Px CON Patología Cardiovascular (2)

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  • 1/20 Questions

    Es el fracaso del corazón para bombear la sangre capaz de cubrir las necesidades metabólicas del organismo. Congestión venosa, pulmonar y/o sistémica, indenpendientemente de la función ventricular y del gasto cardíaco.

    • Insuficiencia cardiaca
    • Cardiopatía isquémica
    • Hipertensión arterial
    • Miocardiopatia
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Px CON Patología Cardiovascular (2) - Quiz

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  • 2. 

    De las siguientes cual es la verdadea

    • Angina inestable: cualquier cambio en el patrón anginoso, puede ser el pródromo de un infarto

    • Angina estable: las arterias no pueden proporcionar oxigeno necesario al aumentar demandas energéticas, aparece el angor

    • Necrosis del músculo por reducción abrupta del flujo coronario

    • A b y c son verdaderas

    Correct Answer
    A. A b y c son verdaderas
    Explanation
    The correct answer is that options a, b, and c are true. This means that any change in the anginal pattern can be a prodrome of a heart attack, the arteries cannot provide enough oxygen during increased energy demands leading to angina, and there can be necrosis of the muscle due to a sudden reduction in coronary blood flow.

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  • 3. 

    Botiquín de 1º auxiliaos Cardiológicos

    • Nitroglicerina, lidocaína 1% ampolla, atropina 0.5mg ampolla

    • Verapamilo comprimido 0mg o ampolla 5mg, nifedipina comprimido 20mg

    • Furosemida comprimido 40mg o ampolla 20mg, Pentazocina ampollas 30mg

    • A b y c

    Correct Answer
    A. A b y c
    Explanation
    The correct answer is "a b y c" because it includes all the listed items in the Botiquín de 1º auxiliaos Cardiológicos. The items listed are nitroglycerin, lidocaine 1% ampoule, atropine 0.5mg ampoule, verapamil tablet 0mg or ampoule 5mg, nifedipine tablet 20mg, furosemide tablet 40mg or ampoule 20mg, and pentazocine ampoules 30mg.

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  • 4. 

    Pacientes con medicación cronotrópica negativa (betabloqueantes, calcinoantagonistas, amidarona) y presentan bradiacardia deben reducir dosis bajo control del especialista previo al tx dental

    • Si

    • No

    Correct Answer
    A. Si
    Explanation
    Patients who are taking negative chronotropic medication (such as beta blockers, calcium antagonists, amiodarone) and have bradycardia should reduce their dosage under the supervision of a specialist before dental treatment.

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  • 5. 

    Hipertensión arterial: por encima de 140/90 mmHg, 95% idiopática

    • Con su medico: pedir informe clínica y detallando el plan de tx, informar lo referente al estrés, pérdid de sangre, duración y complejidad

    • Se pueden emplear enjuagues salinos y también vasoconstrictores para controlar hemorragias

    • Anestesia con adrelnalina en procedimiento de mas de 30 min.

    • A y c

    Correct Answer
    A. A y c
    Explanation
    The correct answer is "a y c". The explanation for this answer is that both options "a" and "c" are correct. Option "a" states that saline rinses can be used to control bleeding, and option "c" states that adrenaline can be used in anesthesia for procedures lasting more than 30 minutes. Therefore, both options are valid and contribute to the management and control of bleeding in patients with arterial hypertension.

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  • 6. 

    Hiperetnsión arterial: es cierto que:

    • Evitar cambios bruscos de posición del sillón. al terminar dejar al px sentado unos minutos, para evitar la hipotensión ortostática (efecto 2rio de la medicación hipotensora)

    • Se emplear enjuagues salinos para control de la higiene bucal

    • Anestesia sin adrenalina en procedimientos de menos de 30 min

    • Emplear vasoconstrictores para controlar hemorragías locales

    Correct Answer
    A. Evitar cambios bruscos de posición del sillón. al terminar dejar al px sentado unos minutos, para evitar la hipotensión ortostática (efecto 2rio de la medicación hipotensora)
    Explanation
    The correct answer is to avoid sudden changes in position of the chair and to allow the patient to sit for a few minutes after finishing, in order to prevent orthostatic hypotension, which is a secondary effect of antihypertensive medication. This is important because sudden changes in position can cause a drop in blood pressure, leading to symptoms such as dizziness or lightheadedness. All the other options mentioned in the question are not correct in the context of hypertension.

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  • 7. 

    Pacientes que presentan angina de pecho en el sillón dental, procedimiento a seguir:

    • Suspender tx, tomar tensión arterial, nitroglicerina sublimgual

    • Tranquilizar al paciente I.V. lentamente una ampolla de pentazocina (analgesico), aflojar prendas de vestir, reclinar al paciente

    • Si cede en 5-10 min continuar con el tx, Si no cede: ambulancia dotada (IV. abbocath, palometa y atropina 0.5mg y lidocaina al 1%)

    • Todas

    Correct Answer
    A. Todas
    Explanation
    The correct answer is "todas" because the given instructions list all the steps to be followed when a patient presents angina in the dental chair. These steps include suspending treatment, taking blood pressure, administering sublingual nitroglycerin, reassuring the patient, administering pentazocine intravenously, loosening clothing, reclining the patient, and if the symptoms do not subside within 5-10 minutes, calling an equipped ambulance and administering atropine and lidocaine intravenously. Therefore, "todas" indicates that all the steps mentioned should be followed in this situation.

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  • 8. 

    Si en el sillón aparece bradicardia administrar una ampolla I.V. de

    • Atropina

    • Lidocaina

    • Verapamilo

    • Furosemida

    Correct Answer
    A. Atropina
    Explanation
    If bradycardia appears on the couch, administering an IV ampoule of atropine is the correct answer. Atropine is a medication commonly used to treat bradycardia, as it helps increase heart rate by blocking certain nerve signals. Lidocaine, verapamil, and furosemide are not typically used to treat bradycardia, so they are not the correct choices in this scenario.

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  • 9. 

    Si se presenta una crisis hipertensiva en el sillón, administrar:

    • Atropina IV ampolla de 0.5mg

    • Nifedipina una capsula de 20mg sublingual

    • Lidacaina al 1%

    • Furosemida comprimido de 40mg

    Correct Answer
    A. Nifedipina una capsula de 20mg sublingual
    Explanation
    The correct answer is nifedipina una capsula de 20mg sublingual. In a hypertensive crisis, nifedipine is commonly used to quickly lower blood pressure. It is a calcium channel blocker that relaxes and widens the blood vessels, allowing for better blood flow and reducing blood pressure. The sublingual route of administration ensures rapid absorption of the medication into the bloodstream, leading to a faster onset of action. Atropine is not indicated for hypertensive crisis but rather for certain cardiac conditions. Lidocaine is a local anesthetic and furosemide is a diuretic, neither of which are appropriate for managing hypertensive crisis.

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  • 10. 

    Los px tienen una obstrucción de origen arterioesclerótico en sus arterias coronarias que dificultan el flujo sanguineo hacia el miocardio y genera isquemia en el mismo

    • Cardiopatía isquemica

    • Angina estable

    • Angina inestable

    • Infarto de miocardio

    • Todas

    Correct Answer
    A. Todas
    Explanation
    The given statement explains that the px (patient) has an arteriosclerotic obstruction in their coronary arteries, which hinders blood flow to the myocardium and causes ischemia. This condition is known as ischemic heart disease. The options provided, including stable angina, unstable angina, and myocardial infarction, are all different manifestations of ischemic heart disease. Therefore, the correct answer is "todas" (all).

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  • 11. 

    Fibrilación ventricular

    • Pulso arritmico, frecuencia cardíaca elevada 150-250 lpm

    • Pulso ritmico y frecuencia cardíaca 100-150 lpm

    • Pulso ritmico, frecuencia cardíaca 150-250 lpm bien tolerada hemodinámicamente

    • Pulso ritmico, frecuencia cardíaca 150-250 lpm y mala tolerancia hemodinámica

    Correct Answer
    A. Pulso arritmico, frecuencia cardíaca elevada 150-250 lpm
    Explanation
    The correct answer is "pulso arritmico, frecuencia cardíaca elevada 150-250 lpm." This answer indicates that the patient has an irregular pulse and a high heart rate of 150-250 beats per minute. This is characteristic of ventricular fibrillation, a serious cardiac arrhythmia where the heart's electrical signals become chaotic, causing ineffective pumping of blood. It is important to identify and treat ventricular fibrillation promptly as it can lead to cardiac arrest and death if not addressed quickly.

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  • 12. 

    Taquicardia paroxística supraventricular y de forma mas infrecuente un flutter auricular

    • Pulso arritmico, frecuencia cardíaca elevada 150-250 lpm

    • Pulso ritmico y frecuencia cardíaca 100-150 lpm

    • Pulso ritmico, frecuencia cardíaca 150-250 lpm bien tolerada hemodinámicamente

    • Pulso ritmico, frecuencia cardíaca 150-250 lpm y mala tolerancia hemodinámica con hipertensión

    Correct Answer
    A. Pulso ritmico, frecuencia cardíaca 150-250 lpm bien tolerada hemodinámicamente
    Explanation
    The given answer states that the patient has a regular pulse and a heart rate of 150-250 beats per minute, but is well tolerated hemodynamically. This suggests that the patient is experiencing paroxysmal supraventricular tachycardia (PSVT), a type of arrhythmia characterized by sudden episodes of rapid heart rate originating above the ventricles. Despite the high heart rate, the patient is able to maintain stable blood pressure and cardiac output, indicating good hemodynamic tolerance.

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  • 13. 

    Consideraciones generales en las cardiopatías isquémicas, excepto:

    • Evitar estres, citar a 1º hora, evitar retrasos y sesiones largas.

    • Benzodiacepinas (Diazepan o Bromazepan 5-10mg) o Barbiturico de acción corta (Pentobarbital 30-60mg o Secobarbital 60-100mg)

    • Nitroglicerina sublingual, con e px ya recostado en el sillón

    • Px que ha sufrido infarto posponer la intervención quirúrgica hasta pasados 6 meses

    Correct Answer
    A. Px que ha sufrido infarto posponer la intervención quirúrgica hasta pasados 6 meses
    Explanation
    The correct answer is to postpone the surgical intervention for a patient who has suffered a heart attack for at least 6 months. This is because after a heart attack, the heart needs time to heal and stabilize before undergoing any surgical procedures. Performing surgery too soon after a heart attack can increase the risk of complications and further damage to the heart. It is important to give the patient enough time to recover and for their heart to regain its strength before considering any surgical interventions.

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  • 14. 

    Historia previa de cardiopatia isquémica y/o taquicardia ventricular

    • Pulso arritmico, frecuencia cardíaca elevada 150-250 lpm

    • Pulso ritmico y frecuencia cardíaca 100-150 lpm

    • Pulso ritmico, frecuencia cardíaca 150-250 lpm bien tolerada hemodinámicamente

    • Pulso ritmico, frecuencia cardíaca 150-250 lpm y mala tolerancia hemodinámica con hipertensión

    Correct Answer
    A. Pulso ritmico, frecuencia cardíaca 150-250 lpm y mala tolerancia hemodinámica con hipertensión
    Explanation
    The given answer states that the patient has a regular pulse with a heart rate of 150-250 beats per minute and poor hemodynamic tolerance accompanied by hypertension. This suggests that the patient is experiencing a rapid and irregular heartbeat (tachycardia) that is not well tolerated by their cardiovascular system, leading to high blood pressure. This could be indicative of a serious condition such as ventricular tachycardia or ischemic heart disease, especially considering the patient's history of cardiac disease.

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  • 15. 

    Insuficiencia cardiaca:  la incorrecta es:

    • No someter a tx a u px con insuficiencia cardiaca descompensada hasta una vez controlada

    • Administrar vit K semanas previas

    • Algunos px presentan leucopenia. Mantienen u equilibrio hidrosalino muy inestable: evitar enjuagues salinos y deshidratación

    • Posición de trabajo: posición reclina

    • Procedimientos cortos, disminuir tensión nerviosa, administrar oxígeno...

    Correct Answer
    A. Posición de trabajo: posición reclina
    Explanation
    The incorrect statement in regards to heart failure is the position of work being in a reclined position. Heart failure patients should avoid reclining positions as it can lead to increased fluid accumulation in the lungs and worsen their symptoms. It is important for heart failure patients to maintain an upright position or elevate the head of the bed to improve breathing and reduce fluid retention.

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  • 16. 

    Respecto a las miocardiopatías, cual es la falsa:

    • Arritmias: px con miocardiopatia dilatada o hipertrófica reciben medicación antiarritmica la cual debe mantenerse en el tx estomatológico

    • Anticoagulación: px con miocardiopatia dilatada o restrictiva, no se disminuye el régimen de anticoagulación previo a la intervención estomatológica

    • Profilaxis endocarditis bacteriana en px con miocardiopatia hipertrófica e insuficiencia mitral

    • Profilaxis endocarditis bacteriana a px con miocardiopatia restrictiva e insuficiencia auriculoventricular

    Correct Answer
    A. Anticoagulación: px con miocardiopatia dilatada o restrictiva, no se disminuye el régimen de anticoagulación previo a la intervención estomatológica
    Explanation
    The false statement is about anticoagulation in patients with dilated or restrictive cardiomyopathy. The correct approach is to decrease the anticoagulation regimen prior to dental intervention in these patients.

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  • 17. 

    Taquicardia sinusal controlable con ansioliticos y tranquilizándolo

    • Pulso arritmico, frecuencia cardíaca elevada 150-250 lpm

    • Pulso ritmico y frecuencia cardíaca 100-150 lpm

    • Pulso ritmico, frecuencia cardíaca 150-250 lpm bien tolerada hemodinámicamente

    • Pulso ritmico, frecuencia cardíaca 150-250 lpm y mala tolerancia hemodinámica con hipertensión

    Correct Answer
    A. Pulso ritmico y frecuencia cardíaca 100-150 lpm
    Explanation
    The correct answer suggests that the patient has a rhythmic pulse with a heart rate of 100-150 beats per minute (bpm). This indicates a normal sinus rhythm with a controlled heart rate, which is considered within the normal range. It suggests that the patient's sinus tachycardia is well managed with anxiolytics and sedatives, resulting in a stable heart rate.

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  • 18. 

    Inyectar ampolla de furosemida 40mg, es tx de:

    • Hipertensión arterial

    • Insuficiencia cardiaca

    • Cardiopatia isquémica

    • Arritmias

    • Miocardiopatias

    Correct Answer
    A. Insuficiencia cardiaca
    Explanation
    Inyectar ampolla de furosemida 40mg se utiliza como tratamiento para la insuficiencia cardiaca. La furosemida es un diurético de asa que ayuda a eliminar el exceso de líquido del cuerpo, lo que puede aliviar los síntomas de la insuficiencia cardiaca, como la acumulación de líquido en los pulmones y las extremidades.

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  • 19. 

    Marcapasos:

    • Es muy práctico disponer de un imán, si se desprograma el marcapasos basta con aplicar el imán sobre el generador para que este comience a lanzar estímulos a intervalos fijos

    • Px de alto riesgo en el sillón dental, preferible atender en un hospital

    • Los instrumentos eñéctricos de odontología pueden interferir en el marcapasos

    • Consultar con el cardiologo sobre el plan de tx, riesgos vinculados, meiddas de precaución y patologia cardiaca fundamental

    Correct Answer(s)
    A. Es muy práctico disponer de un imán, si se desprograma el marcapasos basta con aplicar el imán sobre el generador para que este comience a lanzar estímulos a intervalos fijos
    A. Consultar con el cardiologo sobre el plan de tx, riesgos vinculados, meiddas de precaución y patologia cardiaca fundamental
    Explanation
    The answer explains that it is practical to have a magnet because if the pacemaker is deprogrammed, applying the magnet to the generator will cause it to start sending stimuli at fixed intervals. It also suggests consulting with the cardiologist about the treatment plan, associated risks, precautionary measures, and underlying heart disease.

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  • 20. 

    Tx de la insuficiencia cardiaca aguda durante el procedimiento:

    • Suspender procedimiento, colocarlo sentado, registrar signos vitales

    • Inyectar ampolla de furosemida 40mg, reducir la aprehensión, tranquilizarlo, avisar servicio de urgéncias

    • Inyectar atropina 0.5mg, reducir aprehensión, tranquilizar (Diazepam), avisar ambuancia dotada

    • Todas

    Correct Answer(s)
    A. Suspender procedimiento, colocarlo sentado, registrar signos vitales
    A. Inyectar ampolla de furosemida 40mg, reducir la aprehensión, tranquilizarlo, avisar servicio de urgéncias
    Explanation
    In the given scenario, the patient is experiencing acute heart failure during the procedure. The appropriate steps to manage this situation include suspending the procedure to prioritize the patient's health, placing the patient in a seated position to improve blood flow, and monitoring vital signs to assess the severity of the condition. Administering a dose of furosemide, a diuretic medication, helps to reduce fluid buildup in the body and alleviate symptoms. Additionally, it is important to calm and reassure the patient while promptly notifying the emergency service for further assistance. Therefore, all the mentioned actions are necessary to manage the acute heart failure during the procedure.

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