Notes in 08-X-Cardiovascular Pathophysiology

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Published	12/13/2023	The risk of re-infarction during surgery is greatest within {{c1::30 days}} of an acute MI.
Published	12/13/2023	Any factor that increases {{c1::cardiac output}} will increase myocardial O2 consumption.
Published	12/13/2023	{{c1::Decreases}} in aortic pressure will impair oxygen delivery to the heart.
Published	12/13/2023	Patients with coronary stents are placed on on {{c1::dual antiplatelet}} therapy
Published	12/13/2023	The goal with intraoperative β-blocker therapy is a heart rate < {{c1::80}} BPM.
Published	12/13/2023	When bridging a patient on DAPT, antiplatelet agents are restarted {{c3::as soon as hemostasis is achieved}}.
Published	12/13/2023	{{c1::Autoregulation}} of coronary blood flow increases the cardiac oxygen supply.
Published	12/13/2023	Below the lower cervical segments, the spinal cord depends on blood flow from the {{c1::radicular}} arteries.
Published	12/13/2023	If CVP > ICP, the equation to calculate cerebral perfusion pressure is CPP = {{c1::MAP}} - {{c1::CVP}}
Published	12/13/2023	{{c1::Decreases}} in the oxygen content of blood (CaO2) will impair O2 delivery.
Published	12/13/2023	{{c1::Decreases}} in the capillary density of the heart will impair O2 delivery.
Published	12/13/2023	{{c1::Increases}} in the wall tension will increase the O2 demand of the heart.
Published	12/13/2023	{{c1::Increases}} in the contractility will increase the O2 demand of the heart.
Published	12/13/2023	Hypocapnia is a coronary vaso{{c1::constrictor. }}
Published	12/13/2023	In patients with a normal EKG, the best lead to monitor for intraoperative ST changes is {{c1::V3}}.
Published	12/13/2023	In patients with an abnormal EKG, the best lead to monitor for intraoperative ST changes is {{c1::the region at greatest risk of ischemia}}.
Published	12/13/2023	How does a decreased ventricular compliance affect the compliance curve?{{c1::Shifts up and left}}
Published	12/13/2023	How does an increased ventricular compliance affect the compliance curve?{{c1::Shifts down and right}}
Published	12/13/2023	Increased pericardial pressure causes {{c1::diastolic}} dysfunction of the heart.
Published	12/13/2023	Decreases in ventricular compliance will cause the PAOP to {{c1::over}}estimate the LVEDV.
Published	12/13/2023	What type of heart failure is caused by valvular insufficiency?{{c1::Systolic heart failure}}
Published	12/13/2023	What type of heart failure is caused by valvular stenosis?{{c1::Diastolic heart failure}}
Published	12/13/2023	Chronic uncontrolled hypertension causes what type of heart failure?{{c1::Diastolic}}
Published	12/13/2023	What type of heart failure is caused by cor pulmonale?{{c1::Diastolic heart failure}}
Published	12/13/2023	What type of heart failure is linked to obesity?{{c1::Diastolic heart failure}}
Published	12/13/2023	How does ESV change in heart failure with systolic dysfunction?{{c1::Increased ESV}}
Published	12/13/2023	How does ESV change in heart failure with diastolic dysfunction?{{c1::Normal ESV}}
Published	12/13/2023	What is the initial management for a patient with systolic heart failure that presents with JVD, peripheral edema, and bibasilar crackles?{{c1::Diuret…
Published	12/13/2023	How should afterload be managed in a patient with systolic heart failure?{{c1::Decreased}}
Published	12/13/2023	How should afterload be managed in a patient with diastolic heart failure?{{c1::Increased}}
Published	12/13/2023	How should heart rate be managed in a patient with diastolic heart failure?{{c1::Slow/normal}}
Published	12/13/2023	How should heart rate be managed in a patient with diastolic heart failure?{{c1::slower/normal}}
Published	12/13/2023	What is an elevated blood pressure?{{c1::Systolic 120-129::systolic}} {{c1::and::and/or}} {{c1::Diastolic < 80::diastolic}}
Published	12/13/2023	What is stage 1 hypertension?{{c1::Systolic 130-139::systolic}} {{c1::or::and/or}} {{c1::Diastolic 80-89::diastolic}}
Published	12/13/2023	What is stage 2 hypertension?{{c1::Systolic >140::systolic}} {{c1::or::and/or}} {{c1::Diastolic >90::diastolic}}
Published	12/13/2023	Activation of RAAS will cause the kidneys to {{c2::retain}} {{c1::water}} and {{c1::sodium}}.
Published	12/13/2023	Coarctation of the aorta may cause a {{c1::systolic}} bruit.
Published	12/13/2023	What disease is suggested by nocturnal polyuria and polydipsia?{{c1::Conn's disease (hyperaldosteronism)}}
Published	12/13/2023	Severe pregnancy-induced hypertension can present with {{c1::right upper quadrant}} pain.
Published	12/13/2023	All calcium channel blockers work by blocking the {{c2::α-1}} subunit of the {{c1::L-type}} calcium channel.
Published	12/13/2023	What type of calcium channels are L-type?{{c1::Long lasting or slow channel}}
Published	12/13/2023	What type of calcium channels are N-type?{{c1::Neural}}
Published	12/13/2023	What type of calcium channels are T-type?{{c1::Transient}}
Published	12/13/2023	Which calcium channel blocker is preferred in patients with decreased contractility - diltiazem or verapamil?{{c1::Diltiazem}}
Published	12/13/2023	In patients with constrictive pericarditis, the cardiac output is primarily dependent on {{c1::heart rate}}.
Published	12/13/2023	What heart rate should be avoided in patients with constrictive pericarditis?{{c1::Bradycardia}}
Published	12/13/2023	What condition (dotted → green) is represented by this pressure volume loop?{{c1::Cardiac tamponade}}
Published	12/13/2023	How does cardiac tamponade affect stroke volume?{{c1::Decreased}}
Published	12/13/2023	How does cardiac tamponade affect end-diastolic volume?{{c1::Decreased}}
Published	12/13/2023	How does cardiac tamponade affect ventricular compliance?{{c1::Decreased}}
Published	12/13/2023	The preferred anesthetic technique for a pericardiocentesis is {{c1::local anesthesia}}.
Published	12/13/2023	When administering general anesthesia for a pericardiocentesis, what is the preferred induction agent?{{c1::Ketamine}}
Published	12/13/2023	When administering general anesthesia for a pericardiocentesis, it is important to use drugs that {{c1::preserve myocardial function}}.
Published	12/13/2023	What is the heart rate goal for management of a patient with a cardiac tamponade?{{c1::Maintain or high normal::increase/decrease/maintain}}
Published	12/13/2023	What is the preload goal for management of a patient with a cardiac tamponade?{{c1::Maintain or increase::increase/decrease/maintain}}
Published	12/13/2023	What is the contractility goal for management of a patient with a cardiac tamponade?{{c1::Maintain or increase::increase/decrease/maintain}}
Published	12/13/2023	What is the afterload goal for management of a patient with a cardiac tamponade?{{c1::Maintain::increase/decrease/maintain}}
Published	12/13/2023	What is the preferred rhythm for management of a patient with a cardiac tamponade?{{c1::Normal sinus}}
Published	12/13/2023	Are patients with an unrepaired cardiac valve (e.g. mitral valve prolapse) at increased risk for infective endocarditis?{{c1::No}}
Published	12/13/2023	What physics principle is responsible for systolic anterior motion in left ventricular outflow tract obstruction?{{c1::Venturi effect}}
Published	12/13/2023	How does increased stroke volume affect the left ventricular outflow tract?{{c1::Distends}}
Published	12/13/2023	How does increased contractility affect the left ventricular outflow tract?{{c1::Narrows}}
Published	12/13/2023	How does increased aortic pressure affect the left ventricular outflow tract?{{c1::Distends}}
Published	12/13/2023	How does decreased aortic pressure affect the left ventricular outflow tract?{{c1::Narrows}}
Published	12/13/2023	How does decreased contractility affect the left ventricular outflow tract?{{c1::distends }}
Published	12/13/2023	What surgery can be used to remove a portion of the interventricular septum to treat hypertrophic obstructive cardiomyopathy?{{c1::Septal myomectomy}}
Published	12/13/2023	Injection of {{c1::alcohol}} into the {{c2::septal perforator}} arteries can treat hypertrophic obstructive cardiomyopathy.
Published	12/13/2023	What surgery can be done to fix systolic anterior motion of the mitral valve?{{c1::Mitral valve replacement}}
Published	12/13/2023	What is the recommendation for a patient with a first-generation drug eluding stent after stable ischemic heart disease undergoing nonc…
Published	12/13/2023	What is the recommendation for a patient with a current-generation drug eluding stent after stable ischemic heart disease undergoing no…
Published	12/13/2023	What is the recommendation for a patient with a drug eluding stent after acute coronary syndrome undergoing noncardiac elective surgery…
Published	12/13/2023	What is the recommendation for a patient with after elective CABG undergoing noncardiac elective surgery?Delay {{c1:: 6 weeks }} ‒ ({{c1::3 month…
Published	12/13/2023	When bridging a patient on DAPT, clopidogrel should be stopped {{c1::7 days}} before surgery.
Published	12/13/2023	When bridging a patient on DAPT, ticlopidine should be stopped {{c1::14 days}} before surgery.
Published	12/13/2023	In an emergency, what can be administered to reverse platelet inhibition in patients on DAPT?{{c1::Platelets}}
Published	12/13/2023	What type of CPB pumps produce less trauma to blood cells?{{c1::Centrifugal pumps}}
Published	12/13/2023	The primary disadvantage of {{c2::bubble}} oxygenators is the risk of {{c1::air embolism}}.
Published	12/13/2023	How does hemodilution affect the hematocrit and O2 carrying capacity?{{c1::Decreased}}
Published	12/13/2023	How does hemodilution affect microvascular flow?{{c1::Increased}}
Published	12/13/2023	How does hemodilution affect the plasma concentration of drugs?{{c1::Decreased}}
Published	12/13/2023	In cardiac surgery, awareness is most common during {{c1::sternotomy}}.
Published	12/13/2023	In cardiac surgery, awareness is 2nd most common during {{c1::rewarming}}.
Published	12/13/2023	How does hyperkalemia affect the resting membrane potential?{{c1::Increases  (higher)}}
Published	12/13/2023	Cardioplegic (hyperkalemic) solutions maintain the Na+ channels in an {{c1::inactive}} state.
Published	12/13/2023	How is the radial blood pressure affected after CPB?{{c1::Decreased}}
Published	12/13/2023	One side effect of cardioplegia solution is {{c1::heart block}} after CPB, which is treated via pacing.
Published	12/13/2023	The tip of a balloon pump (IABP) should be positioned {{c1::2 cm distal}} to the {{c2::left subclavian artery}}.
Published	12/13/2023	The balloon pump (IABP) should inflate at the {{c1::dicrotic notch}} (on the aortic pressure waveform).
Published	12/13/2023	What pressure is generated by the balloon pump (IABP) after inflation?{{c1::Diastolic augmentation}}
Published	12/13/2023	Which pressure is higher with an IABP - unassisted systole or diastolic augmentation?{{c1::Diastolic augmentation}}
Published	12/13/2023	Which pressure is higher with an IABP - unassisted systole or assisted systole?{{c1::Unssisted systole}}
Published	12/13/2023	Balloon pump (IABP) {{c2::deflation}} is correlated with the {{c1::R-wave}} on EKG.
Published	12/13/2023	How does a balloon pump affect aortic end-diastolic pressure?{{c1::Decreased}}
Published	12/13/2023	Balloon pumps (IABP) are contraindicated in patients with {{c1::peripheral vascular disease}}, especially in the lower extremities.
Published	12/13/2023	Can NIBP cuffs be used in patients on non-pulsatile LVADs?{{c1::No}}
Published	12/13/2023	The most common cause of death for a patient with an LVAD is {{c1::sepsis}}.
Published	12/13/2023	What type of aortic aneurysm is this?Crawford type {{c1::1}}
Published	12/13/2023	What type of aortic aneurysm is this?Crawford {{c1:: type 2}}
Published	12/13/2023	What type of aortic aneurysm is this?{{c1::Crawford type  3}}
Published	12/13/2023	What type of aortic aneurysm is this?Crawford type {{c1::4}}
Published	12/13/2023	DeBakey type {{c1::1}} aortic dissection involves {{c2::a tear in the ascending aorta and dissection along the entire aorta. …
Published	12/13/2023	DeBakey type {{c1::2}} aortic dissection involves {{c2::a tear in the ascending aorta and dissection only in ascending aorta.&nbsp…
Published	12/13/2023	DeBakey type {{c1::3}} aortic dissection involves {{c2::a tear in the proximal descending aorta. }}
Published	12/13/2023	Surgical repair of Which aortic aneurysm type has the highest risk for paraplegia?{{c1::Crawford type II}}
Published	12/13/2023	The surgical repair of which aortic aneurysm type has the highest risk for renal failure?{{c1::Crawford type II}}
Published	12/13/2023	According to the law of Laplace, what factor significantly increases the risk of rupture in a AAA?{{c1::Vessel diameter}}
Published	12/13/2023	Where do most AAA ruptures occur?{{c1::Left retroperitoneum}}
Published	12/13/2023	Surgical repair of a AAA should occur when the aneurysm exceed {{c1::5.5}} cm or expands by > {{c1::0.7}} cm/year.
Published	12/13/2023	The most common site of aortic cross-clamp is {{c1::infrarenal}}.
Published	12/13/2023	How does an aortic cross-clamp affect the central circulation?{{c1::Increases volume}}
Published	12/13/2023	How does an aortic cross-clamp affect the venous capacity?{{c1::Decreases}}
Published	12/13/2023	How does an aortic cross-clamp affect the venous return?{{c1::Increases}}
Published	12/13/2023	How does an aortic cross-clamp affect the lower body circulation?{{c1::Decreases volume}}
Published	12/13/2023	How does an aortic cross-clamp affect the activated complement?{{c1::Increased}}
Published	12/13/2023	How does an aortic cross-clamp affect the temperature?{{c1::Decreased}}
Published	12/13/2023	How does placement of an aortic cross-clamp affect the SVR?{{c1::Increased}}
Published	12/13/2023	How does release of an aortic cross-clamp affect the pulmonary vascular resistance?{{c1::Increased}}
Published	12/13/2023	How does placement of an aortic cross-clamp affect the MvO2?{{c1::Increased}}
Published	12/13/2023	How does release of an aortic cross-clamp affect the MvO2?{{c1::Decreased}}
Published	12/13/2023	How does placement of an aortic cross-clamp affect the coronary blood flow?{{c1::Increased}}
Published	12/13/2023	How does release of an aortic cross-clamp affect the coronary blood flow?{{c1::Decreased}}
Published	12/13/2023	How does release of an aortic cross-clamp affect the VO2?{{c1::Increased}}
Published	12/13/2023	How does an aortic cross-clamp affect the renal blood flow?{{c1::Decreased}}
Published	12/13/2023	A thoracic cross clamp > {{c1::30}} minutes increases the risk for {{c2::spinal cord ischemia. }}
Published	12/13/2023	In prolonged thoracic cross-clamps, spinal cord perfusion can be enhanced via {{c1::CSF}} drainage and {{c2::proximal hypertension}}.
Published	12/13/2023	In prolonged thoracic cross-clamps, {{c1::moderate (30-32°C)}} hypothermia can be used to reduce spinal cord oxygen consumption.
Published	12/13/2023	In prolonged thoracic cross-clamps, {{c1::hyper}}glycemia can worsen spinal cord ischemia.
Published	12/13/2023	In prolonged thoracic cross-clamps, partial CPB ({{c1::left atrium}} → {{c1::femoral artery}}) can be used to protect the spinal cord.
Published	12/13/2023	What antiarrhythmic can be used to protect the spinal cord with prolonged thoracic cross-clamp?{{c1::Calcium channel blockers}}
Published	12/13/2023	What diuretic can be used to protect the spinal cord with prolonged thoracic cross-clamp?{{c1::Mannitol}}
Published	12/13/2023	Amaurosis fugax is a sign of impending {{c1::stroke}}.
Published	12/13/2023	During a carotid endarterectomy, the best neurologic monitor is {{c1::awake patients}}.
Published	12/13/2023	What nerve blocks can be used for a carotid endarterectomy?{{c1::Superficial cervical plexus (C2-C4)}}{{c1::Deep cervical plexus (C2-C4)}}
Published	12/13/2023	A loss of {{c1::amplitude}} on EEG during anesthesia signifies possible ischemia.
Published	12/13/2023	Decreased {{c1::beta-wave}} activity on EEG during anesthesia signifies possible ischemia.
Published	12/13/2023	How does early hypoxia affect the EEG?{{c1::Increased frequency}}
Published	12/13/2023	How do seizures affect the EEG?{{c1::Increased frequency}}
Published	12/13/2023	How does nitrous oxide affect the EEG?{{c1::Increased frequency}}
Published	12/13/2023	How does light anesthesia affect the EEG?{{c1::Increased frequency}}
Published	12/13/2023	How does extreme hypercarbia affect the EEG?{{c1::Decreased frequency}}
Published	12/13/2023	Manipulation of the head can compress the {{c1::carotid}} or {{c2::verteberal}} arteries.
Published	12/13/2023	Cerebral steal syndrome occurs because distal to cerebral stenosis, vessels are maximally {{c1::dilated}} at baseline
Published	12/13/2023	During a carotid cross-clamp, ipsilateral cerebral perfusion relies on collateral blood flow from the {{c1::circle of Willis}}.
Published	12/13/2023	During a carotid cross-clamp, the blood pressure should be {{c1::elevated}}.
Published	12/13/2023	After a carotid cross-clamp, {{c1::hypertension}} can cause {{c2::reperfusion}} injury → {{c3::cerebral edema}}.
Published	12/13/2023	What nerve injury is a patient undergoing carotid endarterectomy at-risk for?{{c1::Recurrent laryngeal nerve}}
Published	12/13/2023	When performing a carotid artery angioplasty, the heparin is given (dose: {{c1::50-100}} units/kg) to maintain ACT > {{c2::250}} seconds.
Published	12/13/2023	When performing a carotid artery angioplasty, balloon inflation causes {{c1::bradycardia}} and {{c1::hypotension}}.
Published	12/13/2023	The treatment for subclavian steal syndrome is {{c1::subclavian endarterectomy}}.
Published	12/13/2023	In subclavian steal syndrome, the affected arm has a {{c1::weak}} pulse.
Published	12/13/2023	If the pt had a previous MI, the perioperative risk for reinfarction is > 6 month ago = {{c1::6}}%3-6 month ago = {{c1::15}}%<3 month ago =…
Published	12/13/2023	Breast surgery is considered {{c1::low}} cardiac risk
Published	12/13/2023	Carotid endarterectomy is considered {{c1::intermediate}} risk ({{c1::1-5}}%) for adverse cardiac event
Published	12/13/2023	Head and neck surgery is considered {{c1::intermediate}} risk ({{c1::1-5}}%) for adverse cardiac event
Published	12/13/2023	Intrathoracic or intraperitoneal surgery is considered {{c1::intermediate}} risk ({{c1::1-5}}%) for adverse cardiac event
Published	12/13/2023	Orthopedic surgery is considered {{c1::intermediate}} risk ({{c1::1-5}}%) for adverse cardiac event
Published	12/13/2023	Prostate surgery is considered {{c1::intermediate}} risk ({{c1::1-5}}%) for adverse cardiac event
Published	12/13/2023	emergency surgery is considered {{c1::high}} risk ({{c1::>5}}%) for adverse cardiac event
Published	12/13/2023	Open aortic surgery is considered {{c1::high}} risk ({{c1::>5}}%) for adverse cardiac event
Published	12/13/2023	Peripheral vascular surgery is considered {{c1::high}} risk ({{c1::>5}}%) for adverse cardiac event
Published	12/13/2023	The pericardial space typically contain {{c1::10}}-{{c1::50}} cc of clear fluid
Published	12/13/2023	What is Kussmaul's sign{{c1::JVD during inspiration}}
Published	12/13/2023	How would the use of PPV affect pt with constrictive pericarditis?{{c1::can decrease venous return and further decrease CO}}
Published	12/13/2023	What is the characteristics of chest pain in pt with acute (infective) pericarditis?{{c1::increase pain with inspirationpostural nature - leaning forw…
Published	12/13/2023	In pt with acute (infective) pericarditis, chest pain may be relieved by position the pt {{c1::leaning forward}} or {{c1::supine}}
Published	12/13/2023	Infarcted myocardium release 3 biomarkers: {{c1::ceatine kinase-MB}}, {{c1::troponin I}}, and {{c1::troponin T}}
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Published	12/13/2023	MOA of methylene blue as an anti-hypotensive?{{c1::inhibition of nitric oxide synthase - decrease NO and prevent vasodilaiton}}
Published	12/13/2023	If the gray area is a normal pressure - volume loop , what does the green area represent?{{c1::cardiac tamponade - (decrewase LVEDV, decrease SV and d…
Published	12/13/2023	{{c2::Beck}}'s triad is a classic clinical representation of {{c3::cardiac tamponade}}, manifest as {{c1::hypotension}}{{c1::JvD}}{{c1::muffled h…
Published	12/13/2023	What type of ventilation is best in pts with cardiac tamponade?{{c1::spontaneous ventilation - PPV can impair venous reteurn and CO}}
Published	12/13/2023	What would an ideal induction drug in pt with cardiac tamponade?{{c1::Ketamine (maintaining the SNS tone and avoid myocardial depression) }}
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