Cardio Rosh

Question 1

MCC Vfib

Answer 1

severe ischemic cardiac disease

Question 2

does hyperkalemia or hypokalemia cause Vfib

Answer 2

hyperkalemia

Question 3

Tx Vfib

Answer 3

chest compressions and administration of epinephrine 1 mg IV every 3–5 minutes

chest compressions 100-120/min

Question 4

in SVT, if vagal maneuvers are ineffective, what tx should you do next

Answer 4

Adenosine 6 mg then 12 mg

Question 5

In what patient population should you use adenosine with extreme caution?

Answer 5

Those with heart transplants due to prolonged drug effect.

Question 6

Nontraumatic causes of cardiac tamponade include

Answer 6

malignancy, acute pericarditis, uremia, bacterial pericarditis, chronic pericarditis, spontaneous hemorrhage, systemic lupus, post-radiation, and myxedema.

Question 7

PE for cardiac tamponade

Answer 7

tachycardia
low systolic blood pressure
narrow pulse pressure
JVD
distant heart sounds
hypotension

Question 8

tx for pericardial effusion / tamponade

Answer 8

The initial treatment should involve volume expansion with a 500–1,000 mL fluid bolus. However, this is only a temporizing measure, and pericardiocentesis is necessary for definitive therapy. In the setting of hemodynamic instability, pericardiocentesis should be performed in the emergency department

Question 9

What is the most common cause of atraumatic pericardial effusion with tamponade?

Answer 9

malignancy

Question 10

CXR for HF

Answer 10

cardiomegaly
Kerley B lines
pulmonary venous congestion
pulmonary edema
Interstitial perihilar infiltrates, also known as “bat winging,
Pleural effusions, typically right-sided

Question 11

What causes Kerley B lines on chest X-ray?

Answer 11

engorgement of lymphatic vessels

Question 12

A hypertensive emergency is defined as

Answer 12

systolic > 180 mm Hg or diastolic > 120 mm Hg with concomitant end-organ damage

Question 13

Examples of hypertensive emergencies include

Answer 13

acute aortic dissection, acute pulmonary edema, acute myocardial infarction, acute coronary syndrome, acute kidney injury, severe preeclampsia or eclampsia, hypertensive retinopathy, hypertensive encephalopathy, subarachnoid hemorrhage, intracranial hemorrhage, acute ischemic stroke, or a sympathetic crisis

Question 14

initial antihypertensive of choice for patients presenting with aortic dissection

Answer 14

esmolol

add nicardipine if needed

Question 15

Anterior wall ST elevation in leads

Answer 15

v1-v4

Question 16

inferior wall ST elevation in leads

Answer 16

II, III, and aVF

Question 17

Lateral wall ST elevation in leads

Answer 17

I, aVL, V5, and V6

Question 18

Posterior wall ST depressions in leads

Answer 18

V1 through V3 and elevations in leads V8 and V9

Question 19

what artery affected in anterior STEMI

Answer 19

LAD

Question 20

what artery affected in inferior STEMI

Answer 20

RCA and/or LCx

Question 21

what artery affected in lateral STEMI

Answer 21

Lcx or diagonal of LAD

Question 22

what artery affected in posterior STEMI

Answer 22

RCA-posterior descending

Question 23

What antiplatelet agent should be given to patients with acute coronary syndrome who have a true aspirin allergy?

Answer 23

clopidogrel

Question 24

what should be given for NSTEMI and STEMI when PCI is considered

Answer 24

Ticagrelor

Question 25

MCC mitral stenosis

Answer 25

rheumatic fever

Question 26

murmur for mitral stenosis

Answer 26

mid-diastolic rumbling murmur. A loud opening snap after S2 may also be heard

Question 27

After rheumatic heart disease, what is the next most common cause of mitral stenosis?

Answer 27

Mitral annular calcification.

Question 28

important finding in aortic regurgitation

Answer 28

wide pulse pressure

Question 29

murmur of aortic regurgitation

Answer 29

blowing diastolic murmur that is best heard in the second or third intercostal space at the left sternal border

Question 30

MCC of infective endocarditis

Answer 30

staph aureus

gram positive cocci in clusters

Question 31

tx vasospastic angina

Answer 31

smoking cessation, calcium channel blockers (diltiazem is preferred) for prophylaxis, and nitroglycerin as needed during acute episodes

Question 32

Which is the more common finding in volume-depleted adults: hypokalemia or hyperkalemia?

Answer 32

hypokalemia

Question 33

EKG findings for pericarditis

Answer 33

ECG findings of diffuse ST elevation with reciprocal ST depression in leads aVR and V1

Question 34

What viruses commonly cause pericarditis?

Answer 34

Coxsackie viruses A and B, echovirus, adenovirus, HIV, Epstein-Barr virus, influenza, and hepatitis B

Question 35

tx for pericarditis

Answer 35

NSAIDs, colchicine

Question 36

tx cardiogenic shock

Answer 36

dobutamine
NE
if failure –> intraaortic balloon pump

Question 37

most common cause of acute arterial occlusion

Answer 37

Afib

Question 38

murmur of mitral regurgitation

Answer 38

holosystolic murmur at the apex that radiates to the axilla

Question 39

What is the most common location for a AAA?

Answer 39

Below the level of the renal arteries (infrarenal).

Question 40

The midsystolic click is moved earlier in systole by maneuvers that decrease preload, such as

Answer 40

valsalva and standing

Question 41

midsystolic click is moved later in systole by maneuvers that increase preload, such as

Answer 41

squatting
handgrip

Question 42

murmur for aortic stenosis

Answer 42

crescendo-decrescendo systolic murmur that radiates to the carotids

Question 43

first line tx for hypertensive encephalopathy

Answer 43

nicardipine

Question 44

tx for WPW

Answer 44

procainamide

Question 45

Ventricular free wall rupture presents with signs of

Answer 45

cardiac tamponade and shock

Question 46

papillary muscle rupture commonly presents with

Answer 46

new murmur of mitral regurgitation
post MI

Question 47

Which of the following patient history elements is most indicative of cardiac syncope?

Answer 47

absence of a postdrome