Cardiac Treatment

Question 1

Stable VT

Answer 1

IV Amiodarone

Question 2

Unstable VT

Answer 2

Synchronized Cardioversion

Question 3

Pulseless VT

Answer 3

Defibrillation

(+q2 Epi/Amio alternating)

Question 4

Ventricular Fibrillation

Answer 4

Defibrillation

(+q2 Epi/Amio alternating)

Question 5

Stable AFib

Answer 5

BBs

(Metoprolol)

• or CCBs (Verapamil, Diltiazem)
• +/- Warfarin/NOACs (anticoagulation)

Question 6

Stable AFib + WPW

Answer 6

Procainamide

Question 7

Stable AFib in CHF exacerbation

Answer 7

Amiodarone

(or Digoxin)

• Avoid BBs/CCBs in CHF exacerbations

Question 8

Unstable AFib, Bradycardia

(Bradyarrhythmia)

Answer 8

Transcutaneous Pacing

Question 9

Unstable AFib, Regular or Tachycardia

(Tachyarrhythmia)

Answer 9

Synchronized Cardioversion

Question 10

Unstable AFib + WPW

Answer 10

Synchronized Cardioversion

Question 11

SVT

(PSVT, AVNRT, AVRT)

Answer 11

Adenosine or Vagal Maneuvers

Question 12

Atrial Flutter

Answer 12

BBs

(Metoprolol)

Tx same as AFib

• or CCBs (Verapamil, Diltiazem)
• +/- Warfarin/NOACs (anticoagulation)

Question 13

Complete (3^o) Heart Block

Answer 13

Transcutaneous Pacing

Question 14

PVCs (ASx)

Answer 14

Elimination of triggering agent

(No treatment)

Question 15

PVCs + Sx

Answer 15

BBs

(if frequent or troublesome)

Question 16

WPW (w/o AFib)

Answer 16

Radiofrequency ablation of accessory AV conduction pathway

Question 17

Bradycardia or BB overdose

Answer 17

Atropine

(Up ‘n ATropine!)

Question 18

Asystole or PEA

(Flatline or Pulseless electrical activity)

Answer 18

CPR + q4 Epi

Question 19

Order this test before starting pt on amiodarone

Answer 19

TSH

Question 20

Monitor in pts on amiodarone

Answer 20

TSH, LFTs

Question 21

Use caution when giving amiodarone to pts on this medication

Answer 21

Digoxin

Question 22

Avoid this med in pt with ACG (acute closed-angle glaucoma)

Answer 22

Atropine

(due to anticholinergic pupillary dilation [mydriasis])

Question 23

Check for this deficiency before starting pt on Dapsone (antimalarial)

Answer 23

G6PD deficiency

(can lead to dapsone-induced hemolytic anemia)

Question 24

Indication for endarterectomy in carotid stenosis

Answer 24

80% occlusion or 70% + Sx

(or stents)

Question 25

Carotid stenosis medical therapy

Answer 25

ASA + standard CVD Tx

Question 26

Vasospastic Angina

Answer 26

CCBs + NTG

(VasospastiC aNgina)

Question 27

High-risk HOCM

Answer 27

ICD placement

(if increased risk of SCD)

Question 28

Aortic Stenosis (ASx)

Answer 28

No Tx

Question 29

Aortic Stenosis (severe)

Answer 29

Valve replacement

Question 30

Panic attack

Answer 30

• Acute: BDZs
• Chronic: SSRIs

Question 31

Costochondritis

Answer 31

NSAIDs + Rest

Question 32

Acute Pericarditis

Answer 32

NSAIDs

• 2nd line: Colchicine (anti-inflammatory)

Question 33

Aortic Dissection

Answer 33

IV BBs

• +Morphine for pain
• +Surgical repair if ascending

Question 34

Systolic HF CCBs

Answer 34

Amlodipine, Nifedipine

Question 35

Diastolic HF CCBs (HFpEF)

Answer 35

Verapamil, Diltiazem

Question 36

GERD

Answer 36

PPI or H2 blocker

• +Weight loss
• +Head elevation
• +Nissen (last line)

Question 37

Acute decompensated HF Tx

Answer 37

Furosemide + O₂

(+ABCD)

Question 38

AFib, Valvular

Answer 38

Warfarin

(Vitamin K antagonist)

• “Valvular” = MS or artificial valve

Question 39

Cardiotoxicity from TCA overdose (prolonged PR/QRS/QT intervals)

Answer 39

Sodium bicarbonate

(if QRS >100 or ventricular arrhythmia)

• Alleviates inhibitory action of TCAs on the Na⁺_fast channels of the myocardium, improving hypotension & decreasing the risk of fatal ventricular arrhythmias (by shortening the QRS interval)
• Note: Clinical features of TCA overdose:
  
  • CNS ∆s: Drowsiness, delirium, coma, seizures, respiratory depression
  • CV: Sinus tachycardia, hypotension, prolonged PR/QRS/QT, VT, VFib
  • Anticholinergic Sx: No pee, no see, no spit, no shit + tachycardia
  • Tx: O2, IVF, Charcoal (activated) if within 2 hours of ingestion, IV sodium bicarbonate