CSC Hemodynamic Monitoring & Assessment 1 — Questions and Answers
Question 1: Which hemodynamic parameter is calculated as the difference between systolic and diastolic blood pressure?
- Mean arterial pressure
- Pulse pressure (Correct answer)
- Stroke volume index
- Cardiac index
Correct answer: Pulse pressure
Pulse pressure is the arithmetic difference between systolic and diastolic blood pressure and reflects arterial stiffness and stroke volume.
Question 2: A normal cardiac output in a resting adult is approximately:
- 1–2 L/min
- 2–3 L/min
- 4–8 L/min (Correct answer)
- 10–12 L/min
Correct answer: 4–8 L/min
Normal resting cardiac output ranges from 4 to 8 L/min, representing the volume of blood the heart pumps per minute.
Question 3: Pulmonary capillary wedge pressure (PCWP) is used to estimate pressure in which cardiac chamber?
- Right atrium
- Right ventricle
- Left atrium (Correct answer)
- Left ventricle during systole
Correct answer: Left atrium
PCWP approximates left atrial pressure because the inflated balloon occludes forward flow, reflecting the static column of blood back to the left atrium.
Question 4: Which Swan-Ganz catheter waveform finding indicates proper placement in the pulmonary artery?
- Low-pressure venous waveform
- Dicrotic notch and diastolic pressure higher than RV diastolic (Correct answer)
- High-pressure systolic equal to aortic systolic
- Flat line indicating wedge position at rest
Correct answer: Dicrotic notch and diastolic pressure higher than RV diastolic
The pulmonary artery waveform shows a dicrotic notch from pulmonic valve closure and a diastolic pressure higher than right ventricular diastolic pressure.
Question 5: In a patient with cardiogenic shock, which hemodynamic profile is most characteristic?
- Low PCWP, high CO, low SVR
- High PCWP, low CO, high SVR (Correct answer)
- Low PCWP, low CO, low SVR
- High PCWP, high CO, low SVR
Correct answer: High PCWP, low CO, high SVR
Cardiogenic shock is characterized by elevated filling pressures (high PCWP), reduced cardiac output, and compensatory high systemic vascular resistance.
Question 6: Systemic vascular resistance (SVR) is calculated using which formula?
- (MAP – CVP) / CO × 80 (Correct answer)
- (MAP – PCWP) / CO × 80
- (SBP – DBP) / HR
- (CO × HR) / BSA
Correct answer: (MAP – CVP) / CO × 80
SVR = (MAP – CVP) / CO × 80 (dynes·sec·cm⁻⁵), using the pressure gradient across the systemic circulation divided by flow.
Question 7: A central venous pressure (CVP) of 18 mmHg suggests:
- Hypovolemia
- Right heart failure or fluid overload (Correct answer)
- Distributive shock
- Normal filling status
Correct answer: Right heart failure or fluid overload
An elevated CVP (normal 2–8 mmHg) indicates increased right atrial pressure, consistent with right heart failure, volume overload, or cardiac tamponade.
CSC Hemodynamic Monitoring & Assessment 1
Which hemodynamic parameter is calculated as the difference between systolic and diastolic blood pressure?