CVICU EXAM QUESTIONS WITH CORRECT
ANSWERS
Milrinone - CORRECT ANSWER✔✔-phosphodiesterase (PDE3) inhibitor
| | | | |
positive inotrope - enhances CO by directly inhibiting
| | | | | | | |
phosphodiesterase from metabolizing cAMP which increases Ca into | | | | | | | |
cells -> forceful contraction.
| | |
vasodilator properties (lowers afterload & preload- decrease SVR & PVR,
| | | | | | | | |
PAOP lv preload) by decreasing intracellular Ca in vascular smooth
| | | | | | | | | | |
muscle
ideal for pts with RV failure. decreases coronary vascular resistance
| | | | | | | | | |
(good for myocardial o2 consumption.
| | | |
ACLS - CORRECT ANSWER✔✔-1. CPR
| | | |
2. shock VF/pVT (Epi only and no shock for 3. Asystole & PEA)
| | | | | | | | | | | |
4. CPR 2 min, IV/IO access
| | | | |
5. shock
|
6. epi 1mg q 3-5 min
| | | | |
7. CPR 2 min
| | |
8. Amio 300mg then 150mg, or Lido 1mg/kg then 0.5mg/kg
| | | | | | | | |
,9. Treat reversible causes (H/T)
| | | |
H&Ts - CORRECT ANSWER✔✔-Hypovolemia
| | |
Hypoxia |
Hydrogen Ion (acidosis) | |
Hypo/Hyper-Kalemia |
Hypothermia
Hypoglycemia
Tension Pneumothorax |
Tamponade, Cardiac | |
Toxins
Thrombosis, pulmonary |
Thrombosis, coronary |
Vasopressin - CORRECT ANSWER✔✔-ADH | | |
V1 receptors on vascular smooth muscle
| | | | |
V2 receptors on renal collecting ducts(Distal convoluted tubule of the
| | | | | | | | | |
loop of henle)
| |
,Increases water permeability (cAMP-dependent mechanism), which
| | | | | |
leads to decreased urine formation. This increases blood volume,
| | | | | | | | |
cardiac output and arterial pressure.
| | | | |
Contracts vascular smooth muscle -> causes vasoconstriction of
| | | | | | | |
capillaries & small arterioles -> increase MAP
| | | | | |
May improve LV function, which increases CO and coronary blood flow
| | | | | | | | | |
Increases secretion of corticotropin in the anterior pituitary gland that
| | | | | | | | | |
stimulates the adrenal cortex. The adrenal cortex produces cortisol
| | | | | | | | |
which regulates BP. | |
Norepinephrine - CORRECT ANSWER✔✔-Vasopressor (and inotrope) / | | | | | | |
Adrenergic Agonist |
a1 b1 (small b2) - causing vasoconstriction, increased inotropic effects,
| | | | | | | | | |
and cardiac stimulation.
| |
For profound hypotension when volume repletion is inadequate. Can be
| | | | | | | | |
|administered with fluid resus if the pt's BP and CO are significantly
| | | | | | | | | | | |
impaired.
Epinephrine - CORRECT ANSWER✔✔-Adrenergic Agonist / Vasopressor
| | | | | |
, a1 b1 b2
| |
Positive Chronotrope to increase HR in bradycardia. Good in cardiac
| | | | | | | | | |
arrest as it enhances automaticity
| | | | |
For refractory hypotension
| |
Improves cardiac function and enhances SV
| | | | |
Precedex (dexmedetomidine) - CORRECT ANSWER✔✔-a2 agonist
| | | | |
Alpha 2 receptors are responsible for inhibiting presynaptic
| | | | | | | |
norepinephrine production (they SHUT OFF norepi production when
| | | | | | | |
agonized. norepi plays a role in pain signal propagation in the CNS)
| | | | | | | | | | |
Analgesic, Sedative, Anxiolytic
| |
pre-synapse block pain | |
post-synapse decrease BP & HR | | | |
Dexmedetomidine + bupivacaine research study | | | |
ANSWERS
Milrinone - CORRECT ANSWER✔✔-phosphodiesterase (PDE3) inhibitor
| | | | |
positive inotrope - enhances CO by directly inhibiting
| | | | | | | |
phosphodiesterase from metabolizing cAMP which increases Ca into | | | | | | | |
cells -> forceful contraction.
| | |
vasodilator properties (lowers afterload & preload- decrease SVR & PVR,
| | | | | | | | |
PAOP lv preload) by decreasing intracellular Ca in vascular smooth
| | | | | | | | | | |
muscle
ideal for pts with RV failure. decreases coronary vascular resistance
| | | | | | | | | |
(good for myocardial o2 consumption.
| | | |
ACLS - CORRECT ANSWER✔✔-1. CPR
| | | |
2. shock VF/pVT (Epi only and no shock for 3. Asystole & PEA)
| | | | | | | | | | | |
4. CPR 2 min, IV/IO access
| | | | |
5. shock
|
6. epi 1mg q 3-5 min
| | | | |
7. CPR 2 min
| | |
8. Amio 300mg then 150mg, or Lido 1mg/kg then 0.5mg/kg
| | | | | | | | |
,9. Treat reversible causes (H/T)
| | | |
H&Ts - CORRECT ANSWER✔✔-Hypovolemia
| | |
Hypoxia |
Hydrogen Ion (acidosis) | |
Hypo/Hyper-Kalemia |
Hypothermia
Hypoglycemia
Tension Pneumothorax |
Tamponade, Cardiac | |
Toxins
Thrombosis, pulmonary |
Thrombosis, coronary |
Vasopressin - CORRECT ANSWER✔✔-ADH | | |
V1 receptors on vascular smooth muscle
| | | | |
V2 receptors on renal collecting ducts(Distal convoluted tubule of the
| | | | | | | | | |
loop of henle)
| |
,Increases water permeability (cAMP-dependent mechanism), which
| | | | | |
leads to decreased urine formation. This increases blood volume,
| | | | | | | | |
cardiac output and arterial pressure.
| | | | |
Contracts vascular smooth muscle -> causes vasoconstriction of
| | | | | | | |
capillaries & small arterioles -> increase MAP
| | | | | |
May improve LV function, which increases CO and coronary blood flow
| | | | | | | | | |
Increases secretion of corticotropin in the anterior pituitary gland that
| | | | | | | | | |
stimulates the adrenal cortex. The adrenal cortex produces cortisol
| | | | | | | | |
which regulates BP. | |
Norepinephrine - CORRECT ANSWER✔✔-Vasopressor (and inotrope) / | | | | | | |
Adrenergic Agonist |
a1 b1 (small b2) - causing vasoconstriction, increased inotropic effects,
| | | | | | | | | |
and cardiac stimulation.
| |
For profound hypotension when volume repletion is inadequate. Can be
| | | | | | | | |
|administered with fluid resus if the pt's BP and CO are significantly
| | | | | | | | | | | |
impaired.
Epinephrine - CORRECT ANSWER✔✔-Adrenergic Agonist / Vasopressor
| | | | | |
, a1 b1 b2
| |
Positive Chronotrope to increase HR in bradycardia. Good in cardiac
| | | | | | | | | |
arrest as it enhances automaticity
| | | | |
For refractory hypotension
| |
Improves cardiac function and enhances SV
| | | | |
Precedex (dexmedetomidine) - CORRECT ANSWER✔✔-a2 agonist
| | | | |
Alpha 2 receptors are responsible for inhibiting presynaptic
| | | | | | | |
norepinephrine production (they SHUT OFF norepi production when
| | | | | | | |
agonized. norepi plays a role in pain signal propagation in the CNS)
| | | | | | | | | | |
Analgesic, Sedative, Anxiolytic
| |
pre-synapse block pain | |
post-synapse decrease BP & HR | | | |
Dexmedetomidine + bupivacaine research study | | | |
