Invasive Hemodynamics Flashcards by Riyanna Day

What creates the pressure wave that is transmitted through the heart chambers and vessels?
A. Blood flow from the lungs
B. Electrical activity in the SA node
C. Muscular contraction of the heart
D. Closure of the cardiac valves

C. Muscular contraction of the heart

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How is the pressure wave within the heart and vessels typically measured?
A. By Doppler ultrasound
B. Using an external cuff
C. With a catheter connected to a pressure transducer
D. Through echocardiography

C. With a catheter connected to a pressure transducer

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What function does the pressure transducer serve in the cardiac catheterization setup?
A. Generates mechanical contraction
B. Controls fluid flow through vessels
C. Converts pressure into electrical signals
D. Measures oxygen saturation levels

C. Converts pressure into electrical signals

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What best describes the nature of cardiac pressure waveforms?
A. Irregular and unpredictable
B. Linear and constant
C. Cyclical, corresponding with the cardiac cycle
D. Static and only altered by respiration

C. Cyclical, corresponding with the cardiac cycle

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Which of the following provides a comprehensive understanding of cardiac physiology during catheterization?
A. Cardiac enzyme testing
B. ECG alone
C. Blood pressure monitoring
D. Cardiac cycle, ECG, and pressure tracings together

D. Cardiac cycle, ECG, and pressure tracings together

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What is the role of hemodynamic data collection during cardiac catheterization?
A. It is used only for academic purposes
B. It serves as a backup to angiographic imaging
C. It is an essential part of every catheterization protocol
D. It is optional in routine diagnostic procedures

C. It is an essential part of every catheterization protocol

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How can complex hemodynamic data be recorded accurately and quickly?
A. By relying solely on automated systems
B. By using a consistent and efficient method in the lab
C. By reducing the number of measurements taken
D. By shortening the duration of the catheterization procedure

B. By using a consistent and efficient method in the lab

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What is the primary advantage of using a standardized measurement sequence during catheterization?
A. It reduces radiation exposure
B. It allows for rapid administration of contrast
C. It facilitates simultaneous pressure measurements across the heart
D. It eliminates the need for ECG monitoring

C. It facilitates simultaneous pressure measurements across the heart

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Why might different hemodynamic measurements be required during cardiac catheterization?
A. To standardize all procedures
B. To comply with hospital policy
C. To address specific clinical situations
D. To minimize the use of contrast media

C. To address specific clinical situations

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What is true about the measurement sequence described in the catheterization lab protocol?
A. It replaces all other diagnostic tools
B. It is a universal standard applied in all labs
C. It is helpful but not all-inclusive
D. It is used only for pediatric cases

C. It is helpful but not all-inclusive

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What is the correct order of anatomical structures assessed during a standard right-sided heart catheterization?
A. SVC → RA → IVC → RV → PA → PCW
B. IVC → SVC → RA → RV → PA → PCW
C. RA → IVC → RV → SVC → PA → PCW
D. IVC → RA → SVC → RV → PA → PCW

B. IVC → SVC → RA → RV → PA → PCW

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Which scale is used for pressure recordings in the right atrium and right ventricle?
A. 0–20 mm Hg
B. 0–80 mm Hg
C. 0–40 mm Hg
D. 0–100 mm Hg

C. 0–40 mm Hg

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What is the recommended sweep speed for recording phasic pressures in the RA and RV?
A. 50 mm/s
B. 10 mm/s
C. 5 mm/s
D. 25 mm/s

D. 25 mm/s

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What confirms correct pulmonary capillary wedge (PCW) position before recording pressure?
A. A drop in pulmonary artery pressure
B. Fluoroscopy
C. Oxygen saturation sampling
D. ECG waveform changes

C. Oxygen saturation sampling

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Why should only 1–2 drops of heparin be used in the oxygen saturation syringes?
A. To prevent clotting without diluting the sample
B. To improve sample visualization
C. To neutralize the oxygen content
D. To maintain catheter patency

A. To prevent clotting without diluting the sample

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What must be done before crossing the aortic valve during left-sided catheterization?
A. Administer contrast media
B. Record left ventricular pressure
C. Match peripheral and central aortic pressures
D. Inflate the balloon catheter

C. Match peripheral and central aortic pressures

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When using a pigtail catheter for aortic valve assessment, what is important regarding the arterial sheath?
A. It should be the same size as the catheter
B. It should be 2 F smaller than the catheter
C. It should be 1 F larger than the catheter
D. Sheath size does not matter for pressure accuracy

C. It should be 1 F larger than the catheter

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What is the purpose of administering heparin (40 U/kg) during left-sided catheterization?
A. To reduce pain
B. To enhance pressure transmission
C. To prevent thrombus formation
D. To increase contrast uptake

C. To prevent thrombus formation

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What pressure scale is used when recording simultaneous Ao and LV pressures?
A. 0–40 mm Hg
B. 0–100 mm Hg
C. 0–200 mm Hg
D. 0–300 mm Hg

C. 0–200 mm Hg

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What is the correct sequence for zeroing pressures in left-sided catheterization?
A. Zero LV pressure → zero Ao/sheath pressure
B. Zero Ao/sheath pressure → zero LV pressure
C. Zero both at the end
D. No need to zero in left-sided catheterization

A. Zero LV pressure → zero Ao/sheath pressure

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Why are right-sided heart studies often performed before left-sided heart catheterization?
A. They are easier and less risky
B. Right-sided pressures are more critical
C. Simultaneous pressure measurement gives the most precise data
D. To administer medications directly into the right atrium

C. Simultaneous pressure measurement gives the most precise data

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What is the first step in the combined left- and right-heart catheterization protocol?
A. Advance left-heart catheter to aorta
B. Record LVEDP
C. Perform right-sided catheterization and position in PCW
D. Perform left ventriculography

C. Perform right-sided catheterization and position in PCW

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During mitral valve assessment, what should be zeroed before recording pressures?
A. Right atrial and LV pressures
B. LV and pulmonary artery pressures
C. PCW, femoral arterial (FA), and LV pressures
D. Aortic and FA pressures

C. PCW, femoral arterial (FA), and LV pressures

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At what sweep speed should LV vs. PCW pressures be recorded under normal conditions?
A. 25 mm/s
B. 50 mm/s
C. 100 mm/s
D. 10 mm/s

B. 50 mm/s

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If a mitral valve gradient is present, what adjustment should be made to the sweep speed? A. Increase to 100 mm/s B. Decrease to 25 mm/s C. Maintain at 50 mm/s D. Reduce to 10 mm/s

A. Increase to 100 mm/s

How many thermodilution cardiac output measurements are recommended? A. 1 B. 2 C. 3 D. 5

C. 3

Why are simultaneous RV and LV pressure recordings performed during the pullback phase? A. To diagnose pulmonary embolism B. To assess valvular regurgitation C. To evaluate constrictive vs. restrictive physiology D. To estimate coronary perfusion

C. To evaluate constrictive vs. restrictive physiology

What is recorded after left ventriculography is completed? A. Aortic valve area B. Right atrial pressure C. Postventriculography LVEDP D. Femoral artery pressure

C. Postventriculography LVEDP

What is the appropriate pressure scale for the LV pullback to aorta after ventriculography? A. 0–40 mm Hg B. 0–100 mm Hg C. 0–200 mm Hg D. 0–300 mm Hg

C. 0–200 mm Hg

How long does it typically take to collect routine hemodynamic data from both sides of the heart, including blood sampling and CO measurement? A. Less than 15 minutes B. Less than 30 minutes C. About 1 hour D. Over 90 minutes

B. Less than 30 minutes

Which method is considered more accurate for determining cardiac output (CO)? A. Thermodilution (TD) method B. Fick method C. Doppler echocardiography D. Pulse contour analysis

B. Fick method

Despite its greater accuracy, why is the Fick method not routinely used in most catheterization labs? A. It is not approved for clinical use B. It requires radioactive tracers C. It is more complex and time-consuming D. It has a higher risk of complications

C. It is more complex and time-consuming

What is the routine method used for cardiac output (CO) determination in the cath lab? A. Fick method B. Thermodilution (TD) technique C. Ventriculography D. Echocardiography

B. Thermodilution (TD) technique

Blood for oxygen saturation measurements is collected from all of the following sites except: A. Arterial B. Vena cava C. Pulmonary veins D. Right atrium (RA)

C. Pulmonary veins

What is the clinical purpose of collecting oxygen saturation samples from multiple cardiac sites? A. To measure pulmonary artery pressure B. To estimate ejection fraction C. To screen for and quantify intracardiac shunts D. To confirm valve area

C. To screen for and quantify intracardiac shunts

What is the most common clinical indication for performing right-sided heart catheterization? A. Coronary artery disease B. Dyspnea of unclear origin C. Aortic dissection D. Chest pain with ST-elevation

B. Dyspnea of unclear origin

In which of the following patients would right-sided heart catheterization most likely be indicated? A. Patient with isolated chest pain and normal ECG B. Patient with dyspnea and inconclusive noninvasive studies C. Patient with mitral stenosis and angina D. Patient with stable atrial fibrillation

B. Patient with dyspnea and inconclusive noninvasive studies

Which of the following conditions cannot be reliably distinguished without invasive measurement such as right-heart catheterization? A. LV dysfunction vs. coronary artery disease B. Lung disease vs. pulmonary hypertension C. Tricuspid regurgitation vs. mitral stenosis D. Acute vs. chronic pericarditis

B. Lung disease vs. pulmonary hypertension

What type of catheter is most commonly used to perform right-heart catheterization? A. Pigtail catheter B. Judkins catheter C. Pulmonary artery catheter (PAC) D. Swan neck catheter

C. Pulmonary artery catheter (PAC)

Who originally developed the pulmonary artery catheter used in RHC? A. Dotter and Judkins B. Fick and Bernoulli C. Swan and Ganz D. Seldinger and Brockenbrough

C. Swan and Ganz

Which of the following ports is not standard on a pulmonary artery catheter? A. Distal port B. Thermistor port C. Drug-eluting port D. Balloon inflation port

C. Drug-eluting port

What is a potential advantage of using larger-bore end-hole catheters instead of PACs during RHC? A. Reduced procedure time B. Higher fidelity pressure tracings C. Increased access sites D. Fewer complications

B. Higher fidelity pressure tracings

Which of the following is not a common venous access site for pulmonary artery catheter insertion? A. Subclavian vein B. Femoral vein C. Internal jugular vein D. Radial vein

D. Radial vein

Which of the following is not an indication for right-sided heart catheterization? A. Differentiation of types of shock B. Evaluation of mitral valve area by planimetry C. Diagnosis and management of pulmonary hypertension D. Assessment of intracardiac shunts

B. Evaluation of mitral valve area by planimetry

Which condition is a common complication of acute myocardial infarction that may warrant right-sided heart catheterization? A. Aortic dissection B. Pulmonary edema C. Peripheral artery disease D. Stroke

B. Pulmonary edema

Right-sided heart catheterization can be used to evaluate candidacy for which of the following? A. Coronary artery bypass grafting B. Orthotopic heart transplantation (OHTx) C. Mitral valve replacement D. Pacemaker implantation

B. Orthotopic heart transplantation (OHTx)

Which of the following is a relative contraindication to right-sided heart catheterization? A. Active infection B. Severe thrombocytopenia C. Stable heart failure D. Hypertension

B. Severe thrombocytopenia

Why might right-sided heart catheterization be contraindicated in patients with a prosthetic tricuspid valve? A. Risk of damaging the prosthesis B. Increased risk of infection C. Difficulty in catheter insertion D. All of the above

A. Risk of damaging the prosthesis

Which arrhythmia is listed as a relative contraindication for right-sided heart catheterization? A. Atrial fibrillation B. Ventricular arrhythmias C. Sinus tachycardia D. Supraventricular tachycardia

B. Ventricular arrhythmias

Which conduction abnormality is considered a relative contraindication? A. Right bundle branch block B. First-degree AV block C. Left bundle-branch block D. Junctional rhythm

C. Left bundle-branch block

B. Lung disease vs. pulmonary hypertension

What type of catheter is most commonly used to perform right-heart catheterization? A. Pigtail catheter B. Judkins catheter C. Pulmonary artery catheter (PAC) D. Swan neck catheter

C. Pulmonary artery catheter (PAC)

Who originally developed the pulmonary artery catheter used in RHC? A. Dotter and Judkins B. Fick and Bernoulli C. Swan and Ganz D. Seldinger and Brockenbrough

C. Swan and Ganz

Which of the following ports is not standard on a pulmonary artery catheter? A. Distal port B. Thermistor port C. Drug-eluting port D. Balloon inflation port

C. Drug-eluting port

B. Higher fidelity pressure tracings

Which of the following is not a common venous access site for pulmonary artery catheter insertion? A. Subclavian vein B. Femoral vein C. Internal jugular vein D. Radial vein

D. Radial vein

B. Evaluation of mitral valve area by planimetry

B. Pulmonary edema

B. Orthotopic heart transplantation (OHTx)

Which of the following is a relative contraindication to right-sided heart catheterization? A. Active infection B. Severe thrombocytopenia C. Stable heart failure D. Hypertension

B. Severe thrombocytopenia

A. Risk of damaging the prosthesis

Which arrhythmia is listed as a relative contraindication for right-sided heart catheterization? A. Atrial fibrillation B. Ventricular arrhythmias C. Sinus tachycardia D. Supraventricular tachycardia

B. Ventricular arrhythmias

Which conduction abnormality is considered a relative contraindication? A. Right bundle branch block B. First-degree AV block C. Left bundle-branch block D. Junctional rhythm

C. Left bundle-branch block

Which of the following arrhythmias can occur as a complication during right-sided heart catheterization? A. Atrial fibrillation only B. Ventricular arrhythmias only C. Both atrial and ventricular arrhythmias D. Supraventricular tachycardia only

C. Both atrial and ventricular arrhythmias

Which life-threatening mechanical complication can result from right-sided heart catheterization? A. Cardiac tamponade from cardiac perforation B. Stroke C. Myocardial infarction D. Pulmonary edema

A. Cardiac tamponade from cardiac perforation

Which pulmonary complication may occur due to injury during catheter manipulation? A. Pulmonary infarction B. Pulmonary embolism C. Asthma exacerbation D. Pulmonary fibrosis

A. Pulmonary infarction

What is a serious vascular complication that involves vessel rupture during right-heart catheterization? A. Pulmonary artery rupture B. Aortic dissection C. Femoral artery aneurysm D. Coronary artery rupture

A. Pulmonary artery rupture

What rare but potentially fatal complication may occur if air enters the circulation during catheterization? A. Air embolism B. Pneumothorax C. Venous thrombosis D. Endocarditis

A. Air embolism

Infection risk during catheterization can lead to which complication? A. Endocarditis B. Pneumonia C. Cellulitis D. Mediastinitis

A. Endocarditis

Which mechanical complication related to access site can occur during right-sided heart catheterization? A. Arterial puncture B. Stroke C. Intracranial hemorrhage D. Deep vein thrombosis

A. Arterial puncture

Which of the following pulmonary complications can arise from vascular injury or pneumothorax? A. Pneumothorax B. Pulmonary edema C. Bronchiectasis D. Pulmonary fibrosis

A. Pneumothorax

What is the most common complication of right-sided heart catheterization? A. Pulmonary infarction B. Endocarditis C. Arrhythmia D. Pneumothorax

C. Arrhythmia

The arrhythmias during RHC are most commonly triggered by mechanical stimulation of which cardiac structure? A. Right atrium B. Left ventricle C. Right ventricular outflow tract (RVOT) D. Pulmonary valve

C. Right ventricular outflow tract (RVOT)

Which of the following is true about arrhythmias during RHC? A. They are always life-threatening B. They often require antiarrhythmic drugs C. They are usually self-limited and resolve with catheter repositioning D. They occur in fewer than 5% of cases

C. They are usually self-limited and resolve with catheter repositioning

In patients with left bundle-branch block, what may be required if right bundle-branch block develops during catheterization? A. Emergency defibrillation B. Chest tube placement C. Temporary pacemaker D. Cardioversion

C. Temporary pacemaker

What does the “a wave” on the right atrial (RA) pressure waveform represent? A. Atrial emptying B. Tricuspid valve closure C. Atrial contraction D. Ventricular systole

C. Atrial contraction

Which component of the RA waveform reflects passive atrial emptying? A. a wave B. x descent C. v wave D. y descent

D. y descent

Advancing the catheter to 30–35 cm produces which characteristic waveform change? A. Appearance of the dicrotic notch B. Increased diastolic pressure equal to PCWP C. Abrupt increase in systolic pressure with diastolic pressure near RA pressure D. Disappearance of v waves

C. Abrupt increase in systolic pressure with diastolic pressure near RA pressure

Which finding indicates successful entry into the pulmonary artery (PA)? A. Pressure drop with large v waves B. Sudden decrease in systolic pressure C. Dicrotic notch in the waveform D. Loss of pressure waveform

C. Dicrotic notch in the waveform

The pulmonary capillary wedge pressure (PCWP) waveform reflects: A. Right atrial and right ventricular contraction B. Left atrial and left ventricular contraction C. Pulmonary venous compliance D. Aortic valve closure

B. Left atrial and left ventricular contraction

What does the pulmonary capillary wedge pressure (PCWP) most closely approximate in most patients? A. Right atrial pressure B. Pulmonary arterial pressure C. Left atrial pressure D. Left ventricular systolic pressure

C. Left atrial pressure

In which of the following conditions is PCWP not a reliable surrogate for left atrial pressure? A. Mitral regurgitation B. Mitral stenosis C. Aortic stenosis D. Tricuspid regurgitation

A. Mitral regurgitation

Which condition may cause discrepancy between left atrial pressure and PCWP following an atrial fibrillation ablation? A. Atrial septal defect B. Pulmonary embolism C. Pulmonary vein stenosis D. Aortic dissection

C. Pulmonary vein stenosis

What is a potential reason for discrepancies between PCWP and LA pressure readings? A. Patient positioning B. Use of different types of catheters C. Oxygen saturation variability D. Presence of right bundle-branch block

B. Use of different types of catheters

Which type of catheter is typically used for direct left atrial pressure measurement during transseptal catheterization? A. Swan-Ganz catheter B. Pigtail catheter C. Brockenbrough or Mullins-type sheath D. Pulmonary artery catheter

C. Brockenbrough or Mullins-type sheath

When should transseptal LA catheterization be considered during hemodynamic assessment? A. When pulmonary artery pressures are normal B. If discrepancies between PCWP and LA pressure are suspected C. For routine left ventricular pressure recording D. To measure cardiac output

B. If discrepancies between PCWP and LA pressure are suspected

What oxygen saturation value confirms that the catheter is truly in the wedged (PCW) position? A. >75% B. >85% C. >90% D. >95%

D. >95%

Why is it often challenging to obtain a true PCWP oxygen saturation sample? A. There is excess oxygen in the PA B. The catheter balloon may not inflate fully C. Contamination by low-saturation pulmonary artery (PA) blood D. Left atrial pressure varies significantly

C. Contamination by low-saturation pulmonary artery (PA) blood

Which technique helps improve the accuracy of the oxygen saturation sample during PCWP measurement? A. Rapid deflation of the balloon B. Retrograde catheter pullback C. Use of a large-bore catheter and saline flush during antegrade movement D. Rotating the catheter within the right atrium

C. Use of a large-bore catheter and saline flush during antegrade movement

Which of the following best differentiates true PCWP from a damped pulmonary artery pressure? A. Higher systolic pressure B. Use of oximetry only C. A and v waves timed to ECG or LV pressure D. Appearance of a dicrotic notch

C. A and v waves timed to ECG or LV pressure

What type of catheter setup ensures the most accurate PCWP waveform transmission? A. Small, flexible catheter and long tubing B. Stiff, large-bore, end-hole catheter with stiff, short tubing C. Swan-Ganz catheter with air-filled tubing D. Any catheter with a three-way stopcock

B. Stiff, large-bore, end-hole catheter with stiff, short tubing

To maintain waveform fidelity, which of the following should be ensured in the pressure monitoring system? A. Use of non-heparinized saline B. Removal of all air bubbles and thorough flushing C. Keeping the transducer above the heart D. Avoiding saline flushes during catheter advancement

B. Removal of all air bubbles and thorough flushing

According to the Fick principle, what two variables are required to calculate cardiac output? A. Hemoglobin and arterial blood pressure B. Heart rate and stroke volume C. Oxygen consumption and arteriovenous O2 content difference D. Mixed venous oxygen saturation and heart rate

C. Oxygen consumption and arteriovenous O2 content difference

What equation is used to calculate oxygen content in blood (in mL O2/100 mL)? A. 1.36 × hemoglobin × O2 saturation × 10 B. 1.36 + hemoglobin + O2 saturation C. Hemoglobin × O2 saturation / 1.36 D. 10 × hemoglobin / O2 saturation

A. 1.36 × hemoglobin × O2 saturation × 10

Which of the following is true regarding oxygen consumption (VO2) during cardiac catheterization for Fick CO measurement? A. It must be measured using echocardiography B. It should be estimated from BMI-based formulas only C. It must be measured directly for highest accuracy D. It is not relevant to the Fick method

C. It must be measured directly for highest accuracy

Supplemental oxygen should be discontinued how long before measuring VO2 using the Fick method? A. 1–2 minutes B. 3–5 minutes C. 10–15 minutes D. 30–45 minutes

C. 10–15 minutes

Which group shows the greatest discrepancy between measured and estimated VO2 using published formulae? A. Elderly patients B. Women C. Patients with BMI <25 kg/m² D. Severely obese patients (BMI >40 kg/m²)

D. Severely obese patients (BMI >40 kg/m²)

In the absence of an intracardiac shunt, pulmonary blood flow is equal to: A. Left ventricular end-diastolic volume B. Right atrial pressure C. Systemic blood flow D. Stroke volume

C. Systemic blood flow

Which variable is used in all three formulas (Dehmer, LaFarge, and Bergstra) for calculating assumed oxygen consumption (VO2)? A. Heart rate B. Age C. Body surface area (BSA) D. Weight

C. Body surface area (BSA)

The Dehmer formula estimates oxygen consumption (VO2) as: A. 125 × heart rate B. 138.1 × BSA C. 125 × BSA D. 138.1 − (11.49 × log age) + (0.378 × HR)

C. 125 × BSA

Which formula(s) include heart rate as a component in the calculation of VO2? A. Dehmer only B. LaFarge only C. Bergstra only D. Both LaFarge and Bergstra

B. LaFarge only

The LaFarge formula differs by sex primarily in: A. Use of different BSA scaling B. A different heart rate multiplier C. A different log age coefficient D. It uses weight instead of age in females

C. A different log age coefficient

Which formula includes the term “+10 – (10.5 × log age)” only in males? A. Dehmer B. LaFarge C. Bergstra D. None of the above

C. Bergstra

What is a key limitation of using these formulas for oxygen consumption instead of directly measuring it? A. They are not compatible with the thermodilution method B. They significantly overestimate cardiac output in all patients C. They can deviate >25% from measured values, especially in certain populations D. They cannot be used without echocardiography

C. They can deviate >25% from measured values, especially in certain populations

What is the main limitation of using the LaFarge equation for estimating oxygen consumption (VO₂) in adults? A. It overestimates VO₂ in children B. It was derived from pediatric data and is inaccurate in adults C. It ignores body surface area (BSA) D. It is only validated in patients on supplemental oxygen

B. It was derived from pediatric data and is inaccurate in adults

Compared to measured VO₂, the assumption of 3 mL O₂/kg/min for Fick cardiac output has been shown to: A. Accurately reflect cardiac output across all patient populations B. Strongly correlate with measured VO₂ in normal-weight adults C. Correlate poorly, especially in certain populations D. Be more accurate than using metabolic carts

C. Correlate poorly, especially in certain populations

What tool is commonly used to obtain direct VO₂ measurement during cardiac catheterization? A. Swan-Ganz catheter B. Thermodilution sensor C. Echocardiogram D. Metabolic cart (e.g., MCG Diagnostics)

D. Metabolic cart (e.g., MCG Diagnostics)

In which population is estimated VO₂ from formulae especially inaccurate? A. Elderly B. Women C. Athletes D. Severely obese individuals

D. Severely obese individuals

When is direct measurement of VO₂ particularly recommended? A. For routine catheterization with normal hemodynamics B. When assessing for valvular regurgitation C. When precise hemodynamic data is essential for clinical decisions D. When performing echocardiographic stress testing

C. When precise hemodynamic data is essential for clinical decisions

In which of the following scenarios is invasive hemodynamic assessment particularly useful for aortic stenosis (AS)? A. When echocardiography shows a clear high gradient B. In low-output, low-gradient AS with preserved LV ejection fraction C. In asymptomatic patients with mild AS D. When LV ejection fraction is above 60% and there are no symptoms

B. In low-output, low-gradient AS with preserved LV ejection fraction

What clinical finding would most strongly support invasive assessment in a patient with mitral valve disease? A. Normal pulmonary artery pressure by echocardiography B. Mild symptoms with a low transmitral gradient C. Discrepancy between symptoms and noninvasive transmitral gradient or pulmonary pressures D. High-quality Doppler imaging of the mitral valve

C. Discrepancy between symptoms and noninvasive transmitral gradient or pulmonary pressures

Which of the following is NOT listed as an indication for invasive hemodynamic evaluation? A. Primary pulmonary hypertension B. Hypertrophic cardiomyopathy C. Chronic pericarditis with effusion D. Constrictive or restrictive cardiomyopathy

C. Chronic pericarditis with effusion

Invasive hemodynamic assessment is recommended in patients with low-output, low-gradient AS and high peripheral vascular resistance to perform which test? A. Dobutamine stress echocardiography B. Vasodilator challenge C. Cardiac MRI D. Transesophageal echocardiogram

B. Vasodilator challenge

In which condition is invasive hemodynamic assessment favored to evaluate candidacy for advanced therapies? A. Stable angina B. Hypertension C. Orthotopic heart transplantation (OHTx) D. Chronic atrial fibrillation

C. Orthotopic heart transplantation (OHTx)

What is the fundamental principle behind the indicator dilution technique for measuring cardiac output? A. Measurement of oxygen saturation at rest and during exertion B. Observation of ventricular wall motion using echocardiography C. Injection of a known quantity of indicator and measurement of its concentration change over time D. Recording of simultaneous pressure tracings in the right and left heart chambers

C. Injection of a known quantity of indicator and measurement of its concentration change over time

Which component of the Swan-Ganz catheter is responsible for measuring temperature in the thermodilution method? A. Balloon inflation lumen B. Proximal injection port C. Distal end-hole D. Thermistor at the tip

D. Thermistor at the tip

What is the primary function of the balloon on the Swan-Ganz catheter during right-heart catheterization? A. To measure left atrial pressure directly B. To inject indicator dye for CO measurement C. To assist in catheter positioning and facilitate pulmonary artery wedge pressure measurement D. To draw blood samples from the left ventricle

C. To assist in catheter positioning and facilitate pulmonary artery wedge pressure measurement

In thermodilution cardiac output measurement, where is the cold saline indicator typically injected? A. Pulmonary artery B. Right atrium via the proximal port C. Left atrium D. Inferior vena cava

B. Right atrium via the proximal port

During thermodilution, what happens after the cold saline mixes with blood in the right heart? A. The balloon deflates and ejects the saline B. The temperature change is detected by the thermistor in the pulmonary artery C. The catheter measures end-diastolic volume D. The saline flows into the left ventricle for measurement

B. The temperature change is detected by the thermistor in the pulmonary artery

What does a pulmonary artery wedge pressure (PCWP) primarily reflect in a normal patient? A. Right atrial pressure B. Left atrial pressure C. Pulmonary venous oxygen content D. Right ventricular end-diastolic pressure

B. Left atrial pressure

What is the usual volume of saline injectate used in adults during thermodilution cardiac output measurement? A) 5 mL B) 10 mL C) 15 mL D) 20 mL

B) 10 mL

Why is excessive coiling of the catheter in the right atrium or ventricle problematic? A) Causes infection risk B) Prevents proper thermistor positioning leading to inaccurate readings C) Causes balloon rupture D) Increases oxygen saturation

B) Prevents proper thermistor positioning leading to inaccurate readings

What is the minimum temperature difference recommended between the injectate and patient’s blood when using room temperature saline? A) 5°C B) 10°C C) 15°C D) 20°C

B) 10°C

How many cardiac output measurements should be taken and averaged to ensure accuracy? A) 1 B) 2 C) 3 to 5 D) 6 to 8

C) 3 to 5

Which of the following clinical conditions can reduce the accuracy of thermodilution cardiac output? A) Hypertension B) Tricuspid regurgitation C) Aortic stenosis D) Mitral valve prolapse

B) Tricuspid regurgitation

The proximal port of the Swan-Ganz catheter is used for: A) Balloon inflation B) Measuring pulmonary artery pressure C) Right atrial pressure measurement and injectate delivery D) Thermistor placement

C) Right atrial pressure measurement and injectate delivery

What is the function of the balloon on the pulmonary artery catheter? A) To measure cardiac output B) To inflate the catheter tip for pressure readings C) To aid catheter positioning by floating and to enable wedge pressure measurement D) To inject saline

C) To aid catheter positioning by floating and to enable wedge pressure measurement

Which is a common error during thermodilution cardiac output measurement? A) Injecting saline after pressing start B) Using iced saline instead of room temperature saline C) Injecting bolus before pressing the start button on the computer D) Taking more than 3 readings

C) Injecting bolus before pressing the start button on the computer

What adjustment is necessary if a smaller bolus of injectate is used? A) Use a larger catheter B) Change the computation constant on the computer C) Increase the injection speed D) Use iced saline instead of room temperature saline

B) Change the computation constant on the computer

Why should erroneous cardiac output values be ignored in final calculations? A) They are always too high B) They indicate a technical malfunction and skew results C) They always underestimate cardiac output D) They represent perfect measurements

B) They indicate a technical malfunction and skew results

Invasive Hemodynamics Flashcards

(130 cards)