CCI RCIS 2 — Questions and Answers
Question 1: During a right heart catheterization, the pulmonary artery wedge pressure (PAWP) is used to estimate which pressure?
- Right atrial pressure
- Left ventricular end-diastolic pressure (Correct answer)
- Pulmonary artery systolic pressure
- Right ventricular systolic pressure
Correct answer: Left ventricular end-diastolic pressure
PAWP approximates left ventricular end-diastolic pressure (LVEDP) when the mitral valve is normal, reflecting left heart filling pressures.
Question 2: Which vascular access site is MOST associated with retroperitoneal hemorrhage as a complication?
- Radial artery
- Brachial artery
- Femoral artery above the inguinal ligament (Correct answer)
- Femoral artery below the inguinal ligament
Correct answer: Femoral artery above the inguinal ligament
High femoral puncture above the inguinal ligament can lacerate vessels in the retroperitoneal space, making hemorrhage difficult to detect and compress.
Question 3: The Fick method for calculating cardiac output requires measurement of which values?
- Heart rate and stroke volume
- Oxygen consumption and arteriovenous oxygen difference (Correct answer)
- Thermodilution curve area and injectate temperature
- Mean arterial pressure and systemic vascular resistance
Correct answer: Oxygen consumption and arteriovenous oxygen difference
The Fick equation divides oxygen consumption (VO2) by the arteriovenous oxygen content difference to yield cardiac output.
Question 4: A patient develops sudden hypotension and elevated jugular venous pressure immediately after a coronary intervention. The MOST likely diagnosis is:
- Vasovagal reaction
- Cardiac tamponade (Correct answer)
- Contrast nephropathy
- Air embolism
Correct answer: Cardiac tamponade
Cardiac tamponade classically presents with hypotension, elevated venous pressure, and muffled heart sounds (Beck's triad) after perforation.
Question 5: Which radiation protection principle states that dose decreases with the square of the distance from the source?
- ALARA
- Inverse square law (Correct answer)
- Half-value layer
- Dose-response relationship
Correct answer: Inverse square law
The inverse square law means doubling your distance from the X-ray source reduces radiation exposure to one-quarter.
Question 6: During coronary angiography, a 'damping' of the pressure waveform in the guide catheter most likely indicates:
- Vasospasm distal to the tip
- Catheter tip occlusion of the coronary ostium (Correct answer)
- Ventricular fibrillation
- Air in the manifold system
Correct answer: Catheter tip occlusion of the coronary ostium
Damping occurs when the catheter tip obstructs coronary flow, reducing the pulsatile pressure signal and risking ischemia or dissection.
Question 7: What is the normal resting systemic vascular resistance (SVR) range in dynes·sec·cm⁻⁵?
- 20–120
- 800–1200 (Correct answer)
- 2000–3000
- 100–300
Correct answer: 800–1200
Normal SVR is approximately 800–1200 dynes·sec·cm⁻⁵, representing the afterload against which the left ventricle pumps.
CCI RCIS 2
During a right heart catheterization, the pulmonary artery wedge pressure (PAWP) is used to estimate which pressure?