PCCN UPDATED Exam Questions and
CORRECT Answers
S1 - CORRECT ANSWER- Mitral and tricuspid "lub" of "lub dub"
S2 - CORRECT ANSWER- Aortic and pulmonic "dub" of "lub dub"
S3 - CORRECT ANSWER- Ventricular Gallup. Beginning of diastole after S2. Too much
volume
S4 - CORRECT ANSWER- Rare. Atrial Gallup. Resistance to filling. End of diastole
1/avl/V5/v6 - CORRECT ANSWER- Lateral (Circumflex): AVL- High Lateral V6 Low
Lateral
Less common/ less severe
II/III/avf - CORRECT ANSWER- Inferior
V1/v2/ v3/ v4 - CORRECT ANSWER- Anterior
V4R/ V5R - CORRECT ANSWER- RV
CO - CORRECT ANSWER- HRXSV
SV - CORRECT ANSWER- Preload/ after load/ contractility
SVO2 from central line - CORRECT ANSWER- ~=70%
Is increased SVO2 good or bad? - CORRECT ANSWER- Bad- it means that the tissues are
not up taking O2. This should be "used blood" so the number should be lower
, Parasympathetic response - CORRECT ANSWER- Slows things down/ vagal response/
atropine blocks the vagas nerve and speeds up HR
Betablockers - CORRECT ANSWER- ⬇️HR ⬇️contractility=⬇️BP/ ⬇️myocardial O2 demand
Used in acute coronary syndrome. Can cause HF. Look for crackles and S3
One of the first drugs we give with angina because it decreases myocardial O2 consumption
Sympathetic response - CORRECT ANSWER- Speeds things up/ epi/ dopamine
Calcium Channel Blockers - CORRECT ANSWER- ⬇️HR and contractility us in rapid
rhythm. Don't use in ACS. Amlodapine, dilt, nicardipine
Reduce afterload by lowering intracellular Ca+ which inhibits smooth muscle contraction.
Decreases contractility
Digoxin - CORRECT ANSWER- Increase contractility= increased myocardial O2 demand.
Takes 6 hrs to work. Don't use in ACS
Pulse Pressure - CORRECT ANSWER- Difference between Diastolic and Systolic pressures.
Must be at least 40. <40 patient is not being filled properly (dry) or has vasoconstriction.
Preload - CORRECT ANSWER- Volume. Measured by CVP. How full in the ventricle before
contraction.
How to reduce Preload - CORRECT ANSWER- Reduce volume (diuretics)/ vasodilation
(when you cant get rid of volume: Nitro, dilt, morphine)/ dialysis
Replace preload - CORRECT ANSWER- Crystalloids: NS, isotonic, fluid bolus
Colloids: Hetastarch, albumin, blood products:Expand intravascular volume. Use with
caution in pulmonary edema
Blood: ⬇️H&H, can increase afterload.
Potential blood admin problems - CORRECT ANSWER- Can increase afterload
CORRECT Answers
S1 - CORRECT ANSWER- Mitral and tricuspid "lub" of "lub dub"
S2 - CORRECT ANSWER- Aortic and pulmonic "dub" of "lub dub"
S3 - CORRECT ANSWER- Ventricular Gallup. Beginning of diastole after S2. Too much
volume
S4 - CORRECT ANSWER- Rare. Atrial Gallup. Resistance to filling. End of diastole
1/avl/V5/v6 - CORRECT ANSWER- Lateral (Circumflex): AVL- High Lateral V6 Low
Lateral
Less common/ less severe
II/III/avf - CORRECT ANSWER- Inferior
V1/v2/ v3/ v4 - CORRECT ANSWER- Anterior
V4R/ V5R - CORRECT ANSWER- RV
CO - CORRECT ANSWER- HRXSV
SV - CORRECT ANSWER- Preload/ after load/ contractility
SVO2 from central line - CORRECT ANSWER- ~=70%
Is increased SVO2 good or bad? - CORRECT ANSWER- Bad- it means that the tissues are
not up taking O2. This should be "used blood" so the number should be lower
, Parasympathetic response - CORRECT ANSWER- Slows things down/ vagal response/
atropine blocks the vagas nerve and speeds up HR
Betablockers - CORRECT ANSWER- ⬇️HR ⬇️contractility=⬇️BP/ ⬇️myocardial O2 demand
Used in acute coronary syndrome. Can cause HF. Look for crackles and S3
One of the first drugs we give with angina because it decreases myocardial O2 consumption
Sympathetic response - CORRECT ANSWER- Speeds things up/ epi/ dopamine
Calcium Channel Blockers - CORRECT ANSWER- ⬇️HR and contractility us in rapid
rhythm. Don't use in ACS. Amlodapine, dilt, nicardipine
Reduce afterload by lowering intracellular Ca+ which inhibits smooth muscle contraction.
Decreases contractility
Digoxin - CORRECT ANSWER- Increase contractility= increased myocardial O2 demand.
Takes 6 hrs to work. Don't use in ACS
Pulse Pressure - CORRECT ANSWER- Difference between Diastolic and Systolic pressures.
Must be at least 40. <40 patient is not being filled properly (dry) or has vasoconstriction.
Preload - CORRECT ANSWER- Volume. Measured by CVP. How full in the ventricle before
contraction.
How to reduce Preload - CORRECT ANSWER- Reduce volume (diuretics)/ vasodilation
(when you cant get rid of volume: Nitro, dilt, morphine)/ dialysis
Replace preload - CORRECT ANSWER- Crystalloids: NS, isotonic, fluid bolus
Colloids: Hetastarch, albumin, blood products:Expand intravascular volume. Use with
caution in pulmonary edema
Blood: ⬇️H&H, can increase afterload.
Potential blood admin problems - CORRECT ANSWER- Can increase afterload
