Cardiology

Question 1

What conditions other than an MI can cause trooping to go up

Answer 1

CHF, PE, burns, sepsis, critical illness

Question 2

What are the guidelines for the use of thromolytic with stem I

Answer 2

Greater than 1 mm st segment elevation in at least 2 contagious limb and. At least 2 contiguous pre cordial leads
And presenting 12 hours since the onset of pain, age < 75 yrs

1 to 2 mm of ST segment elevation in at least two Kentucky was precordial leads plus new complete bundle branch block that of scares the ST segment analysis has a history of suggestive of them.

Question 3

What is the dose for in Knox suppression for anticoagulation versus dvt prophylaxis

Answer 3

1 mg /kg sc every 12 hours for an Mi and 30 mg up to you every 12 hours for DVT prophylaxis

Heparin can be used at 60 units/kilogram bolus with the drip of 15 units/kilogram/hour

Question 4

After an MI when is an antiarrythmics is indicated like lidocaine, mood atone

Answer 4

PVC couplets, triplets, nonsustained ventricular tachycardia or greater than 10 Pvc / min

Question 5

What are the indications for CABG

Answer 5

1) significant left main coronary artery disease greater than 50%

2) 3 vessel disease with evidence LV dysfunction less than 50%
3) proximal LAD/LCX disease left main equivalent

Question 6

In atrial fibrillation when do you cardio convert versus rate control

Answer 6

When the a fib is a known or greater than 48 hours you would want to do with control. If you know that it is less than 48 hours you can cardioconvert

Question 7

For atrial fib relation, what anticoagulation can you use prior to cardio conversion and how long

Answer 7

Warfarin, Xa inhibitors- xarelto (roxaban), Eliquis ( epixaban), dabigatran (pradaxa)

Question 8

What is the chads vas score for a fib

Answer 8

CHF
HTN
Age >75
Stroke,Tia
Vascular ds ( Cad,Pad)
Age- 65-74
Sex female

Question 9

What is the treatment criteria for a fib based on chads

Answer 9

0-1 male- give Asa 81-350 mg
1 female- Asa
2 or greater- warfarin or other coags

Question 10

What are the bugs / treatment that affect the rolling age
< 1 month
1-23 months
2-50 yrs
> 50 yrs

Answer 10

1month-GBS, E. Coli, Listeria: Abx- amp + Cefotaxime
1-23months. -strep pneumoniae,
Niesseria meningitis ,
H. Influenza. Vancomycin+ 3rd gen Ceph

2-50 yrs. N. Meningitis
S. Pneumoniae. Van + 3 rd gen ceph
>50 yrs old - N. Meningitis, strep pneumoniae. L. Monocytogenes
Van + 3rd gen Ceph+ amp

Question 11

What antihypertensive medication causes erectile dysfunction and lithium toxicity

Answer 11

Lithium

Question 12

1) what do you seen in an chest X-ray w/ Histoplasmosis

2) coxiella burnetti causes what

Answer 12

1) calcified mediastinal nodes

2) causes Q- fever , moist area and animals placenta

Question 13

What lung doses seen with patients with severe asthma brownish sputum, chronic cough,eosinophilia, elevated IgE and central brochietsis.

Answer 13

Allerigic bronchopulomonary Aspergillosis

Question 14

1) what leads are affected with inferior wall MI
2) Anterior wall MI
3) anteroseptal MI
4) best treatment for Mi

Answer 14

1) 11, 111, aVF leads
2) V3V4V5 leads
3) V1, V2, V5 leads
4) PTCA- percutaneous transluminal coronary angioplasty
And stent placement within 90 min

Question 15

After an acute MI when do you place a transvenous pacemaker

Answer 15

1) complete heart block
2) second degree heart Block Mobitz 11
3) new lobby with first degree AV block

Question 16

Inferior MI associated bradycardia can be caused by what

Answer 16

Mobitz type 1 second degree hear block

Third degree heart block

Question 17

What are the indication for pacemaker in pt with acute MI

Answer 17

1) New left bundle branch block plus first-degree AV block
2) New right bundle branch block plus left anterior or posterior fascicular block +1st° AV block
3) Mobitz type to heart block,
4) 3rd° heart block,
5) symptomatic bradycardia unresponsive to atropine

Question 18

What is the dosing regimen for Enoxaprin and heparin when it is required to be given with thrombolytics

Answer 18

Enoxaprin : 1 mg/ kg SC every 12 hours

Heparin: 60 units/ kg bolus then 15 units/kg/hr achieve aPtt of 1.5

Question 19

in the setting of an acute MI when you give antiarrhythmics

Answer 19

Only for complex everything is such as PVC couplets, triplets, none sustained ventricular tachycardia or greater than 10 PVCs per minute

Question 20

What are the indication for CABG

Answer 20

Significant left main coronary artery disease test and 50%,
three vessel disease with evidence LV dysfunction such as ejection fracture less than 50%,
origin/ proximal left anterior descending and left circumflex

Question 21

What can happen after three weeks after an MI that causes chest pain and fever

Answer 21

Post pericardotomy syndrome similar to Dressler syndrome
( pericarditis and fever.
Treatment- NSAIDs , indomethassin and ASA first line
Can use colchicine and corticosteroid

Question 22

These meds are used for what

1) lidocaine
2) amiodaron
3) adenosine

Answer 22

1) wide complex tachy
2) second line can cause torsades de pointes, longer to control the rate
3) PSVT blocks the AV node

Question 23

What is the dose for vitamin k for elevated INR

Answer 23

Vit K 5 mg po x 1
If INR>4.5 hold the next dose
If INR >4.5-10 hold 1-2 dose if not bleeding
If going to surgery can give 5 mg of Vit K the another 1-1.5 mg in 24 hours
If INR >10 give Vit k 2.5-5.0 even if not bleeding

Question 24

What medication for CHF reduces but mortality rate

Answer 24

Metoprolol succinate
Ace
Spironolactone
Hydralazine
Nitrates
Both spironolactone and nitrates second line
Dig and diuretics not affect mortality

Question 25

Digoxin can be used when
Dig should be avoided when
Side effects of Of digoxin

Answer 25

Diastolic failure a fib
Pt with sig AV block
Shoukd be avoided with amiodarone verapamil quinidine dronedarone clarythromycin erythro, itraconazole cyclosporinhypo
Hypokalemia, hypomagnesium, hypothyroidism