4G SOAL POSTTEST RESIDEN KARDIOLOGI STASE ICU PASCA BEDAH DEWASA * Required Name * Your answer © Triste arequted question Email * Your answer © Tris is arequied question Questions ‘Treatment of hyperkalemia after cardiac operation, is:* 25 points © Bolus of Magnesium sulfet O Infusion of dextrose © infusion of dextrose - insulin O Spironolactone tabletWhich one of the following conditions is most likely to have low systemic vascular 25 points ressistance (afterload) in the presence of low blood pressure? * © Cardiogenic shock © Pericardial tamponade Septic shock © Pulmonary embolism Which one of the following choices is most correctly paired as far as rationale for 25 points, choosing a particular ventilatory mode? * Assist control volume ventilation-minute ventilation remains constants despite ‘changes in patient breathing rate ‘Synchronized intermittent mandatory ventilation (SIMV)- typically leads to reduced work of breathing compared to assist control Pressure support ventilation-increased patient comfort and tolerance as its primary clinical utility © Pressure contol ventilation ~ in the patent without spontaneous breathing effort, provide constant minute ventilation despite changes in airways resistance Other: Which statement is incorrect among the following chocies concerning positive 25 points pressure ventilation’? * Mimic physiologic condition © Giving positive pressure to patient lungs © camimpede venous return © commoniy used in ventilator O other: Whar should be a concern in using high PEEP for patients? * 25 points O VolutraumaO Barotrauma O Atelectasis Pneumonia Which one of following is more specific for mereased left ventricular peload as 25 points ‘opposed to increased right ventricular preload? * © Distended neck veins O Enlarged iver O Leg edema Diffuse rales and hypoxemia Factor that affecting oxygenation quality in patient with mechanical ventilation is: * 25 points O Respiratory rate Minute volume O peer © Pacoz Fresh whole blood is except: * 28 points Low potassium level O Rich 2,3 PG © Low capacity carrying oxygen O Storage time less than 48 hours Cardiomegaly, hypotension, and hypoxemia developing in a previously healthy 25 points patient in che last month of pregnancy makes which one of the following diagnoses ost likely? * CO Atrial septal Defect© Peripartum Cardiomyopathy Pulmonary embolism © Mita insuticiency Which of the following hemodynamic profile is not compatible with hypovolemic 25 points, shock (severe hemorshage or dehydration)? * Left ventricular filling pressure decreased © Stroke volume decreased © Hiate rate increased © systemic vascular resistance increased Which one of the following is the least appropriate management for unstable 25 points angina? * O Aspirin O Heparin O Nitrogiycerin Digoxin When patient post cardiac surgery with pulmonary hypertension, which of this 25 points following action is not appropriate for the patient? * CO ‘Sedating patient CO Give pulmonary vasolidator Lowering fraction oxygen O ive inhated itoprost When considering post cardiac surgery with pulmonary hypertension, which of this 25 pents following action is not appropriate for the patient? *Esophageal intubation should be suspected when no improvement in oxygen saturation occurs following intubation © ‘esophageal intubation is suspected, direct visualization of larynx appropriate © esophageal intubation is suspected, removal of endotracheal tube and reinstttion of bag mask ventilation is appropriate © Esophageal intubation reliably predicted or excluded by auscultation of chest and epigastrium What creatment should be advised to patient with cardiac enzym clevaced? * 25 points O Beta blocker © Ace inhibitor Beta blocker and ACE inhibitor © inotropic Cause of atrial fibrilation post CABG is * 25 points CO Electrotyte imbalance © BBlocker withdrawal © inflammation, CPB All statements above is correct Pericardial effusion is characterised by: * 28 points ‘An anechoic space in pericardium © Ananechoic space posterior to descending aorta in pasteral long axis © Anyperehoic space anterior to the heart O None of above Which of the following is/are important sign(s) of cardiac tamponade? * 28 pointsCO Lage pericardial effusion © RVorRAcollapsing CO iated and non-collapsing IVC All of the above The presence of segmental wall motion defect is highly suggestive of? * © Dilated cardiomyopathy © Hypertrophic cardiopathy Ischemic heart disease O biastoic heart fature Spontaneous echo contrast in the LV is Poor LV funetion CO Dilated cardiomyopathy © Weayssynchrony O Hypovoiemia IVC ean be used for? * Predicting RAP in mechanically ventilated patients © Predicting RAP in spontaneously breathing patients © Predicting fluid responsiveness in all mechanically ventilated patients O Ruling out pericardial effusion Signs of fluid overload include: * DD Wiccine sn 25 points 25 points 25 points 28 pointsDilated RA © smaliand collapsing ive O Dilates aorta Which of che Following are sign of pneumothorax? * © Allines and lung sliding ‘lines and lung point © Blines and tung sliding © Biines and ung point Clinical risk of early deflation of intra aortic balloon pulsation is: * © Reduced augmentation time Reduced stroke volume. © increased ivsw © increased dyssynchrony Which of che Following are the goals of IABP? * © Reduced preload and increased afterload Increased preload and reduced afterload © Reduced preload and reduced afterload © Increased preload and increased afterload 28 points 25 points 25 points Which of che Following pressures is augmented by intra-aortic balloon pump (IABP) 25 points inflation? * CO Left ventricular systolic© Lett ventricular diastolic O Aortic systolic Aortic diastolic Which of che Following pressures is augmented by intra-aortic balloon pump (IABP) 25 points inflation? * © Counterpulsation adds volume to the aorta during dastole to inerease diastolic blood pressure Counterpulsation adds volume to the aorta during systole increase systolic blood Pressure © Lounterpulsation decreases volume tothe aorta during dastoe to increase diastolic blood pressure © Launterpulsaton decreases volume to the aorta during systole to increase systolic blood pressure In related with antibiotic treatment for pneumonia, laboratorium test important 25 points related to drug dose is: * © Pave O Bitrubin © Albumin Kreatinin According to AT'S guidelines about management of hospital pneumonia, sputum 25 points, culture evaluation needed if patient has not showed improvement with empiric antibiotic theraphy in period of: * 4B hours O 72hours O 9%6hours O None aboveFor hypoxemia management, finding causes and grading hypoxemia are imporcant thing, normal ‘Alveolar ~arterial oxygen gradiene” (A-aDOa) is:* © fav02> 60 mmig O Aav02 40-60 mmHg © Aav02 20-40 mmHg ‘AaD02 < 20 mmHg When should a tube feeding be recommended? * © When a person has an inadequate oral nutrient intake for 2-4 days © When a person has severe diarrhea When GI tract works, but patient cannot meet nutrient needs orally © When a person has severe acute pancreatitis How do enteral and parenteral nutrition differ? * © Enteral is administered via a vein; parenteral via the tum © Enteral is administered via a blood vessel; parenteral via the mouth © Parenteral is administered via Gl tract enteral va a site outside the Gl tract Enteral is administered via the GI tract; parenteral via a site outside the Gl tract, What is the approximate osmolality of body fluid? * ‘© 500 mosm © 400m0sm © 100 mosm 300 mOsm 28 points 25 points 25 points 25 pointsWhich one of the following conditions is most likely co have low systemic vascular 25 points resistance (afterload) in the presence of low blood pressure? * O Pericardial tamponade O Pulmonary embolism © Cardiogenic shock Septic shock In an adult with severe sepsis, blood pressure 90/60 mmlg (baseline blood pressure 25 points 130/80 mmHg), which one of the following is typically the most important initial empiric treatment modality? * © Dobutamine © Packed red blood cells Crystalloid or colloid resuscitation © Norepinephrine Which one of the following statements is most correct concerning treatment of 25 points, clevated intracranial pressure (ICP)? * Hyperventilation should be utilized early for emergent control of ICP and subsequently replaced by other therapeutic measured © Manitolis contraindicated O supine position, passive leg raising Maintain PaCO2 above 45 mmHg to reduced cell swelling Which one of the following hemodynamic profile is most compatible with 25 points hypovolemic shock (severe hemorthage or dchydration)2PAOP = Pulmonary Artery Occlusion Pressure, CO = Cardiac output, SVR systemic Vascular Resistance * © PAOP increased, CO decreased, SVR increased O PAOP increased, CO decreased, SVR decreased PAOP decreased, CO decreased, SVR increasedO PAOP decreased, CO decreased, SVR decreased Which one of the following is the least appropriate variable ro use as a target of successfl fluid resuscitation? * © Return to normal mental status O Rise inpaoz © Clearance of tactic acidosis Urine output more than 1 co/kg/hour Effect of positive pressure ventilation to heart? * Decreasing RV preload CO Decreasing RV afterload © Increasing LV afterload © increasing LV preload Which one factor below that has the least influence to delivery oxygen? * © Arterial oxygen content © Hemoglobin CO Stroke volume Central vein saturation Which one is not the adverse effece of protamin? * CO systemic vasoconstriction due to histamin relesse Pulmonary vascular resistance decrease © Pulmonary vascular resistance increase 25 points 28 points 25 points 25 points© Anapylactic Shock