RCIS EXAM 300 QUESTIONS AND CORRECT ANSWERS ALREADY A GRADED 2023-2024 UPDATE|BRAND NEW What drug acts as an anticoagulant, preventing the development of clot and existing clot growth? - ANSWER- Angiomax (bibaldirudin) What is a trapped or jailed wire? What does it mean? - ANSWER- When you place a stent over a branch protecting wire When you see an inverted t wave it is a sign of? - ANSWER- Ischemia. Needs to be in 2 or more contiguous leads FFR values indicative of ischemia - ANSWER- 0.75-0.80 Heparin dose - ANSWER- 50-70 x a patient's weight Thermodilution Cardiac Output - ANSWER- The smaller the modulation curve, the highest CO What are important things to know about propranolol (inderal)? - ANSWER- Do not give to anyone with COPD! Affects both the heart and the lungs Important facts about beta blockers. - ANSWER- If stopped suddenly there is a risk of stroke. BBs stop adrenoline from binding to beta sites. Which valve receives the least amount of stress? - ANSWER- The pulmonic valve What is pulsus paradoxus? - ANSWER- When the BP > 10 mmHg on expiration than on inspiration BP Drop of more than 10mmHg with inspiration. Usually caused by cardiac tamponade How long should the TR band stay in place? - ANSWER- 90 minutes for diagnostic cases 180 minutes for interventions What is a disinfectant? - ANSWER- Destroys microorganisms on non living objects What is rotational atherectomy? - ANSWER- grinds away hardened plaque. Ex: Rotoblator What medication is given in SVT? - ANSWER- adenosine What do alpha 1 receptors do? - ANSWER- constrict arteries. Work on smooth muscle. Why would you use a covered stent? - ANSWER- Dissection or perforation What physiological parameter does not change with exercise? - ANSWER- Diastolic blood pressure What type of wire would you never jail? - ANSWER- Hydrophilic What are the signs of a RBBB? - ANSWER- QRS > 0.12 sec V1, V2 positive deflection What is aminocaproic acid? - ANSWER- tPA antagonist What does a Fogarty embolectomy do? - ANSWER- Used to remove arterial emboli catheter is passed through the clot, then inflated and the clot is pulled out. What is a normal FFR? - ANSWER- FFR = 1.0 What is the difference between fluoro vs Cine? - ANSWER- 10x more radiation with cine To reduce the chance of contrast problems.... - ANSWER- Limit contrast to 3ml x kg Give patient 500ccs normal saline 3 hours prior to the case What are the signs of hypertrophic obstructive cardiomyopathy? - ANSWER- pulsus bisferiens (Double pulse) There is asymmetrical hypertrophy in ventricular wall. What is a normal creatine kinase? (CK) - ANSWER- normal range is 22 to 198 U/L (units per liter) Catheters and sheaths are measured in _____? - ANSWER- French Circumference in mm 0.33mm per French What are the contraindications for an IABP? - ANSWER- Aortic insufficiency AO aneurysm Chronic end stage heart disease with no anticipation of recovery aortic stents AO dissection What needle is used to access the LA to measure pressures? - ANSWERBrochenbrough needle The smaller the field of view the - ANSWER- greater the emission of radiation What is the correct ratio of IVUS pullback? - ANSWER- .5mm per second The small burr (1.25-2.0mm) rotates at ______ - ANSWER- 160,000-180,000 RPM What defects make up Tetralogy of Fallot? - ANSWER- VSD overriding AO (over the VSD) RV hypertrophy pulmonary valve stenosis The RCA forms this letter in LAO - ANSWER- C What are the contraindications for rotoblator? - ANSWER- Saphenous vein grafts thrombotic lesions severe angulares (>45) or tortuous lesions due to eccentric passage of the burr. What is the first enzyme that is released due to muscle injury? - ANSWER- Myoglobin What are contraindications for radial access? - ANSWER- Allen's test longer than 6 seconds occluded ulnar artery What part of the heart are biopsy samples taken? - ANSWER- Right ventricle septum wall 0.5mm of lead is the equivalent of ______ shielding from xray - ANSWER- 95% shielding from xray Why are extra long wires used? (>260cm) - ANSWER- Used for exchange "over the wire" balloons What is the angiographic view for right coronary ostium? - ANSWER- 30-40 LAO What are baroreceptors? - ANSWER- Located on arch of aorta and R&L internal carotid True or False: During a left heart biopsy you should give heparin. - ANSWER- Yes, 5000IU to avoid thrombi going to the brain What is the maximum annual Radiation exposure? - ANSWER- 5 REM What is the therapeutic INR range for someone on warfarin/coumadin? - ANSWER- 2.0- 3.0 What is a normal INR for someone not on coumadin/warfarin? - ANSWER- INR 0.6-1.2 When using FFR, what drug is given and how is it delivered? - ANSWER- Adenosine causes hyperemia (Increased blood flow to the tissues. Can be delivered by either IV or IC What are the pros and cons of a mechanical aortic valve? - ANSWER- Pros: last longer Cons: Prone to thrombus formation Why would you use Cardiac Resynchronization Therapy (CTR) pacing device (such as biventricular pacing)? How many leads does it use? Where are they placed? - ANSWER- uses 2-3 leads placed through a vein in the RA, RV and into coronal sinus vein to pace the LV A CRT device sends small electrical impulses to both lower chambers of the heart to help them beat together in a more synchronized pattern. What are the angioplasty guidewire calibers? - ANSWER- 0.014-0.018 inch When can you detect Myoglobin after an MI? - ANSWER- * 2-4 hours after symptom onset * normal in 24-36 hours What is the diameter of the standard J wire? - ANSWER- 0.035 What is the Warfarin ( Coumadin) antagonist? - ANSWER- vitamin K When shooting a LIMA, the cuff should be? - ANSWER- Isolateral (same side as LIMA) left arm What is the usual time for restenosis to occur? - ANSWER- within 6 months What size is the red sheath? - ANSWER- *4F-red What size is the grey sheath? - ANSWER- 5F-grey What size is the green sheath? - ANSWER- 6F- green What size is the orange sheath? - ANSWER- 7F-orange What size is the blue sheath? - ANSWER- 8F-blue What size is black sheath? - ANSWER- 9F-black