FCCS FCCS Cardiovascular Emergencies 1 — Questions and Answers
Question 1: Which hemodynamic pattern is classic for cardiogenic shock?
- High CO, low SVR, low PCWP
- Low CO, high SVR, high PCWP (Correct answer)
- Low CO, low SVR, low PCWP
- High CO, high SVR, low PCWP
Correct answer: Low CO, high SVR, high PCWP
Cardiogenic shock is characterized by low cardiac output, compensatory high systemic vascular resistance, and elevated pulmonary capillary wedge pressure reflecting fluid backup.
Question 2: The first-line vasopressor for septic shock per Surviving Sepsis Guidelines is:
- Epinephrine
- Vasopressin
- Norepinephrine (Correct answer)
- Dopamine
Correct answer: Norepinephrine
Norepinephrine is recommended as the first-choice vasopressor for septic shock due to its superior vasoconstrictive effect and favorable safety profile.
Question 3: What is the classic ECG finding in hyperkalemia that precedes ventricular fibrillation?
- ST elevation
- Peaked T waves progressing to wide QRS (Correct answer)
- Prolonged PR interval only
- Shortened QT interval
Correct answer: Peaked T waves progressing to wide QRS
Hyperkalemia produces progressive ECG changes from peaked T waves to widened QRS complex, which can degenerate into ventricular fibrillation if untreated.
Question 4: In a patient with pulseless electrical activity (PEA), which of the following is a reversible cause?
- Hypomagnesemia
- Tension pneumothorax (Correct answer)
- Hypernatremia
- Hyperthyroidism
Correct answer: Tension pneumothorax
Tension pneumothorax is one of the 5 H's and 5 T's reversible causes of PEA arrest and requires immediate needle decompression.
Question 5: What is the appropriate initial energy for defibrillation of ventricular fibrillation with a biphasic defibrillator?
- 100 J
- 120–200 J (Correct answer)
- 360 J
- 50 J
Correct answer: 120–200 J
Biphasic defibrillators typically use 120–200 J for the initial shock in ventricular fibrillation, following manufacturer recommendations.
Question 6: A MAP of less than what value generally requires vasopressor initiation in septic shock?
- 60 mmHg
- 65 mmHg (Correct answer)
- 70 mmHg
- 55 mmHg
Correct answer: 65 mmHg
The Surviving Sepsis Campaign recommends targeting a mean arterial pressure of at least 65 mmHg, initiating vasopressors when MAP falls below this threshold.
FCCS FCCS Cardiovascular Emergencies 1
Which hemodynamic pattern is classic for cardiogenic shock?