ECMO SPECIALIST EXAM QUESTIONS WITH WELL DETAILED ANSWERS PLUS
RATIONALES/GRADE A+ ASSURED!!
Question 1
Which acronym is used to remember the key signs for recognizing cardiogenic shock?
A) ECLS
B) ARDS
C) CS-MODE
D) PAPI
E) CPO
Correct Answer: C) CS-MODE
Rationale: CS-MODE stands for Cardiac Rhythm, SBP <90, Markers- cardiac, Output- oliguria,
Drips - Inotropes/pressors, and Exam - cool, clammy, resp distress, which are the key
indicators for recognizing cardiogenic shock.
Question 2
According to the ECLS acronym for diagnosing shock, what does the 'S' stand for?
A) Sepsis screen
B) SBP <90
C) Surgeon consult
D) Swan catheter
E) Sedation level
Correct Answer: D) Swan catheter
Rationale: The ECLS acronym for diagnosing shock includes ECG, Consult- surgeon, Labs-
lactates, abgs etc., and Swan catheter.
Question 3
What is the primary purpose of calculating the Pulmonary Artery Pulsatility Index (PAPi) score?
A) To determine the cardiac power output
B) To differentiate between LV and RV dysfunction
C) To measure the degree of anaerobic metabolism
D) To assess the severity of ARDS
,E) To calculate the required ECMO flow rate
Correct Answer: B) To differentiate between LV and RV dysfunction
Rationale: The PAPi score is used to differentiate between left ventricular and right ventricular
dysfunction. A low score is indicative of RV dysfunction.
Question 4
What is the correct formula for calculating the PAPi score?
A) (sPAP + dPAP) / RA
B) RA / (sPAP - dPAP)
C) MAP x CO / 451
D) (sPAP - dPAP) / RA
E) (sPAP - RA) / dPAP
Correct Answer: D) (sPAP - dPAP) / RA
Rationale: The formula for PAPi is the systolic pulmonary artery pressure (sPAP) minus the
diastolic pulmonary artery pressure (dPAP), divided by the right atrial (RA) pressure.
Question 5
A patient's PAPi score is calculated to be 0.8. What does this value typically indicate?
A) Normal right ventricular function
B) Severe left ventricular dysfunction
C) Right ventricular dysfunction
D) Normal biventricular function
E) Severe aortic stenosis
Correct Answer: C) Right ventricular dysfunction
Rationale: A normal PAPi score is >1.0. A score less than 1.0, such as 0.8, is indicative of right
ventricular dysfunction.
Question 6
What is the formula used to calculate Cardiac Power Output (CPO)?
A) (sPAP - dPAP) / RA
B) MAP x CO / 451
,C) CaO2 x CO x 10
D) ECMO flow x (s1-s2)/(s3-s2)
E) (Hgb x 1.34) x SaO2
Correct Answer: B) MAP x CO / 451
Rationale: The formula for Cardiac Power Output is the Mean Arterial Pressure (MAP)
multiplied by the Cardiac Output (CO), divided by 451.
Question 7
What is considered a normal value for Cardiac Power Output (CPO)?
A) 0.1 to 0.5 W
B) 2.0 to 3.0 W
C) <0.6 W
D) 5.0 to 6.0 W
E) 0.7 to 1.0 W
Correct Answer: E) 0.7 to 1.0 W
Rationale: A normal CPO value ranges from 0.7 to 1.0 Watts. It represents the energy available
to maintain vital organ perfusion.
Question 8
Which of the following are considered the three key measurements for assessing cardiogenic
shock?
A) PAPi, CPO, and Lactate
B) CVP, MAP, and Heart Rate
C) SVO2, CPO, and dPAP
D) Lactate, CVP, and PAPi
E) Ejection Fraction, CPO, and sPAP
Correct Answer: A) PAPi, CPO, and Lactate
Rationale: The three key measurements used to evaluate and manage cardiogenic shock are
the PAPi score, Cardiac Power Output, and serum Lactate levels.
, Question 9
What physiological process does an elevated blood lactate level indicate?
A) Aerobic metabolism
B) Normal organ perfusion
C) Anaerobic metabolism
D) Adequate oxygen delivery
E) Hyper-oxygenation
Correct Answer: C) Anaerobic metabolism
Rationale: Lactate is a byproduct of anaerobic metabolism, which occurs when tissues are not
receiving enough oxygen to meet their metabolic demands.
Question 10
What is the normal range for blood lactate?
A) 3.0 to 4.5 mmol/L
B) <0.5 mmol/L
C) 0.9 to 1.7 mmol/L
D) 2.5 to 3.5 mmol/L
E) >2.0 mmol/L
Correct Answer: C) 0.9 to 1.7 mmol/L
Rationale: The normal value for blood lactate is between 0.9 and 1.7 mmol/L. Levels above
this range suggest tissue hypoperfusion.
Question 11
What are the two primary goals of mechanical circulatory support like ECMO?
A) Increase blood pressure and heart rate
B) Restore adequate end-organ perfusion and ventricular unloading
C) Decrease lactate and increase CVP
D) Replace cardiac function and replace pulmonary function
E) Provide anticoagulation and reduce inflammation
Correct Answer: B) Restore adequate end-organ perfusion and ventricular unloading
RATIONALES/GRADE A+ ASSURED!!
Question 1
Which acronym is used to remember the key signs for recognizing cardiogenic shock?
A) ECLS
B) ARDS
C) CS-MODE
D) PAPI
E) CPO
Correct Answer: C) CS-MODE
Rationale: CS-MODE stands for Cardiac Rhythm, SBP <90, Markers- cardiac, Output- oliguria,
Drips - Inotropes/pressors, and Exam - cool, clammy, resp distress, which are the key
indicators for recognizing cardiogenic shock.
Question 2
According to the ECLS acronym for diagnosing shock, what does the 'S' stand for?
A) Sepsis screen
B) SBP <90
C) Surgeon consult
D) Swan catheter
E) Sedation level
Correct Answer: D) Swan catheter
Rationale: The ECLS acronym for diagnosing shock includes ECG, Consult- surgeon, Labs-
lactates, abgs etc., and Swan catheter.
Question 3
What is the primary purpose of calculating the Pulmonary Artery Pulsatility Index (PAPi) score?
A) To determine the cardiac power output
B) To differentiate between LV and RV dysfunction
C) To measure the degree of anaerobic metabolism
D) To assess the severity of ARDS
,E) To calculate the required ECMO flow rate
Correct Answer: B) To differentiate between LV and RV dysfunction
Rationale: The PAPi score is used to differentiate between left ventricular and right ventricular
dysfunction. A low score is indicative of RV dysfunction.
Question 4
What is the correct formula for calculating the PAPi score?
A) (sPAP + dPAP) / RA
B) RA / (sPAP - dPAP)
C) MAP x CO / 451
D) (sPAP - dPAP) / RA
E) (sPAP - RA) / dPAP
Correct Answer: D) (sPAP - dPAP) / RA
Rationale: The formula for PAPi is the systolic pulmonary artery pressure (sPAP) minus the
diastolic pulmonary artery pressure (dPAP), divided by the right atrial (RA) pressure.
Question 5
A patient's PAPi score is calculated to be 0.8. What does this value typically indicate?
A) Normal right ventricular function
B) Severe left ventricular dysfunction
C) Right ventricular dysfunction
D) Normal biventricular function
E) Severe aortic stenosis
Correct Answer: C) Right ventricular dysfunction
Rationale: A normal PAPi score is >1.0. A score less than 1.0, such as 0.8, is indicative of right
ventricular dysfunction.
Question 6
What is the formula used to calculate Cardiac Power Output (CPO)?
A) (sPAP - dPAP) / RA
B) MAP x CO / 451
,C) CaO2 x CO x 10
D) ECMO flow x (s1-s2)/(s3-s2)
E) (Hgb x 1.34) x SaO2
Correct Answer: B) MAP x CO / 451
Rationale: The formula for Cardiac Power Output is the Mean Arterial Pressure (MAP)
multiplied by the Cardiac Output (CO), divided by 451.
Question 7
What is considered a normal value for Cardiac Power Output (CPO)?
A) 0.1 to 0.5 W
B) 2.0 to 3.0 W
C) <0.6 W
D) 5.0 to 6.0 W
E) 0.7 to 1.0 W
Correct Answer: E) 0.7 to 1.0 W
Rationale: A normal CPO value ranges from 0.7 to 1.0 Watts. It represents the energy available
to maintain vital organ perfusion.
Question 8
Which of the following are considered the three key measurements for assessing cardiogenic
shock?
A) PAPi, CPO, and Lactate
B) CVP, MAP, and Heart Rate
C) SVO2, CPO, and dPAP
D) Lactate, CVP, and PAPi
E) Ejection Fraction, CPO, and sPAP
Correct Answer: A) PAPi, CPO, and Lactate
Rationale: The three key measurements used to evaluate and manage cardiogenic shock are
the PAPi score, Cardiac Power Output, and serum Lactate levels.
, Question 9
What physiological process does an elevated blood lactate level indicate?
A) Aerobic metabolism
B) Normal organ perfusion
C) Anaerobic metabolism
D) Adequate oxygen delivery
E) Hyper-oxygenation
Correct Answer: C) Anaerobic metabolism
Rationale: Lactate is a byproduct of anaerobic metabolism, which occurs when tissues are not
receiving enough oxygen to meet their metabolic demands.
Question 10
What is the normal range for blood lactate?
A) 3.0 to 4.5 mmol/L
B) <0.5 mmol/L
C) 0.9 to 1.7 mmol/L
D) 2.5 to 3.5 mmol/L
E) >2.0 mmol/L
Correct Answer: C) 0.9 to 1.7 mmol/L
Rationale: The normal value for blood lactate is between 0.9 and 1.7 mmol/L. Levels above
this range suggest tissue hypoperfusion.
Question 11
What are the two primary goals of mechanical circulatory support like ECMO?
A) Increase blood pressure and heart rate
B) Restore adequate end-organ perfusion and ventricular unloading
C) Decrease lactate and increase CVP
D) Replace cardiac function and replace pulmonary function
E) Provide anticoagulation and reduce inflammation
Correct Answer: B) Restore adequate end-organ perfusion and ventricular unloading
