CEN Exam Study Questions and Answers with Verified Solutions Graded A 2024 , MUGWE [Date] [Course title] MAP calculation - [( 2xDBP) + SBP] / 3 cushing's triad - widened pulse pressure, bradycardia, and irregular respirations (indicative of increased ICP) chronotropes - affect the heart rate at the SA node (cardizem) inotropes - affect contractility (dopamine) dromotropes - affect automaticity of the heart ACE inhibitors adverse effects - dry cough, angioedema, renal impairment ARB (sartans) - block angiotensin 2 receptors, resulting in vasodilation antidote for vasopressor extravasation - phentolamine (regitine) Prinzmetal angina - -episodic CP unrelated to exertion -ST elevation is variant and resolves when vasospasm resolves inferior MI ST elevation - leads II, III A VF Lateral MI ST elevation - I, A VL, V5, V6 Anterior ST elevation - V1-V4 inferior MI vessel involvement - RCA (feeds SA and A V nodes) inferior MI presentation - Epigastric pain bradycardia and heart blocks anterior MI vessel involvement - LAD (supplies L ventricle) anterior MI presentation - crushing CP "I can't breathe" Ventricular failure and arrhythmias right ventricle -involved MI - -get right sided ekg -NO nitro or morphine` tx for MI - oxygen aspirin nitroglycerin PCI within 90 mins beta-blockers for HTN **reperfusion dysrhythmias are a good sign with PCI aortic dissection BP - difference of 20 mmHg or more in SBP b/t arms aortic dissection tx - #1 priority is 2 large bore IV's maintain HR of 60 -80 (beta blocker) maintain BP of 100 -120 (nitro) post ROSC - keep O2 sat 90% CO2 35 -45 SBP >90 TTM at 32 -36 celsius medications that cause prolonged QT interval - erythromycin, levofloxacin, cipro haldol tricyclic antidepressants sotolol, procainamide zofran antidote for beta blockers - glucagon pericarditis (dressler's syndrome) - retrosternal cp, worse with inspiration, activity and laying flat relieved by sitting up or leaning forward diffuse ST elevation in most or all leads (not contiguous) tx is NSAIDs hypertensive emergency/crisis - SBP >180 or DBP >120 AND evidence of impending end -organ damage hypertensive emergency tx - nitroglycerin or nitroprusside slowly to decrease bp by 25% in first 2 hours of tx cardiac tamponade - pericardial sac accumulates excess fluid, causing obstructive shock Beck's Triad: muffled heart sounds, hypotension, JVD risk factors for DVT - Stasis, endothelial injury and hypercoagulability (Virchow's triad) non-invasive positive pressure ventilation contraindications - risk of aspiration hypotension succinylcholine contraindications - hyperkalemia, crush injuries, renal failure, burns, malignant hyperthermia, increased ICP, neuromuscular disorders malignant hyperthermia treatment - Dantrolene Causes of metabolic acidosis - DKA, alcoholic acidosis, shock, renal disease, diarrhea Causes of metabolic alkalosis - severe vomiting, excessive GI suctioning, Causes of respiratory acidosis - respiratory depression, hypoventiation Causes of respiratory alkalosis - hyperventilation, anxiety attack, pulmonary embolus croup - obstruction of the larynx caused by viral infection steeple sign on X -ray tx with racemic epinephrine low grade fever, barky cough, inspiratory stridor epiglottitis - thumbprint sign on X -ray
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