APEX Cardiovascular
Pathophysiology AMD Question and
answers already passed 2026/2027
What disease/symptom is considered the greatest perioperative cardiac risk for an MI and how is it
defined? - correct answer Unstable angina
Defined as Angina at rest
New onset <2months
Longer than 30 min
Increasing symptoms
Symptoms become less responsive to therapy
Name the 6 cardiac risk index qualifiers. - correct answer High risk surgery
Hx of ICD
Hx of CHF
DM
Hx of CVA
Creatinine >2.0
What is the perioperative risk for an MI in the general population compared with a pt who has had an
MI < 3 months> - correct answer General pt: 0.3%
MI <3 months: 30%
Highest risk for reinfarction is how many days, and therefore, AHA recommends elective surgery be
postponed to when after an MI? - correct answer Highest risk is 30 days
Wait 4-6 weeks
,Name 4 high risk (>5%) surgeries according to the AHA cardiac risk guidelines. - correct answer
Emergency (especially in the elderly)
Open Aortic
Peripheral vascular
Long surgical procedures with significant fluid shift/blood loss
Name 5 intermediate risk (1-5%) surgeries according to the AHA cardiac risk guidelines. - correct answer
Head and neck
Intrathoracic/intraperitoneal
Orthopedic
Prostate
Carotid Endarterectomy
Name 5 low risk (<1%) surgeries according to the AHA cardiac risk guidelines. - correct answer
Ambulatory surgery
Cataract
Breast
Endoscopic
Superficial procedures
List the best EKG leads to monitor for ST changes when a normal EKG (or no EKG) is on file. What about
with previously abnormal EKG? - correct answer V3>V4>V5>III>avf
Abnormal: Monitor areas of ischemia
What lead is best to monitor afib/flutter/junctional? - correct answer II
, Which is more sensitive? Cardiac troponins or CKMB? - correct answer Troponins
When is the initial elevation for CKMB, Troponin I and Troponin T? - correct answer 3-12 hours
Which cardiac marker may peak the earliest OR the latest of the 3? - correct answer Troponin T: 12-48
hours
The other 2 peak at 24 hours
Which cardiac maker returns to baseline the earliest? The latest? - correct answer CKMB earliest: 2-3
days
Troponin T: 5-14 days
Troponin I: 5-10days
Decreased ventricular compliance will shift the curve which way? - correct answer Up and to the left
Increased ventricular compliance will shift the curve which way? - correct answer Down and to the right
With decreased ventricular compliance, what happens to the filling pressure in order to maintain
adequate CO? - correct answer Increases
For a condition that reduces ventricular compliance, what two pressures may overestimate LVEDV? -
correct answer CVP and PAOP
What are two common conditions that increase ventricular compliance? - correct answer Aortic
insufficiency and dilated cardiomyopathy.
Why is administering propofol to a pt with CHF dangerous? - correct answer They rely on increased
sympathetic tone and by blunting that, their pressure will drop
Pathophysiology AMD Question and
answers already passed 2026/2027
What disease/symptom is considered the greatest perioperative cardiac risk for an MI and how is it
defined? - correct answer Unstable angina
Defined as Angina at rest
New onset <2months
Longer than 30 min
Increasing symptoms
Symptoms become less responsive to therapy
Name the 6 cardiac risk index qualifiers. - correct answer High risk surgery
Hx of ICD
Hx of CHF
DM
Hx of CVA
Creatinine >2.0
What is the perioperative risk for an MI in the general population compared with a pt who has had an
MI < 3 months> - correct answer General pt: 0.3%
MI <3 months: 30%
Highest risk for reinfarction is how many days, and therefore, AHA recommends elective surgery be
postponed to when after an MI? - correct answer Highest risk is 30 days
Wait 4-6 weeks
,Name 4 high risk (>5%) surgeries according to the AHA cardiac risk guidelines. - correct answer
Emergency (especially in the elderly)
Open Aortic
Peripheral vascular
Long surgical procedures with significant fluid shift/blood loss
Name 5 intermediate risk (1-5%) surgeries according to the AHA cardiac risk guidelines. - correct answer
Head and neck
Intrathoracic/intraperitoneal
Orthopedic
Prostate
Carotid Endarterectomy
Name 5 low risk (<1%) surgeries according to the AHA cardiac risk guidelines. - correct answer
Ambulatory surgery
Cataract
Breast
Endoscopic
Superficial procedures
List the best EKG leads to monitor for ST changes when a normal EKG (or no EKG) is on file. What about
with previously abnormal EKG? - correct answer V3>V4>V5>III>avf
Abnormal: Monitor areas of ischemia
What lead is best to monitor afib/flutter/junctional? - correct answer II
, Which is more sensitive? Cardiac troponins or CKMB? - correct answer Troponins
When is the initial elevation for CKMB, Troponin I and Troponin T? - correct answer 3-12 hours
Which cardiac marker may peak the earliest OR the latest of the 3? - correct answer Troponin T: 12-48
hours
The other 2 peak at 24 hours
Which cardiac maker returns to baseline the earliest? The latest? - correct answer CKMB earliest: 2-3
days
Troponin T: 5-14 days
Troponin I: 5-10days
Decreased ventricular compliance will shift the curve which way? - correct answer Up and to the left
Increased ventricular compliance will shift the curve which way? - correct answer Down and to the right
With decreased ventricular compliance, what happens to the filling pressure in order to maintain
adequate CO? - correct answer Increases
For a condition that reduces ventricular compliance, what two pressures may overestimate LVEDV? -
correct answer CVP and PAOP
What are two common conditions that increase ventricular compliance? - correct answer Aortic
insufficiency and dilated cardiomyopathy.
Why is administering propofol to a pt with CHF dangerous? - correct answer They rely on increased
sympathetic tone and by blunting that, their pressure will drop
