FFICM Critical Care Monitoring and Hemodynamics Flashcards

Which vasopressor is the first-line agent recommended by the Surviving Sepsis Campaign for septic shock?

Answer: Norepinephrine

Norepinephrine is the first-line vasopressor for septic shock due to its potent alpha-1 agonist effects and relatively low risk of tachyarrhythmias compared to dopamine.

What is the target mean arterial pressure (MAP) recommended for most patients in septic shock?

Answer: ≥65 mmHg

A MAP ≥65 mmHg is the recommended initial resuscitation target in septic shock, balancing adequate perfusion pressure against vasopressor burden.

Which echocardiographic finding is most consistent with cardiac tamponade?

Answer: Diastolic right ventricular collapse

Diastolic collapse of the right ventricle indicates that pericardial pressure exceeds right ventricular diastolic pressure, a hallmark of cardiac tamponade.

In cardiogenic shock, which hemodynamic pattern distinguishes it from distributive shock?

Answer: Low cardiac output with elevated pulmonary capillary wedge pressure

Cardiogenic shock is characterized by low cardiac output and elevated filling pressures (PCWP >18 mmHg), reflecting pump failure rather than vasodilation.

Which intervention is most likely to improve outcomes in massive pulmonary embolism with hemodynamic instability?

Answer: Systemic thrombolysis

Systemic thrombolysis with alteplase is indicated in massive PE with hemodynamic compromise when no absolute contraindications exist, rapidly restoring right heart outflow.

Point-of-care ultrasound in the ICU showing a hyperechoic (bright) structure posterior to the liver with acoustic shadowing most likely represents:

Answer: Gallstones

Gallstones appear hyperechoic on ultrasound with posterior acoustic shadowing due to high calcium content blocking sound transmission.