3

Question 1

PSVT Presentation

Answer 1

Abrupt attacks
Palpitations
Generalized weakness
HR 160-220

Question 2

Pathophys of PSVT

Answer 2

RE-entry into AV node

Question 3

Management for PSVT

Answer 3

VAgal maneuver - Valsalva, carotid sinus massage, cold water immersion

Adenosine - short acting AV nodal blocker

Question 4

What is myoclonus

Answer 4

Involuntary jerking of muscle

Question 5

Choriocarcinoma Presentation

Answer 5

Vaginal bleeding
Enlarged uterus
Pelvic pain

Postpartum woman w/ pulmonary sx’s and multiple nodules on CXR

Question 6

MC location of mets in choriocarcinoma

Answer 6

Lungs

May see pulmonary sx’s, hemoptysis

Question 7

Epidural spinal cord compression

Answer 7

Hx of malignancy
Back pain with motor and sensory abnormalities
Bladder and bowel dysfunction

Question 8

TX for epidural spinal cord compression

Answer 8

IV Glucocorticoids

MRI

Question 9

Cough in pertussis

Answer 9

20-30 min coughing paroxysms
Inspiratory whoop
Staccato cough
Posttussive emesis 
Apnea, cyanosis
Lasts 2-6 weeks

Question 10

DX of pertussis

Answer 10

Pertussis culture or PCR

Lymphocyte-predominant leukocytosis

Question 11

TX for pertussis

Answer 11

Macrolides

Question 12

When do we do screening for hyperlipidemia

Answer 12

Men > 35
Women > 45

Younger if Risk factors for CAD

Question 13

What lipid lowering agents are never combined

Answer 13

Statins + Fibrates

Question 14

What kind of agent is Cholestyramine?

What is special about use?

Answer 14

Bile Acid Sequestrant

Binds C. Dif

Question 15

Which agent to lower TGs

Answer 15

Fibric Acid, Omega 3 Fatty Acids
Gemfibrozil
Fenofibrate

Question 16

What meds are avoided in Prinzmetal’s?

Why?

Answer 16

Beta blockers
ASA
Exacerbate vasospasm

Question 17

Time frame for thrombolytics during MI?

Stroke?

Answer 17

MI: Within 12 hours

Stroke: Within 3, Possibly 6 if can admin directly to site

Question 18

Indications for CABG

Answer 18

1. Left main stenosis > 50%
2. 3 Vessel Dz
3. Hx of CAD + DM

Question 19

In heart patients, what should K and Mg levels be

Answer 19

K > 4

Mg > 2

Question 20

Management of MI pt with PVCs

Answer 20

Only in select patients - symptomatic
Beta blockers
Amiodarone

Question 21

TX for WPW syndrome

Answer 21

Amiodarone

Procainamide

Question 22

TX for PSVT

Answer 22

Carotid massage/Valsalva
IV Adenosine
CCB if hemodynamically unstable

Question 23

What is Eisenmerger syndrome?

Pathophys?

Answer 23

L to R sided shunt becomes
R to left sided

More blood from LV causes Pulm HTN causing RV hypertrophy, causing R to L shunt

Question 24

CXR findings in CHF

Answer 24

Kerley B lines

Cephalization of pulmonary vessels

Question 25

What are Kerley B lines

Answer 25

Thickening of subpleural interstitium
Horizontal
< 2 cm
MC in peripheral and lower lobe

Question 26

When do we see Kerley B lines

Answer 26

LV Failure
Mitral Valve disease
Lymphatic Obstruction
Lymphangitis

Question 27

Ways to measure EF

Answer 27

Echo

Cardiac Cath

Question 28

Indication for biventricular pacemaker

Answer 28

EF < 35% for greater than 3 months

Question 29

What is Cushing’s Triad?

Indicative of?

Answer 29

HTN
Bradycardia
Bradypnea

Increased ICP

Question 30

Signs of increased ICP

Answer 30

Papilledema
AMS
Pupil asymmetry

Question 31

How to Decrease ICP in head trauma pts

Answer 31

Elevate head of bed to 30 degrees
Pretx w Lidocaine if pt needs intubation
Mannitol
Intubate and hyperventilation

Question 32

What kind of shock is seen with spinal cord injury

Answer 32

Neurogenic shock

Question 33

What is peritoneal lavage? when is it done

Answer 33

Saline infused by catheter into abdominal cavity, then removed and examined
Used to detect blood and feces

Question 34

What is management in penetrating trauma? Examples of?

Answer 34

Exploratory Laparotomy

Stab wounds, GSW