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97 Cards in this Set
- Front
- Back
***1. When do the coronary arteries fill/perfuse
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During ventricular diastole
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2. Which coronary arteries run thru the right and left AV (atrial ventricular) grooves?
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RCA and CX
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3. Name the coronary artery that runs down the interventricular Septum
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LAD
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4. True or False: the Diagonal branches supply the Anterior Lateral free wall of the left ventrical
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True
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***5. True or Flase: The obtuse Marginal (OM) supplies the lateral free wall of the LV ?
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TRUE
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6. The primary Pathways of collaterals for the LAD?
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LAD or its branches collateralize to the PDA, also the PDA will collateralize the LAD
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7. The primary Pathways of collaterals for the RCA
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RCA to CX
or CX to Distal RCA |
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8. True or False
A Significant Lesion in the Native Vessel is where collaterals come in to play |
True
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9. True or False Cannulation of the RIMA may be difficult because of the need to avoid the right internal Carotid artery
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True
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***10. True or False: In patients with a short or narrow aortic root, a 3.5mm tip catheter may be needed
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true
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12. True or False: Most common grafts to the LCA arise from the LEFT anterior surface of the aorta?
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True
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13. True or False Grafts to the RCA usually originate from the RIGHT anterior surface of the aorta?
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True
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14. Do the RCA and CX run between the AV Sulcus or the intraventricular sulcus?
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The AV (atrial ventricular) sulcus.
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15. True or False
The Conus Branch supplies the RV outflow tract and is the first branch off of the RCA. |
TRUE
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16. The Acute Marginal supplies the free wall of the LV True or False
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False- the Acute marginal branch comes off the RCA and supplies the right ventricular free wall.
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17. Where do you mostly see dampening?
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During Right Coronary Artery injection.
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18. Hand held flow rates (not using a power injector) are how many ml/sec?
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2-4ml/sec
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19. How many ml are needed to fill the RCA with contrast?
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4-8 ml are needed to fill the RCA
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20. Where do you mostly see Ventricularization?
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During left coronary artery injections.
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21. How many ml are needed to fill the LCA?
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7-10ml
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22. A frame rate of ____ frames/sec is commonly used?
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30 fps
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23. The ideal maximim contrast volume ot be given to the patient is?
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3ml/kg
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24. A patient weighing 100kg, what is the ideal maximum amount of contrast to be given?
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300ml
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25. Ventricular arrythmias are most common during the injection of whch coronary artery?
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RCA
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26. ****How many mm in diameter is a 6 french catheter?
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2.0mm
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27. ***How many mm in diameter is an 8 french catheter?
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2.6mm
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28.How many mm in diameter is the Left main?
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4.5mm
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29. How many mm in diameter is the Circ?
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3.4mm
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30. How many mm in diameteris the RCA?
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2.8mm
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31. In terms of RAO and LAO the R and the L refer to what?
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The position of the image intensifier
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32. Osmolality refers to the ability of the contrast to:
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Pull fluid into the intravascular space
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33. The Contrast that is best for a patient is:
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low osmolality
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34. ***What is the best view to see the LAD and CX bifurcation
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Spider View
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35. ****Spider view
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50-60 degrees LAO and 10 to20 degrees caudal (spider view)
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36. Typical settings for power injections of the RCA are____ml/sec and____psi?
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RCA: 6 ml at 3 ml/sec; maximal psi 450
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37. Typical settings for power injections of the LCA are_____ml/sec and ____psi?
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LCA: 10 ml at 4 ml/sec; maximal psi 450
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38. The absence of reflux of contrast media into the aortic root on left coronary injection is associated with_______ stenosis
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Ostial (LMCA) left main stenosis
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39.**** Starting most medial, name the location of the femoral vessels and nerve.
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Vein, artery ,nerve
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40. ****Starting laterally, the mnemonic for femoral artery location is NAVL.What does each letter represent?
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Nerve, Artery, Vein, empty space Lymphatics (deep inguinal lymph nodes are medial to the vein)
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41.****True or False
In obese patients the inguinal skin crease may be lower than the inguinal ligament so locating the middle of femoral head (medial aspect) under x-ray and marking it with a hemostat, provides a good landmark for arterial puncture. |
True
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42. ***Femoral puncture for arterial access should be made above or below the inguinal crease?
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1-2cm Below the inguinal crease
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43. ***True or False In the inguinal ligament lies directly below the inguinal skin crease?
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True
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44. The _______ artery is the target entry point for femoral arterial access.
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Common Femoral Artery
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45. The common femoral artery is located above the bifurcation of what two branches?
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Profunda and superficial femoral branches
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46. True or false
VCD's (vascular closure devices) should be used with caution or not at all in patients with a low arterial puncture (at or below the femoral bifurcation). |
True
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47.***Wire contact with blood forms thrombi despite anticoagulation. The operator should limit wire-loaded catheter manipulations to _____ minutes, maintain adequate activated clotting time (ACT) and use a meticulous flush technique.
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2-3minutes
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48. True or False
The most common complication of femoral cardiac catheterization is hemorrhage and local hematoma formation? |
True
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49. True or False
Infections are more common in patients who undergo repeat ipsilateral (same site) femoral punctures or prolonged femoral sheath maintenance (within 1 to 5 days). |
True
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50. ***Pseudoaneurysm is associated with low or high femoral arterial puncture?
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LOW
(usually below the head of the femur). |
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51. ***Two physical findings when diagnosing a Pseudoaneurysm include:
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1. pulsatile mass ( a pulsatile hematoma)
2. audible systolic bruit |
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52. Name three operator factors that may lead to a psiedoaneurysm formation.
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1. multiple sheath exchanges,
2. poor hemostasis during the procedure or after catheter removal 3.puncture placed too low (below the common femoral artery, in the superficial or profunda femoral artery) |
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53. ***Name at least 4 Predisposing patient factors that may lead to pseudoaneurysm formation include:
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1. anticoagulation
2. age greater than 70 3. female gender 4. low platelet count, 5.. hypertension 6.. atherosclerosis 7.. aortic insufficiency |
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54. ***The treatment for pseudoaneurysm?
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Manual compression of the expansile growing mass guided by Doppler ultrasound with or without thrombin or collagen injection is an acceptable therapy for femoral pseudoaneurysm
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55. ***Contrast media is radiopaque because it blocks or absorbs x-ray?
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Contrast media absorbs X-ray
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56. Risk of death from heart catheterization is ?
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Less than 0.2%
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57.***The correct steps of opening a sterile instrument tray when preparing a sterile table include:
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1. open the first flap away from you careful not to touch the inside of the flap
2. next open the flaps on the sides individually 3. then the final flap is open towards you |
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58.***When holding pressure on an arterial sheath, it is important to hold pressure in what location?
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2-3 cm or 1 inch above the skin puncture site
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59. true or false
When holding manual pressure, hold 3 minutes per french size for arterial site and 2 minutes per french size for venous sites. |
True
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60. true or false
Diabetic patients with preexisting renal insufficiency are particularly prone to develop contrast induced renal failure. |
True
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61.
Recommended Pre procedural IV hydration for renal insufficiency |
1ml/kg of NS or .45NS for 12 hours before and after the procedure
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62. True or False
In patients with CKD (Chronic Kidney disease) with a creatinine clearance less than 60ml/min or a creatinine >1.5, the volume of contrast media should be minimized |
True
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63. A Sodium Bicarb drip given for Renal insufficiency, What is the rate pre and post procedure?
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Initial intravenous (IV) bolus of 3 ml/kg/hr for 1 hour immediately before contrast followed by a rate of 1 ml/kg/hr during the contrast exposure and for 6 hours after the procedure)
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64.*** True or False
The use of radial artery access can be useful to decrease access site complications |
True
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65.***high femoral punctures have an increased risk of________?
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Retroperitoneal hemorrhage.
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66. True or False
In patients with a synthetic graft, arterial access is possible after the graft is a few months old and complication rates are not increased. |
True
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67. Name three conditions in which the Radial artery approach is especially appealing?
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1. Morbidly Obese patients
2. Patients with a coagulopathy or Patients with an elevated PT/INR from coumadin therapy 3. Patients with PVD |
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68. ***What is the intent of the time-out?
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The intent of the time-out is for all members of the team to improve patient care by collectively discussing the case.
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69. The content of a time-out must include a minimum of 5 things, name them.
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1.confirmation of the correct patient
2.correct side and site 3.agreement on the procedure to be performed 4. correct patient position, 5. availability of needed equipment, supplies, and implants. |
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70. The risk of stent thrombosis is greatest within the first __ days after implantation.
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30 days
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71. True or False
The use of Dual antiplatelet therapy is required for 30 days after implantation of BMS (bare metal stent) |
True
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72. The biggest cause for DES (drug eluding stent) thrombosis is?
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Early discontinuation of DAPT(dual antiplatelet therapy)
asa and plavix or asa and effient |
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73. True or False
EDP's (embolic protection device) ie: Filterwire should be used during saphenous vein graft (SVG) PCI when technically feasible. |
True
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74. Patients undergoing cardiac catheterization with contrast media should receive adequate pre procedural hydration
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1.0 to 1.5 mL/kg per hour for 3 to 12 hours before the procedure and continuing for 6 to 24 hours after the procedure
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75.***A patient has developed a pericardial tamponade during a myocardial bx. procedure.
What area of the chest should be prepped urgently to peform a pericardialcentesis? |
subxyphoid area
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76.*** When starting an IV on a patient for a procedure, supplies include
IV catheter, skin disinfectant, cap, flush and: a. Blood tubing and an IV pump b. Sterile dressing with date c. Blood tubing and tape d. Paper tape to secure directly over the insertion site |
b. Sterile dressing with date
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77. Which of the following is not a sign of a potential airway problem?
a) Stridor b) Hx of sleep apnea c) Hypertension d) Obesity |
c) Hypertension
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78. *** The femoral vein is ____ to the femoral artery
a) lateral b) caudal c) medial d) inferior |
c) medial
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79. ***If a patient has an AV fistula, dialysis shunt in the right arm, what should be done to perform a radial artery approach?
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Go to the contralateral side (left radial)
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80. ***The Seldinger technique employs all the following except:
a) Lumenless needle b) wire c) sheath d) dilator |
a) Lumenless needle
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81. ***Patient and family support mechanisms include
a) newsletter b) support groups c) educational pamphlets d) all the above |
d) all the above
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82.***When an 18G Cook needle is used to puncture the the front wall of the artery, This technique is known as the ______ technique and prevents posterior arterial bleeding or venous communication from the puncture.
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Modified Seldinger
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83. What radiologic view is usually best to image the normal origin of the right coronary ostiuim.
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30-40 degree LAO
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84. ***During arterial puncture, the Pt. becomes brady, hypotensive, sweaty, nauseated.
What is happening? |
Vagal response
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85. ***How do you treat a Vagal response?
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Atropine 0.5mg-1.0mg IV, IVF bolus
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86.***True or False
After injection of the RCA it is normal to get transient hypotension and bradycardia, no need to treat. |
True
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87. Hints for identifying vessels
If the spine is on the right it is an ____ view |
LAO
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88. If the spine is on the left it is and ____ view
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RAO
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89. The ____will always be next to the spine.
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CX
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90. The LAD is on the _____ in RAO.
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Right
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91. The LAD is on the ____ in LAO.
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Left
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92. The Apex points to the ____ in LAO
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Left
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93. The Apex points to the ____ in RAO.
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Right
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94. ***When doing an LV gram 40ml
@10ml/sec What is the total time in seconds of the angiogram. |
4 seconds
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95. When attempting to engage the right catheter,advance it to the right coronary cusp (facing the left cusp) and rotate it _______to engage the ostium of the RCA.
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Clockwise
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96. What is the best view to check for aortic dissection ?
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LAO, LAO Cranial
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97. In general , cranial angulation is good for visualizing ____ segments of a vessel
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Distal
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98. In general , caudal angulation is good for visualizing ____ segments of a vessel
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Proximal
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