Cardiogenic Shock

Question 1

Effect of IABP on LV

Answer 1

Decreases stress from afterload, increases CO, coronary blood flow W/O increasing myocardial O2 demand, augments diastolic pressure

Question 2

Timing of IABP

Answer 2

Inflated - diastole; deflated - systole

Question 3

ST Elevation on EKG - II, III, aVF

Answer 3

Inferior wall

Question 4

ST Elevation on EKG - V1-V4

Answer 4

Anterior wall

Question 5

ST Elevation on EKG - I, aVL, V5-6

Answer 5

Lateral wall - LV

Question 6

Global ST Segment Elevation

Answer 6

Pericarditis. Treat w/ O2, NSAIDS - toradol, and steroids.

Question 7

Inotropes

Answer 7

Increase contractility. Examples include: Digoxin, dobutamine, dopamine, epi, norepi…

Question 8

What is seen w/ RV infarct?

Answer 8

Increased RAP (CVP). Decreased PAOP d/T decreased blood flow to LV.
Normal CVP: 2-8
Normal PAOP: 8-12

Question 9

Commotio Cordis

Answer 9

Occurs when the precordial area of chest is struck during refractory period of cardiac cycle (T wave) resulting in VF or asystole.

Question 10

Pericardial tamponade: S/S

Answer 10

Narrow pulse pressure, jugular vein distention, muffled heart tones - Beck’s triad. TX - pericardiocentesis

Question 11

What indicates the IABP is supporting perfusion of coronary arteries?

Answer 11

Peak of augmented diastole > than peak of unassisted systole.

Question 12

What EKG change is seen w/ hypercalcemia?

Answer 12

Shortened ST segments, prolonged PR interval, lengthening of QRS, flattened or inverse T wave.

Question 13

Probable cause of an U-wave on EKG?

Answer 13

Hyperkalemia

Question 14

Which med has been removed from ACLS algorithm?

Answer 14

Vasopressin