Page 4/59 · Cardiovascular Critical Care II

Data Tables

Cardiovascular Critical Care II

Patrick M. Wieruszewski ~3 min read Module 12 of 20

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Cardiovascular Critical Care II

T.B. has return of spontaneous circulation (ROSC)

after 15 minutes of total resuscitation. The team

is deciding whether temperature control would be

appropriate for T.B. Which is the most accurate

statement regarding temperature control for T.B.?

A.He should not be considered because his initial

presentation was VF arrest.

B.He should not be considered because he has

transaminitis.

C.He should be considered with SCr monitoring.

D.He should be considered, but thrombolysis

should be initiated concurrently because of the

associated risk of clotting.

The medical team wants further information about

the literature regarding temperature control. Which

is the most appropriate information regarding the

data to support temperature control?

A.Improves survival in PEA cardiac arrests.

B.Shown to improve neurologic outcomes.

C.Superiority found when targeting a core tem-

perature of 36°C compared with 33°C.

D.Most studied in patients with asystole.

Questions 6–8 pertain to the following case.

J.H. is a 48-year-old woman with no known medical his-

tory who presents to the emergency department (ED) for

acute onset of shortness of breath, right-side pain, and

some blurry vision. She denies any illicit drug or ciga-

rette use, but she confirms social alcohol intake (about

3 drinks per week). Urine toxicology is negative. Initial

vital signs are as follows: blood pressure (BP) 202/140

mm Hg, heart rate (HR) 88 beats/minute, respiratory rate

(RR) 22 breaths/minute, and pain 4/10 (chest and right-

side pain). Initial laboratory values are as follows: SCr

0.8 mg/dL, AST 608 U/L, ALT 458 U/L, lipase 20 U/L,

total bilirubin (Tbil) 1 mg/dL, direct bilirubin (Dbil) 0.4

mg/dL, WBC 6 x 103 cells/mm3, hemoglobin 11 mg/dL,

troponin T less than 0.01 ng/mL, and D-dimer less than

0.5 mcg/mL. Chest radiography shows moderate bilat-

eral pleural effusions and no focal consolidations. Chest

computed tomography (CT) is negative for pulmonary

embolism. Of note, J.H. is taking no prescription or over-

the-counter medications.

Which laboratory abnormality or presenting symp-

tom best qualifies J.H. for hypertensive emergency?

A.None; she is having asymptomatic markedly

elevated blood pressure.

B.Her SCr.

C.Her AST/ALT.

D.Her D-dimer.

Which is the most appropriate initial treatment strat-

egy for J.H.’s BP?

A.Phentolamine 1 mg intravenously every 30

minutes.

B.Metoprolol 25 mg orally every 12 hours.

C.Nitroprusside 0.25 mcg/kg/minute by continu-

ous intravenous infusion.

D.Enalaprilat 10 mg intravenously every 6 hours.

Which is the most appropriate goal for J.H.’s BP

reduction?

A.Goal mean arterial pressure (MAP) reduction

of 25% during the first 60 minutes.

B.Goal MAP reduction of 50% during the first 60

minutes.

C.Goal MAP reduction of 25% during the first 24

hours.

D.Goal MAP reduction of 50% during the first 24

hours.

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