Cardiology

Question 1

A pt with WPW is predisposed to what arrhythmia?

Answer 1

SVT with wide QRS complex -

specifically AV re-entry tachycardia (AVRT)

Question 2

Immediate treatment of stable narrow complex SVT

Answer 2

1st- vagal maneuver/carotid massage
2nd - adenosine
3rd - Beta-blocker or CCB (diltiazem, verapamil)

Question 3

Treatment for sick sinus syndrome

Answer 3

permanent pacemaker

Question 4

Definitive treatment of SVT

Answer 4

radio-frequency ablation

Question 5

Treatment of unstable SVT

Answer 5

cardioversion

Question 6

What arrhythmia is commonly associated with severe COPD (hypoxia)?

Answer 6

multifocal atrial tachycardia

Question 7

Anticoagulant Rx for patients with Afib

Answer 7

Warfarin

Apixaban (low risk of GI bleed, less need for monitoring)

Question 8

Rx regimen for patient with Afib

Answer 8

Rate control: Metoprolol or Diltiazem
Rhythm control: Amiodarone
Anticoagulant (likely): Apixaban

Question 9

CHA2DS2-VASc score

Answer 9

CHF
HTN
Age >75 (2 pt)
DM
Stroke hx (2 pt)
Vasc disease (prior MI, PAD, CAD)
Age 65-74
Sex (female)

Question 10

treatment for stable sustained VT

Answer 10

amiodarone

2nd choice: lidocaine

Question 11

treatment for unstable VT with a pulse

Answer 11

synchronized cardioversion

Question 12

VT no pulse

Answer 12

treat like V fib

Question 13

treatment for ventricular fibrillation

Answer 13

unsynchronized cardioversion (defibrillation) + CPR

Question 14

treatment for pulseless electrical activity

Answer 14

CPR + epinephrine + check for “shockable” rhythm

Question 15

treatment for Torsades de Pointes

Answer 15

IV magnesium sulfate (other lytes prn)
defibrillation
did a drug cause QT prolongation?

Question 16

Rx for stable angina

Answer 16

aspirin
beta blocker
statin
NTG as needed

Question 17

Rx for STEMI

Answer 17

within 3 hours: PCI

if unable to get PCI: alteplase

Question 18

Rx post-MI

Answer 18

Statin
Aspirin
Beta blocker
ACE-inhibitor

Question 19

Rx for variant angina

Answer 19

CCB

Question 20

Rx for stable heart failure

Answer 20

ACE-i
diuretic
add beta-blocker

Systolic failure adjuncts: spironolactone, hydralazine + NTG, digoxin

Question 21

Rx for acute pericarditis

Answer 21

aspirin or NSAIDS x 7-14 days
if refractory: corticosteroids
if s/p MI (Dressler’s): aspirin or colchicine

Question 22

diffuse ST elevations.

think:

Answer 22

acute pericarditis

Question 23

low voltage QRS.

think:

Answer 23

pericardial effusion
constrictive pericarditis
restrictive CMP

Question 24

pulses paradoxus
muffled heart sounds
JVP
hypotension

Answer 24

pericardial tamponade

Question 25

Rx for dilated CMP

Answer 25

standard systolic HF rx (ACE, diuretic, beta blocker, digoxin) implantable defibrillator if EF <30

Question 26

Rx for hypertrophic CMP

Answer 26

``` ICD placement beta blocker (negative inotropes) cautious/don't use diuretic, digoxin, nitrates ```