Cardiac Quiz Questions And Answers

A 12-lead ECG should be completed within 10 minutes of entry to the Emergency Department. This is because an ECG is a quick and non-invasive test that can provide important information about the heart's electrical activity. It can help identify any abnormalities or signs of cardiac issues, such as a heart attack or arrhythmias. Since time is critical in emergency situations, performing an ECG early on can help guide the appropriate treatment and management of the patient. The other options mentioned, such as a PET scan, CT scan, or esophagogastroduodenoscopy, are more specialized tests that may be necessary in certain cases but are not typically required within the first 10 minutes of arrival.

Hemodynamic stability refers to the ability of the cardiovascular system to maintain adequate blood flow and perfusion to the body's organs and tissues. Pulse and blood pressure are two basic measurements that assess hemodynamic stability. The pulse represents the heart rate and rhythm, indicating the strength and regularity of the heartbeat. Blood pressure measures the force exerted by the blood against the walls of the arteries, providing information about the efficiency of the heart's pumping action and the resistance in the blood vessels. Monitoring these parameters helps healthcare professionals determine if a patient's cardiovascular system is functioning properly and if interventions are needed to maintain hemodynamic stability.

The correct answer is Physical presentation, ECG and positive serum enzymes. STEMI (ST-elevation myocardial infarction) is diagnosed based on the patient's physical symptoms, such as chest pain, shortness of breath, and sweating, along with the findings on an electrocardiogram (ECG) that shows ST-segment elevation. Additionally, blood tests are done to measure the levels of certain enzymes, such as troponin, which are released into the bloodstream when there is damage to the heart muscle. The combination of physical presentation, ECG changes, and positive serum enzymes helps confirm the diagnosis of STEMI.

Aspirin is the first initial treatment for acute chest pain because it acts as an anti-platelet by inhibiting thromboxane A2. Thromboxane A2 is responsible for promoting platelet aggregation and blood clot formation, so by inhibiting its production, aspirin helps prevent the formation of blood clots in the coronary arteries. This can be crucial in cases of acute chest pain, as blood clots in the coronary arteries can lead to a heart attack. Additionally, aspirin is easily absorbed and readily available, making it a convenient and effective option for immediate treatment.

During Nitroglycerin titration, it is important to monitor blood pressure. Nitroglycerin is a medication used to treat angina and heart failure, and it works by dilating blood vessels, which can cause a decrease in blood pressure. Monitoring blood pressure allows healthcare professionals to adjust the dosage of Nitroglycerin to ensure that the patient's blood pressure remains within a safe range. This helps prevent complications such as hypotension or low blood pressure. Monitoring heart rate, heart rhythm, and pulse oximetry are also important in assessing the patient's overall cardiovascular health, but blood pressure is specifically important during Nitroglycerin titration.

Administration of fluid bolus challenge enhances preload, which refers to the amount of blood returning to the heart. By increasing preload, more blood is available to be pumped out by the heart, leading to an increase in stroke volume and cardiac output. This can be beneficial in situations where there is inadequate blood volume or low blood pressure. Additionally, increasing preload can also help improve tissue perfusion and oxygen delivery.

Nitroglycerin reduces ischemia by causing vasodilation. Vasodilation refers to the widening of blood vessels, which leads to an increase in blood flow and oxygen supply to the affected area. By dilating the blood vessels, nitroglycerin helps to relieve the constriction and narrowing of blood vessels that occurs during ischemia, improving blood flow and reducing the symptoms of ischemia. This mechanism of action makes nitroglycerin an effective medication for treating conditions such as angina and myocardial infarction.

A STEMI patient is rushed to the Cardiac Cath Lab because "time is muscle". This means that the longer it takes to restore blood flow to the heart, the more damage occurs to the heart muscle. The Cardiac Cath Lab is equipped to quickly diagnose and treat the blockage in the coronary arteries, allowing for timely intervention and minimizing the amount of heart muscle damage. This is crucial in order to improve the patient's chances of survival and reduce the risk of complications.

Women experiencing a STEMI (ST-segment elevation myocardial infarction) may exhibit various symptoms, including chest pain, shortness of breath, and/or epigastric pain. These symptoms are commonly reported by women during a STEMI event. Additionally, women may describe the sensation as an elephant sitting on their chest. Profound fatigue can also be a characteristic symptom of a STEMI in women. It is important to note that not all women may experience all of these symptoms, and some may only have chest pain discomfort.

The patient's symptoms of unstable angina, indigestion, and difficulty breathing suggest a cardiac issue. The elevated blood pressure and sinus rhythm with frequent PVCs indicate potential myocardial ischemia. Nitroglycerin is the initial treatment of choice for unstable angina as it helps to relieve chest pain by dilating the coronary arteries and improving blood flow to the heart. Maalox is an antacid and would not address the underlying cardiac issue. Beta-blockers may be used for long-term management, but they are not the initial treatment. Fibrinolytics are used in the treatment of acute myocardial infarction (heart attack) with ST-segment elevation, which is not indicated in this case.

A decreased level of consciousness can indicate an intracranial bleed because it suggests that there is increased pressure within the skull due to bleeding. This increased pressure can compress the brain and lead to a decrease in consciousness. It is important to recognize this symptom in order to promptly diagnose and treat the intracranial bleed to prevent further complications.

When the heart is chronically overstretched, it loses its ability to contract effectively. This leads to all of the presented choices being true. The heart's decreased contractility results in a greater preload, as it has more capacity to hold blood volume. Additionally, the heart has to work harder to pump blood, leading to an increased oxygen demand. Finally, the poor blood ejection can lead to a backup of blood in the lungs, increasing the risk of pulmonary edema.

Aortic stenosis is a condition characterized by the narrowing of the aortic valve, which obstructs the outflow of blood from the left ventricle to the aorta. This obstruction increases the afterload, which refers to the resistance that the heart must overcome to eject blood into the circulation. As a result, the heart has to work harder to pump blood out of the left ventricle, leading to an increase in afterload. Therefore, the correct answer is "Increase afterload due to outflow obstruction."

Beta-blockers are medications that work by blocking the effects of adrenaline on the body's beta receptors. This leads to a decrease in heart rate and blood pressure. Therefore, if a patient already has a systolic blood pressure less than 90 mmHg, prescribing beta-blockers can further lower their blood pressure to dangerously low levels, leading to hypotension and potential organ damage.

The correct answer is "The last part of relaxation before contraction." End-diastolic refers to the phase of the cardiac contraction cycle where the ventricles are at their maximum volume and are relaxed before the next contraction. This phase occurs right before the ventricles contract and pump blood out of the heart.

Sympathetic stimulation causes vasoconstriction, which leads to an increase in the volume of blood returning to the heart, known as preload. Additionally, vasoconstriction also increases the resistance against which the heart has to pump, known as afterload. Therefore, sympathetic stimulation increases both preload and afterload.

Dangling the patient's legs while at the bedside can help reduce preload in a patient with acute heart failure. This position allows gravity to assist in venous return, which decreases the amount of blood returning to the heart and subsequently reduces preload. By reducing preload, the workload on the heart is decreased, which can help improve cardiac function and relieve symptoms of heart failure.

Afterload refers to the resistance that the heart must overcome to eject blood into the systemic circulation. It is determined by the systemic vascular resistance, which is the resistance to blood flow in the arteries. When systemic vascular resistance is high, such as in conditions like hypertension, the afterload increases, making it more difficult for the heart to pump blood out of the ventricles. Therefore, the correct answer is "Determined by systemic vascular resistance."

Dopamine is indicated for hypotension in pulmonary edema. Dopamine is a medication that can increase blood pressure by stimulating the heart and blood vessels. In flash pulmonary edema, the sudden accumulation of fluid in the lungs can cause a drop in blood pressure. Dopamine can help to increase the blood pressure and improve perfusion to the organs, which is important in managing the condition.

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The correct answer is "reduce preload with no effect on afterload." Atrial fibrillation and crackles auscultated in all fields suggest fluid overload, which is commonly seen in heart failure. Lasix (furosemide) is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the loop of Henle, leading to increased urine output and reduction in fluid volume. By reducing preload, Lasix helps to decrease the amount of blood returning to the heart, thereby improving symptoms of fluid overload. It does not have a significant effect on afterload, which is the resistance against which the heart pumps blood.

This ECG pattern of ST-segment elevation in leads V1, V2, V3, V4 and ST-segment depression in leads II, III, and AVF is indicative of an anteroseptal STEMI. Anteroseptal STEMI refers to the occlusion of the left anterior descending (LAD) coronary artery, which supplies the anterior and septal walls of the heart. The ST-segment elevation in leads V1-V4 corresponds to the involvement of the anterior wall, while the ST-segment depression in leads II, III, and AVF suggests reciprocal changes in the inferior leads.

The major effect of an intraaortic balloon pump (IABP) is afterload reduction. An IABP is a mechanical device that helps improve cardiac function by reducing the workload on the heart. It does this by inflating during diastole (when the heart is at rest) and deflating during systole (when the heart is contracting). This inflation and deflation cycle helps to increase blood flow to the coronary arteries and decrease the resistance that the heart has to pump against, thus reducing the afterload on the heart. This can improve cardiac output and help support a failing heart.

The ST segment on an electrocardiogram (ECG) should be monitored to detect abrupt closure of the coronary artery post-PTCA. Abrupt closure of the artery can cause changes in the ST segment, indicating myocardial ischemia. Monitoring the ST segment allows healthcare professionals to promptly identify any complications and take appropriate actions to prevent further damage to the heart.

Venous vasodilating medications decrease preload by dilating the veins, which reduces the amount of blood returning to the heart. This decreases the volume of blood in the ventricles during diastole, leading to a decrease in preload. Additionally, by reducing preload, there may be a secondary decrease in afterload, as the heart has to work less forcefully to pump blood out of the ventricles. However, the effect on afterload can vary depending on the specific medication and patient factors.

CK-MB is an enzyme found in high levels in the heart muscle. When there is damage to the myocardial cells, CK-MB is released into the bloodstream. Therefore, an elevated level of CK-MB indicates myocardial cell injury. The reference interval (RI) is a range of values within which a normal result is expected. In this case, the CK-MB level of 4.6 ng/ml and RI of 2.6 suggests that the CK-MB level is elevated, further indicating myocardial cell injury.

When the pulmonary artery catheter is wedged in the pulmonary capillary, it reflects the left ventricular preload. This is because the wedging of the catheter in the pulmonary capillary provides information about the pressure in the left atrium, which is directly related to the left ventricular preload. By measuring the left ventricular preload, healthcare professionals can assess the volume of blood in the left ventricle before it contracts, giving them important information about the function of the left ventricle and the overall cardiac output.

V4R is the correct answer because it is the only lead that is 100% specific for a right ventricular infarction. The other leads mentioned (V1R, V3R, V2R) may show ST elevation in a right ventricular infarction, but they are not as specific as V4R.

Reteplase is a thrombolytic medication used to dissolve blood clots in patients with unstable angina. The second dose of reteplase should be administered 20 minutes after the initial dose. This is because reteplase has a short half-life and is rapidly cleared from the body. Administering the second dose within 20 minutes ensures that the drug remains at therapeutic levels in the bloodstream to effectively dissolve the blood clot and prevent further complications.

Arterial vasoconstriction is a factor that affects afterload. Afterload refers to the pressure that the heart must overcome to eject blood into the systemic circulation. When the arteries constrict, the resistance to blood flow increases, leading to an increase in afterload. This puts additional strain on the heart as it has to work harder to pump blood against the increased resistance. Therefore, arterial vasoconstriction is a factor that affects afterload.