • 33. 

    You are the SRNA for Mr. Ompei, your day has gone to crap as you just verified your pt is having an intra-op MI. His BP is 162/ 88 with HR 136. You informed the surgeon of the situation, what is the most important thing to do next?

    • A.

      Call for an ICU bed

    • B.

      Start NTG drip at 0.25 mcg/min to treat HTN

    • C.

      Place an arterial line

    • D.

      Give esmolol to treat tachycardia

    Correct Answer
    D. Give esmolol to treat tachycardia
    Explanation
    The most important thing to do next is to give esmolol to treat the tachycardia. This is because the patient's heart rate is elevated at 136 beats per minute, which can be detrimental in the setting of an intra-op MI. Esmolol is a beta-blocker that can help decrease the heart rate and reduce the workload on the heart, improving myocardial oxygen supply and demand balance. This intervention should be prioritized to stabilize the patient's condition and prevent further complications.

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  • 34. 

    You are the SRNA for Mrs. Collier today. During the procedure, she becomes bradycardic to an HR of 50 beats per minute. Her BP is currently 90/52. How do you treat this bradycardia?

    • A.

      Give Ephedrine 5-10 mg

    • B.

      Give Robinol 0.2 mg

    • C.

      Give Epinephrine 10 mcg

    • D.

      Start Isoproteronol drip at 1mcg/min

    Correct Answer
    A. Give Ephedrine 5-10 mg
    Explanation
    Ephedrine is a sympathomimetic drug that acts on alpha and beta adrenergic receptors, causing vasoconstriction and increased heart rate. In this scenario, the patient is experiencing bradycardia (low heart rate) and hypotension (low blood pressure). Ephedrine can help increase the heart rate and improve blood pressure by stimulating the sympathetic nervous system. Therefore, giving Ephedrine 5-10 mg would be an appropriate treatment for this bradycardia.

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  • 35. 

      Which of the following occurs during the A-B segment of the cardiac pressure volume loop?

    • A.

      Isovolumetric relaxation

    • B.

      Filling Phase

    • C.

      Isovolumetric contraction

    • D.

      Ejection Phase

    Correct Answer
    B. Filling Phase
    Explanation
    During the A-B segment of the cardiac pressure volume loop, the ventricles are in diastole and are filling with blood. This phase is known as the filling phase. The atria contract and push blood into the ventricles, causing the ventricular volume to increase while the ventricular pressure remains low. This allows for the passive filling of the ventricles before the next phase of the cardiac cycle.

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  • 36. 

      Which of the following occurs during the D-A segment of the cardiac pressure volume loop?

    • A.

      Isovolumetric relaxation

    • B.

      Filling Phase

    • C.

      Isovolumetric contraction

    • D.

      Ejection Phase

    Correct Answer
    A. Isovolumetric relaxation
    Explanation
    During the D-A segment of the cardiac pressure volume loop, isovolumetric relaxation occurs. This phase represents the period when the ventricles are in diastole and the pressure within the ventricles decreases while the volume remains constant. The mitral valve is closed, preventing blood from flowing into the ventricles, and the aortic valve is also closed, preventing blood from flowing out of the ventricles. This phase allows the ventricles to relax and refill with blood before the next contraction.

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  • 37. 

      Which of the following occurs during the C-D segment of the cardiac pressure volume loop?

    • A.

      Isovolumetric relaxation

    • B.

      Filling Phase

    • C.

      Isovolumetric contraction

    • D.

      Ejection Phase

    Correct Answer
    D. Ejection Phase
    Explanation
    During the C-D segment of the cardiac pressure volume loop, the ejection phase occurs. This is the phase where the ventricles contract and push blood out of the heart into the arteries. The pressure in the ventricles increases, causing the semilunar valves to open and blood to be ejected. The volume of blood in the ventricles decreases during this phase, leading to the ejection of blood.

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  • 38. 

    The above pressure loop represents which valvular disorder? 

    • A.

      Mitral Stenosis

    • B.

      Mitral Regurge

    • C.

      Aortic Stenosis

    • D.

      Aortic Regurge

    Correct Answer
    D. Aortic Regurge
    Explanation
    The given pressure loop represents Aortic Regurge. This can be determined based on the characteristics of the pressure loop, which typically shows a rapid drop in pressure during diastole due to the regurgitation of blood from the aorta back into the left ventricle. This causes an increase in left ventricular end-diastolic volume and pressure, leading to a rapid rise in pressure during systole. This pattern is consistent with Aortic Regurge.

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  • 39. 

    The above pressure loop represents which valvular disorder? 

    • A.

      Mitral Stenosis

    • B.

      Mitral Regurge

    • C.

      Aortic Stenosis

    • D.

      Aortic Regurge

    Correct Answer
    C. Aortic Stenosis
    Explanation
    The correct answer is Aortic Stenosis. Aortic stenosis is a valvular disorder characterized by the narrowing of the aortic valve, which leads to restricted blood flow from the left ventricle to the aorta. This results in increased pressure in the left ventricle during systole, as shown in the pressure loop. The pressure curve rises steeply during systole and then drops quickly during diastole, indicating the difficulty in pushing blood through the narrowed valve.

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  • 40. 

    The above pressure loop represents which valvular disorder? 

    • A.

      Mitral Stenosis

    • B.

      Mitral Regurge

    • C.

      Aortic Stenosis

    • D.

      Aortic Regurge

    Correct Answer
    B. Mitral Regurge
    Explanation
    The pressure loop shown in the question represents Mitral Regurge. This is indicated by the backward flow of blood from the left ventricle to the left atrium during systole. Mitral regurgitation occurs when the mitral valve does not close properly, allowing blood to leak back into the left atrium. This results in a characteristic pressure loop pattern, which is depicted in the given diagram.

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  • 41. 

    The above pressure loop represents which valvular disorder? 

    • A.

      Mitral Stenosis

    • B.

      Mitral Regurge

    • C.

      Aortic Stenosis

    • D.

      Aortic Regurge

    Correct Answer
    A. Mitral Stenosis
    Explanation
    The pressure loop represents Mitral Stenosis because it shows a decrease in pressure during diastole, which is characteristic of this valvular disorder. Mitral Stenosis occurs when the mitral valve becomes narrowed, making it difficult for blood to flow from the left atrium to the left ventricle. This results in increased pressure in the left atrium and decreased pressure in the left ventricle during diastole.

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  • 42. 

    Which of the following is not a determinant of myocardial function?

    • A.

      Oxygen demand

    • B.

      Preload

    • C.

      Heart rate

    • D.

      Contractility

    Correct Answer
    A. Oxygen demand
    Explanation
    Oxygen demand is not a determinant of myocardial function because it refers to the amount of oxygen needed by the heart muscle to function properly, rather than directly affecting the heart's ability to contract and pump blood. The other options, such as preload, heart rate, and contractility, all directly influence myocardial function by affecting the force of contraction and the amount of blood pumped by the heart.

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  • 43. 

    Which of the following will not cause an increase in myocardial oxygen consumption?

    • A.

      Increase Afterload

    • B.

      Decrease in HR

    • C.

      Increase SV

    • D.

      Dilation of Ventricle

    Correct Answer
    B. Decrease in HR
    Explanation
    A decrease in heart rate will not cause an increase in myocardial oxygen consumption because when the heart rate decreases, the heart has more time to fill with blood during diastole. This allows for increased coronary perfusion and oxygen delivery to the myocardium, resulting in a decrease in oxygen demand.

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  • 44. 

    Where are pacemaker leads inserted for a biventricular pacemaker?

    • A.

      Thebesian veins

    • B.

      Directly into Right Atria

    • C.

      Coronary Sinus

    • D.

      Ventricular Septum

    Correct Answer
    C. Coronary Sinus
    Explanation
    Pacemaker leads are inserted into the coronary sinus for a biventricular pacemaker. The coronary sinus is a large vein located on the posterior side of the heart, and it receives blood from smaller cardiac veins. By placing the leads in the coronary sinus, the pacemaker can stimulate the left ventricle to contract in synchronization with the right ventricle, improving the coordination and efficiency of the heart's pumping action.

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  • 45. 

    Which portion of the cardiac conduction system causes a delay in transmission of the action potential?

    • A.

      Transitional cells

    • B.

      SA Node

    • C.

      Purkinje fibers

    • D.

      AV node

    Correct Answer
    D. AV node
    Explanation
    The AV node causes a delay in transmission of the action potential in the cardiac conduction system. This delay allows the atria to contract and empty their blood into the ventricles before the ventricles contract. This coordination ensures efficient blood flow and prevents the atria and ventricles from contracting at the same time, which could lead to ineffective pumping of blood.

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  • 46. 

    A Bundle-branch block most likely represents an issue with what part of the cardiac conduction system?

    • A.

      Purkinje fibers

    • B.

      AV node

    • C.

      SA node

    • D.

      Pacemaker cells

    Correct Answer
    A. Purkinje fibers
    Explanation
    A bundle-branch block refers to a delay or blockage in the electrical signals that travel through the bundle branches of the cardiac conduction system. The bundle branches are responsible for conducting the electrical impulses from the atria to the ventricles. Purkinje fibers are a specialized network of cells that extend from the bundle branches and are responsible for transmitting the electrical signals to the ventricular muscle, causing it to contract. Therefore, a bundle-branch block most likely represents an issue with the Purkinje fibers.

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  • 47. 

    Decreased contraction of the ventricles is known as…

    • A.

      Akinesis

    • B.

      Hypokinesis

    • C.

      Dyskinesis

    • D.

      Bradycardia

    Correct Answer
    B. Hypokinesis
    Explanation
    Hypokinesis refers to a decreased contraction of the ventricles. This means that the ventricles are not contracting as strongly as they should be. This can be caused by a variety of factors, such as damage to the heart muscle or a decrease in blood supply to the heart. Hypokinesis can lead to decreased pumping of blood from the heart, which can result in symptoms such as fatigue, shortness of breath, and decreased exercise tolerance.

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  • 48. 

    Paradoxical bulging of the ventricles is known as…

    • A.

      Akinesis

    • B.

      Hypokinesis

    • C.

      Dyskinesis

    • D.

      Fibrillation

    Correct Answer
    C. Dyskinesis
    Explanation
    Dyskinesis refers to the paradoxical bulging of the ventricles. This condition occurs when a portion of the ventricular wall moves in the opposite direction of the rest of the ventricle during contraction. It is typically caused by a regional abnormality in the myocardium, such as scar tissue or aneurysm. Dyskinesis can impair the pumping function of the heart and lead to decreased cardiac output.

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  • 49. 

    The primary risk factor for the development of CAD is…

    • A.

      Family history

    • B.

      Aortic stenosis

    • C.

      Hx of DVT

    • D.

      Hypertension

    Correct Answer
    D. Hypertension
    Explanation
    Hypertension, or high blood pressure, is the correct answer because it is a well-known risk factor for the development of coronary artery disease (CAD). Hypertension can cause damage to the walls of the arteries, leading to the formation of plaque and narrowing of the blood vessels. This can restrict blood flow to the heart, increasing the risk of CAD. Additionally, hypertension can also lead to other cardiovascular conditions such as heart failure and stroke, further contributing to the development of CAD. Family history, aortic stenosis, and a history of deep vein thrombosis (DVT) may also be risk factors for CAD, but hypertension is considered the primary risk factor.

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  • 50. 

    What does Starling’s Law state?

    • A.

      States that the greater the amount of blood entering the heart during diastole, the greater the amount of blood ejected during systole

    • B.

      Relates ventricular pressure to wall tension

    • C.

      Demonstrates the relationship between certain pressures in the heart and differing points in the cardiac cycle

    • D.

      None of above.

    Correct Answer
    A. States that the greater the amount of blood entering the heart during diastole, the greater the amount of blood ejected during systole
    Explanation
    Starling's Law states that the greater the amount of blood entering the heart during diastole, the greater the amount of blood ejected during systole. This means that the heart will pump out a larger volume of blood if it receives a larger volume of blood during the relaxation phase. This law helps to explain the relationship between the amount of blood entering the heart and the amount of blood pumped out, highlighting the importance of preload in cardiac function.

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 20, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • May 29, 2009
    Quiz Created by
    Scottishduffy
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