Critical Care

Question 1

‘A’ wave

Answer 1

Atrial contraction

Question 2

‘C’ wave

Answer 2

Onset of ventricular contraction

Question 3

‘X’ descent

Answer 3

Atrial relaxation

Question 4

‘V’ wave

Answer 4

Atrial filling

Question 5

‘Y’ descent

Answer 5

Ventricular relaxation/filling

Question 6

Etiology of posterior papillary muscle rupture

Answer 6

Inferior wall MI (RCA)

Question 7

Etiology of interventricular septum rupture

Answer 7

Anterior wall MI (LAD)

Question 8

Amplitude of pulse decreasing with each beat

Answer 8

Free wall rupture

Question 9

RA and RV collapse during diastole

Answer 9

Cardiac tamponade

Question 10

Most common arrhythmia in HD

Answer 10

Afib

Question 11

Syncope post MI day 3-5

Answer 11

VTach, VFib, or myocardial rupture

Question 12

Large parasternal (RV) heave
Split 2nd heart sound
Loud pulmonic component

Answer 12

Pulmonary hypertension

Question 13

Evaluation for CTEPH

Answer 13

V/Q scan

Question 14

Mainstay maintenance therapy in PAH I and IV

Answer 14

Warfarin

Question 15

Inc RAP
Inc PAP (70s-80s)
Normal PCWP

Answer 15

Pulmonary hypertension

Question 16

Inc RAP
Inc PAP (40s-50s)
Normal PCWP

Answer 16

Pulmonary embolism

Question 17

Inc RAP
Inc PAP
Inc PCWP
(Values relatively equal to each other)

Answer 17

Cardiac Tamponade

Question 18

Inc PCWP > Inc PAP > Inc RAP

Answer 18

CHF (PCWP/RAP ~ 2)

Question 19

Inc PCWP
Dec CO
Inc SVR
Dec SvO2

Answer 19

Cardiogenic shock

Question 20

Dec PCWP
Dec CO
Inc SVR
Dec SvO2

Answer 20

Hypovolemic shock

Question 21

Normal PCWP
Dec CO
Inc SVR
Dec/normal SvO2

Answer 21

Pulmonary embolism

Question 22

Inc PCWP
Dec CO
Inc SVR
Dec/normal SvO2

Answer 22

Cardiac Tamponade

Question 23

Normal PCWP
Inc CO
Dec SVR
Inc SvO2

Answer 23

Septic/Anaphylactic shock

Question 24

Management for auto-PEEP

Answer 24

Reduce MV
Increase expiratory time
Treat airway obstruction.
Disconnect ventilator and bag patient

Question 25

Improve mortality in ARDS

Answer 25

Decrease TV | Increase PEEP

Question 26

Appropriate vent setting for asthma or COPD exacerbation

Answer 26

Low TV Dec RR High inspiration flow rate

Question 27

Inc Peak Pressure (end inspiration) | No change Plat Pressure (before exhalation)

Answer 27

Mucus plugging Kinked ETT Bronchospasm

Question 28

Inc Peak Pressure (end inspiration) | Inc Plat Pressure (before exhalation)

Answer 28

Pneumothorax Pleural effusion ARDS CHF

Question 29

Dec Peak Pressure (end inspiration) | Dec Plat Pressure (before exhalation)

Answer 29

Ventilator cuff leak

Question 30

Etiology for post-extubation pulmonary edema

Answer 30

Decreased intrathoracic pressure due to removal of positive pressure ventilation >> increased venous return

Question 31

Contraindications to extubation

Answer 31

``` RR > 35 HR > 140 or < 50 SpO2 < 90% BP > 180/90 Inability to follow commands ```

Question 32

Adverse effects of Propofol

Answer 32

Hypotension Green urine Propofol infusion syndrome Metabolic acidosis with rhabdomyolysis of cardiac and skeletal muscle leading to respiratory and cardiac failure