What is the formula for calculating cardiac output?
CO = PA - 1SVC
CO = AO x PA
CO = HR x SV
Stroke volume is...
Related to preload
Related to afterload
The same as ejection fraction
Preload is most impacted by
Mean arterial pressure
Increased filling volumes
Ejection fraction
A patient with chronic untreated hypertension would demonstrate...
Increased afterload
Decreased afterload
Decreased preload
Vascular resistance/pressure is most influenced by...
Radius of the vessel
Blood viscosity
Length of the vessel
BMI
The formula for BP is...
BP = SV x SVR
BP = CO x SVR
BP = HR x SVR
What component of a Pulmonary Capillary Wedge pressure indicates Mitral insufficiency?
A wave
C wave
P wave
V wave
An elevated RVEDP is found in which pathology?
LV infarct
Aortic stenosis
RV infarct
Mitral Regurgitation
If the RA waveform is 2x the normal value, where would this be demonstrated in the physical assessment?
Decreased exercise tolerance
Decreased O2 sat
Increased O2 sat
JVD
What is the most common cause of Pulmonic stenosis?
Aging
Congenital
Cardiomyopathy
Mitral regurgitation
The blue proximal port of the swan is located how far from the distal tip of the swan?
15 cm
30 cm
45 cm
5 cm
When performing a thermodilution cardiac output, the operator injects 10 cc of saline into the ____________ and the temperature change is measured in the _____________
LA, AO
RV, PCWP
RA, PA
RA, LA
Based on these oxygen saturation so, what type of shunt is present? SVC sat = 67% IVC sat = 71% RA sat = 85% RV sat = 85% PA sat = 85% LA sat = 98% LV sat 98% AO sat = 98%
R to L ASD
L to R ASD
L to R VSD
It is all normal, there is no shunt
The type of ASD, located in the middle 1/3 of the the atrial septum (the former site of the fossa ovalis) is called?
Ostium Primium
Sinus Venosus
Ostium Secundum
What is the Flamm's equation?
3 (SVC) +1 (IVC) / 4
6 (SVC) + 2 (IVC) / 2
3 (PA) + 2 (AO) / 4
The formula used to calculate MAP is...
HR x SV / SVR
Mean AO - mean RA
1 (systolic) + (diastolic) / 3
Equalization of RVEDP and LVEDP are found in...
Tamponade
Restrictive Pericarditis
Acute MI
LV MI
Signs of right sided heart failure include...
SOB
Pulmonary embolism
What are the four anomalies associated with Tetralogy of Fallot?
ASD, VSD, LVH, RVH
VVH, PS, Over riding aorta, RVH
Over riding aorta, RVH, LVH, ASD
Pulmonic stenosis, over riding aorta, RVH, VSD
Which fetal anomaly is characterized by a large VSD over which a large single great vessel arises?
Transposition of the Great Vessels
Tricuspid Atresia
Tetralogy of Fallot
Truncas Arteriosus
Pulsus Pardoxus is a sign of...
Constrictive Pericarditis
Cardiac Tamponade
COPD
What does RAD stand for?
Radiation absorbed dose
Radiation attenuated date
Radiation attributable distance
Which component of the X-Ray system converts light rays into images?
Image intensifier
X-Ray tube
Photon tube
Anode
What is the maximum annual dose of radiation one can receive annually?
5 RAD
5 Currie
0.5 REM
5 REM
Lead protection should be at least how many millimeters of lead?
1.0
0.25
0.5
What is the minimum safe distance to position oneself from the X-Ray source?
3 feet
6 feet
10 feet
15 feet
In an X-Ray tube the...
Cathode is positive and the anode is negative
Cathode is negative and the anode is positive
The charges alternate depending on the heat generated
Which view exposes the operator to the GREATEST amount of radiation?
AP
LAO Cranial
Lateral
RAO with cranial 30
What converts X-rays into an image?
Filament
Kvp
The contrast that is best for a patient is...
Low osmolality
High osmolality
Renografin
Radiolucent means...
X-Rays are not permitted to pass through
X-rays are randomly deflected
X-rays are permitted to pass through
Radiopaque means...
X-rays are not permitted to pass through
ReoPro works on...
Fibrin
Prothrombin
Antithrombin
IIb/IIIa receptors
Heparin potentiates (increases) the action of...
Factor III
Factor IX
Factor VIII
Fibrinogen is converted to fibrin by the action of...
Pro thrombin
Tissue factor
Platelates
Thrombin
There are ___ known pathways to imitate the clotting cascade.
2
1
3
4
Aspirin inhibits the action of...
Von Willebrand Factor
Arachidonic Acid
Which agent is not an antiplatelet?
ASA (aspirin)
Heparin
Plavix
Reopro
If a patient has diabetes and renal failure with a creatinine of 2.0, what would you give?
Lasix
Fluids to hydrate
Ionic contrast
If a patient is taking NPH (injectable) insulin, which medication should not be given?
Protamine
Which medication is most commonly given to a patient with Supravetricular Tachycardia (SVT)
NTG
Lidocaine
Dopamine
Adenosine
If a patient has a creatinine greater than 1.4, contrast volume should be minimized.
Lidocaine converts from 2gm in 500cc to...
8gm in 1cc
400mg in 250cc
4mg in 1cc
Dopamine concentration 1600 mcg/ml in 250 cc yields a concentration of...
200 mg in 250 cc
400 mg in 250 cc
100 mg in 250 cc
The best short acting medication/anxietolytic to sedate a patient is...
Fentanyl
Valium
Versed/Midazilam
The drug of choice for treating coronary spasm is...
Verapamil
Amiodarone
Amiodarone is used to treat...
Atrial arrhythmias only
Ventricular arrhythmias only
Atrial and ventricular arrhythmias
What medication is used as a preload and afterload reducer?
Dobutamine
NTG (nitroglycerin)
Diabetic patients have a greater incidence of developing ______________ post contrast administration.
Renal failure
Infarct
Systemic infection
Which rhythm is most likely to become lethal?
1st degree block
Wenchebach
Mobitz 2
The Impella catheter most clearly resembles...
JR 4
Amplatz
Pigtail
IMA
When performing an LV gram with the LV injector, what is the purpose of setting a "rate of rise"?
It controls the total volume injected
It makes for a smoother injection, less catheter whip, limits ectopy
It adjusts the PSI for the correct catheter size
The EKG demonstrates ST elevation in leads II, III, and AVF. Which coronary would you suspect?
Inferior wall
Lateral wall
Apical wall
An EKG demonstrates ST elevation in leads V5, V6, lead I, and AVL. Which coronary artery is most likely occluded?
RCA
LAD
CX
How do you test the defibrillator?
Hold the paddles in the air and discharge
Discharge into the defibrillator (dummy load)
Never test, call biomed
What happens if you deliver a shock to a patient on the T wave?
They are easily cardioverted to a sinus rhythm
You could put them into Vfib
You could make them hypertensive
In 1st degree heart block, where is the conduction delay?
AV node
SA node
Bundle of His
In the RA
What is the normal PR interval
.08 - .12
> .20
.12 - .20
If a patient is attached to the monitor, Vtach is the rhythm, the patient has no pulse and is not responding, what should you do?
Synchronized cardioversion
Unsynchronized cardioversion
Call the MD before taking action
Check a blood pressure
If a patient is on a monitor in SVT, systolic BP is 70, the patient is diaphoretic, dusky and short of breath. What should you do?
Do immediate unsynchronized cardioversion
Do immediate synchronized cardioversion
Give adenosine 6mg
A common complication of placing a pacing electrode/wire is...
MI
Perfusion/Pericardial Effusion/Tamponade
Cardiac arrest
A pacing generator that paces in both chambers, senses in both chambers, and inhibits QRS complexes is a...
DDI
DVI
AAI
A pacing generator that paces both chambers, senses in both chambers, and triggers or inhibits pacing is a...
DDD
A pacing generator that paces in the atria, senses in the atria, and inhibits pacing is a...
AAO
What is the formula for calculating SVR
Mean AO - Mean RA/CO
Mean PA - Mean PCWP/CO
EDV - ESV / EDV
Which cardiac output would be more accurate in a patient with tricuspid regurgitation?
Thermals
LVMF
Fick
Which right heart pressure best reflects LV preload?
PA systolic pressure
PCWP
RA pressure
Which balloon is used for valvuloplasty?
ICE balloon
Tran-septal balloon
Inoue
Self-expanding
Aortic stenosis demonstrates a pressure that is elevated in the left ventricle and a pressure that is lower in the ____________.
Left atrium
Aortic arch
Pulmonary artery
RV
If a patient has a pulsatile mass below the sheath site, and a bruit is present, what should be suspected?
Hematoma
Aortic dissection
Thrombus
Pseudoaneurysm
An abdominal aortic pulsation greater than 3.0cm can be a finding for what?
Normal finding
Anomalous renal artery
Increased BMI
Aortic aneurysm
Back pain not relieved with nitroglycerin, morphine or oxygen and not associated with EKG changes can indicate...
PVD
Occluded LAD
Which stent is self expanding?
Cypher
Wall stent
Vision
A catheter has a diameter of 2.66mm. What French size is it?
7FR
6Fr
5Fr
8FR
In relation to a coronary lesion where should the wire not be placed?
As distal as possible
In the nearest side branch
In a distal side branch
Proximal to the lesion
All of the above
Which lesion is best addressed with a Rotoblador?
Calcified
Soft thrombus
New dissection
Very small vessels
Which catheter should be used to cannulate an LAD with a high take off?
JL4
Multipurpose
Landmarks for an internal jugular approach include the...
Head of the sternocleidomastoid muscle and the clavicular head
Superior and inferior carotid pulsations
2cm proximal to the xyphoid process
When performing a myocardial biopsy where are the tissue samples taken from?
LV
LA
Left atrial appendage
Hypokinetic means...
No movement at all
Decreased movement
Hyper or increased movement
Disorganized movement
In the formula BP = HR x SV x SVR, Dobutamine acts as an ____________, to _______________ by increasing ______________.
Chronotrope decrease stroke volume, contractility
Chronotrope, increase stroke volume, contractility
Inotrope, increase stroke volume, contractility
Which of the following are Angiotensin Receptor Blockers (ARBS)?
Lisiopril
Losartan
Metoprolol
Valsartan
NTG works to decrease preload when given during an MI by dilating?
Peripheral arteries
Arterioles
Veins
Coronary arteries
Low dose Dopamine, 1-5mcg/kg/min...
Improves renal function and urine output
Increases the heart rate
Increases systolic blood pressure
Increases stroke volume
If the patient complains of pain down the leg when attempting to cannulate the right femoral artery, which way do you move the needle?
Medial
Anterior
Medial and superior
Coronary arteries perfume best during...
Systole
When the systolic blood pressure is less than 140mmHg
Diastole
Equally well during systole and diastole
What is the purpose of the IABP?
Increased coronary perfusion, decreased afterload
Increased coronary perfusion, decreased preload
Raise systolic blood pressure
Increase renal perfusion
Inotropic drugs:
Digitalis
Epinephrine
All the above
Another name for Versed
Diphenhydramine
Diazepam
Midazolam
None of the above
Another name for Valium
Another name for Benadryl
Sedatives with NO analgesic properties:
Versed
Ibuprofen
Benadryl
Demeral
Acetaminophen
Heparin prevents clot formation by preventing the conversion of prothrombin to thrombin.
ReoPro inhibits IIb/IIIa receptors.
INR (international normalized ratio) measures the levels of Coumadin.
PT evaluates the coagulation factors VII, X, V, II and I (fibrinogen).
PTT (Partial Thromboplastin Time) test evaluates coagulation factors XII, XI, IX, VIII, X, V, II (prothrombin), and I (fibrinogen)
Medication of choice for Supraventricular Tachycardia is Adenosine.
Normal RA pressure:
25/10
25/5
120/80
0-4
120/10
7-12
Normal PA pressure:
Normal RV pressure:
Normal PCW pressure
Normal LV pressure:
Normal AO pressure:
Mean Arterial Pressure (MAP) calculation:
Systolic + Diastolic / 2
Systolic + Diastolic / 3
Diastolic + 2 x Systolic / 3
Systolic + 2 x Diastolic / 3
Pulse Pressure calculation:
AO Systole - AO Diastole
AO Diastole - AO Systole
PA Systole - AO Diastole
Stroke Volume (SV) calculation:
HR x CO
End Diastolic Volume - End Systolic Volume
HR - EDV
CO / BSA:
Cardiac Index
Regurgitant Fraction
Aortic Valve Flow
HR x SV / 1000
CO Angiographic (LVMF)
Gorlin's Constant used for Aortic valve area:
44.5
37.7
44.7
37.5
Gorlin constant for Mitral valve area:
Mean PA - Mean PCW / CO:
PVR
SVR
MVA
MVF
Mean AO - Mean RA / CO:
LV Systole - AO Systole:
Peak to Peak Gradient
Aortic Valve Area
CO / SEP ( systolic ejection period):
Aortic Valve Area (AVA)
Mitral Valve Area (MVA)
Aortic Valve Flow (AVF)
Mitral Valve Flow (MVF)
SV / EDV:
Fick CO
Normal O2 consumption
Ejection Fraction
SV
What is the normal range of potassium (K+) in the blood?
3.0 - 5.5
3.5 - 5.5
3.5 - 5.0
3.0 - 5.0
INR measures the levels of which drug?
Ticlid
Aspirin
Coumadin
Lovenox impacts Antithrombin and Factor Xa.
Ticlid and Plavix turn off receptor sites on platelets.
TPA acts by
Preventing platelet adhesion
Dissolving fibrin
Activates Plasminogen
Activates Troponin
Troponin is the most accurate measurement of cardiac muscle fiber damage after a MI.
Which lab value does NOT evaluate the extent of an MI?
SGOT
Serum Creatinine
CK-MB
LDH
Check pulse for one minute is the best way to calculate pulse rate.
Metabolic Acidosis has a low level of HCO3 (bicarb)
A pH less than 7.35 or greater than 7.45 is called:
Compensated
Uncompensated
Metabolic
Respiratory
What would be the appropriate intervention for a patient with Respiratory Acidosis?
Decreased ventilation
Increased ventilation
Oxygen
Uncompensated acidosis
To increase arterial PO2:
Hyperventilation
Hold breath
Give bicarb
Interpret the following blood gas: pH = 7.25 CO2 = 60 HCO (bicarb) = 22
Uncompensated Metabolic Acidosis
Compensated Respiratory Acidosis
Compensated Metabolic Alkalosis
Uncompensated Respiratory Acidosis
How will a high CO2 level impact pH?
lower
raise
will not affect
Not enough information
How will an increase in HCO2 (bicarb) affect pH?
Have no affect
The inner most layer of an after is the intima.
When a patient has a DILATED AORTIC ROOT, what diagnostic catheter is best utilized to visualize the LAD?
JR4
JL5
During a pericardiocentesis, the needle enters the sub-xyphoid process.
Where should assist on the IABP be set when a patient has a heart rate of 150?
1:1
1:2
2:1
2:2
Jugular vein distention can be caused by:
TR (tricuspid regurgitation)
Pulmonary hypertension
Ventricular arrhythmias are most common during injection of the right coronary artery.
Osmolality refers to the ability of the contrast to pull fluid into the intravascular space.
Synchronous pacemakers sense the heartbeats intrinsic activity and pace only when needed.
The purpose of an ICD is to:
Monitor bradycardia, tachycardia, VT, and Vfib
Monitor bradycardia, tachycardia, VT, and Vfib; and convert if necessary
Monitor bradycardia only
Monitor tachycardia only
The R and the L in RAO and LAO refer to the position of the image intensifier
What shows a TRUE posterior infarct on an EKG?
V1, V2, V3
V1, V2, and V7-V9
V7-V9
V1, V2
Time is the most important factor in decreasing Xray exposure to a patient.
What is the normal amount of blood in the pericardium?
50cc
100 cc
70 cc
500 cc
The most common renal stenosis is located in the ostial.
A dislodged lead will cause a fail to capture pacemaker in the RV.
Monophasic defibrillation protocol is:
200-300-360
200-300-400
200-300-600
200-300-630
What does the "c" wave represent?
Onset of atrial contractions
Onset of Systole
Onset of ventricular contractions
Does not represent anything
Inject in the RA and read in the PA measures THERMAL DILUTION cardiac output.
Which would likely increase pulmonary blood flow, possibly pulmonary edema?
VSD
PDA
ASD
Truncus Arteriosis
RVEDP and LVEDP are different because there is less space in the LV to do the workload.
When endothelium cells build a chemical to equalize the vessel pressure, it is called INFLAMMATORY RESPONSE.
A MI would increase LVEDP, but NOT LV systolic pressure
A/V stenosis would increase LV systolic pressure.
Every clotting factor is made in the liver
What is the complication shown at the arrow?
This IVUS cross-section shows:
The smaller the stent, the lower re-stenosis rate.
The Rotoblator, 1.25-2.0 mm burrs should operate at approximately:
180,000 rpm
100,000 rpm
160,000 rpm
80,000 rpm
The Rotoblator 2.15 mm and larger burrs should operate at approximately:
Identify the venous and ECG waves marked.
Mitral regurgitation is virtually certain when atrial "v" waves:
Are over 40 mmHg
Exceed the height of the "a" wave
Exceed 3 times the atrial mean pressure
Occur throughout systole and extend into diastole
High PCWP with normal EDP is:
Mitral Valve Stenosis
Mitral Valve Regurgitation
Tricuspid Valve Stenosis
Tricuspid Valve Regurgitation
High "v" wave equals:
Tricuspid Stenosis
What is the normal range of pH in the blood?
7.45 - 7.55
7.25 - 7.35
7.35 - 7.45
None of these
What is the normal range of PaCO2 in the blood?
35 - 45
25 - 35
45 - 55
What is the normal range of HC03 in the blood?
22 - 26
20 - 30
25- 30
Identify the ports labeled.
What is the best view for visualization of a stent?
LAO 40, Cranial 0
RAO 40, Caudal 0
LAO 30, Cranial 0
LAO 60, Cranial 0
Which imaging results in a image with more NOISE?
Cine imaging
Fluoro
Cine acquisition delivers a lower dose of radiation to the patient than Fluoro imaging.
Which image delivers a HIGHER amount of energy to the patient?
Fluoro imaging