BKAT Study Questions and Answers 2023 What to do first if patient has chest pain. - Correct Answer Rest!ECG changes in an acute MI - Correct Answer ST elevation in 2 or more contiguous leads. Ischemia d/t full thickness loss of muscle. EMERGENCY.Inferior leads - Correct Answer II, III, aVF. RCA occlusion.Septal leads - Correct Answer V1 & V2.Anterior leads - Correct Answer V1 - V4. LAD lesion.Lateral leads - Correct Answer V5, V6, I, and aVL. Circumflex lesion.Cardiac enzymes - Correct Answer Troponins, CK-MB, and CK
Changes in CK - Correct Answer Rise: 3-6 hours
Peak: 24 hours
Normal: 3-4 days
Changes in CK-MB - Correct Answer Released after myocardial necrosis. Specific for myocardial damage.
Rise: 3-12 hours
Peak: 24 hours
Normal: 2-3 days
Troponin I - Correct Answer Protein found in cardiac muscle. High sensitivity.
Rise: 3-12 hours
Peak: 24 hours
Normal: 5-10 days
Troponin T - Correct Answer Protein found in cardiac muscle. High sensitivity.
Rise: 3-12 hours
Peak: 12-48 hours
Normal: 5-14 days
Common conditions that cause a murmur - Correct Answer Aortic dissection, aortic regurgitation (both acute & chronic), mitral valve regurgitation (both acute & chronic), mitral valve stenosis Drugs to decrease afterload/SVR/PVR - Correct Answer (Arterial Dilators) Nitroprusside, nitroglycerin, amrinone, alpha (Regitine) & Ca channel blockers 1 / 2
Drugs to increased afterload/SVR/PVR - Correct Answer (Vasopressors) Epinepherine, norepinepherine, dopamine, neosynephrine Drugs to decrease contractility/SVI - Correct Answer Beta blockers (atenolol, metoprolol, propranolol, labetolol, esmolol) and Ca channel blockers Drugs to increase contractility/SVI - Correct Answer Positive inotropes, dobutamine, dopamine, milrinone, and digoxin Drugs to decrease preload/CVP/PAWP - Correct Answer Venous Dilators - Nitroglycerin, nitroprusside, amrinone, alpha & Ca channel blockers Diuretics - Furosemide, bumex, mannitol Drugs to increase preload/CVP/PAWP - Correct Answer Volume - Colloid, crystalloids, blood, hetastarch Dysrhythmia control - antirhythmics, pacemaker, AICD Complications when using thrombolytics - Correct Answer Allergic reaction, bleeding/hemorrhage, stroke Failure to capture - Correct Answer Pacer delivers a stimulus at the appropriate time but no depolarization occurs. No P or QRS wave after pacer spike.Failure to fire/pace - Correct Answer No pacer spikes seen Failure to sense - Correct Answer Pacemaker does not detects heart's intrinsic activity or interprets noncardiac activity as intrinsic activity. Spikes in inappropriate times.Normal PR - Correct Answer 0.12 - 0.20 Normal QRS - Correct Answer 0.04-0.10 Normal QT - Correct Answer Less than 0.48. Varies by age, HR, and gender.Vasopressors - Correct Answer Epinepherine, norepinepherine, dopamine, phenylephrine/neosynephrine, vasopressin/pitressin, milrinone/Primacor, dobutamine/Dobutrex Indication for dopamine/Intropin - Correct Answer Acts on SNS to increased HR and BP. Indicated for hypotension, low CO, decreased renal blood flow. Use if patient is bradycardic.
Doses of dopamine - Correct Answer Low: 0.5-2 mcg/kg/min (dopaminergic)
Intermediate: 2-10 mcg/kg/min (beta receptors, increases CO)
High: over 10 mcg/kg/min (alpha receptors, vasoconstrict)
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