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RCIS Study question with complete
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Treatment of pseudoaneuryms - correct answer Cover stent, US probe compression of the neck, US guided THROMBIN injection, open surgical ligation Treatment for vasovagal reaction - correct answer Atropine Rotational atherectomy burr speed - correct answer 160,000 rpms Regurgitant Fraction Formula - correct answer SV (valve) - SV (systemic) / SV (valve) Ejection Fraction Formula - correct answer SV / LVEDV Laser safety equipment - correct answer goggles, yes wear UV safety goggles Where is the Laser situated in relation to the lesion for it to work? - correct answer Directed at a lesion to photo ablate it Reversal agent for Fentanyl ( - correct answer Naloxone Treatment for radial artery spasm - correct answer Verapamil Minimum time after administering Heparin to check ACT - correct answer 3-5 minutes to 10 Minutes What is a potassium <3.5 called - correct answer Hypokalemia Information needed for Patient Identification - correct answer Name, Date of Birth
Chemical used for sterilization - correct answer Ethylene Oxide Most important factors in steam sterilization - correct answer Pressure, Time, Temperature, Con What equipment is used in mitral valvuloplasty - correct answer Mullins Sheath and a transseptal needle (Brockenbrough needle) What leads point to an inferior MI? - correct answer II, III, aVF What is the starting dose for versed and fentanyl? - correct answer 0.5 to 1.0 mg Versed, 25-50 mcg Fentanyl Common stick resulting in a PSA (Pseudoaneyurism) - correct answer Low Stick > 1cm below the inguinal fold Common stick for retroperineal bleed - correct answer High Stick Common stick resulting in a Hematoma - correct answer Multi sticks Meds for PEA and Asystole - correct answer Epinephrine and Vasopressin How do you test the defib monitor - correct answer Discharge paddles into aa dummy load Common place for radiation badge - correct answer On lead near neck by thyroid Yearly dose for cath lab staff - correct answer 5 REM
What size is a 2.33 mm sheath - correct answer 7 French 1 french size equals? - correct answer .33mm What size is a 2.66mm sheath? - correct answer 8 french What do you do if you feel resistance and the patient states he has pain while inflating a foley balloon? - correct answer Deflate the balloon and attempt advancement Anterior Leads - correct answer V2 - V When do the valves open and close (wiggers diagram) - correct answer Beginning of Isovolumic Contraction: A-V valves close End of Isovolumic contraction: Aortic Valve opens Beginning of Isovolumic relaxation: Aortic Valve closes End of Isovolumic relaxation: A-V valve opens What do you do if the pressure tracing ventricularizes - correct answer Adjust the catheter until pressure tracing normalizes What does an injury current during periocardiocentisis mean? - correct answer The needle is in the myocardium What stent is best used in tortuous Situations - correct answer Open Cell stent What piece of equipment should you prepare for a rotablator case - correct answer Temp pacer should be prepped and placed What should you do prior to a PCI of the RCA for a patient with a LBBB - correct answer Place a temp pacer
Fick Formula - correct answer O2 consumption / (Hgb x 1.34 x AO2)-(Hgb x 1.34 x PO2) x 10 Regurgitant Fraction - correct answer (CO angio) - (CO fick) / (CO angio) Qp/Qs - correct answer Ao sat - RA sat / PV sat - PA sat Qp/Qs > 1 - correct answer Left to right shunt Qp/Qs < 1 - correct answer Right to Left shunt Where must an ASD be located in order to perform a closure - correct answer Ostium Secundum or Fossa Ovalis When is distal protection best used - correct answer Carotids and Grafts What is the wire size on a distal protection device - correct answer 0. What equipment is needed for a PCI - correct answer Guide catheter, guide wire, tuoghy, inflation device What may happen is the roughy is overtightened - correct answer The balloon will not inflate What is the best device for stent opposition? - correct answer OCT or IVUS Can the PFO closure device be resheathed before it is deployed - correct answer Yes TIMI Flows - correct answer TIMI 0 - No perfusion, no flow beyond the coronary occlusion
What is the normal range of Potassium (K+) in the blood - correct answer 3.5-5. Name some anti platelet meds - correct answer ASA, Ticlid, Plavix If a patient has a high creatinine, what should you consider? - correct answer Use as small amount of contrast as possible, pre procedure fluid hydration (3ml/kg) How does Heparin prevent clot formation? - correct answer Prevents the conversion of prothrombin to thrombin, combines with antithrombin to make it more effective What is the action of Reopro? - correct answer inhibits IIb/IIIa INR measures the levels of what drug? - correct answer Coumadin Lovenox impacts what? - correct answer Antithrombin, Factor Xa What might be the medication of choice for SVT? - correct answer adenosine What short acting benzodiazepine is commonly used in the cath lab for sedation - correct answer Versed What is a quick and easy way to check a patients clotting time after being given heparin - correct answer ACT How do Ticlid and Plavix act? - correct answer Turn off receptor sites on the platelets (super aspirin) If a patient is on NPH insulin, what medication should not be given? - correct answer Protamine What does ASA (aspirin) do? - correct answer ASA prevents platelet adhesion
TPA acts by? - correct answer Dissolving fibrin, Activates plasminogen What labs look at kidney function? - correct answer BUN and Creatinine, GFR, Creatinine clearance The most accurate measure of cardiac muscle fiber damage after an MI is what? - correct answer Troponin Which lab value does not evaluate the extent of an MI? SGOT Serum Creatinine CK-MB LDH - correct answer Serum Creatinine Post procedure renal dysfunction is more likely to occur in patients with? - correct answer Diabetes Pre-procedure dehydration Frequent NSAID use ACE Inhibitors What is a pseudoaneyurysm? - correct answer Pseudoanuerysm is a false aneurysm, Often a pulsatile mass near the sheath site with a bruit present If the transducer is positioned to low at the side of a table, the patients pressure will read? - correct answer falsely high If you are checking the radial/ulnar pulse when you press and release one side at a time, what test are you performing? - correct answer Allen's test What is the best way to calculate a patients pulse rate? - correct answer Check pulse for one minute If the patients IV is infiltrated, what should you do? - correct answer Turn it off
They symptoms of increased heart rate, decreased BP, and SOB during biopsy indicate what? - correct answer Cardiac perforation What diagnostic catheter is best utilized for visualizing the LAD when the patient has a dilated aortic root? - correct answer JL 2.66 mm diameter is what size catheter - correct answer 8 Fr What device uses saline to dissolve and suction thrombus during and acute MI? - correct answer Angiojet During a rotablator intervention, what is the most common cause of "no flow"? - correct answer Distal embolization Where does the needle enter for a pericardialcentisis? - correct answer Sub-xyphoid process What is a possible complication of over tightening the tuoghy? - correct answer Inability to inflate the balloon If a patient has a heart rate of 150, assist on the IABP should be set at? - correct answer 1: What is the best balloon to use on an artery that has a tendency to close? - correct answer A perfusion balloon Jugular Vein Distention (JVD) can be caused by? - correct answer RV Infarct, Pulmonary Hypertension, Tricuspid Regurgitation Shortness of breath indicates left or Right sided heart failure? - correct answer Left sided Ventricular Arrhythmias are most common during injection of which coronary artery? - correct answer RCA
Osmolality refers to the ability of the contrast to? - correct answer Pull fluid into the intravascular space The ideal contrast volume to be given to the patient is? - correct answer 3ml/kg Synchronous (demand) pacemakers have what unique ability? - correct answer They sense the hearts intrinsic activity and pace only when needed In order, the first three letter of the pacemaker code mean what? - correct answer Chamber paced, chamber sensed, chamber triggered The purpose of biventricular pacemakers is to - correct answer To synchronize the contraction of both ventricles The purpose of ICDs is to? - correct answer Monitor bradycardia, tachycardia, VT, and V-Fib and convert if necessary In the terms RAO and LAO, the R and L refer to what? - correct answer The position of the Image intensifier What is the best view to see the LAD and circle bifurcation - correct answer LAO caudal (spider view) On an EKG, what shows a "true" posterior infarct? - correct answer V7-V9, V1 and V What catheter does an IMA (internal mammory artery) catheter resemble? - correct answer JR If the pt. has a dilated aortic root, which catheter might you need to cannulate the right coronary system? - correct answer JR In a routine PTCA, what might be some complications caused by the handling of the wire? - correct answer Arterial dissection or perforation
What will cause failure to capture of a pacemaker in the RV? - correct answer Lead dislodgement You have a 50 y/o admitted to the cath lab, HR 200, BP 90/50, what would you do? - correct answer Synchronized cardioversion Vascular resistance is most greatly influenced by? - correct answer The radius of the tube (vessel) What is the ACLS protocol for monophonic defibrillation - correct answer 200-300- How do you test a defibrillator? - correct answer Discharging paddles into the dummy load If there is a valve with regurgitation, what CO method should you use? - correct answer FICK What does a c wave represent? - correct answer Onset of ventricular contraction Where do you measure thermodilution cardiac outputs? - correct answer Inject in the RA and measure in the PA What are the 4 abnormalities associated with Tetrology of Fallot? - correct answer Pulmonic Stenosis, VSD, RV hypertrophy, Overriding Aorta Which valve has the smallest valve area? - correct answer Aortic valve A PDA most like causes? - correct answer Increased pulmonary blood flow, possibly pulmonary edema What is a sign of right sided heart failure - correct answer Jugular vein distention What is the purpose of the IABP? - correct answer Increased coronary artery perfusion, Decrease Afterload
Mean Arterial Blood Pressure - correct answer Systolic x 2 Diastolic / 3 Pulse Pressure - correct answer AO systolic - AO diastolic Normal O2 consumption - correct answer Adult 250 ml/min Child 150 ml/min Fick Cardiac Output - correct answer O2 consumption / AVO2 Diff x 10 Stroke Volume - correct answer End Diastolic Volume - End Systolic Volume Ejection Fraction - correct answer Stroke Volume / End Diastolic Volume Cardiac Output Angiographic - correct answer Heart Rate x Stroke Volume / 1000 Cardiac Index - correct answer Cardiac Output / BSA Regurgitant Fraction - correct answer SV angio - SV fick / SV angio Categories of Regurgitant Fraction - correct answer < 40% mild, 40%-60% moderate, >60% severe How is Systolic Ejection Period measured? - correct answer The amount of time the aortic valve is open. It is found between the beginning of arterial systole and the dicrotic notch. Aortic Valve Flow - correct answer 1. Convert CO to ml/min
- SEP x HR (converts seconds per beat to second per minute (Systolic Ejection Time)
- CO/SET Gorlin Aortic Valve Area - correct answer Aortic Valve Flow / 44.5 x SQRT of Mean AO valve gradient
