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Monthly Archives: September 2014

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Recipe from “Forks over Knives the Cookbook”.

Spicy Tropical Green Smoothie

 

Ingredients:

2 cups tightly packed spinach leaves

1 cup frozen pineapple chunks

1 cup frozen mango chunks

1 small tangerine, peeled and pitted OR juice from 1 lime

1 cup coconut water

1/4 teaspoon cayenne pepper (optional)

 

Combine all ingredients into a blender and blend on high until smooth. Serves one, enjoy cold.

 

 

ACLS PRE-TEST
ANNOTATED ANSWER KEY
June, 2011
Question 1:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm X Third-degree AV block
Polymorphic ventricular tachycardia
Question 2:
There is no pulse with this rhythm. Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole X Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 3:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
X Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 4:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation X Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 5:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation X Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 6:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
X Polymorphic ventricular tachycardia
Question 7:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation X Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 8:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation X Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 9:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation X Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 10:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation X Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 11:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
X Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 12:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation X Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 13:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
X Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 14:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter X Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 15:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
X Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 16:
Please identify the rhythm by selecting the best single answer
X Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 17:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
X Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 18:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia X Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 19:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter X Second-degree AC block (Mobitz I Wenckebach)
Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 20:
Please identify the rhythm by selecting the best single answer
Agonal rhythm/asystole Pulseless electrical activity
Atrial fibrillation Reentry supraventricular tachycardia
Atrial flutter Second-degree AC block (Mobitz I Wenckebach)
X Coarse ventricular fibrillation Second-degree AV block (Mobitz II block)
Fine ventricular fibrillation Sinus bradycardia
Monomorphic ventricular tachycardia Sinus tachycardia
Normal sinus rhythm Third-degree AV block
Polymorphic ventricular tachycardia
Question 21: Which of the following statements about the use of magnesium in cardiac arrest is most accurate?

Apple Green Smoothie – Tastes like apple pie!

Apple-Pie-Green-Smoothie-2

Try this wonderful smoothie to start off your day.

This recipe is: egg-free, gluten-free, grain-free, no refined sugars, vegan, and dairy-free

Ingredients

  • 1/2 cup of almond milk
  • 1/2 cup of water
  • 1 tablespoon walnuts
  • 1/2 teaspoon ground cinnamon
  • 1/4 teaspoon vanilla extract
  • pinch ground nutmeg
  • 1/2 English cucumber
  • 2 cups spinach
  • 1 apple, chopped and frozen
  • 1/4 avocado, chopped and frozen
  • 4-6 ice cubes

 

Blend ingredients to desired consistency. Tastes like apple pie!

Recipe from http://www.healthfulpursuit.com/recipe/apple-pie-green-smoothie/

Happy Rosh Hashanah from all of us at The Cardiovascular Institute!

The New Year is a great opportunity to make new resolutions to improve your health. Please consider enhancing your diet and exercise programs!

We wish you and your loved ones a happy and meaningful Holiday.

Please view the card below. It explains the significance of the New Year Holiday.

Shanah Tovah!

Untitled

 

Cruciferous Vegetables

Cruciferous vegetables are one of the healthiest vegetables you get eat. Here are some points to what makes them healthy. They contain:

  •  An abundance of vitamins, minerals, and other nutrients. Cruciferous vegetables are known to contain a rich source of vitamins C, E, and K, folate, and minerals.

 

  • Carotenoids: carotenoids are primary known as beta-carotene, lycopene, lutein, and zeaxanthin. Carotenoids are found in cruciferous vegetables such as broccoli. They provide several nutritional benefits and are changed into vitamin A during the digestion processes. Vitamin A is known to help prevent cancer and heart disease. Carotenoids have also shown some clinical results in helping to prevent certain types of cancer. This molecule also has several antioxidant characteristics.

 

  • Fiber: cruciferous vegetables are also a rich source of fiber. It also helps keep blood sugars and appetite in check. Some studies show that fiber can help prevent heart disease and diabetes.

 

  • Glucosinolates: glucosinolates are compunds that are broken down by chewing. These compounds break down into active molecules such as indoles, nitriles, thiocyanates, and isothiocyanates. Many of these molecules have been studied for anticancer effects. Some have been found to stop cancer growth in different organs of small mammals. Studies in humans have been inconclusive so far.

 

These healthy vegetables tend to be dark green and leafy. Cruciferous vegetables include but are not limited to broccoli, cauliflower, brussel sprouts, kale, cabbage, and bok choy. Share your favorite vegan dishes that have these veggies!

 

 

What are carotenoids? http://health.howstuffworks.com/wellness/food-nutrition/vitamin-supplements/what-are-carotenoids.htm

Cruciferous Vegetables and Cancer Prevention http://www.cancer.gov/cancertopics/factsheet/diet/cruciferous-vegetables

Fiber http://www.hsph.harvard.edu/nutritionsource/carbohydrates/fiber/

Click to download

ELECTROCARDIOGRAM REVIEW 

by Nincy Samuel, Western PA student

EKG1

When reading an EKG, it is vital to have a systematic approach!

  1. Determine Cardiac Rhythm
    1. Is the rhythm regular or irregular?
    2. Identify atrial activity
    3. Determine P-QRS relationship
  2. Measure heart rate
    1. Is the rate normal? (60-100 bpm) bradycardia (<60bpm)? Or tachycardia (>100 bpm)?

How to determine heart rate: count the number of small squares (0.04 secs) between two QRS complexes

EKG2

5 small boxes between the 2 QRS complexes 300 bpm
10 small boxes 150 bpm
15 small boxes 100 bpm
20 small boxes 75 bpm
25 small boxes 60 bpm
30 small boxes 50 bpm
35 small boxes 43 bpm
40 small boxes 37 bpm

 

 

  1. Evaluate P wave morphology
    1. Inspect P waves in lead II and VI for right and left atrial enlargement
      1. What is the amplitude? Duration? Direction?
      2. EKG3
  2. Assess PR, QRS, and QT interval
    1. PR interval- normal is 0.12-0.20 seconds. Is it short or prolonged?
      1. Short PR intervals (less than 0.12 second) indicate that the impulse originated somewhere other than the SA node. This variation is associated with junctional arrhythmias and preexcitation syndromes.
      2. Prolonged PR intervals (greater than 0.20 second) may represent a conduction delay through the atria or AV junction due to digitalis toxicity or heart block – slowing related to ischemia or conduction tissue disease.
    2. QRS interval- normal is (less than or equal to 0.10 seconds.
      1. Make sure to check for a bundle branch block!
      2. EKG4
    3. QT interval- what is the duration? Normal QT is less than or equal to one-half of the R-R interval (if HR is normal
    4. )EKG5
  3. Determine Mean QRS Axis
    1. Normal is between +90 degrees and -30 degrees
    2. Is there left or right axis deviation?
      1. Check leads I and aVF!
      2. KEGGEKG6KKKKKKG
  4. Evaluate QRS Complex, ST and T wave Morphologies
    1. Is a Q wave present? If it is, what is the distribution?
      1. Q waves are normal at a width of <0.04 seconds and height of <1/3 of the QRS complexEKG7
      2. EKG8
    2. Is the QRS amplitude normal? Increased? Or decreased?
      1. Check for left or right ventricular hypertrophy!
      2. EKG10
      3. EKG9EKG11
    3. Is the ST segment elevated, depressed, or isoelectric?
      1. Check for ischemia, infarction, pericarditis, metabolic/chemical abnormalities!
      2. EKG 12
    4. Is the T wave upright or inverted?
    5. EKG13
    6. Is the amplitude increased or diminished?

 

  1. Identify Abnormal ECG Pattern
    1. Myocardial ischemia and infarction
    2. Cardiac chamber enlargement and hypertrophy
    3. Arrhythmias and conduction disturbances
    4. Miscellaneous patterns (e.g., pericarditis, WPW syndrome, electrolyte imbalances, drug effects)
    5. EGKEGK

References:
Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine
Clinical Cardiology Made Ridiculously Simple (Edition 4)
Rutgers PANCE/PANRE Review Course
http://www.medskills.eu/index.php/wiki/en/cellular/chest%20pain/heart%20and%20blood%20vessels/ecg%20presentation/
http://www.teaems.com/ekg-review.htm
Fitsweb.uchu.edu

l

Shanah Tovah! Wishing you an easy fast!

 

For more information on what the holiday is about:

http://www.jewfaq.org/holiday4.htm

For information on how to fast on Yom Kippur with diabetes:

http://www.joslin.org/info/Yom-Kippur-and-Diabetes.html

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