boards 5

Question 1

HOCM murmur inc and dec

Answer 1

dec filling - inc murmur - valsalva, standing up – harsh mid systolic murmur at LLSB —- dec murmur, hand grip, trendelenburg, volume expansion

Question 2

med to give in HOCM

Answer 2

b blocker, ca blocker s - neg inotropes

Question 3

tx pericarditis

Answer 3

nsaids, colchicine

Question 4

right sided diastolic collapse

Answer 4

pericardial tamponade

Question 5

mcc viral myocarditis

Answer 5

parvo b 19 , cox b

Question 6

sinus tach out of proportion to fever

Answer 6

myocarditis, signs of chf, enlarged heart, troponin

Question 7

htn urgency guidelines

Answer 7

dbp >110, do not lower acutely in ED unless end organ dmg

Question 8

tx aortic dissection

Answer 8

shear first - b blockers- esmolol- then nitropussure or nicardipine- prevent reflex tachy

Question 9

tx htn in catchecholamine crisis- pheo cocaine maoi

Answer 9

oppoiste of aortic dissection- do not use b lbocker alone- upooposed constriction use labetalol plus phentolamine alpha blocker

Question 10

stemi assn with dissection

Answer 10

Type a- RCA - inferior stemi

Question 11

location of AAA

Answer 11

majority are infrarenal, mc missed diagnosis is renal colic, microscopic hematuria

Question 12

older patient with abdominal or back pain

Answer 12

AAA and mesneteric ischemia

Question 13

coplication of DVT

Answer 13

phlegmasia cerulea doelns - prevents obstrucion, stagnat blood- cyanotic and blue, bullae, compartment syndrome, or Phelgmasia alba dolens – pale doughy- causes arterial spasm

Question 14

hypo/hyper ca effect one kg

Answer 14

hypo- proloooonged, hyper- shert

Question 15

prolonged QT elecetrolytes

Answer 15

hypooo K hypoo ca hypooo mg

Question 16

MAT

Answer 16

irregular irregular narrow complex, 3 diff p wave morphology- associated with hypoxia, copd, theopylline-

Question 17

how to pace torasades

Answer 17

overdrive pacing - 120

Question 18

what does magnet due to pacemaker

Answer 18

convernts from sensing to fixed rate

Question 19

way to find WPW on ekg

Answer 19

short PR then look for delta

Question 20

a fib with changing morphologies

Answer 20

WPW with A fib - do not use nodal blockers- (amio b bloc ca block) use procainamide or electicity

Question 21

drug to treat stable v tach

Answer 21

procainamide, or amio

Question 22

accelerated idoventricular rhythem

Answer 22

rate under 120 - assn AMI and reperfusion, - just observe - can also have in tox / OD like hyper K, TCA

Question 23

2nd deg type 1 wenkebach

Answer 23

gradually inc PR then beat dropped (tx atropine if unstable)

Question 24

2nd deg typ 2 mobitz II

Answer 24

constant wider PR then beat dropped (pace if unstable)

Question 25

sudden cardiac arrest - AD - SE asian males - pseudo RBBB pattern, ST elevation v1 v2

Answer 25

brugada- AICD - ski slope T wave

Question 26

indication for hyptnermia

Answer 26

initial rhythem V fib