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CMC CERTIFICATION QUESTIONS WITH CORRECT ANSWERS
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CMC CERTIFICATION QUESTIONS WITH CORRECT ANSWERS
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CMC CERTIFICATION QUESTIONS WITHCORRECT ANSWERS
HITs(heparinsinducedsthrombocytopenia)s-sans--
BivalirudinsandsArgatrobansaresdirectsthrombinsinhibitorssandsalternativessforsanticoagulat
ionsforspatientsswithsHIT.
-
sHITsissansimmunesmediatedsadversesdrugsreactionscausedsbysantibodiessthatsdevelopsaft
ersexposurestosheparin,splateletssbecomesactivatedsplacingspatientssatsrisksforsdevelopme
ntsofsthrombosis
pericarditiss-sans--inflammationsofspericardialssac,schestspain-sharp,stabbing,sdull,sachys
painsimprovedswithssittings&leaningsfoward,spainsworseswithscough,spositionalschangessa
ndsinspiration,
pericardialsfrictionsrub,sfever,sDiffusesSTschangess(depressionsofsPRsinterval,sconcavesST
ssegmentsinslimbsleads,stselevationsinsleadssIsandsII
Papillarysmusclesruptures-sans---associatedswithsanteriorsorsinferiorswallsMI
-
shemodynamicsinstability,snewsloudssystolicsmurmur,sacutesmitralsregurgitation,slargesVsw
avessonsPAOPswaveform
-streatments-shemodynamicssupport,sEmergentssurgicalsrepair/valvesreplacement
Ventricularsseptalsruptures-sans---associatedswithsseptalswallsMI
-oxygensrichsbloodsshuntsstosrightssidesofsheartsfromsthesleft
Symptomssofsventricularsseptalsruptures-sans---acutesSOB
-S3sheartssound
-crackles
-holosystolicsmurmur
-sPAsCathetersinsertion--
>sfalselysincreaedsCO,sbecausesCOsreadingsissderivedsfromsthesrightsventricle,sincreaseds
Svo2sduestosleftstosrightsshunting,slargesVswavessonsCVPswaveform,sdiagnosedsbysECHO
-streatementssurgicalsrepair
cardiogenicsshocks-sans--
S3spulmonarysedema,stachycardia,sdysrhythmias,ssignssofsdecreasedsperfusions(mottling
),sdecreasedsUOPs<0.5ml/kg/hr,shypotension,slowsCO/CI,selevatedsSVRsoftens>s1600sdyn
es/sec/cm,selevatedsRAP/CVP,sPAOPs>16smmhg,sdecreasedssvo2s(<65%)
othersdiagnosticssforscardiogenicsshocks-sans---
scardiacscatheterizationsifsrelatedstosischemia-sPCIsforsreperfusion
,-sABG-smixedsrespiratorysandsmetabolicsacidosis:hypoxemia-
slacticsacidosissduestosdecreasedsperfusionsandsanaerobicsmetabolism
-ECHO:sdecreasedswallsmotion,reducedsejectionsfraction
-
Chestxray:spulmonarysedemas&congestion,smaysnotesopacitysduestosenlargedspulmonary
svasculature,senlargesdsheart,sKerleysBslinessinslowerszonessfromsinterstitialsedema,s
-sBUN/CR-smonitorsforsacuteskidneysinjury
-smonitorsothersorganssforsdysfunctionsandsfailure
supportivestreatmentsforscardiogenicsshocks-sans---mechanicalssupports(IABP,impella)
-
vasopressorsstossupportsbloodspressures(useswithscautionsasstheysincreasesSVRsandswor
kloadsofsheart)
-positivesinotropestosimprovescontractilitys
-diureticss
afterloadsreductions/svenoussvasodilators
cardiogenicspulmonarysedemas-sans---
fluidsinsthesalveolussduestosincreasedsalveolarshydrostaticspressures
-simpairedsgassexchange,shypercapnia
-shypoxemia-sS3sheartssound,sshortnesssofsbreath,scrackles,spinkysfrothyssputum,sanxiety
Causessofscardiogenicspulmonarysedemas-sans--
myocardialsinfarction,sheartsfailure,shypertensivescrisis,smitralsregurgitation,stamponade
Treatmentsofspulmonarysedemas-sans---decreasespreload
-loopsdiuretics
-nitroglycerin
-morphine
-sCPAPsorsBIPAP
-sPositivesinotropestosimprovescontractility
Cardiacsoutputs(CO)s-sans--4-8sL/min
Cardiacsindexs(CI)s-sans--2.5-4sL/min/m2
Strokesvolumes(SV)s-sans--50-100sml/beat
Strokesvolumesindexs-sans--35-60sml/beat/m2
Rightsventricularsstrokesworksindexs(RVSWI)s-sans--5-10sg/m2/beat
Leftsventricularsstrokesworksindexs(LVSWI)s-sans--50-62sg/m2/beat
SVO2s-sans--60-75%
, Scvo2s-sans--overs70%s(70-85%)
pulmonarysarteryspressures-sans--25/10smmHG
PAOPs-sans--8-12smmHG
RAP/CVPs-sans--2-8smmHG
SVRs-sans--900-1400sdynes/sec/cm-5
SVRIs-sans--1970-2390sdynes/sec/cm-5/m2
PVRs-sans--90-250sDynes/sec/cm-5
LVspressures-sans--100smmhg
Cardiacsoutputsformulas-sans--CO=SVxHR
MAP=s-sans--COsxsSVR
Cardiacsoutputscansbesmeasuresswiths-sans--
Pulmonarysarteryscatheter,sechocardiogram,sindirectlysviasfunctionalshemodynamics,snon
invasivesmethodss(bioreactancesandscontinuoussdigitsCO),sficksequation
inslowsoutputsstatesspatientsscompensateswiths-sans--
tachycardia,sCOsmaysbesnormalswhensthespatientsisstachycardicswithslowersSV
Strokesvolumesformulas-sans--SV=sendsdiastolicsvolume-sendssystolicsvolumes
SV=EDV-ESV
TypicalsEDVs-sans--120sml
amountsofsbloodsinsthesheartsatsthesendsofsdiastole
TypicalsESVs-sans--50sml
amountsofsbloodsinsthesventriclessatsendsofsejection/systole
Threesmeasuressthatscontributestosstrokesvolumes-sans--contractility,spreload,safterload
Preloads-sans--myocardialsfiberslengthsatsthesendsofsdiastoles-
stretchingsofscardiacsmyocytesspriorstosejection
afterloads-sans--resistancesthesheartshasstosejectsagainstsduringssystole
contractilitys-sans--strengthsofsmyofibrilscontraction
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