MORGAN AND MIKHAILS CLINICAL
ANESTHESIOLOGY EXAM 2025
ORGANIZED QUESTIONS AND 100%
CORRECT EXPERT VERIFIED ANSWERS
GRADED A+ (ORIGINAL COPY!!!!!)
Exaggerated variations in size during respiratory cycle =
hypovolemia
CVC indications - THE CORRECT ANSWER-- Monitoring central
venous pressure
- Administration of fluids to treat hypovolemia and shock
- Infusion of caustic drugs and TPN
- Aspiration of air emboli
- Insertion of transcutaneous pacing leads
- Gaining venous access in pts with poor peripheral veins.
CVC contraindications: - THE CORRECT ANSWER-Relative: tumors,
clots, tricuspid valve vegetations that could be dislodged or
embolized during cannulation.
Subclavian CVC is relatively contraindicated in pts on what
class of medication? - THE CORRECT ANSWER-Anticoagulants: due to
inability to provide direct compression in the event of an
accidental arterial puncture
,Optimal placement of CVC catheter tip? - THE CORRECT ANSWER-
Just superior to or at the junction of the SVC and the right
atrium
Left IJ CVC placement has an increased risk of this unique
complication? - THE CORRECT ANSWER-Pleural effusion and
chylothorax
Risks of CVC placement? - THE CORRECT ANSWER-- Line
infection/bloodstream infection
- Air or thrombus embolism
- Arrhythmia (catheter tip is in the RA or RV).
- Hematoma, thrombosis
- Pneumothorax, hemothorax, hydrothorax, chylothorax (left IJ
placement).
- Cardiac perforation with cardiac tamponade
- Trauma to nearby nerves and arteries
Central venous pressure (CVP) approximates pressure in which
chamber of the heart? - THE CORRECT ANSWER-Right atrium
Very low CVP may indicate?
Very high CVP may indicate? - THE CORRECT ANSWER-Volume
depleted pt
,Volume overloaded pt, poor ventricular compliance, or both.
central venous tracing - THE CORRECT ANSWER-A wave = atrial
contraction (absent in pts with A-fib, exaggerated in pts with
junctional rhythms)
C wave = tricuspid elevation during ventricular contraction
X and Y descents = downward displacement of the tricuspid
valve during systole and tricuspid valve opening during
diastole.
V wave = venous return against a closed tricuspid valve.
Function of a Pulmonary artery (Swan-Ganz) Catheter? - THE
CORRECT ANSWER-Catheter provides measurements of both cardiac
output and pulmonary artery occlusion (wedge) pressures and
was used to guide hemodynamic therapy, esp when pts became
unstable.
Indications for Pulmonary artery (Swan-Ganz) Catheter? - THE
CORRECT ANSWER-PA (Swan Ganz) catheterization should be
considered whenever cardiac index, preload, volume status, or
the degree of mixed venous blood oxygenation need to be
known.
These measurements might prove particularly important in
surgical patients at greatest risk for hemodynamic instability or
during surgical procedures associated with greatly increased
incidence of hemodynamic complications (thoracic aortic
aneurysm repair)
Determination of the "wedge" or pulmonary capillary occlusion
pressure by inflating the Swan Ganz catheter estimates
, __________? - THE CORRECT ANSWER-Left ventricular end
diastolic pressure.
***When the balloon tipped catheter wedges/occludes the
pulmonary artery branch, the pulmonary artery pressure
equates the left atrium, which should be a reflection of the LV
end diastolic pressure.
A decreased stroke volume in the setting of a low LV end
diastolic pressure indicates? - THE CORRECT ANSWER-Hypovolemia
and the need for volume administration
A low stroke volume in the setting of a high LV end diastolic
pressure indicates? - THE CORRECT ANSWER-A "Full" heart in need of
a positive inotropic drug.
A normal or increased stroke volume in the setting of low LV
end diastolic pressure indicates need for? - THE CORRECT ANSWER-
vasopressors to restore SVR in a vasodilated patient.
Contraindications for PA (Swan Ganz) catheter? - THE CORRECT
ANSWER-- LBBB (due to concern for complete heart block)
- Conditions associated with a greatly increased risk of
arrhythmia.
Complications of PA catheters? - THE CORRECT ANSWER-All of the
complications associated with CVC catheterization, as well as:
- Endocarditis
ANESTHESIOLOGY EXAM 2025
ORGANIZED QUESTIONS AND 100%
CORRECT EXPERT VERIFIED ANSWERS
GRADED A+ (ORIGINAL COPY!!!!!)
Exaggerated variations in size during respiratory cycle =
hypovolemia
CVC indications - THE CORRECT ANSWER-- Monitoring central
venous pressure
- Administration of fluids to treat hypovolemia and shock
- Infusion of caustic drugs and TPN
- Aspiration of air emboli
- Insertion of transcutaneous pacing leads
- Gaining venous access in pts with poor peripheral veins.
CVC contraindications: - THE CORRECT ANSWER-Relative: tumors,
clots, tricuspid valve vegetations that could be dislodged or
embolized during cannulation.
Subclavian CVC is relatively contraindicated in pts on what
class of medication? - THE CORRECT ANSWER-Anticoagulants: due to
inability to provide direct compression in the event of an
accidental arterial puncture
,Optimal placement of CVC catheter tip? - THE CORRECT ANSWER-
Just superior to or at the junction of the SVC and the right
atrium
Left IJ CVC placement has an increased risk of this unique
complication? - THE CORRECT ANSWER-Pleural effusion and
chylothorax
Risks of CVC placement? - THE CORRECT ANSWER-- Line
infection/bloodstream infection
- Air or thrombus embolism
- Arrhythmia (catheter tip is in the RA or RV).
- Hematoma, thrombosis
- Pneumothorax, hemothorax, hydrothorax, chylothorax (left IJ
placement).
- Cardiac perforation with cardiac tamponade
- Trauma to nearby nerves and arteries
Central venous pressure (CVP) approximates pressure in which
chamber of the heart? - THE CORRECT ANSWER-Right atrium
Very low CVP may indicate?
Very high CVP may indicate? - THE CORRECT ANSWER-Volume
depleted pt
,Volume overloaded pt, poor ventricular compliance, or both.
central venous tracing - THE CORRECT ANSWER-A wave = atrial
contraction (absent in pts with A-fib, exaggerated in pts with
junctional rhythms)
C wave = tricuspid elevation during ventricular contraction
X and Y descents = downward displacement of the tricuspid
valve during systole and tricuspid valve opening during
diastole.
V wave = venous return against a closed tricuspid valve.
Function of a Pulmonary artery (Swan-Ganz) Catheter? - THE
CORRECT ANSWER-Catheter provides measurements of both cardiac
output and pulmonary artery occlusion (wedge) pressures and
was used to guide hemodynamic therapy, esp when pts became
unstable.
Indications for Pulmonary artery (Swan-Ganz) Catheter? - THE
CORRECT ANSWER-PA (Swan Ganz) catheterization should be
considered whenever cardiac index, preload, volume status, or
the degree of mixed venous blood oxygenation need to be
known.
These measurements might prove particularly important in
surgical patients at greatest risk for hemodynamic instability or
during surgical procedures associated with greatly increased
incidence of hemodynamic complications (thoracic aortic
aneurysm repair)
Determination of the "wedge" or pulmonary capillary occlusion
pressure by inflating the Swan Ganz catheter estimates
, __________? - THE CORRECT ANSWER-Left ventricular end
diastolic pressure.
***When the balloon tipped catheter wedges/occludes the
pulmonary artery branch, the pulmonary artery pressure
equates the left atrium, which should be a reflection of the LV
end diastolic pressure.
A decreased stroke volume in the setting of a low LV end
diastolic pressure indicates? - THE CORRECT ANSWER-Hypovolemia
and the need for volume administration
A low stroke volume in the setting of a high LV end diastolic
pressure indicates? - THE CORRECT ANSWER-A "Full" heart in need of
a positive inotropic drug.
A normal or increased stroke volume in the setting of low LV
end diastolic pressure indicates need for? - THE CORRECT ANSWER-
vasopressors to restore SVR in a vasodilated patient.
Contraindications for PA (Swan Ganz) catheter? - THE CORRECT
ANSWER-- LBBB (due to concern for complete heart block)
- Conditions associated with a greatly increased risk of
arrhythmia.
Complications of PA catheters? - THE CORRECT ANSWER-All of the
complications associated with CVC catheterization, as well as:
- Endocarditis
