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Cardiac CSC exam (160 questions and answers).
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Cardiac CSC exam (160 questions and answers).
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Cardiac CSC exam(160 questions and
answers)
A patient in cardiogenic shock is most likely
to have which of the following hemodynamic
profiles:
A. Cardiac output = 6 L/min, CVP = 15 mmHg,
PAOP = 26 mmHg, SVR = 1600 dynes/sec/cm-
5.
B. Cardiac output = 2.5 L/min, CVP = 4
mmHg, PAOP = 8 mmHg, SVR = 600
dynes/sec/cm-5.
C. Cardiac output = 5 L/min, CVP = 8 mmHg ,
PAOP = 12 mmHg, SVR = 800 dynes/sec/cm-5.
D. Cardiac output = 2.5 L/min, CVP = 15
mmHg, PAOP = 30 mmHg, SVR = 1800
dynes/sec/cm-5. - answer D. In cardiogenic
shock, cardiac contractility is decreased and
filling pressures (CVP and PAOP) are high
because the ventricles can't eject their
contents adequately. SVR increases as
compensatory vasoconstriction occurs in an
,attempt to support BP. A normal CO is 4-8
L/min; CVP is 2-6 mmHg, PAOP is 8-12 mmHg,
and SVR is 800-1200 dynes/sec/cm-5.
A patient with a right ventricular infarction is
likely to have which of the following
hemodynamic profiles:
A. Low cardiac output, high CVP, low PAOP,
high SVR.
B. High cardiac output, low CVP, low PAOP,
high SVR.
C. Low cardiac output, high CVP, high PAOP,
low SVR.
D. Low cardiac output, low SVR, low CVP, low
PAOP. - answer A. In right ventricular
infarction right ventricular contractility is
reduced, which causes RV pressure to rise
(high CVP) and decreases forwards flow
through the lungs and into the left ventricle,
reducing LV filling pressure (low PAOP). SVR
increases as peripheral vasoconstriction
attempts to compensate for reduced left
ventricular stroke volume in an effort to
maintain BP.
,The hemodynamic profile most consistent
with cardiogenic shock is:
A. Decreased cardiac output, increased
preload, decreased afterload and decreased
contractility.
B. Decreased cardiac output, increased
preload, increased afterload, and decreased
contractility.
C. Decreased cardiac output, decreased
preload, increased afterload, and decreased
contractility.
D. Decreased cardiac output, increased
preload, increased afterload, and increased
contractility. - answer B. Cardiac output is
decreased as a direct result of decreased
contractility of the left ventricle in
cardiogenic shock. Preload increases as a
result of backward failure and afterload
increases due to a compensatory
vasoconstriction of the arterioles in an effort
to support blood pressure.
Cardiogenic shock is primarily due to:
A. Hypovolemia.
B. Inappropriate peripheral vasodilation.
, C. Volume overload.
D. Decreased cardiac contractility. - answer
D. Shock states are due to either PUMP
problems, VOLUME problems, or VESSEL (or
TANK) problems. Cardiogenic shock is a pump
problem.
Volume overload and hypovolemia are
volume problems. Hypovolemia causes
hypovolemic shock; volume overload can
contribute to cardiogenic shock in the
presence of reduced LV function (a pump
problem).
Peripheral vasodilation is a vessel problem
and can result in vasodilatory shock.
A patient in cardiogenic shock is most likely
to display:
A. Bradycardia, hypotension, narrow pulse
pressure, JVD.
B. Tachycardia, widened pulse pressure,
hypotension, JVD.
C. Hypotension, narrow pulse pressure,
tachycardia, crackles in the lungs.
D. Hypotension, bradycardia, and clear lungs.
- answer C. In cardiogenic shock, the cardiac
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