Cardiology

Question 1

Ultimately, heart failure is diagnosed ___.

We get the echo. . .

Answer 1

Ultimately, heart failure is diagnosed clinically, on the basis of history, exam, labs, and CXR.

We get the echo:

1. To differentiate between HFpEF and HFrEF
2. To assess for secondary heart failure (valve problems, structural disease)

Question 2

ACLS loop

Answer 2

For drugs: Alternate between epinephrine and amiodarone, starting with epinephrine.

Dosing: Epinephrine 1 mg each bolus, amiodarone 300 mg first bolus, 150 mg second bolus.

Question 3

Managing atrial fibrillation without RVR

Answer 3

Question 4

Managing atrial fibrillation with RVR

Answer 4

Question 5

Hallmark EKG finding of AVNRT

Answer 5

Narrow QRS complexes without p waves (just t waves!)

Question 6

When to use synchronized cardioversion vs defibrillation

Answer 6

Both are used as first-line only when the patient is hypotensive

Synchronized: A. fib, A. flutter, or monomorphic VT with palpable pulse.

Defibrillation: Pulselss VT or polymorphic VT with palpable pulse.

Question 7

Post-Rheumatic Fever secondary prophylaxis

Answer 7

For RF w/o carditis: 5y or until 21

For RF w/ carditis: 10y or until 21

For RF w/ carditis and permanent heart damage: 10y or until 40

For each, you pick whichever option is longer and prophylax with oral or IM penicillin.

Question 8

Appropriate pharmacotherapy for MSSE endocarditis

Answer 8

6 weeks of IV nacfillin, rifampin and 2 weeks of IV gentamicin

Question 9

Single most common cause of infective endocarditis in patients with damaged heart valves who do not have other risk factors (ex, IVDU)

Answer 9

Streptococcus viridans group (sanguinis, mitis, mutans, salivarius, angiosus)

Question 10

Single most common cause of infective endocarditis in patients with native heart valves who do not have other risk factors (ex, IVDU)

Answer 10

S. aureus

Question 11

Treatment of choice for HACEK group endocarditis

Answer 11

IV Ceftriaxone

Remember, HACEKs are all gram negative