ACP Random Cards
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- Causes of Multifocal Atrial Tachycardia (8)
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-Severe COPD
-Hypoxia
-Acute Coronary Syndrome
-Digoxin Toxicity
-Rheumatic Heart Disease
-Theophyline Toxicty
-Electrolyte Embalanaces - Nonmodifiable Cardiac Risk Factors (4)
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-Heredity
-Race
-Gender
-Age - Modifiable Cardiac Risk Factors (7)
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-High BP
-Elevated Serum Cholesterol Levels
-Tobacco Use
-Diabetes
-Physical inactivity
-Obesity
-Metabolic syndrome - Contributing Cardiac Risk Factors (4)
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-Stress
-Inflammatory markers
-Psychosocial factors
-Alcohol intake - Patch-4-MD
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-Pulmonary Embolism
-Acidosis
-Tension Pneumothorax
-Cardiac tamponade
-Hypovolemia
-Hypoxia
-Heat/Cold (hypo/hyperthermia)
-Hypo/Hyperkalemia (and other electrolytes)
-Myocardial infarction
-Drug Overdose/accidents - Five H's and 5 T's
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-Hypovolemia
-Hypoxia
-Hypothermia
-Hypo/Hyperkalemia
-Hydrogen Ion (acidosis)
-Tamponade, Cardiac
-Tension Pneumothorax
-Thrombosis: lungs (massive P.E.)
-Thrombosis: Heart (actue coroary syndrome)
-Tablets/toxins: drug overdose - Upper Airway
- -outside chest cavity--nose, nasal cavitities, pharynx, and larynx (warm, filter, humidify, protect lower airway surfaces)
- Lower Airway
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-organs in chest cavity
-includes trachea, bronchi, bronchioles, alveoli, and lungs
-exchange of o2 and co2 - Tidal Volume
- -volume of air in and out of lungs during a normal breath
- Minute Volume
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-amount of air moved in and out of lungs in 1 minute (tidal volume X resp rate)
-change in tidal volume or resp rate will change minute volume - Right Coronary Artery
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-RCA from right side of aorta, tavels along grove between Right atrium and right ventricle
-Blockage--inferior wall MI and/or AV nodal conduction disturbance - Left Coronary Artery
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-from left side of aorta
-first part LCA, main left main blood to left anterior descending (LAD) and left circumflex (LCx)
-Blocked septal branch of LAD--Septal MI
-Diagonal branch LAD block--anterior wall MI
-LAD can result pump failure and/or conduction delays
-LCx circles around left side of heart, embedded in epicardium--blocked--Lateral wall MI - Properties of Cardiac Cells (4)
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-automaticity
-Excitability (irritability)
-Conductivity
-Contractility - Depolarization of Cardiac Cells
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-Change in cell membrane Na+ ions rush in thru fast Na+ channels.
-Calcium moves slowly in thru Ca+(2)channels
-inside of cell more positive
-Cell depolarizes, cardiac contraction occurs (innermost layer to outermost layer--endocardium to epicardium) - Repolarization of cardiac cells
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-Fast Na+ channels close
-Ca+(2) channels close and potassium flows out of cell
-Active transport via sodium-potassium pump begins restoring K+ to inside and Na+ to outside
-happens gradually until cell repolarized
-from epicardium to endocardium - Lead I--positive, negative, view
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-positive-Left arm
-negative-right arm
-view-Lateral - Lead II--Positive, negative, view
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-(+)-Left leg
-(-)-Right arm
-view-Inferior - Lead III-Positive, negative, view
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-(+)-left leg
-(-)-Right Arm
-view-Inferior - AVR (+), view
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(+)-Right arm
-none - aVL (+), view
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(+)-left arm
-lateral - aVF (+), view
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(+) left leg
-inferior -
V1 View
V2 View -
-Septum
-Septum -
V3 View
V4 View -
Anterior
Anterior -
V5 View
V6 View -
-Lateral
-Lateral - Abnormal Q Wave
- -Pathologic- more than 0.04 (1 small box) and more than one third the height of the R wave in that lead
- QRS duration
- -0.06 to 0.10 (<.10)
- P Wave (+) in which leads
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-I
-II
-aVF
-V2 to V6 - PR interval
- -0.12 to 0.20
- QT Interval
- -0.38
- T wave
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-ventricular repolarization
-Upright all leads except aVR, positive or negative Leads III and V1
-inverted suggest myocardial ischemia
-tall, pointed (peaked)=hyperkalemia
-Low amplitude T = hypokalemia - Absolute Refractory Period
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-effective refractory period
-Onset of the QRS to Peak of T wave
-myocardial cells will not respond to further stimulation - Relative Refractory Period
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-vulnerable period
-downslope of T wave
-some cardiac cells have repolarized to their threshold potential and can be stimulated to respond (stronger than normal impulse) - Supernormal period
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-after relative refractory period
-weaker than normal impulse can cause depolarization
-end of T wave, possible for cardiac dysrhythmias to develop during this period. - Causes of Sinus Tach
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-Exercise, hypoxia
-Fever, Pain
-Fear and anxiety
-CHF, Acute MI
-Infection, Sympathetic stimulation
-Shock, dehydration, hypovolemia
-P.E., Hyperthyroidism
-Medications eg:epi, atropine
-Caffenine beverages
-nictoine
-Drugs eg: cocaine, amphetamines, cannabis - Causes of Atrioventricular Nodal Reentrant Tachycardia
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-Hypoxia, stress
-Overexertion, Anxiety
-Caffeine, smoking
-Sleep deprivation
-Medications - Causes of Accelerated Idioventricular Rhythm
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-Digitalis toxicity
-Cocaine toxicity
-Subarachnoid hemorrhage
-Acute Myocarditis
-Hypertensive Heart disease
-dilated cardiomyopathy - Causes of Ventricular Tachycardia
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-Acute Coronary syndromes
-Cardiomyopathy
-Tricyclic antidepressant overdose
-digitalis toxicity
-Valvular heart disease
-Cocaine abuse
-Mitral Valve prolapse
-Acid-Base Imbalance
-Trauma (myocardial contusion)
-Electrolyte imbalance (hypokalemia, hyperkalemia, hypomanesemia) - Endotracheal Medications
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-Naloxone
-atropine
-Vasopressin
-Epinephrine
-Lidocaine - Sympathetic Stimulation Terms
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-sympathomimetic
-Sympathetic agonist
-Adrenergic
-Adrenergic Agonist - Sympathetic Inhibition Terms
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-Sympatholytic
-Adrenergic blocker
-Sympathetic blocker
-Antiadrenergic
-Sympathetic antagonist - Parasympathetic Stimulation Terms
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-Parasympathomimetic
-Parasympathetic agonist
-Cholinergic
-Cholinergic agonist - Parasympathetic Inhibition Terms
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-Parasympatholytic
-Cholinergic blocker
-Parasympathetic blocker
-Anticholinergic
-Parasympathetic antagonist
-vagolytic - Chronotrope
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Affects the heart rate
-Positive Chronotrope= Increase H.R.
-Negative Chronotrope = decrease H.R. - Inotrope
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A substance that affects myocardial contractility
-Positive inotrope = increase force of contraction
-Negative inotrope = decrease force of contraction - Dromotrope
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affects AV conduction velocity
-Positive dromotrope = increase AV conduction velocity
-Negative Dromotrope = decrease conducation velocity - Preload
- -pressure/volume in the left ventricle at the end of diastole
- Afterload
- -pressure or resistance against which the heart must pump
- agonist
- -produces predictable response (stimulates action)
- antagonist
- -exerts an action opposite to another (blocks action)
- Medications in Acute Coronary Synromes
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MONA
-Morphine
-Oxygen
-Nitroglycerin
-Aspirin