Cardiology/ Hemodynamics/ Invasive Lines

Question 1

If you detect an inferior MI what coronary artery do you suspect is injured?

Answer 1

RCA

The distal portion of RCA is called the PDA

Question 2

If you detect an anterior MI, what coronary artery do you suspect is injured?

Answer 2

LAD

Question 3

If you detect a Lateral MI, what coronary artery do you suspect is injured?

Answer 3

LCX

Question 4

If you detect a posterior MI, what coronary arteries do you suspect is injured?

Answer 4

RCA or LCX ( RCA is slightly more common)

Question 5

What drug do you avoid in a symptomatic bradycardia Pt that has had a heart transplant?

Answer 5

Do not give atropine

It won’t work due to the vagus nerve being cut.

Question 6

What do you give to treat a wide complex tachycardia in the presence of TCA ingestion?

Answer 6

Sodium Bicarbonate

Question 7

How to treat a wide complex dysrhythmia where you suspect hyperkalemia?

Answer 7

Calcium

Question 8

What is S1Q3T3 and what does it represent?

Answer 8

S wave in lead I, a small Q and flipped t wave in lead III

Pulmonary Embolism

Question 9

What’s the difference between endocarditis and myocarditis/ Pericarditis?

Answer 9

Endocarditis is inflammation of the inner walls of the heart. Caused most often by valvular repair and surgery. Look for peds with CHD’s receiving surgery. Bacterial.

Myocarditis/pericarditis is caused by a viral infection.

Question 10

Any polymorphic Vtach that involves prolonged QTc of 500 or more, should receive what drug?

Answer 10

Magnesium

Question 11

CVP parameter

Answer 11

2-6 mm/Hg

Question 12

PAP parameters

Answer 12

Systolic 20-30
Diastolic 8-15

Question 13

Wedge parameter

Answer 13

8-12 mm/Hg

Question 14

MAP parameter

Answer 14

65-100 mm/Hg

Question 15

Cardiac Output parameter

Answer 15

4-8 L/min

Question 16

Cardiac Index (CI) parameter

Answer 16

2.1-4 L/min/m2

Question 17

Stroke volume parameter

Answer 17

60-100 mL

Question 18

Ejection Fraction parameter

Answer 18

55-70%

Question 19

Calculate MAP

Answer 19

2x diastolic
Add the systolic
Divide by 3

Question 20

The balloon tip of the PAC is measured with how much air?

Answer 20

1.5 mL

Question 21

The balloon should always be ____ during transport?

Answer 21

Deflated

Question 22

IABP

Tip of balloon is placed where?

Answer 22

2-4 cm from aortic arch

Question 23

Where is the balloons location in the body?

Answer 23

Above the renal artery and below subclavian

Question 24

When should the balloon inflate?

Answer 24

Just prior to the dicrotic notch

Question 25

What are the two lethal timing errors?

Answer 25

Early inflation Late deflation

Question 26

What does it indicate if you notice rust colored flakes in the supply tubing?

Answer 26

Balloon Rupture

Question 27

What do you do in case of IABP failure?

Answer 27

Manually inflate the balloon once every 30 minutes

Question 28

Where to auscultate the aortic valve?

Answer 28

2nd intercostal to the right of the sternum

Question 29

Where to auscultate the Pulmonic valve?

Answer 29

2nd intercostal to the left of the sternum

Question 30

Where to auscultate the Mitral valve?

Answer 30

4th or 5th intercostal mid-clavicular line

Question 31

If you hear an S3 heart tone what is it and what does it indicate?

Answer 31

Ventricular gallop Indicates dilated cardiomyopathy

Question 32

If you hear an S4 heart tone what does it indicate?

Answer 32

Hypertrophy, pulmonary hypertension, CHF. Diastolic problem

Question 33

What is Debakey

Answer 33

Classifications of thoracic aneurysms

Question 34

How can an aneurysm present?

Answer 34

Wide mediastinum on CXR Weak/absent pulses on one side Tearing like back pain

Question 35

First line treatments for aneurysm with hypertension

Answer 35

Beta blockers Esmolol, Metoprolol, Labetalol

Question 36

Second line of aneurysm with hypertension treatments

Answer 36

Vasodilators Nicardipine and nitroprusside Manage the pain

Question 37

SVR parameters

Answer 37

800-1200

Question 38

What could be wrong if there is a low or decreased SVR?

Answer 38

Anaphylaxis, neurogenic shock, septic shock, vasodilatory drugs

Question 39

Increased SVR could mean?

Answer 39

Hypothermia, hypovolemic shock, decreased CO

Question 40

As far as hemodynamics go, when would dobutamine be used?

Answer 40

Pts with low CI and high PAWP with SBP above 80