CPD Questions (5-question approach for echo of undifferentiated shock)

Name:: First Name:
Last Name:
Contact Email:
Submission date:
I confirm that I have watched the accompanying video in full before completing these CPD questions and claiming CPD points.:: Yes
A 72-year-old patient with septic shock undergoes echocardiographic assessment with the findings as below. Which of the following is the most appropriate interpretation?:: A. Normal stroke volume and normal cardiac outputB. Low stroke volume with critically low cardiac outputC. Low cardiac output despite preserved stroke volumeD. Cardiac output preserved despite low stroke volume, in the context of tachycardiaE. Hyperdynamic cardiac output due to distributive shock
Stroke volume index of 27 mL/m², cardiac index of 2.5 L/min/m² and a heart rate of 108 bpm.
2. Which of the following best describes the recommended role of echocardiography in undifferentiated shock?:: A. Establish whether hypotension is presentB. Should only be performed by critically trained sonographersC. Replace invasive haemodynamic assessmentD. Determine the single predominant mechanism of shockE. Identify and quantify potentially coexisting mechanisms contributing to shock
3. A patient with septic shock is tachycardic with a small hyperdynamic LV. Which additional abnormality should be specifically sought in all shocked patients, according to the authors?:: A. Mid-cavity obliteration only if hypertrophic cardiomyopathy is knownB. Pulmonary vein systolic flow reversalC. Left ventricular outflow tract obstructionD. Left atrial appendage thrombusE. Aortic pressure recovery
4. A mechanically ventilated patient with septic shock has an average E/e prime of 16. Which interpretation is most appropriate?:: A. LAP must be normal because the patient is ventilatedB. E/e prime (E/e') cannot be used in critically ill patientsC. This confirms an elevated pulmonary capillary wedge pressureD. This provides evidence supporting elevated LAP but should be integrated with other findingsE. The result indicates impaired LV relaxation but provides no information regarding LAP
5. A patient in shock has severe RV systolic dysfunction and severe tricuspid regurgitation. TR Vmax is only 2.7 m/s. Which conclusion is most appropriate?:: A. Pulmonary hypertension is excludedB. Pulmonary vascular resistance must be normalC. PASP can be calculated accurately using the standard Bernoulli equationD. The low TR velocity confirms isolated RV infarctionE. Significant pulmonary hypertension may still be present despite the relatively low TR velocity
6. A shocked patient has a measurable TR Vmax of 4.2 m/s. What does this finding particularly suggest?:: A. Acute hypovolaemiaB. Acute pulmonary embolism is the only likely diagnosisC. Normal pulmonary vascular resistance with increased cardiac outputD. Pulmonary vascular resistance is likely to have been chronically elevatedE. Severe TR must be present
7. In a shocked patient, pulmonary artery acceleration time (PAAT) is 88 ms. Which interpretation is most appropriate?:: A. This excludes elevated PVRB. This confirms acute pulmonary embolismC. This indicates elevated LAPD. This confirms chronic pulmonary hypertension regardless of heart rateE. This supports elevated PVR when concordant with other findings
8. A patient with haemorrhagic shock has a markedly dilated left atrium but other findings suggest very low preload. Which is the best explanation?:: A. Chronic LA enlargement may persist despite an acute fall in preload and LAPB. The LA measurement is unreliable during shockC. LA enlargement indicates acute volume overloadD. A dilated LA excludes hypovolaemiaE. The patient must have elevated LAP
9. A patient with septic shock initially demonstrates a small underfilled LV. Following fluid resuscitation, repeat echocardiography shows a hyperdynamic LV with preserved cardiac output but ongoing shock. What principle does this best illustrate?:: A. Septic shock is exclusively distributiveB. Hyperdynamic LV function excludes ongoing shockC. The initial echocardiogram was technically incorrectD. Serial echocardiography is unnecessary once cardiac output normalisesE. The relative contributions of different shock mechanisms can change during the course of critical illness
10. A patient develops new severe LV systolic dysfunction during septic shock. Cardiac function improves clinically after recovery. According to the authors proposed approach, which strategy is most appropriate?:: A. No further imaging is required if blood pressure normalisesB. Repeat echocardiography before discharge only if LVEF was <20%C. Perform an echocardiogram after resolution of the acute illnessD. Repeat echocardiography only if symptoms recurE. Perform coronary angiography in all cases

CPD Questions (5-question approach for echo of undifferentiated shock)

Quick Links

Committees

Resources

Meetings/Events

Contact Us

CPD Questions (5-question approach for echo of undifferentiated shock)

Quick Links

Committees

Resources

Meetings/Events

Contact Us

Follow Us