CMC certification Questions with Answers 100% Solved

CMC certification Questions with
Answers 100% Solved
HITM(heparinMinducedMthrombocytopenia)M-
MAnswerMBivalirudinMandMArgatrobanMareMdirectMthrombinMinhibitorsMandMalternativesMf
orManticoagulationMforMpatientsMwithMHIT.

-
MHITMisManMimmuneMmediatedMadverseMdrugMreactionMcausedMbyMantibodiesMthatMdev
elopMafterMexposureMtoMheparin,MplateletsMbecomeMactivatedMplacingMpatientsMatMriskM
forMdevelopmentMofMthrombosis



pericarditisM-MAnswerMinflammationMofMpericardialMsac,MchestMpain-
sharp,stabbing,Mdull,MachyM

painMimprovedMwithMsittingM&leaningMfoward,MpainMworseMwithMcough,MpositionalMchan
gesMandMinspiration,

pericardialMfrictionMrub,Mfever,MDiffuseMSTMchangesM(depressionMofMPRMinterval,Mconcav
eMSTMsegmentMinMlimbMleads,stMelevationMinMleadsMIMandMII



PapillaryMmuscleMruptureM-MAnswerM-associatedMwithManteriorMorMinferiorMwallMMI

-
MhemodynamicMinstability,MnewMloudMsystolicMmurmur,MacuteMmitralMregurgitation,Mlarge
MVMwavesMonMPAOPMwaveform

-MtreatmentM-MhemodynamicMsupport,MEmergentMsurgicalMrepair/valveMreplacement



VentricularMseptalMruptureM-MAnswerM-associatedMwithMseptalMwallMMI

-oxygenMrichMbloodMshuntsMtoMrightMsideMofMheartMfromMtheMleft



SymptomsMofMventricularMseptalMruptureM-MAnswerM-acuteMSOB

-S3MheartMsound

-crackles

-holosystolicMmurmur

-MPAMCatheterMinsertion--
>MfalselyMincreaedMCO,MbecauseMCOMreadingMisMderivedMfromMtheMrightMventricle,Minc
reasedMSvo2MdueMtoMleftMtoMrightMshunting,MlargeMVMwavesMonMCVPMwaveform,Mdiag
nosedMbyMECHO

-MtreatementMsurgicalMrepair

,cardiogenicMshockM-
MAnswerMS3MpulmonaryMedema,Mtachycardia,Mdysrhythmias,MsignsMofMdecreasedMperfusi
onM(mottling),MdecreasedMUOPM<0.5ml/kg/hr,Mhypotension,MlowMCO/CI,MelevatedMSVRMof
tenM>M1600Mdynes/sec/cm,MelevatedMRAP/CVP,MPAOPM>16Mmmhg,MdecreasedMsvo2M(<6
5%)



otherMdiagnosticsMforMcardiogenicMshockM-MAnswerM-
McardiacMcatheterizationMifMrelatedMtoMischemia-MPCIMforMreperfusion

-MABG-MmixedMrespiratoryMandMmetabolicMacidosis:hypoxemia-
MlacticMacidosisMdueMtoMdecreasedMperfusionMandManaerobicMmetabolism

-ECHO:MdecreasedMwallMmotion,reducedMejectionMfraction

-
Chestxray:MpulmonaryMedemaM&congestion,MmayMnoteMopacityMdueMtoMenlargedMpulmo
naryMvasculature,MenlargeMdMheart,MKerleyMBMlinesMinMlowerMzonesMfromMinterstitialMe
dema,M

-MBUN/CR-MmonitorMforMacuteMkidneyMinjury

-MmonitorMotherMorgansMforMdysfunctionMandMfailure



supportiveMtreatmentMforMcardiogenicMshockM-MAnswerM-
mechanicalMsupportM(IABP,impella)

-
vasopressorsMtoMsupportMbloodMpressureM(useMwithMcautionMasMtheyMincreaseMSVRMan
dMworkloadMofMheart)

-positiveMinotropeMtoMimproveMcontractilityM

-diureticsM

afterloadMreductionM/MvenousMvasodilators



cardiogenicMpulmonaryMedemaM-MAnswerM-
fluidMinMtheMalveolusMdueMtoMincreasedMalveolarMhydrostaticMpressures

-MimpairedMgasMexchange,Mhypercapnia

-Mhypoxemia-
MS3MheartMsound,MshortnessMofMbreath,Mcrackles,MpinkyMfrothyMsputum,Manxiety



CausesMofMcardiogenicMpulmonaryMedemaM-
MAnswerMmyocardialMinfarction,MheartMfailure,MhypertensiveMcrisis,MmitralMregurgitation,M
tamponade

,TreatmentMofMpulmonaryMedemaM-MAnswerM-decreaseMpreload

-loopMdiuretics

-nitroglycerin

-morphine

-MCPAPMorMBIPAP

-MPositiveMinotropeMtoMimproveMcontractility



CardiacMoutputM(CO)M-MAnswerM4-8ML/min



CardiacMindexM(CI)M-MAnswerM2.5-4ML/min/m2



StrokeMvolumeM(SV)M-MAnswerM50-100Mml/beat



StrokeMvolumeMindexM-MAnswerM35-60Mml/beat/m2



RightMventricularMstrokeMworkMindexM(RVSWI)M-MAnswerM5-10Mg/m2/beat



LeftMventricularMstrokeMworkMindexM(LVSWI)M-MAnswerM50-62Mg/m2/beat



SVO2M-MAnswerM60-75%



Scvo2M-MAnswerMoverM70%M(70-85%)



pulmonaryMarteryMpressureM-MAnswerM25/10MmmHG



PAOPM-MAnswerM8-12MmmHG



RAP/CVPM-MAnswerM2-8MmmHG



SVRM-MAnswerM900-1400Mdynes/sec/cm-5

, SVRIM-MAnswerM1970-2390Mdynes/sec/cm-5/m2



PVRM-MAnswerM90-250MDynes/sec/cm-5



LVMpressureM-MAnswerM100Mmmhg



CardiacMoutputMformulaM-MAnswerMCO=SVxHR



MAP=M-MAnswerMCOMxMSVR



CardiacMoutputMcanMbeMmeasuresMwithM-
MAnswerMPulmonaryMarteryMcatheter,Mechocardiogram,MindirectlyMviaMfunctionalMhemody
namics,MnoninvasiveMmethodsM(bioreactanceMandMcontinuousMdigitMCO),MfickMequation



inMlowMoutputMstatesMpatientsMcompensateMwithM-
MAnswerMtachycardia,MCOMmayMbeMnormalMwhenMtheMpatientMisMtachycardicMwithMlo
werMSV



StrokeMvolumeMformulaM-MAnswerMSV=MendMdiastolicMvolume-MendMsystolicMvolumeM

SV=EDV-ESV



TypicalMEDVM-MAnswerM120Mml

amountMofMbloodMinMtheMheartMatMtheMendMofMdiastole



TypicalMESVM-MAnswerM50Mml

amountMofMbloodMinMtheMventriclesMatMendMofMejection/systole



ThreeMmeasuresMthatMcontributeMtoMstrokeMvolumeM-
MAnswerMcontractility,Mpreload,Mafterload



PreloadM-MAnswerMmyocardialMfiberMlengthMatMtheMendMofMdiastoleM-

stretchingMofMcardiacMmyocytesMpriorMtoMejection