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Quiz by Haemodynamic UMMC
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- Q1
How long before surgery should a patient ideally have a preoperative assessment?
2-4 days
> 6 months
2-4 months
2-4 weeks
60s - Q2
A 68-year old man comes to pre-surgical testing clinic for a cataract repair. He has a past medical history significant for Type 2 Diabetes, hypertension and dyslipidemia. He develops shortness of breath when he walks up the stairs and gets chest pain when he used a lawn mower last month. His ECG is normal sinus rhythm with a rate of 72 and significant for a left axis deviation and left ventricular hypertrophy.
Which of the following is the best next step in managing this patient?
Proceed with surgery without further testing
Order a CPET
Order an echocardiogram
Order an exercise stress test
60s - Q3
Which of the following is the LEAST invasive method of calculating cardiac output?
Thermodilution
Volume clamp (Penaz method) eg Finapress
Lithium dilution, eg LIDCO
Indirect Fick Method
60s - Q4
You are explaining to a medical student how the cardiac output is calculated. If you assume that each factor acts independently, a doubling of which of the following factors will lead to the largest increase in cardiac output?
Preload
Heart rate
Contractility
Afterload
60s - Q5
Which of the following best describes the microcirculation?
The mean arterial pressure reliably predicts microcirculatory perfusion and oxygenation
Capillary refill time is a reliable alternative to lactate measurement in septic shock
ScVO2 measurement in Early Goal Directed Therapy contributes to reduced sepsis mortality
A low central venous-arterial PCO2 gradient (Pcv-aCO2) reflects tissue hypoperfusion
60s - Q6
The following best describes the capillaries :
Transcapillary filtration occurs at the venule end of the capillary
Hypervolaemia increases endothelial glycocalyx shedding
The gut microcirculation probe is the most used capillary flow monitor
Low syndecan-1 and heparan sulphate levels reflect high endothelial glycocalyx shedding
60s - Q7
Which of the following would be the condition where pulse pressure variation is less reliable and would give a false negative result?
Spontaneous breathing
Low tidal volume
Cardiac arrhythmias
Intraabdominal hypertension
60s - Q8
The following tests for fluid responsiveness will need the measurement of cardiac output or its surrogates, EXCEPT
Mini fluid challenge
Tidal volume challenge
Passive leg raising
End-expiratory occlusion test
60s - Q9
The most important function of cardiac output is to
Remove carbon dioxide from peripheral tissues
Maintain blood flow
Provide tissue oxygenation
Maintain acid base balance
60s - Q10
The Frank Starling curve describes the relationship between the initial length of myocardial fibres and the force generated during contraction.
In a heart with normal function, this means :
Reducing preload at the steep part of the curve leads to a smaller stroke volume
Increasing preload throughout the curve leads to a larger stroke volume
Increasing preload at the flat part of the curve reduces the stroke volume
Increasing preload at the steep part of the curve leads to a larger stroke volume
60s - Q11
Which of the following is NOT part of the oxygen delivery equation?
SaO2
Haemoglobin
FiO2
PaO2
60s - Q12
Which of the following statements concerning the nervous regulation of the circulation is correct?
The baroreceptors are mainly responsible for the long-term regulation of systemic blood pressure
If the arterial pressure suddenly falls, the baroreceptor reflex increases the heart rate
The baroreceptors have no effect on the cardiac contractility
The baroreceptors are found in the aortic and carotid bodies
60s - Q13
Regarding advance intraoperative hemodynamic monitoring
A high cardiac output indicate adequate microcirculation and regional blood flow
Cardiac output was derived by Stewart Hamilton principle of thermodilution curve
Functional hemodynamic parameters todetermine fluid responsiveness is not affected by chest compliance
Pulse contour analysis is accuratein event of frequent ventricular ectopics
60s - Q14
Which of the following is not the function of endothelial glycocalyx?
ATP production
Vascular permeability
Mechanotransduction
Control of coagulation
60s - Q15
The following statements are true about the VTI variation except
VTI variation is calculated as thedifference between the maximum and the minimum VTI divided by the mean of thetwo values
VTI variation has a very highsensitivity and specificity
VTI variationof more than 12% predicts fluid responsiveness
VTI variation uses parasternal longaxis view
60s