Cardiology

Question 1

How are CVP, PCWP, Cardiac index, SVR, and SvO2 impacted in the setting of hypovolemic shock?

Answer 1

CVP ↓
PCWP ↓
Cardiac index ↓
SVR ↑
SvO2 ↓

Question 2

How are CVP, PCWP, Cardiac index, SVR, and SvO2 impacted in the setting of cariogenic shock?

Answer 2

CVP ↑
PCWP ↑
Cardiac index ↓
SVR ↑
SvO2 ↓

Question 3

How are CVP, PCWP, Cardiac index, SVR, and SvO2 impacted in the setting of obstructive shock?

Answer 3

CVP ↑
PCWP ↑
Cardiac index ↓
SVR ↑
SvO2 ↓

Question 4

How are CVP, PCWP, Cardiac index, SVR, and SvO2 impacted in the setting of distributive shock?

Answer 4

CVP ↓
PCWP ↓/－
Cardiac index ↑
SVR ↓
SvO2 ↑

Question 5

What are the indications for statin therapy in the prevention of ASCVD?

Answer 5

• Hx of clinical ASCVD (ACS, stable angina, CABG, PAD, stroke, or TIA)
• LDL > 190
• Age ≥40 with DM
• ASCVD 10-year risk > 7.5%

Question 6

How is atrial fibrillation (including a fib w/ RVR) with hemodynamic instability managed?

Answer 6

Synchronized direct current cardioversion

Question 7

How is chronic atrial fibrillation managed?

Answer 7

• 3 weeks of Anticoagulation
• TEE (to make sure no clot in the atrial appendage)
• Anticoagulation
• Rate/rhythm control

Question 8

How is ventricular tachycardia or pulseless VT managed?

Answer 8

If hemodynamically stable: Meds: amiodarone, lidocaine, then procainamide. If meds fail, cardiovert.

If hemodynamically unstable: electrical cardio version followed by meds:
2 min of CPR (+Epinephrine) → SHOCK⚡️→ 2 min of CPR (+Amiodarone) → SHOCK⚡️→ 2 min of CPR (+Epinephrine) → SHOCK⚡️→ 2 min of CPR (+Amiodarone)

Question 9

How is ventricular fibrillation managed?

Answer 9

V-fib = De-fib (Defibrillation aka unsynchronized cardioversion)

Question 10

How is asystole managed?

Answer 10

Epinephrine