Think you are ready for the CRNA (Certified Registered Nurse Anesthetist) exam? Our deck rates 525 of its 1050 flashcards as hard — testing concepts like AS, Aortic Stenosis, MR, Mitral Regurgitation. Try the free samples below; if they feel comfortable, you are in good shape.
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A patient with severe Aortic Stenosis (AS) undergoes induction. What characteristic changes are seen on their LV pressure-volume loop compared to a normal loop?
Show answer →1) Significantly higher peak LV systolic pressure (taller loop) to overcome the valvular gradient. 2) Narrower loop (decreased SV) due to high afterload. 3) Increased LV End-Diastolic Pressure (LVEDP) due to concentric hypertrophy and reduced compliance. Clinical Pearl: AS is a pressure overload state. NBCRNA emphasizes the need for full, slow, and constricted (maintain preload/SVR, avoid tachycardia).
Describe the LV pressure-volume loop changes in chronic Mitral Regurgitation (MR).
Show answer →1) Absence of true isovolumetric phases (contraction and relaxation) because blood leaks into the LA as soon as the LV starts contracting. 2) Increased EDV (preload) due to the regurgitant volume returning from the LA. 3) Decreased ESV (LV empties into low-pressure LA). 4) Loop looks rounded or egg-shaped. Exam Strategy: MR is the classic volume overload state. NBCRNA Distractor: MR often shows a normal EF despite LV dysfunction because of the low-resistance exit into the LA.
How does the area within the LV pressure-volume loop relate to myocardial oxygen consumption (MVO2) and Stroke Work?
Show answer →The area inside the loop equals Stroke Work (SW). MVO2 is determined by the Pressure-Volume Area (PVA), which is the sum of SW and the Potential Energy (PE) stored in the wall. Clinical Insight: Conditions increasing the area (e.g., high afterload or high SV) increase MVO2. Tachycardia and increased wall tension (Laplace) are the most significant drivers of MVO2 in the clinical setting.
An elderly patient with HFpEF shows a steeper End-Diastolic Pressure-Volume Relationship (EDPVR). What does this signify?
Show answer →A steeper EDPVR signifies decreased LV compliance (increased stiffness). For any given volume (preload), the pressure (LVEDP) will be higher. This is the hallmark of diastolic dysfunction. Clinical Pearl: These patients are highly sensitive to small changes in volume; they develop pulmonary edema quickly with fluid boluses. NBCRNA Tip: Differentiate compliance (change in volume/pressure) from contractility (ESPVR).
In Aortic Regurgitation (AR), what specific changes occur to the phases of the LV pressure-volume loop?
Show answer →1) No true isovolumetric relaxation: The LV fills from the aorta immediately after the aortic valve closes. 2) Massive increase in EDV (rightward shift). 3) Increased SV (widened loop) to compensate for backward flow. 4) High systolic pressure with low diastolic pressure (wide pulse pressure). Exam Strategy: AR is a combined pressure and volume overload state leading to eccentric hypertrophy.
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Try 30 free CRNA cards first525 of the 1050 flashcards in the CRNA deck carry a "hard" difficulty rating. 5 free samples are on this page.
Difficulty ratings describe our deck, not the official exam. Practicing above test level builds a margin of safety — check the official NBCRNA materials for representative difficulty.
Assessment
30 cards
Basics
30 cards
Diagnostics
60 cards
Equipment
80 cards
Management
190 cards
Pathology
130 cards
Pharmacology
150 cards
Physiology
150 cards
Procedures
210 cards
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