FP-C - Flight Paramedic-Certification Critical Care Cardiology Questions and Answers

Question 1

A 68-year-old male is being transported by air after a complicated PCI for a large anterior STEMI.
He is now in cardiogenic shock, supported by an intra-aortic balloon pump (IABP).
You notice the diastolic augmentation on the IABP waveform is suddenly significantly reduced.
Which of the following is the LEAST likely cause for this change?

Accepted Answer

The patient has developed severe aortic regurgitation.

Answer

The balloon has migrated distally and is now too low.

Answer

There is a helium leak in the IABP catheter or console.

Answer

The patient's cardiac output has significantly decreased.

Question 2

You are transporting a patient with a left ventricular assist device (LVAD) who is now complaining of a severe headache and appears confused. The LVAD controller is alarming for high power consumption. What is the most likely cause of this presentation?

Accepted Answer

Pump thrombosis

Answer

Gastrointestinal bleeding

Answer

Driveline infection

Answer

Controller malfunction

Question 3

A flight paramedic is managing a 55-year-old female who is 12 hours post-ROSC from a V-Fib arrest. She remains comatose. According to current AHA/ERC guidelines for targeted temperature management (TTM), which of the following is the most appropriate intervention?

Accepted Answer

Maintain a constant core temperature between 32°C and 36°C for at least 24 hours.

Answer

Rapidly cool the patient to 30°C to maximize neuroprotection.

Answer

Allow passive rewarming as long as the patient's temperature remains below 38°C.

Answer

Administer prophylactic antibiotics and begin cooling to 34°C for 48 hours.

Question 4

You are treating a patient with an acute inferior wall STEMI who develops severe hypotension (BP 70/40 mmHg) and bradycardia after receiving a sublingual nitroglycerin tablet. A right-sided ECG reveals ST elevation in V4R. Which of the following is the most appropriate immediate intervention?

Accepted Answer

Administer a 500 mL normal saline fluid bolus.

Answer

Initiate a dopamine infusion to support blood pressure.

Answer

Administer a second dose of nitroglycerin.

Answer

Immediately perform transcutaneous pacing.

Question 5

Which of the following conditions is an absolute contraindication to the placement and use of an intra-aortic balloon pump (IABP)?

Accepted Answer

Severe aortic insufficiency

Answer

Cardiogenic shock

Answer

Acute mitral regurgitation

Answer

Left main coronary artery stenosis

Question 6

A patient in cardiogenic shock is being managed with an IABP. The flight paramedic observes the arterial waveform and notes that balloon inflation occurs well after the dicrotic notch, and the peak of diastolic augmentation is lower than the patient's own systolic pressure. This timing error is best described as:

Accepted Answer

Late inflation

Answer

Early inflation

Answer

Late deflation

Answer

Early deflation