36. Cardiovascular monitoring

Question 1

Pulse deficit

Answer 1

HR - Pulse rate

Question 2

ECG filters. Types and range

Answer 2

Diagnostic 0.05-150 Hz. Good for spiking (pacemaker)
Monitor 0.05-40 Hz (ST)
Filter 0.5-20Hz (the best for noise)

Question 3

Usually gain at ECG

Answer 3

10 mm/mV

Question 4

ST elevation

Answer 4

Transmural ischemia

Question 5

ST depression

Answer 5

Subendocardial ischemia
Transmural ischemia in contralateral leads

Question 6

NIBP and MAP estimation

Answer 6

MAP tends to be underestimated during HyperT
MAP tends to overestimate during HypoT

Question 7

Dicrotic notch
Anacrotic notch

Answer 7

Dicrotic notch Aortic valve closes
Anacrotic notch Aortic stenosis

Question 8

Aortic stenosis sounds

Answer 8

Pulsus parvus (narrow Pulse pressure)
Pulsus tardus (delayed upstroke)

Question 9

Aortic regurgitation sound

Answer 9

Pulsus bisferiens (double peak)
Wide PP

Question 10

Sound in cardiac tamponade

Answer 10

Pulsus paradoxus

Question 11

Sound in Left ventricular failure

Answer 11

Pulsus alternans

Question 12

Sound in hypertrophic cardiomyopathy

Answer 12

Spike and dome

Question 13

CVP letters and meaning

Answer 13

a - End diastolic (atrial contraction)
c - Early systolic (TC closes)
x - Mid S
v - Late S
y - Early D (tricuspid opens)
h - Mid late D

Question 14

Rigth pressures. Atrium, ventricle, PA, PAW

Answer 14

RA a - 6 v - 5 Mean 3
RV 25/6
PA 25/9 (15)
PAW 9

Question 15

CVP in A fib, Tricuspid Reg, T stenosis

Answer 15

Afib. No a, tall C
TR. Tall c-v
TSt. Tall a

Question 16

SVR formula

Answer 16

(MAP-CVP) *80/CO

Question 17

PVR formula

Answer 17

(MPAP - PAWP )*80/CO

Question 18

Radial vs Axillary a line (systolic, diastolic, PP, D. notch)

Answer 18

Radial. Increase Systolic, decrease diastolic, PP wider, D notch faster
Axillary opposite

Question 19

Best lead in ECG for ischemia

Answer 19

V5 75%
II + V5 80%
II + V4 + V5 100%

Question 20

Positioning on NIBP

Answer 20

40 % of arm circumference, 80% length of the upper

Question 21

Hypovolemia hypervolemia and BP

Answer 21

Hypo overestimates
Hyper underestimates

Question 22

Gold standard for CO

Answer 22

Thermodilution

Question 23

Korotoff characteristics

Answer 23

Turbulence sounds
To measure BP
NO measure MAP

Question 24

Compare to A line, NIBP

Answer 24

Underestimates systolic
Overestimates diastolic

Question 25

Acceptable difference between NIBP and A line

Answer 25

20 mmHg

Question 26

Location of A line transducers

Answer 26

5 cm posterior to sternum

Question 27

Zone for PA wedge

Answer 27

Zone 3

Question 28

How do the monitor measure heart rate

Answer 28

R - R interval in ECG

Question 29

Damped waveform

Answer 29

Under. Systolic pressure overshoot.
Over. Flat waveform

Question 30

Systolic upstroke in ECG

Answer 30

R wave

Question 31

Pulse pressure variation normal until

Answer 31

13-17%

Question 32

Systolic pressure variation normal until

Answer 32

5-6 mmHg

Question 33

Mitral Reg wedge pressure waveform

Answer 33

Prominent V

Question 34

Square root sign in ECG

Answer 34

Constrictive pericarditis