Harry T Harper Jr., M.D. School of Cardiac and Vascular Technology
A Program of University Hospital’s Georgia Heart Institute
DIS 150 Registry Review
Week 8
1.
A diagnostic heart cath on a child with Kawasaki’s disease might be expected to
find:
a. Aortic stenosis
b. Pulmonary stenosis
c. Coronary artery aneurysms
d. Coronary artery stenosis
2.
According to the classification proposed by DeBakey, a dissection whose initial
tear is localized to the proximal portion of the ascending aorta, just above the
aortic valve, with the false lumen extending around the arch to the descending
aorta is described as:
a. Type I
b. Type II
c. Type III
d. Type IV
3.
The term true aneurysm implies that the:
a. Aortic wall actually has been perforated and the extravasating blood is
contained by adjacent tissue and by thrombus formation
b. Aneurysm is located in the ascending aorta
c. Outer wall of the aneurysm is composed of the three arterial wall layers
d. Aneurysm is circular
4.
According to Grossman, all of the following are important factors to avoid a
stroke during cardiac cath EXCEPT:
a. Careful catheter flushing
b. Avoidance of air bubbles during contrast injection
c. Keeping catheter and wires out of the arch vessels
d. Limiting “wire-time” to 30 seconds when attempting to cross a stenotic AV
5.
According to Grossman, most strokes appear to be caused by:
a. Emboli released after disruption of unrecognized plaques on the walls of AO
b. Air injected during contrast injection
c. Not carefully wiping wire
d. Failing to time the wire correctly
6.
What is the most common location of a myxoma?
a. RV
b. LV
c. LA
d. RA
7.
A congenital nodular glycogenic degeneration of myocardial fibers which may be
found as single or multiple nodules, especially in the hearts of infants and
children is known as:
a. Myxoma
b. Rhabdomyoma
c. Sarcoma
d. Rhabdomyosarcoma
8.
Myocardial biopsy is commonly performed on what two types of heart cath
patients?
1. Replacement of infected prosthetic valve
2. Cardiomyopathy
3. Heart transplant follow-up
4. LA or LV Myxoma
a. 1,2
b. 1,4
c. 2,3
d. 3,4
9.
The normal blood oxygen saturation in the right heart is:
a. 20-40%
b. 50-70%
c. 70-80%
d. 90-100%
10.
According to Mrs. Thomas we should all feel 100% ready to pass the RCVT
Registry exam. Which of the following best describes how you feel about the
Registry?
a. Almost ready
b. Nauseated
c. Will never be ready
d. Dizziness and sweating
e. All of the above
11.
How could you reduce the artifacts seen on the ECG in Figure 1?
a. Relax and quiet the patient
b. Check for electric motor, improper ground, other 60 Hz
c. Increase the damping on the machine
d. Reapply the ECG electrodes further out on the limbs
12.
Match the hypertrophy pattern labeled at #3 in the box in Figure 2.
a. Right Atrial Enlargement (RAE)
b. Left Atrial Enlargement (LAE)
c. Right Ventricular Hypertrophy (RVH)\
d. Left Ventricular Hypertrophy (LVH)
13.
The precordial ECG leads in Figure 3 shows:
a. LVH with strain
b. LVH with ischemia
c. LAH
d. RAH
14.
The most common sensor in VVIR mode pacemakers is:
a. PR interval
b. QRS duration
c. Motion
d. Venous PO2
e. Temperature
15.
Identify the mode of the schematic pacemaker labeled #2 on Figure 4:
a. VVI
b. AAI
c. VDD
d. DVI
16.
Which physiologic pacemaker mode is rate responsive? (A sense “P” wave precedes each
ventricular artifact) Figure 5
a. AAI
b. VAT
c. VVT
d. DVI
17.
The ECG in Figure 6 shows:
a. Atrial bigeminy
b. Ventricular bigeminy
c. AAI pacing
d. VVI pacing
18.
The ECG and arterial pressure in Figure 7 shows:
a. Atrial bigeminy
b. Ventricular bigeminy
c. AAI pacing with occasional loss of capture
d. VOO pacing with occasional loss of capture
19.
In Figure 8, what does the notched “T” wave indicate in the ECG?
a. Hyperkalemia
b. Hypokalemia
c. Bigeminal PVCs with “R” on “T”
d. Re-entrant retrograde “P” waves
20.
This ventricular pacemaker ECG in Figure 9 shows what problem?
a. 3rd degree block with rapid atrial response
b. Second degree block with 5:1 conduction
c. Anti-tachy pacemaker with severe over sensing
d. Runaway pacemaker with non-capture
21.
On an atrial pressure waveform the “a” wave is produced by
a. Atrial relaxation
b. Atrial contraction
c. Ventricular relaxation
d. Ventricular contraction
22.
On an atrial pressure waveform the “v” wave represents
a. Filling of the atrium during ventricular systole
b. A kick
c. Atrial systole
d. Filling of the ventricle during atrial systole
23.
On an atrial pressure waveform the “c” wave represents
a. AV valve closure
b. SL valve closure
c. Opening snap
d. Ejection click
24.
The “y” descent on a left atrial waveform is reflective of
a.
Closure of the mitral valve with an increase in left atrial pressure as passive emptying into
the left ventricle occurs.
b.
Closure of the tricuspid valve with an increase in right atrial pressure as
passive
emptying into the right ventricle occurs.
c.
Opening of the mitral valve with a decrease in left atrial pressure as passive emptying into
the left ventricle occurs.
d.
Opening of the tricuspid valve with a decrease in right atrial pressure as passive emptying
into the right ventricle occurs.
25.
On the ECG the “a” wave
a. Follows the T wave
b. Follows the P wave
c. Follows the QRS complex
d. Follows the ST segment
26.The “v” wave on the ECG
a. Falls within the ST segment
b. Follows the P wave
c. Follows the T wave
d. Follows the QRS complex
27.
Calculate the following:
EDV= 125 ml
ESV= 60 ml
HR= 65 bpm
BSA= 1.4m2
1. Stroke volume
2. ejection fraction
3. Angiographic C.O.
4. Angiographic C.I.
a. 72ml/.24ml/6.0 Lper min/ 7.6 Lper min per m2
b. 48ml/.33ml/4.9L per min/ 4.6 L per min per m2
c. 65ml/.52ml/4.23 L per min/3.02 L per min per m2
28.
Calculate aortic valve area from the following data:
HR=70 bpm
C.O= 5.6 L per min
sep=.35 sec/beat
mean gradient = 56 mmhg
a. .29 cm2
b. .32 cm2
c. .48 cm2
d. .69 cm2
29.
Determine the valve area from the following:
C.O.=4680 ml per min
mitral diastolic gradient of 30 mmhg
a. .85 cm2
b. .76 cm2
c. .42 cm2
d. .97 cm2
30.
Determine the shunt from the following 02 sat’s
AO= 98%
LA=98%
LV=98%
SVC=72%
PA= 87%
RA= 71%
RV=88%
IVC= 72%
a. L to R ASD
b. R to L ASD
c. L to R VSD
d. R to L VSD
31. Nonspecific symptoms of infectious Pericarditis include which of the following:
a. Fever
b. Malaise
c. Lassitude
d. All of the above
32.
What procedure is the most important and specific in the detection of pericardial fluid?
a. Echocardiography
b. Cardiac catheterization
c. Chest X-ray
33.
Which of the following is the main hazard of an Endomyocardial Biopsy?
a. Conduction abnormalities
b. Air embolism
c. Vascular trauma
d. Cardiac perforation
34.
Which of the following is an indication for Endomyocardial Biopsy?
a. Endomyocardial fibrosis
b. Unexplained ventricular arrhythmias
c. Cardiac allograft rejection
d. None of the above
e. All of the above
35.
The consequence of pericardial tamponade is:
a. Decrease in intrapericardial pressure
b. Increase in intrapericardial pressure
c. No change in intrapericardial pressure
36.
In pericardial tamponade a frequent electrographic sign is:
a. Pulses paradoxes
b. Pulses biferans
c. Electrical alternans
37.
Left ventricular biopsy should not be done in patients with recent myocardial infarction.
a. True
b. False
38.
The recommended number of separate specimens obtained from either the right or left ventricle is:
a. 2-4
b. 3-5
c. 4-6
d. Doesn’t really matter
39.
Adriamycin is a potent ------- that is used in many tumors, but whose usefulness is limited by
its tendency to cause cardiotoxicity:
a. Steroid
b. Anti-coagulant
c. Thrombolytic
d. Antibiotic
40. One area where cardiac biopsy has proven useful is in acquired immune deficiency
syndrome?
a. True
b. False
41.
Oxygen chemically combined with hemoglobin for transport is termed:
a.
Oxyhemoglobin
b.
Oxyferroglobin
c.
Carboxyhemoglobin
d.
Carbamino hemoglobin
42.
Following a cardiac arrest and resuscitation a patient’s arterial blood gases are as follows:
pH 7.30, PCO2 52, P O2 96. The most probable acid base diagnosis is:
43.
44.
a.
Pure respiratory acidosis
b.
Pure metabolic acidosis
c.
Compensated respiratory acidosis
d.
Partially compensated respiratory acidosis
Normal CO2 and O2 arterial blood gas tensions are:
a.
PCO2=20, PO2=48 mmHg.
b.
PCO2=20, PO2=80 mmHg.
c.
PCO2=40, PO2=48 mmHg.
d.
PCO2=40, PO2=80 mmHg.
Anxiety produced hyperventilation will produce which of the following changes in arterial pH and
pCO2?
45.
a.
Decreased pH, decreased PCO2
b.
Decreased pH, increase PCO2
c.
Increased pH, decreased PCO2
d.
Increased pH, increased PCO2
Bicarbonate functions as a base by:
a.
Releasing CO2 into solution
b.
Removing free H+ ions from solution
c.
Releasing hydrogen ions
d.
46.
47.
48.
49.
Neutralizing OH-in solution
Volatile acids are those that:
a.
Give off gaseous products
b.
Are eliminated primarily through the kidneys
c.
Are conjugated in the liver
d.
Are flammable when liberated from solution
Respiratory failure allows which of the following acids accumulate in the blood?
a.
Carbonic acid
b.
Oxalic acid
c.
Pyruvic acid
d.
Lactic acid
As acidosis evolves in acute respiratory failure, patients tend to:
a.
Speed up in response to a neural stimulus
b.
Become irregular in response to CO2 toxicity
c.
Slow in order to conserve CO2
d.
Become shallower in order to conserve CO2
Which three of the following may lead to respiratory acidosis?
1.
Narcotic overdose
2.
Depression of respiratory rate or depth
3.
Deficient production of carbon dioxide
4.
Poor diffusion of carbon dioxide across alveolar membrane
50.
51.
a.
1, 2, 3
b.
1, 2, 4
c.
1, 3, 4
d.
2, 3, 4
What does high arterial PH (e.g. 7.60) indicate?
a.
Excess of H+ ions
b.
Deficiency of H+ions
c.
Excess of HOH molecules
d.
Deficiency of HOH molecules
___________ results from inadequate ventilation, CO2 retention and increased levels of carbonic
acid in the blood.
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic acidosis
d. Metabolic alkalosis
52.
__________ results from excessive amounts of CO2 being eliminated from circulation and
treatment consists of rebreathing CO2.
a. Metabolic alkalosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Respiratory acidosis
53.
Metabolic acidosis occurs when the body produces excessive amounts of metabolic acids. This
increase in acid consumes bicarbonate buffer causing further acid build up and a decrease in
base which causes a:
a. Decrease in pH but CO2 level remain normal
b. Increase in pH but CO2 level remain normal
c. Decrease in pH and CO2 level decreases
d. Increase in pH and CO2 level decreases
54.
Following a cardiac arrest and resuscitation a patients arterial blood gases are as follows pH
7.35, PCO2 39 mmHg, HCO3 15 mEq/dl, PO2 96mmHg. The most probable diagnosis is:
a. Pure respiratory acidosis
b. Pure metabolic acidosis
c. Compensated respiratory acidosis
d. Partially compensated respiratory acidosis
55.
What therapy would be indicated for the above patient?
a. increase ventilation
b. decreased ventilation
c. Rebreather mask with O2
d. Give 1 amp. Bicarbonate
56.
Following a cardiac arrest and resuscitation a patients arterial blood gases are as follows:pH7.30,
PCO2 52, PO2 96. The most probable diagnosis is:
a. Pure respiratory acidosis
b. Pure metabolic acidosis
c. Compensated respiratory acidosis
d. Partially compensated respiratory acidosis
57.
What therapy would be indicated for the patient in question #6?
a. Increase ventilation
b. Rebreather mask with O2
c. Give 1 amp. Bicarbonate
d. Give 2 amps. Bicarbonate
58.
Respiratory failure allows which of the following acids to accumulate in the blood?
a. Carbonic acid
b. Oxalic acid
c. Pyruvic acid
d. Lactic acid
59.
Which of the following may lead to respiratory acidosis?
1. Narcotic overdose
2. Depression of respiratory rate or depth
3. Deficient production of carbon dioxide
4. Poor diffusion of carbon dioxide across alveolar membrane
a.1,2,3
b.1,2,4
c.1,3,4
d.2,3,4
60.
In chronic respiratory acidosis, such as COPD renal compensation results in:
a. Decreased retention of HCO3
b. Increased retention of HCO3
c. Decreased retention of CO2
d. Increased retention of CO2