Cardio

Question 1

Differentials for narrow QRS

Answer 1

-Sinus
-Atrial
-AV nodal

Question 2

Differentials for wide/bizarre QRS

Answer 2

-Ventricular
-Conduction abnormality (BBB)

Question 3

Differentials for no P for every QRS

Answer 3

-A fib
-Ventricular complex

Question 4

Differentials for no QRS for every P

Answer 4

-AV block (2nd and 3rd)
-Atrial flutter

Question 5

Class I antiarrhythmics

Answer 5

Na+ channel blockers
-lidocaine
-mexiletine

Question 6

Class II antiarrhythmics

Answer 6

Beta-blockers
-Uses: supraventricular and less commonly ventricular arrhythmias
-Side effects: Negative inotrope, bradycardia, hypotension
-Atenolol
-Propanolol

Question 7

Class III antiarrhythmics

Answer 7

K+ channel blockers
-Uses: ventricular arrhythmias, supraventricular arrhythmias, a-fib (amiodarone)
-Sotalol
-Amiodarone

Question 8

Class IV antiarrhythmics

Answer 8

Ca2+ channel blockers
-Diltiazem
-Slows AV node conduction
-Uses: a-fib, supraventricular arrhythmias
-Side effects: negative inotrope, weakness, hypotension

Question 9

Miscellaneous antiarrhythmics

Answer 9

Digoxin

Question 10

Antiarrhythmic Drug Actions

Answer 10

Question 11

Lidocaine/Mexiletine

Answer 11

Class 1b
Na2+ blocker
Shortens AP duration
Uses: Ventricular arrhythmias

Question 12

Procainamide

Answer 12

Class 1a
Na2+ blocker, affects some K+ channels
Prolonged AP
Uses: ventricular arrhythmias, a-fib, +/- supraventricular tachyarrhythmias

Question 13

Sotalol

Answer 13

Class III
K+ channel blocker
Increases AP duration
Non-selective beta blocker at higher doses
Uses: chronic ventricular arrhythmias
Contraindications: prolonged QT

Question 14

Amiodarone

Answer 14

Class III
K+ channel blocker - increases AP duration
Uses: ventricular arrhythmias, a-fib, other supraventricular arrhythmias

Question 15

Diltiazem

Answer 15

Class IV
Ca2+ ch blocker- slows conduction through AV node, increases refractory period of AV node
Uses: supraventricular tachyarrhythmias (a-fib, sustained supraventricular tachyarrhythmias)

Question 16

Digoxin

Answer 16

Antiarrhythmics
Inhibits Na+/K+/ATPase -> increases intercellular Na2+ -> exchanged for extracellular Ca2+ -> increased intracellular Ca2+ = forceful contraction
Uses: a-fib

Question 17

Atenolol

Answer 17

Class II
Beta blocker- decreases autimacity, slows conduction through AV node, increases refractory period through AV node
Uses: supraventricular tachyarrhythmias, feline supraventricular tachyarrhythmias

Question 18

Indications for temporary pacing

Answer 18

-Transient bradyarrhythmias
-Toxicities/overdosing in chronotropic incompetence (diltiazem overdosing)
-Emergency stabilization of critical bradyarrhythmias (high grade 2 AV block, 3rd degree AV block, sinus arrest, persistent atrial standstill)

Question 19

What bacteria can cause endocarditis?

Answer 19

-Strep canis and bovis
-Bartonella
-Staph. spp
-E. Coli, pseudomonas, salmonella, citrobacter, klebsiella, proteus, pasteurella
-Actinomyces, mycobacterium, corynebacterium, enterococcus

Question 20

Tree of Life

Answer 20

Question 21

Diagnosis of FATE with 5p rule

Answer 21

-pallor (purple or pale toes)
-polar (cold extremities)
-pulselessness
-paralysis
-pain

Question 22

BLASTT study

Answer 22

Prospective randomized study comparing thrombolysis with tissue plasmatogen activator (tPA) two placebo had an overall discharge rate of 37.5% for bilateral FATE