CEN PRACTICE QUESTIONS AND ANSWERS

Pulse pressure is the difference between systolic blood pressure and diastolic blood pressure, and is widened in which of the following disorders? (A) Early hypovolemic shock (B) Increased ICP (C) Cardiac tamponade (D) Neurogenic shock - Answer-(B) Increased ICP [pulse pressure is narrow in early shock, cardiac tamponade, and aortic valve stenosis] Parents bring in their 4-week-old infant with non-bilious projectile vomiting and persistent hunger. Which of the following conditions is suspected? - Answer-(A) Pyloric stenosis [PS is characterized by non-bilious projectile vomiting and persistent hunger; volvulus has bilious vomiting] Systemic vascular resistance (SVR) is decreased in which type of shock? - Answer-(D) Distributive [Afterload (pressure) is low in distributive shock (neurogenic, septic, anaphylactic) due to vasodilation, and high in all other forms of shock due to vasoconstriction] Which is the following is the hallmark symptom of Prinzmetal's angina? - Answer-Pain at rest due to coronary vasospasm; may be seen with stimulant use ST segment elevation in ECG leads II, III and aVF indicates injury to which area of the heart? - Answer-Inferior wall [V1-V4 look at the anterior wall; I, aVL, V5, V6 look at the lateral wall of the left ventricle] A 40F who is 36-weeks pregnant presents to the ED with painless bright red vaginal bleeding. The nurse knows a pelvic exam is contraindicated since the most likely cause of the bleeding is - Answer-Placenta previa [think P's - painless privates, placenta previa; abrupt placenta - always painful] A 14-year-old c/o lightheadedness & palpitations. Which cardiac disorder is characterized by a short PR interval and a Delta wave? - Answer-Wolff-Parkinson-White (WPW) syndrome [WPW is characterized by a short PR interval, and a slurred QRS on the upstroke, yielding a widened QRS complex; this morphology is referred to as a "Delta wave"] A 22F c/o thick, white, "cottage-cheese" like vaginal discharge, pruritus, vulvar burning an