BRAINSCAPE1
HFHS Critical Care Exam with
complete solutions latest version
5 points/location of Cardiac Assessment Landmarks - CORRECT ANSWER-Aortic- R
sternal border, 2nd ICS
Pulmonic- L sternal border, 2nd ICS
Erbs point- L sternal border, 3rd ICS
Tricuspid- L sternal border, 4th ICS
Mitral- L MCL, 5th ICS
s1- closure of mitral-tricuspid
s2- closure of aortic-pulmonic
Normal PR interval - CORRECT ANSWER-0.12-0.20 seconds (3-5 small boxes)
Normal QRS interval - CORRECT ANSWER-0.06 - 0.10 sec, anything greater than 0.12
sec is considered prolonged
(1 - 3 small boxes)
Normal QT interval - CORRECT ANSWER-0.36 to 0.44 seconds (9-11 boxes)
Define pacing threshold. - CORRECT ANSWER-The minimum amount of energy
needed required for the pacemaker to cause the cardiac mm to depolarize/respond
--- ex. If there is failure to capture, try increasing the pacing threshold
Define Cardioversion vs Defibrillation & give energy levels - CORRECT ANSWER-
Cardioversion- Shock given to pt who has a pulse but it hemodynamically unstable. ex.
afib, aflutter, vtach with pulse
Defibrillation- shock given to pt who does NOT have a pulse. ex. pulseless VTACH, vfib
Biphasic energy- 120-200 joules
First reaction to pulseless VTACH or vfib? & 2 drugs - CORRECT ANSWER-Defibrillate
then EPI then amio
First reaction to PEA/asystole? - CORRECT ANSWER-not a shockable rhythm. EPI
only/reversible causes
BRAINSCAPE1
, BRAINSCAPE1
H & T's - CORRECT ANSWER-Hypovolemia
Hypoxia
Hypoglycemia
Hydrogen/acidosis
Hypo-Hyperkalemia
Hypothermia
Cardiac Tamponade
Tension pneumo
Toxins
Pulmonary Thrombosis
Cardiac Thrombosis
ACLS bradycardia - CORRECT ANSWER-1mg atropine every 3-5 mins up to 3mg
-If not effective consider transcutaneous pacing or dopamine/epi infusion
Hypokalemia on EKG - CORRECT ANSWER-Flat t wave or u wave
Hyperkalemia on EKG - CORRECT ANSWER-peaked t wave
Acidosis on EKG - CORRECT ANSWER-Low amplitude of QRS
Tension pneumo on EKG - CORRECT ANSWER-Slow HR/Narrow QRS
Cardiac tamponade/PE on EKG - CORRECT ANSWER-Rapid HR/Narrow QRS
ACLS tx for stable tachycardia - CORRECT ANSWER-Vasovagal maneuvers;
adenosine 6mg then 12mg then progress to procainamide/amio bolus and inufsion
ACLS tx for unstable tachycardia - CORRECT ANSWER-synchronized cardioversion
Define Point of Maximal Impulse - CORRECT ANSWER-point of maximal impulse
against the chest that can be felt
-at apex of heart; L MCL, 5th ICS
Calculate pulse pressure - CORRECT ANSWER-systolic pressure - diastolic pressure
normal: 40-60 mmHg
narrow= heart failure, hypotension
wide= HTN, atherosclerosis
normal cardiac output - CORRECT ANSWER-4-8 L/min
Low- dehydrated, heart attack, valve disease, arrhythmias, pulm disease, HF, HTN
(high afterload)
High- anemia, hyperthryoidism
normal cardiac index - CORRECT ANSWER-2.5-4 L/min
BRAINSCAPE1
HFHS Critical Care Exam with
complete solutions latest version
5 points/location of Cardiac Assessment Landmarks - CORRECT ANSWER-Aortic- R
sternal border, 2nd ICS
Pulmonic- L sternal border, 2nd ICS
Erbs point- L sternal border, 3rd ICS
Tricuspid- L sternal border, 4th ICS
Mitral- L MCL, 5th ICS
s1- closure of mitral-tricuspid
s2- closure of aortic-pulmonic
Normal PR interval - CORRECT ANSWER-0.12-0.20 seconds (3-5 small boxes)
Normal QRS interval - CORRECT ANSWER-0.06 - 0.10 sec, anything greater than 0.12
sec is considered prolonged
(1 - 3 small boxes)
Normal QT interval - CORRECT ANSWER-0.36 to 0.44 seconds (9-11 boxes)
Define pacing threshold. - CORRECT ANSWER-The minimum amount of energy
needed required for the pacemaker to cause the cardiac mm to depolarize/respond
--- ex. If there is failure to capture, try increasing the pacing threshold
Define Cardioversion vs Defibrillation & give energy levels - CORRECT ANSWER-
Cardioversion- Shock given to pt who has a pulse but it hemodynamically unstable. ex.
afib, aflutter, vtach with pulse
Defibrillation- shock given to pt who does NOT have a pulse. ex. pulseless VTACH, vfib
Biphasic energy- 120-200 joules
First reaction to pulseless VTACH or vfib? & 2 drugs - CORRECT ANSWER-Defibrillate
then EPI then amio
First reaction to PEA/asystole? - CORRECT ANSWER-not a shockable rhythm. EPI
only/reversible causes
BRAINSCAPE1
, BRAINSCAPE1
H & T's - CORRECT ANSWER-Hypovolemia
Hypoxia
Hypoglycemia
Hydrogen/acidosis
Hypo-Hyperkalemia
Hypothermia
Cardiac Tamponade
Tension pneumo
Toxins
Pulmonary Thrombosis
Cardiac Thrombosis
ACLS bradycardia - CORRECT ANSWER-1mg atropine every 3-5 mins up to 3mg
-If not effective consider transcutaneous pacing or dopamine/epi infusion
Hypokalemia on EKG - CORRECT ANSWER-Flat t wave or u wave
Hyperkalemia on EKG - CORRECT ANSWER-peaked t wave
Acidosis on EKG - CORRECT ANSWER-Low amplitude of QRS
Tension pneumo on EKG - CORRECT ANSWER-Slow HR/Narrow QRS
Cardiac tamponade/PE on EKG - CORRECT ANSWER-Rapid HR/Narrow QRS
ACLS tx for stable tachycardia - CORRECT ANSWER-Vasovagal maneuvers;
adenosine 6mg then 12mg then progress to procainamide/amio bolus and inufsion
ACLS tx for unstable tachycardia - CORRECT ANSWER-synchronized cardioversion
Define Point of Maximal Impulse - CORRECT ANSWER-point of maximal impulse
against the chest that can be felt
-at apex of heart; L MCL, 5th ICS
Calculate pulse pressure - CORRECT ANSWER-systolic pressure - diastolic pressure
normal: 40-60 mmHg
narrow= heart failure, hypotension
wide= HTN, atherosclerosis
normal cardiac output - CORRECT ANSWER-4-8 L/min
Low- dehydrated, heart attack, valve disease, arrhythmias, pulm disease, HF, HTN
(high afterload)
High- anemia, hyperthryoidism
normal cardiac index - CORRECT ANSWER-2.5-4 L/min
BRAINSCAPE1
