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 3
1. What can cause Cardiac Output values to be lower than expected:
1. Catheter tip in RV
2. Injectate volume greater than designated amount
3. VSD
4. Fibrin covering thermistor
a. 1,3,4
b. 2,3
c. 1,2,3
d. All of the above
2. An ASD or Patent foramen ovale is best detected by injection into the:
a. SVC
b. IVC
c. PA
d. RV
3. In non-equilibrating VSD the shunt is the direct function of the size of the shunt.
a. True
b. False
4. The simplest way to screen blood for a L-R shunt is to sample blood from:
a. PA & AO
b. IVC & SVC
c. SVC & PA
d. RV & LV
5. Determine the regurgitant fraction from the following information:
CO = 2000 cc/min
HR = 60
SV (thermal) = 10 cc/beat
a. 60%
b. 90%
c. 70%
d. Unable to determine
6. Determine the level of the shunt from the following information:
IVC = 82%
PA = 87%
Factor = 1.34
SVC = 71%
PCW = 98%
HGB = 15 gm/dl
RA = 75%
LV = 98%
RV = 88%
AO = 98%
O2 Consumption = 225 ml/min
a. ASD
b. PDA
c. VSD
7. Determine the Ejection Fraction:
EDV = 125 ml
HR = 65 bpm
ESV = 60 ml
BSA = 1.4 m
a. 59%
b. 63%
c. 52%
d. 80%
8. The equilibrating VSD is invariably associated with:
a. Pulmonary hypotension
b. Pulmonary hypertension
c. Pulmonary stenosis
d. Mitral insufficiency
9. The ASD located in the posterior portion of the septum is:
a. Secundum type
b. Sinus venosus type
c. Septum primum type
10. Determine the level of the shunt and the ratio of systemic to pulmonary blood flow:
IVC = 69%
PA = 84%
Factor = 1.34
SVC = 68%
AO = 96%
HGB = 14
RA = 70%
LA = 96%
O2 Consumption = 245 ml/min
RV = 70%
LV = 96%
a. VSD/2:1
b. ASD/ 1:1
c. PDA/ 2:1
11. ---------- are used to treat hypertension by indirectly reducing blood pressure by
producing sodium and water loss and lowering the tone or rigidity of the arteries.
a. Diuretics
b. Vasodilators
c. Calcium channel blockers
d. Adrenergic antagonists
12. Which of the following is a calcium channel blocker used to treat hypertension?
a. Furosemide
b. Clonidine
c. Verapamil
d. Catopril
13. Which of the following would be used in local anesthesia?
a. Valium
b. Versed
c. Lidocaine
d. Lasix
14. What is the trade name for lidocaine?
a. Procaine
b. Xylocaine
c. Mercaine
d. Carbocaine
15. Heparin is used for all of the following except
a. Short term anticoagulant
b. Long term anticoagulant
c. Treatment of venous thrombosis
d. Pulmonary emboli
16. ------------ prevents the conversion of fibrinogen to fibrin.
a. Nitrates
b. Anticoagulants
c. Thrombolytics
d. Contrast agents
17. Thrombolytic therapy is used to/for
1. Prevent clot formation
2. Short term anticoagulation
3. Dissolve clots formed in the coronary arteries
4. Treat MI
a. All of the above
b. 1, 3, 4
c. 3 only
d. 3 and 4
18. The key player in thrombolytic therapy is
a. Fibrin
b. Fibrinogen
c. Plasminogen
d. Plasmin
19. All of the following are thrombolytic agents except
a. TPA
b. Plasminokinase
c. Streptokinase
d. Urokinase
20. Which thrombolytic is used for fast acting intracoronary therapy?
a. TPA
b. Urokinase
c. Streptokinase
21.
Which of the following is a common RESULT of right sided heart failure?
a.
b.
c.
d.
22.
Which of the following is NOT a clinical manifestation of shock?
a.
b.
c.
d.
23.
Dyspnea
Pulmonary congestion
Pulmonary hypertension
Neck vein distension
Pallor
Metabolic acidosis
Slow bounding pulse
Falling BP
If an embolus were to lodge in the distal RCA at the crux, which segment of the heart
would suffer damage?
a. RV
b. Inferior LV wall
c. Anterior LV wall
d. Posterior-lateral wall
24.
An OLD myocardial infarct is seen on the ECG as a significant:
a.
b.
c.
d.
25.
Left heart failure if allowed to progress will lead to:
a.
b.
c.
d.
26.
Heparin drip / 4-6 hours
Heparin drip / 24-48 hours
Thrombolytic drugs / 4-6 hours
Thrombolytic drugs / 24-48 hours
Atherosclerosis is best defined as:
a.
b.
c.
d.
28.
Mitral valve prolapse
Mitral regurge
Systemic hypertension
Pulmonary hypertension
A patient has signs and symptoms of myocardial infarction. Myocardium may be
preserved from necrosis if a ______is administered within _______hours of the symptom
onset.
a.
b.
c.
d.
27.
Q - wave
Inverted T - wave
Elevated ST segment
Depressed ST segment
Thickening of the arterial walls
Hardening of the arterial walls
Deposits of fatty plaques within arterial lumen
Thrombus formation in the lumen of the arteries
Some acute MI’s only affect the inner layer of the myocardium. This type of heart attack
is called:
29.
a. Epicardial infarction
b. Transmural infarction
c. Subendocardial infarction
d. Subdural infarction
Shock is an acute inability of the heart to maintain adequate perfusion to:
a.
b.
c.
d.
30.
Maintain an average BP > 80mmHg
Maintain an average BP > 100mmHg
Sustain function of the vital organs at rest
Sustain metabolism of all organ systems at rest
Heart failure is an abnormal state of cardiac function which fails to meet needs of
metabolizing tissues or can only meet them with:
a.
b.
c.
d.
Increased coronary flow
Increased cholinergic stimulation
Increased BP
Increased venous pressure
31. Which coronary arteries arise near the “Crux?”
1. Posterior Descending Coronary origin
2. Diagonal Branch origin
3. Acute Marginal Branch origin
4. AV Nodal Branch origin
a. 1,3
b. 1.4
c. 2,3
d. 2,4
32. Which Left Coronary Artery is nearest the backbone in the most oblique X-ray view?
a. LAD
b. RAD
c. LAO
d. Circumflex
e. PDCA
33. Occlusion of the mid RCA would cause infarction of the LV:
a. Anterior wall and anterior interventricular septum
b. Lateral wall
c. Posterior wall (base of the heart)
d. Inferior wall (diaphragmatic surface)
34. Which of these coronary occlusions results solely in a RV Myocardial Infarction?
a. PDCA occlusion
b. Diagonal occlusion
c. Obtuse marginal occlusion
d. Acute marginal occlusion
35.
Considering the branching anatomy of coronary arterial perforators which area of the
heart is most susceptible to heart attack and injury?
a. Pericardial
b. Epicardial
c. Endocardium
d. SA node
e. AV node
36. The lowest blood oxygen saturation normally found in the heart is in the:
a. Coronary sinus
b. Pulmonary artery
c. Inferior vena cava
d. Superior vena cava
37. The right or left coronary system is dominant, depending on which one supplies the
heart’s?
1. Anterior IV Septum
2. Posterior IV Septum
3. RV Lateral wall
4. LV Lateral wall
5. Diaphragmatic LV wall
a. 1,4
b. 2,4
c. 2,5
d. 3,5
38. The _______ returns deoxygenated blood from the myocardium to the ___________.
a. Azygous vein, RA
b. Azygous vein, LA
c. Coronary sinus, RA
d. Coronary sinus, LA
39.
Left coronary blood flow occurs primarily during the ____ phase of the cardiac cycle
because ____.
a. Systolic, coronary driving pressure is great.
b. Systolic, systolic ejection opens the aortic valve.
c. Diastolic, semilunar valves cover the coronary ostium in systole.
d. Diastolic, diastole releases compressed endocardial capillaries.
40. The “widow-maker” lesion is a stenosis in which coronary artery?
a. LAD
b. Diagonal
c. Circumflex
d. Main stem left
e. Main right coronary
41.
The reason for tapping on the Pressure injector syringe just before performing a test
injection is to:
a. Assure a tight catheter- syringe connection
b. Make sure you have drawn back blood into the injection syringe
c. Test the integrity of the injection system
d. Break loose any bubbles at the tip of the injection syringe
42. Calculate the total injection time for the injector settings of 8 for 40 total:
a. 2 sec
b. 3 sec
c. 5 sec
d. 9 sec
43.
For coronary arteriography Drs. Sones and Judkins recommend the 3 port manifold
setup. The sidearm of the stopcock nearest the catheter should be connected
to the:
a. Contrast bottle
b. Saline I.V. bottle
c. Pressure injector
d. Pressure transducer
44.
If the parameters of angiographic pressure injection were changed, according to
Poiselle’s law which below would allow the highest flow rate?
a. Catheter length halved
b. Injector pressure doubled
c. Injectate viscosity halved
d. Catheter inside lumen area doubled
45.
A cardiac pressure recording made with the pressure transducer 25 cm. below the
patients mid-chest level will be in error. All recordings will read as:
a. 10 mmHg too high
b. 20 mmHg too high
c. 10 mmHg too low
d. 20 mmHg too low
46.
All of the following are factors that affect transducers commonly causing problems
for patients and technicians EXCEPT for:
a. Safety issues due to contact
b. Physical wear and abuse due to motion
c. Accuracy and calibration
d. Converting physical parameters
47.
A thermistor mounted in a Wheatstone bridge functions as a transducer converting
which parameter to a voltage?
a. Temperature
b. Body Temperature
c. Blood Pressure
d. Weight
48.
When using the power injector the physician will verbally state what settings are to
be used. Your first response will be to:
a. Tell him your ready to inject
b. Set the parameters asked for
c. Repeat the injection parameters back to the physician
d. Inject when you are ready
49. The proper position for placing the transducer in an apexcardiogram is:
a. 4th intercostal space at left sternal border
b. V6 position of the ECG
c. Wherever the point of maximum intensity is felt or seen
d. Wherever the loudest sound is heard on the chest
50.
Which pressure tube connecting the catheter to the pressure transducer will have
the lowest (poorest) frequency response?
a. 50 cm. long soft small diameter pressure tube
b. 50 cm. long stiff large diameter pressure tube
c. 100 cm. long soft small diameter pressure tube
d. 100 cm. long stiff large diameter pressure tube
51.
Percutaneous entry made through a triangle formed by the two Sternocleido-mastoid
muscle insertions and the sternum is called?
52.
a.
Subclavian vein
b.
Azygous vein
c.
Internal jugular vein
d.
External jugular vein
Which type of IV cannulation system is seldom used because it may accidentally
shear off catheter and embolize into the vein?
53.
54.
a.
Catheter over needle
b.
Catheter through needle
c.
Catheter over guide wire
d.
Sheath and dilator over wire
On which IV access site is it hardest to control hemostasis?
a.
Femoral vein
b.
Subclavian vein
c.
Internal jugular vein
d.
External jugular vein
To clear damped indwelling arterial catheters which are suspected of being clotted,
you should pull the catheter back below the Renal arteries and then?
a.
Flush gently with heparinized saline
b.
Flush forcefully with thrombolytic agent
c.
Push guide wire through catheter, then flush
d.
Aspirate clot then flush with heparinized saline
55.
Arterial lines should be connected to a continuous flush device which at 300 mmHg
infusion pressure will deliver approximately:
56.
a.
1-2 ml flush/min
b.
5-10 ml flush/min
c.
3-5 ml flush/hour
d.
20-40 ml flush/hour
Anxiety produced hyperventilation will produce which of the following changes in
arterial pH and pCO2?
57.
a.
Decreased pH, decreased PCO2
b.
Decreased pH, increased PCO2
c.
Increased pH, decreased PCO2
d.
Increased pH, increased PCO2
A weak and ineffective cough, high pitched noises on inhalation, increasing
respiratory difficulty and cyanosis are signs of:
58.
a.
Status Asthmaticus
b.
Totally obstructed airway
c.
Partially obstructed airway with good air exchange
d.
Partially obstructed airway with poor exchange
Which is NOT true of correct performed Endotrachial intubation:
59.
60.
a.
Prevents gastric distension and aspiration
b.
Provides a route for administration for some mediations
c.
Over insertion places the catheter tip in the left main stem bronchus
d.
Patients should be hyper-oxygenated prior to ET tube insertion
All below are accepted maneuvers used to assist in opening the airway EXCEPT:
a.
Tilting the patient’s head backward
b.
Pressing your palm onto the patient’s forehead
c.
Pulling up with your hand under the patient’s neck
d.
Pulling up with your hand beneath the patient’s chin
Cath lab personnel may terminate CPR under all of the following circumstances
EXCEPT:
a.
His/her exhaustion
b.
The MD pronounces patient dead
c.
The code team assumes responsibility
d.
The patient is unresuscitatable