Which of the following would most likely decrease the heart rate
|
Absolute Neurocritical Care Review. 2017 Sep 5 : 143–188. Guest Editor (s): Zachary David Levy Assistant Professor of Emergency Medicine and Neurosurgery, Hofstra Northwell School of Medicine, Hempstead, New York USA A 73-year-old male with a history of hypertension and hyperlipidemia is currently in
the stroke unit after suffering a right middle cerebral artery infarct. His symptoms started 2 h prior to arrival at the hospital, and tPA was administered. The patient is plegic on the left side and with mild dysarthria, but is otherwise neurologically intact. His labwork is within normal limits. Which of the following describes the optimal deep venous thrombosis (DVT) prophylaxis regimen for this patient? A. Wait 6 h post tPA, then administer unfractionated
heparin (UFH) along with intermittent pneumatic compression (IPC) B. Wait 24 h post tPA, then administer UFH along with IPC C. Wait 6 h post tPA, then administer low molecular weight heparin (LMWH) along with IPC D. Wait 24 h post tPA, then administer LMWH along with IPC E. IPC only for the first 72 h, then LMWH or UFH after obtaining follow-up imaging All of the following causes of acute encephalitis have the matching characteristic radiological features except:
Which of the following categorizations is most accurate regarding acute respiratory distress syndrome (ARDS) in the setting of subarachnoid hemorrhage (SAH)?
A 52-year-old female is admitted to the ICU with a Hunt-Hess 1, modified Fisher 2 subarachnoid hemorrhage. Her past medical history is significant for hypertension, diabetes mellitus, and chronic renal insufficiency. She undergoes craniotomy for surgical clipping of an anterior cerebral artery aneurysm, and does not experience any additional complications. Two weeks later, she begins complaining of left calf pain, and a lower extremity sonogram demonstrated a proximal deep venous thrombosis (DVT). The patient weighs 60 kg. Her laboratory values are as follows: sodium 142 mEq/L, potassium 3.4 mEq/L, carbon dioxide 18 mEq/L, blood urea nitrogen (BUN) 70 mg/dL, and serum creatinine 2.5 mg/dL. What would be the optimal treatment for this patient’s proximal DVT?
All of the following are currently implicated in uremic encephalopathy except:
A 70-year-old female is hospitalized with a recent ischemic infarct. As part of stroke core measures, you obtain a hemoglobin A1c of 10.0. What is an approximate estimation of this patient’s average blood glucose level over the last several months?
A 28-year-old female with no known past medical history is in the ICU in status epilepticus, with anti-N-methyl D-aspartate (NMDA) receptor antibodies isolated in the cerebrospinal fluid. Which of the following is most likely to identify the root cause of her illness?
A 17-year-old male with no significant past medical history collapses during a high school football game, and goes into cardiac arrest. He did not have any complaints earlier in the day. The patient is brought to a nearby hospital, where is he resuscitated, intubated, and transferred to the ICU for further management. The patient is currently undergoing therapeutic hypothermia, and a work-up is underway to determine the cause of his sudden collapse. Which of the following is the most likely diagnosis?
A 31-year-old female at 38 weeks gestation is currently hospitalized for the treatment of preeclampsia. Due to her medical condition, her obstetrician is currently considering induced labor. At which point will this patient no longer be at risk for developing frank seizure activity as a result of her condition?
A 38-year-old male with no prior medical history presents to the emergency department with fever and severe headaches for several days. A CT scan of the brain is unremarkable, and the results of a lumbar puncture are pending. What is the most appropriate empiric antimicrobial regimen at this time?
The majority of intramedullary spinal cord neoplasms are:
Which of the following derived parameter formulas is correct?
A 23-year-old female marathon runner is currently in the ICU after suffering from heat stroke following an outdoor run on a particularly hot summer day. She was initially delirious in the emergency department, but progressed to coma and respiratory failure requiring mechanical ventilation. Her oral temperature is 42.1 °C. Which of the following would be most effective in reducing this patient’s severe hyperthermia?
Hyperinsulinemia-euglycemia (HIE) therapy may be useful for toxicity related to which of the following?
A 71-year-old female with a history of alcohol abuse is currently intubated in the ICU following a catastrophic spontaneous left basal ganglia hemorrhage with resultant herniation. You have just declared her brain dead. The patient’s family agrees to make her an organ donor, and the organ donation coordinator requests you initiate levothyroxine therapy. Which of the following benefits would be expected with this treatment?
Which of the following is not an element of the Full Outline of Unresponsiveness (FOUR) score?
A 23-year-old female is currently in the ICU with status asthmaticus. She was initially on noninvasive positive pressure ventilation, with an arterial blood gas (ABG) as follows: pH 7.13, pCO2 60 mmHg, PaO2 is 61 mmHg, HCO3 24 mmol/L, and oxygen saturation of 90%. She is given continuous inhaled albuterol, intravenous steroids, and magnesium sulfate. She subsequently becomes more lethargic and is intubated, with settings as follows: volume assist-control, rate of 12 breaths/min, tidal volume of 500 cc, PEEP of 5 cm H2O, and FiO2 of 50%. Peak airway pressure is 50 cm H2O and plateau pressure is 15 cm H2O. A stat portable chest x-ray shows hyperinflation with no pneumothorax. A repeat ABG after 30 min of invasive ventilation shows the following: pH of 7.24, pCO2 49 mmHg, PaO2 71 mmHg, HCO3 is 25 mmol/L. Which of the following should be performed next?
Which of the following mechanisms is implicated in super-refractory status epilepticus?
A 85-year-old male with a history nephrolithiasis, mild dementia, and alcohol abuse presented to the emergency department after a fall from standing, and was found to a right holohemispheric subdural hematoma. His clot was evacuated successfully, in spite of his oozing diathesis in the operating room (INR on arrival was 1.4 with a platelet count of 88 × 103/μL). His serum transaminases are twice the normal value, and he has had refractory chronic hyponatremia. He has had three convulsions during this week of hospitalization, in spite of levetiracetam therapy at 1.5 g twice a day. Over the past 24 h, he has had a marked increase in agitation. He has also just had a 5-s run of non-sustained ventricular tachycardia, and his systolic blood pressure is now 85 mmHg. You are considering discontinuing his levetiracetam and starting a new agent. Which of the following would be the best choice in this scenario?
A 65-year-old male with a history of COPD on rescue albuterol and ipratropium is diagnosed with myasthenia gravis, and started on an acetylcholinesterase inhibitor. He returns several days later complaining of increased salivation and worsening bronchial secretions in the absence of fevers, purulent sputum, or increasing dyspnea. These symptoms are not relieved by use of his albuterol. On exam, he has slightly decreased air movement throughout both lung fields without any clear wheezing, no focal rales, and a normal inspiratory to expiratory ratio. Which treatment option is most likely to be beneficial?
Regarding states of impaired consciousness, which of the following statements regarding arousal and awareness is correct?
A 62-year-old female is currently in the ICU following craniotomy for clipping of a cerebral aneurysm. Postoperatively, she is noted to have an oxygen saturation of 92% on 50% non-rebreather face mask, and her respiratory rate is 32 breaths/min. She denies chest pain. Her blood pressure is 96/72 mmHg and heart rate is 120 beats/min. Nimodipine has been held according to blood pressure parameters. A portable chest x-ray shows hazy opacities bilaterally, and bedside echocardiogram shows decreased left ventricular systolic function with apical, septal, lateral, anterior, anteroseptal and inferolateral wall akinesis, along with apical ballooning. Which of the following should be performed next?
Which of the following is the most common etiology of acute spinal cord ischemia and infarction?
A 62-year-old female with a history of coronary artery disease has just been admitted to the ICU with a left-sided spontaneous basal ganglia hemorrhage. The patient takes 325 mg of aspirin daily at home, and you are considering platelet transfusion. Which of the following has been demonstrated regarding platelet transfusion in this setting?
Which of the following therapies has been shown to decrease the incidence of delayed cerebral ischemia (DCI) in the setting of subarachnoid hemorrhage (SAH)?
A 70-year-old male with a history of diabetes, hypertension, and cigarette smoking (one pack per day for the last 40 years) is currently in the ICU with a COPD exacerbation. This is his third exacerbation this year, and was discharged from the hospital only 3 weeks prior. On your examination, he is alert, his breathing is labored, and he has rales at the right lung base. His vital signs are as follows: blood pressure 90/60 mmHg, heart rate 120 beats per minute, respirations 28 per minute, and temperature 38.3 °C. His oxygen saturation on 50% face mask is 93%, and his most recent PCO2 is 55 mmHg. Labs are notable for the following: white blood cell count 14.4 × 109/L with 90% neutrophils, blood urea nitrogen (BUN) 30 mg/dL, serum creatinine 1.2 mg/dL, and glucose 240 mg/dL. Ketones are negative. He is currently on noninvasive positive pressure ventilation at 10/5 cm H2O and 50% FiO2, and broad spectrum antibiotics have been administered. An hour later, the nurse pages you because his heart rate is now 140 beats per minute and irregular, blood pressure is 85 systolic, oxygen saturation is 85%, and he is minimally responsive. You now hear bilateral rales, most prominently in the right lung base, and scattered wheezes. Which of the following should be performed next?
A 57-year-old male with a history of epilepsy is currently in the stroke unit following a large right middle cerebral artery infarction. A nasogastric tube has been inserted, and 24 h continuous enteral feeds have been initiated. The patient is currently on 100 mg of phenytoin every 8 h for seizure prophylaxis. Which of the following measures should be taken to prevent the patient from developing subtherapeutic phenytoin levels?
A 37-year-old female presents to the emergency department with approximately 2 weeks of progressively worsening clumsiness and drastic mood swings. Her past medical history is significant only for Crohn’s disease, for which she takes both natalizumab and infliximab. A contrast-enhanced CT scan of her head is performed, revealing hypodense, non-enhancing lesions in the cortical white matter of the frontal and parietal lobes. Despite treatment, the patient expires 1 month later. Which of the following is true regarding the most likely diagnosis?
A 58-year-old female presents to the emergency department with dry cough, fever and rapidly progressive dyspnea over 1 week. She has a history of rheumatoid arthritis (RA) and is maintained on weekly methotrexate and daily prednisone (which was increased to 30 mg starting 1 month ago for an acute flare). She takes no other medications. Her vital signs are as follows: blood pressure 100/70 mmHg, heart rate 110 beats/min, respiratory rate 20 breaths/min, and temperature 38.0 °C. In the ED she develops progressive hypoxemia with oxygen saturation 92% on 100% nonrebreather, and is increasingly diaphoretic. She is emergently intubated, and a chest x-ray post intubation shows extensive bilateral lung opacities. Which of the following should be administered at this time?
A 45-year-old woman undergoes uncomplicated transsphenoidal resection of a pituitary macroadenoma. She appears well hydrated and is not complaining of excessive thirst. Post-operatively, she is noted to have increased urine output. Serum sodium is 137 mEq/L, and serum osmolarity is 275 mOsm/kg. What is the most likely cause of her polyuria?
A 36-year-old female with a recent lumbar puncture to rule out subarachnoid hemorrhage is now complaining of a severe headache unlike anything she has experienced previously. She reports her headache is worse when standing, and better upon lying flat. She is otherwise neurologically intact. All of the following medications may be beneficial in this scenario except:
Which of the following is the most common overall cause of acute myocardial infarction?
A 78-year-old male is in the ICU recovering from sepsis and pneumonia. He was just recently extubated after 2 days of mechanical ventilation and sedation with a fentanyl infusion. Over the ensuing days, he develops worsening abdominal distention, poor bowel sounds, and no stool output. CT scan reveals significant colonic distention, but no mass or obstruction. Records demonstrate a normal routine colonoscopy performed 6 weeks ago. You have appropriately hydrated the patient, corrected any electrolyte abnormalities, placed a rectal tube, withheld all opiates, and given intravenous erythromycin, but to no avail. Abdominal x-rays continue to demonstrate marked cecal dilatation greater than 12 cm in diameter. What is the next best appropriate therapy for this patient?
Which of the following is the most common cerebral vascular malformation in the general population?
A 49-year-old female with a history of acute lymphoblastic leukemia and recent subcutaneous cerebrospinal fluid (CSF) reservoir placement presents to the emergency department with fever, chills, and increased confusion for the past 3 days. Her CSF reservoir was last accessed 1 week ago. A thorough work-up reveals no other obvious infectious source, and there is concern for CSF reservoir-associated meningitis. Which of the following is the most likely causative organism?
A 47-year-old woman presents to the emergency department with headache, nausea, and vomiting. Non-contrast head CT is performed, revealing subarachnoid blood in the right Sylvian fissure, and conventional angiography reveals the presents of a large right-sided MCA aneurysm. The patient undergoes successful surgical clipping of her aneurysm, and is being observed in the ICU. On admission, the patient’s serum sodium was 142 mEq/L and the hematocrit was 37%; by the seventh post-operative day, the serum sodium is 127 mEq/L and the hematocrit is 44%. Bedside ultrasonography demonstrates an IVC diameter of approximately 0.9 cm. Which of the following interventions would be least reasonable at this time?
Which of the following is true regarding central (non-infectious) fever?
Flaccid paralysis is most commonly associated with which of the following forms of encephalitis?
Which of the following would not be considered appropriate therapy for heparin-induced thrombocytopenia (HIT)?
A 45-year-old male with severe blunt traumatic brain injury (TBI) from a motor vehicle collision suffered a ventricular fibrillation cardiac arrest at the time of injury with return of spontaneous circulation (ROSC) in the field after endotracheal intubation and one dose of epinephrine. On arrival to the emergency department, no regional wall motion abnormalities were noted on surface echocardiography and no ST segment changes were seen on the presenting EKG. Head CT revealed cerebral contusions but no extra-axial mass lesions. The patient is now in the ICU and found to be comatose without sedation. Mild therapeutic hypothermia to 33° is being considered in the management of this post-arrest patient. Which of the following statements is true?
A 35-year-old male is in the intensive care unit following resection of a large right-sided meningioma. He is currently intubated and sedated on a continuous fentanyl infusion. The nurse calls you to the bedside due to concerns over “unusual ventilator waveforms”. Upon arrival, you note the following (see Image 1). What is the best way to describe this phenomenon?
Exam 4 Answers
References1. Nyquist P, Bautista C, Jichici D, et al. Prophylaxis of venous thrombosis in neurocritical care patients: an evidence-based guideline: a statement for healthcare professionals from the Neurocritical Care Society. Neurocrit Care. 2016;24(1):47–60. doi: 10.1007/s12028-015-0221-y. [PubMed] [CrossRef] [Google Scholar] 2. Gilden D, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. Lancet Neurol. 2009;8(8):731–740. doi: 10.1016/S1474-4422(09)70134-6. [PMC free article] [PubMed] [CrossRef] [Google Scholar] 3. Theodore J, Robin ED. Speculations on neurogenic pulmonary edema (NPE) Am Rev Respir Dis. 1976;113(4):405–411. [PubMed] [Google Scholar] 4. Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice guidelines for the management of bacterial meningitis. Clin Infect Dis. 2004;39(9):1267–1284. doi: 10.1086/425368. [PubMed] [CrossRef] [Google Scholar] 5. Samartzis D, Gillis CC, Shih P, O'toole JE, Fessler RG. Intramedullary spinal cord tumors: part I-epidemiology, pathophysiology, and diagnosis. Global Spine J. 2015;5(5):425–435. doi: 10.1055/s-0035-1549029. [PMC free article] [PubMed] [CrossRef] [Google Scholar] 6. Smith JE. Cooling methods used in the treatment of exertional heat illness. Br J Sports Med. 2005;39(8):503–507. doi: 10.1136/bjsm.2004.013466. [PMC free article] [PubMed] [CrossRef] [Google Scholar] 7. Engebretsen KM, Kaczmarek KM, Morgan J, Holger JS. High-dose insulin therapy in beta-blocker and calcium channel-blocker poisoning. Clin Toxicol (Phila). 2011;49(4):277–283. doi: 10.3109/15563650.2011.582471. [PubMed] [CrossRef] [Google Scholar] 8. Joseph B, Aziz H, Pandit V, et al. Levothyroxine therapy before brain death declaration increases the number of solid organ donations. J Trauma Acute Care Surg. 2014;76(5):1301–1305. doi: 10.1097/TA.0000000000000184. [PubMed] [CrossRef] [Google Scholar] 9. Nedeltchev K, Loher TJ, Stepper F, et al. Long-term outcome of acute spinal cord ischemia syndrome. Stroke. 2004;35(2):560–565. doi: 10.1161/01.STR.0000111598.78198.EC. [PubMed] [CrossRef] [Google Scholar] 10. Baharoglu MI, Cordonnier C, Al-Shahi Salman R, et al. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet. 2016;387(10038):2605–2613. doi: 10.1016/S0140-6736(16)30392-0. [PubMed] [CrossRef] [Google Scholar] 11. Bauer LA. Interference of oral phenytoin absorption by continuous nasogastric feedings. Neurology. 1982;32(5):570–572. doi: 10.1212/WNL.32.5.570. [PubMed] [CrossRef] [Google Scholar] 12. Mandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44(Suppl 2):S27–S72. doi: 10.1086/511159. [PMC free article] [PubMed] [CrossRef] [Google Scholar] 13. Basurto Ona X, Uriona Tuma SM, Martínez García L, Solà I, Bonfill Cosp X. Drug therapy for preventing post-dural puncture headache. Cochrane Database Syst Rev. 2013;(2):CD001792. [PMC free article] [PubMed] 14. Bentzon JF, Otsuka F, Virmani R, Falk E. Mechanisms of plaque formation and rupture. Circ Res. 2014;114(12):1852–1866. doi: 10.1161/CIRCRESAHA.114.302721. [PubMed] [CrossRef] [Google Scholar] 15. Kayani B, Spalding DR, Jiao LR, Habib NA, Zacharakis E. Does neostigmine improve time to resolution of symptoms in acute colonic pseudo-obstruction? Int J Surg. 2012;10(9):453–457. doi: 10.1016/j.ijsu.2012.08.008. [PubMed] [CrossRef] [Google Scholar] 16. Mead PA, Safdieh JE, Nizza P, Tuma S, Sepkowitz KA. Ommaya reservoir infections: a 16-year retrospective analysis. J Infect. 2014;68(3):225–230. doi: 10.1016/j.jinf.2013.11.014. [PubMed] [CrossRef] [Google Scholar] 17. Rabinstein AA, Sandhu K. Non-infectious fever in the neurological intensive care unit: incidence, causes and predictors. J Neurol Neurosurg Psychiatr. 2007;78(11):1278–1280. doi: 10.1136/jnnp.2006.112730. [PMC free article] [PubMed] [CrossRef] [Google Scholar] 18. Jeha LE, Sila CA, Lederman RJ, Prayson RA, Isada CM, Gordon SM. West Nile virus infection: a new acute paralytic illness. Neurology. 2003;61(1):55–59. doi: 10.1212/01.WNL.0000073617.08185.0A. [PubMed] [CrossRef] [Google Scholar] 19. Jacob M, Hassager C, Bro-jeppesen J, et al. The effect of targeted temperature management on coagulation parameters and bleeding events after out-of-hospital cardiac arrest of presumed cardiac cause. Resuscitation. 2015;96:260–267. doi: 10.1016/j.resuscitation.2015.08.018. [PubMed] [CrossRef] [Google Scholar] 20. Kienbaum P, Thürauf N, Michel MC, Scherbaum N, Gastpar M, Peters J. Profound increase in epinephrine concentration in plasma and cardiovascular stimulation after mu-opioid receptor blockade in opioid-addicted patients during barbiturate-induced anesthesia for acute detoxification. Anesthesiology. 1998;88(5):1154–1161. doi: 10.1097/00000542-199805000-00004. [PubMed] [CrossRef] [Google Scholar] 21. Ghassemi KA, Jensen DM. Lower GI bleeding: epidemiology and management. Curr Gastroenterol Rep. 2013;15(7):333. doi: 10.1007/s11894-013-0333-5. [PMC free article] [PubMed] [CrossRef] [Google Scholar] 22. Woodring JH, Goldstein SJ. Fractures of the articular processes of the cervical spine. Am J Roentgenol. 1982;139(2):341–344. doi: 10.2214/ajr.139.2.341. [PubMed] [CrossRef] [Google Scholar] 23. Jones SC, Sorbello A, Boucher RM. Fluoroquinolone-associated myasthenia gravis exacerbation: evaluation of postmarketing reports from the US FDA adverse event reporting system and a literature review. Drug Saf. 2011;34(10):839–847. doi: 10.2165/11593110-000000000-00000. [PubMed] [CrossRef] [Google Scholar] 24. Pham TN, Cancio LC, Gibran NS. American Burn Association practice guidelines burn shock resuscitation. J Burn Care Res. 2008;29(1):257–266. doi: 10.1097/BCR.0b013e31815f3876. [PubMed] [CrossRef] [Google Scholar] 25. Nava S, Gregoretti C, Fanfulla F, et al. Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients. Crit Care Med. 2005;33(11):2465–2470. doi: 10.1097/01.CCM.0000186416.44752.72. [PubMed] [CrossRef] [Google Scholar] 26. Walters BC, Hadley MN, Hurlbert RJ, et al. Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery. 2013;60(Suppl 1):82–91. doi: 10.1227/01.neu.0000430319.32247.7f. [PubMed] [CrossRef] [Google Scholar] 27. Zambon M, Vincent JL. Mortality rates for patients with acute lung injury/ARDS have decreased over time. Chest. 2008;133(5):1120–1127. doi: 10.1378/chest.07-2134. [PubMed] [CrossRef] [Google Scholar] 28. Calfee CS, Eisner MD, Ware LB, et al. Trauma-associated lung injury differs clinically and biologically from acute lung injury due to other clinical disorders. Crit Care Med. 2007;35(10):2243–2250. doi: 10.1097/01.CCM.0000280434.33451.87. [PMC free article] [PubMed] [CrossRef] [Google Scholar] 29. Herridge MS, Tansey CM, Matté A, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364(14):1293–1304. doi: 10.1056/NEJMoa1011802. [PubMed] [CrossRef] [Google Scholar] 30. Willison HJ, Veitch J, Paterson G, Kennedy PG. Miller Fisher syndrome is associated with serum antibodies to GQ1b ganglioside. J Neurol Neurosurg Psychiatr. 1993;56(2):204–206. doi: 10.1136/jnnp.56.2.204. [PMC free article] [PubMed] [CrossRef] [Google Scholar] 31. Friedewald VE, Goldfarb S, Laskey WK, et al. The editor’s roundtable: contrast-induced nephropathy. Am J Cardiol. 2007;100(3):544–551. doi: 10.1016/j.amjcard.2007.05.021. [PubMed] [CrossRef] [Google Scholar] 32. Bhutta AQ, Garcia-tsao G. The role of medical therapy for variceal bleeding. Gastrointest Endosc Clin N Am. 2015;25(3):479–490. doi: 10.1016/j.giec.2015.03.001. [PubMed] [CrossRef] [Google Scholar] 33. Mayglothling J, Duane TM, Gibbs M, et al. Emergency tracheal intubation immediately following traumatic injury: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S333–S340. doi: 10.1097/TA.0b013e31827018a5. [PubMed] [CrossRef] [Google Scholar] 34. Ko R, Ramos L, Chalela JA. Conventional weaning parameters do not predict extubation failure in neurocritical care patients. Neurocrit Care. 2009;10(3):269–273. doi: 10.1007/s12028-008-9181-9. [PubMed] [CrossRef] [Google Scholar] 35. Sayedy L, Kothari D, Richards RJ. Toxic megacolon associated Clostridium difficile colitis. World J Gastrointest Endosc. 2010;2(8):293–297. doi: 10.4253/wjge.v2.i8.293. [PMC free article] [PubMed] [CrossRef] [Google Scholar] 36. Higashida R, Alberts MJ, Alexander DN, et al. Interactions within stroke systems of care: a policy statement from the American Heart Association/American Stroke Association. Stroke. 2013;44(10):2961–2984. doi: 10.1161/STR.0b013e3182a6d2b2. [PubMed] [CrossRef] [Google Scholar] 37. The Multi-Society Task Force on PVS Medical aspects of the persistent vegetative state. N Engl J Med. 1994;330(21):1499–1508. doi: 10.1056/NEJM199405263302107. [PubMed] [CrossRef] [Google Scholar] 38. Summaries for patients: diagnosis of obstructive sleep apnea in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161(3):1-28. [PubMed] 39. Hu X, Lee JS, Pianosi PT, Ryu JH. Aspiration-related pulmonary syndromes. Chest. 2015;147(3):815–823. doi: 10.1378/chest.14-1049. [PubMed] [CrossRef] [Google Scholar] 40. Schrager S, Sabo L. Sheehan syndrome: a rare complication of postpartum hemorrhage. J Am Board Fam Pract. 2001;14(5):389–391. [PubMed] [Google Scholar] Which of the following would decrease heart rate quizlet?Which of the following would decrease heart rate? increased parasympathetic stimulation of nodal fibers. Identify the structure labeled "8." atrial systole.
Which of the following will slow the heart rate?The parasympathetic nervous system (PNS) releases the hormone acetylcholine to slow the heart rate. Such factors as stress, caffeine, and excitement may temporarily accelerate your heart rate, while meditating or taking slow, deep breaths may help to slow your heart rate.
What can cause the normal heart rate to increase or decrease quizlet?The hormone epinephrine (or adrenalin) causes the heart rate to increase. The sympathetic nervous system can cause the heart rate to increase; the parasympathetic nervous system can cause the heart rate to decrease. Numerous other molecules and/or medications can cause the heart rate to change.
Which of the following would cause an increase in the heart rate?Stress, exercise, or even too much alcohol or caffeine can cause your heart to beat faster than normal. But if your heart races a lot—or if you notice your heartbeat is often irregular—then you should see a doctor.
|
