A 72-year-old woman with a recent onset of syncopal episodes has ...

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A 72-year-old woman with a recent onset of syncopal episodes has been referred to a cardiologist by her family physician.
 
  As part of the client's diagnostic workup, the cardiologist has ordered her to wear a Holter monitor for 24 hours. Which of the following statements best captures an aspect of Holter monitoring?
  A)
  A Holter monitor is preferable to standard ECG due to its increased sensitivity to cardiac electrical activity.
  B)
  The primary goal is to allow the cardiologist to accurately diagnose cardiomyopathies.
  C)
  Accurate interpretation of the results requires correlating the findings with activity that the woman was doing at the time of recording.
  D)
  Holter monitors are normally set to record electrical activity of the heart at least once per hour.

Question 2

A physician is providing care for a child who has a diagnosis of cystic fibrosis (CF). Place the following events in the etiology of CF in ascending chronological order. Use all the options.
 
  A) Airway obstruction
  B) Recurrent pulmonary infections
  C) Impaired Cl- transport
  D) Decreased water content of mucociliary blanket
  E) Increased Na+ absorption

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Answer to Question 1

Ans:
C

Feedback:

It is imperative that activity level be correlated with Holter monitor results in order to draw accurate diagnostic conclusions. It is the long-term gathering of data, rather than sensitivity or accuracy that gives Holter monitoring an advantage over standard ECG measurement. The goal is to diagnose arrhythmias, not cardiomyopathies. The hallmark of Holter monitoring is its continuous, rather than intermittent, measurement.

Answer to Question 2

Ans:
C, E, D, A, B

Feedback:

CF is associated with impaired Cl- transport and a consequent increase in Na+ absorption. These result in a lowered water content of the mucociliary blanket making it more viscid. These changes to the mucociliary blanket cause airway obstruction and, ultimately, pulmonary infections.

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