CMC certification Exam Questions with
complete solutions 2024
HIT j(heparin jinduced jthrombocytopenia) j- jANS✓✓-Bivalirudin jand jArgatroban
jare jdirect jthrombin jinhibitors jand jalternatives jfor janticoagulation jfor jpatients
jwith jHIT.
- jHIT jis jan jimmune jmediated jadverse jdrug jreaction jcaused jby jantibodies jthat
jdevelop jafter jexposure jto jheparin, jplatelets jbecome jactivated jplacing jpatients
jat jrisk jfor jdevelopment jof jthrombosis
pericarditis j- jANS✓✓-inflammation jof jpericardial jsac, jchest jpain-
sharp,stabbing, jdull, jachy j
pain jimproved jwith jsitting j&leaning jfoward, jpain jworse jwith jcough, jpositional
jchanges jand jinspiration,
pericardial jfriction jrub, jfever, jDiffuse jST jchanges j(depression jof jPR jinterval,
jconcave jST jsegment jin jlimb jleads,st jelevation jin jleads jI jand jII
Papillary jmuscle jrupture j- jANS✓✓--associated jwith janterior jor jinferior jwall jMI
- jhemodynamic jinstability, jnew jloud jsystolic jmurmur, jacute jmitral jregurgitation,
jlarge jV jwaves jon jPAOP jwaveform
- jtreatment j- jhemodynamic jsupport, jEmergent jsurgical jrepair/valve jreplacement
Ventricular jseptal jrupture j- jANS✓✓--associated jwith jseptal jwall jMI
-oxygen jrich jblood jshunts jto jright jside jof jheart jfrom jthe jleft
Symptoms jof jventricular jseptal jrupture j- jANS✓✓--acute jSOB
-S3 jheart jsound
-crackles
-holosystolic jmurmur
- jPA jCatheter jinsertion--> jfalsely jincreaed jCO, jbecause jCO jreading jis jderived
jfrom jthe jright jventricle, jincreased jSvo2 jdue jto jleft jto jright jshunting, jlarge jV
jwaves jon jCVP jwaveform, jdiagnosed jby jECHO
- jtreatement jsurgical jrepair
cardiogenic jshock j- jANS✓✓-S3 jpulmonary jedema, jtachycardia, jdysrhythmias,
jsigns jof jdecreased jperfusion j(mottling), jdecreased jUOP j<0.5ml/kg/hr,
jhypotension, jlow jCO/CI, jelevated jSVR joften j> j1600 jdynes/sec/cm, jelevated
jRAP/CVP, jPAOP j>16 jmmhg, jdecreased jsvo2 j(<65%)
,other jdiagnostics jfor jcardiogenic jshock j- jANS✓✓-- jcardiac jcatheterization jif
jrelated jto jischemia- jPCI jfor jreperfusion
- jABG- jmixed jrespiratory jand jmetabolic jacidosis:hypoxemia- jlactic jacidosis
jdue jto jdecreased jperfusion jand janaerobic jmetabolism
-ECHO: jdecreased jwall jmotion,reduced jejection jfraction
-Chestxray: jpulmonary jedema j&congestion, jmay jnote jopacity jdue jto jenlarged
jpulmonary jvasculature, jenlarge jd jheart, jKerley jB jlines jin jlower jzones jfrom
jinterstitial jedema, j
- jBUN/CR- jmonitor jfor jacute jkidney jinjury
- jmonitor jother jorgans jfor jdysfunction jand jfailure
supportive jtreatment jfor jcardiogenic jshock j- jANS✓✓--mechanical jsupport
j(IABP,impella)
-vasopressors jto jsupport jblood jpressure j(use jwith jcaution jas jthey jincrease
jSVR jand jworkload jof jheart)
-positive jinotrope jto jimprove jcontractility j
-diuretics j
afterload jreduction j/ jvenous jvasodilators
cardiogenic jpulmonary jedema j- jANS✓✓--fluid jin jthe jalveolus jdue jto jincreased
jalveolar jhydrostatic jpressures
- jimpaired jgas jexchange, jhypercapnia
- jhypoxemia- jS3 jheart jsound, jshortness jof jbreath, jcrackles, jpinky jfrothy
jsputum, janxiety
Causes jof jcardiogenic jpulmonary jedema j- jANS✓✓-myocardial jinfarction, jheart
jfailure, jhypertensive jcrisis, jmitral jregurgitation, jtamponade
Treatment jof jpulmonary jedema j- jANS✓✓--decrease jpreload
-loop jdiuretics
-nitroglycerin
-morphine
- jCPAP jor jBIPAP
- jPositive jinotrope jto jimprove jcontractility
Cardiac joutput j(CO) j- jANS✓✓-4-8 jL/min
Cardiac jindex j(CI) j- jANS✓✓-2.5-4 jL/min/m2
Stroke jvolume j(SV) j- jANS✓✓-50-100 jml/beat
Stroke jvolume jindex j- jANS✓✓-35-60 jml/beat/m2
Right jventricular jstroke jwork jindex j(RVSWI) j- jANS✓✓-5-10 jg/m2/beat
, Left jventricular jstroke jwork jindex j(LVSWI) j- jANS✓✓-50-62 jg/m2/beat
SVO2 j- jANS✓✓-60-75%
Scvo2 j- jANS✓✓-over j70% j(70-85%)
pulmonary jartery jpressure j- jANS✓✓-25/10 jmmHG
PAOP j- jANS✓✓-8-12 jmmHG
RAP/CVP j- jANS✓✓-2-8 jmmHG
SVR j- jANS✓✓-900-1400 jdynes/sec/cm-5
SVRI j- jANS✓✓-1970-2390 jdynes/sec/cm-5/m2
PVR j- jANS✓✓-90-250 jDynes/sec/cm-5
LV jpressure j- jANS✓✓-100 jmmhg
Cardiac joutput jformula j- jANS✓✓-CO=SVxHR
MAP= j- jANS✓✓-CO jx jSVR
Cardiac joutput jcan jbe jmeasures jwith j- jANS✓✓-Pulmonary jartery jcatheter,
jechocardiogram, jindirectly jvia jfunctional jhemodynamics, jnoninvasive jmethods
j(bioreactance jand jcontinuous jdigit jCO), jfick jequation
in jlow joutput jstates jpatients jcompensate jwith j- jANS✓✓-tachycardia, jCO jmay
jbe jnormal jwhen jthe jpatient jis jtachycardic jwith jlower jSV
Stroke jvolume jformula j- jANS✓✓-SV= jend jdiastolic jvolume- jend jsystolic
jvolume j
SV=EDV-ESV
Typical jEDV j- jANS✓✓-120 jml
amount jof jblood jin jthe jheart jat jthe jend jof jdiastole
Typical jESV j- jANS✓✓-50 jml
amount jof jblood jin jthe jventricles jat jend jof jejection/systole
Three jmeasures jthat jcontribute jto jstroke jvolume j- jANS✓✓-contractility,
jpreload, jafterload
complete solutions 2024
HIT j(heparin jinduced jthrombocytopenia) j- jANS✓✓-Bivalirudin jand jArgatroban
jare jdirect jthrombin jinhibitors jand jalternatives jfor janticoagulation jfor jpatients
jwith jHIT.
- jHIT jis jan jimmune jmediated jadverse jdrug jreaction jcaused jby jantibodies jthat
jdevelop jafter jexposure jto jheparin, jplatelets jbecome jactivated jplacing jpatients
jat jrisk jfor jdevelopment jof jthrombosis
pericarditis j- jANS✓✓-inflammation jof jpericardial jsac, jchest jpain-
sharp,stabbing, jdull, jachy j
pain jimproved jwith jsitting j&leaning jfoward, jpain jworse jwith jcough, jpositional
jchanges jand jinspiration,
pericardial jfriction jrub, jfever, jDiffuse jST jchanges j(depression jof jPR jinterval,
jconcave jST jsegment jin jlimb jleads,st jelevation jin jleads jI jand jII
Papillary jmuscle jrupture j- jANS✓✓--associated jwith janterior jor jinferior jwall jMI
- jhemodynamic jinstability, jnew jloud jsystolic jmurmur, jacute jmitral jregurgitation,
jlarge jV jwaves jon jPAOP jwaveform
- jtreatment j- jhemodynamic jsupport, jEmergent jsurgical jrepair/valve jreplacement
Ventricular jseptal jrupture j- jANS✓✓--associated jwith jseptal jwall jMI
-oxygen jrich jblood jshunts jto jright jside jof jheart jfrom jthe jleft
Symptoms jof jventricular jseptal jrupture j- jANS✓✓--acute jSOB
-S3 jheart jsound
-crackles
-holosystolic jmurmur
- jPA jCatheter jinsertion--> jfalsely jincreaed jCO, jbecause jCO jreading jis jderived
jfrom jthe jright jventricle, jincreased jSvo2 jdue jto jleft jto jright jshunting, jlarge jV
jwaves jon jCVP jwaveform, jdiagnosed jby jECHO
- jtreatement jsurgical jrepair
cardiogenic jshock j- jANS✓✓-S3 jpulmonary jedema, jtachycardia, jdysrhythmias,
jsigns jof jdecreased jperfusion j(mottling), jdecreased jUOP j<0.5ml/kg/hr,
jhypotension, jlow jCO/CI, jelevated jSVR joften j> j1600 jdynes/sec/cm, jelevated
jRAP/CVP, jPAOP j>16 jmmhg, jdecreased jsvo2 j(<65%)
,other jdiagnostics jfor jcardiogenic jshock j- jANS✓✓-- jcardiac jcatheterization jif
jrelated jto jischemia- jPCI jfor jreperfusion
- jABG- jmixed jrespiratory jand jmetabolic jacidosis:hypoxemia- jlactic jacidosis
jdue jto jdecreased jperfusion jand janaerobic jmetabolism
-ECHO: jdecreased jwall jmotion,reduced jejection jfraction
-Chestxray: jpulmonary jedema j&congestion, jmay jnote jopacity jdue jto jenlarged
jpulmonary jvasculature, jenlarge jd jheart, jKerley jB jlines jin jlower jzones jfrom
jinterstitial jedema, j
- jBUN/CR- jmonitor jfor jacute jkidney jinjury
- jmonitor jother jorgans jfor jdysfunction jand jfailure
supportive jtreatment jfor jcardiogenic jshock j- jANS✓✓--mechanical jsupport
j(IABP,impella)
-vasopressors jto jsupport jblood jpressure j(use jwith jcaution jas jthey jincrease
jSVR jand jworkload jof jheart)
-positive jinotrope jto jimprove jcontractility j
-diuretics j
afterload jreduction j/ jvenous jvasodilators
cardiogenic jpulmonary jedema j- jANS✓✓--fluid jin jthe jalveolus jdue jto jincreased
jalveolar jhydrostatic jpressures
- jimpaired jgas jexchange, jhypercapnia
- jhypoxemia- jS3 jheart jsound, jshortness jof jbreath, jcrackles, jpinky jfrothy
jsputum, janxiety
Causes jof jcardiogenic jpulmonary jedema j- jANS✓✓-myocardial jinfarction, jheart
jfailure, jhypertensive jcrisis, jmitral jregurgitation, jtamponade
Treatment jof jpulmonary jedema j- jANS✓✓--decrease jpreload
-loop jdiuretics
-nitroglycerin
-morphine
- jCPAP jor jBIPAP
- jPositive jinotrope jto jimprove jcontractility
Cardiac joutput j(CO) j- jANS✓✓-4-8 jL/min
Cardiac jindex j(CI) j- jANS✓✓-2.5-4 jL/min/m2
Stroke jvolume j(SV) j- jANS✓✓-50-100 jml/beat
Stroke jvolume jindex j- jANS✓✓-35-60 jml/beat/m2
Right jventricular jstroke jwork jindex j(RVSWI) j- jANS✓✓-5-10 jg/m2/beat
, Left jventricular jstroke jwork jindex j(LVSWI) j- jANS✓✓-50-62 jg/m2/beat
SVO2 j- jANS✓✓-60-75%
Scvo2 j- jANS✓✓-over j70% j(70-85%)
pulmonary jartery jpressure j- jANS✓✓-25/10 jmmHG
PAOP j- jANS✓✓-8-12 jmmHG
RAP/CVP j- jANS✓✓-2-8 jmmHG
SVR j- jANS✓✓-900-1400 jdynes/sec/cm-5
SVRI j- jANS✓✓-1970-2390 jdynes/sec/cm-5/m2
PVR j- jANS✓✓-90-250 jDynes/sec/cm-5
LV jpressure j- jANS✓✓-100 jmmhg
Cardiac joutput jformula j- jANS✓✓-CO=SVxHR
MAP= j- jANS✓✓-CO jx jSVR
Cardiac joutput jcan jbe jmeasures jwith j- jANS✓✓-Pulmonary jartery jcatheter,
jechocardiogram, jindirectly jvia jfunctional jhemodynamics, jnoninvasive jmethods
j(bioreactance jand jcontinuous jdigit jCO), jfick jequation
in jlow joutput jstates jpatients jcompensate jwith j- jANS✓✓-tachycardia, jCO jmay
jbe jnormal jwhen jthe jpatient jis jtachycardic jwith jlower jSV
Stroke jvolume jformula j- jANS✓✓-SV= jend jdiastolic jvolume- jend jsystolic
jvolume j
SV=EDV-ESV
Typical jEDV j- jANS✓✓-120 jml
amount jof jblood jin jthe jheart jat jthe jend jof jdiastole
Typical jESV j- jANS✓✓-50 jml
amount jof jblood jin jthe jventricles jat jend jof jejection/systole
Three jmeasures jthat jcontribute jto jstroke jvolume j- jANS✓✓-contractility,
jpreload, jafterload
