cardiovascular

Question 1

heart failure with preserved EF

Answer 1

HFPEF-typically diastolic dysfunction that impairs ventricular filling. 1. Mortality sl lower than w reduced EF, 2. no drug shown to dec motality. 3. Treat underlying HTN, afib

Question 2

Pheo

Answer 2

antihypertensive choice alpha blocker -phenoxybenzamine, second line calcium channel blocker,
pts often volume depleted. Precipitated by medications & foods Look at adrenal mass; Most MENII or VonHippel Lindau. Dx: plasma metameph, MIBG-131I scan,

Question 3

idiopathic ventricular fibrillation

Answer 3

age<40; nl Echo, Rx ICD, b-blocker; rule out catechol induced v tach

Question 4

Brugada syndrome, pattern

Answer 4

Sudden death v fib; J pt elevation, coved ST, inverted T leads V2. NO structural disease, related to genetic causes-

Question 5

Cardiogenic shock

Answer 5

NE better than Dop in card shock subgroup
No benefit IABP initially
Mortality 40-45%
Highest cause of mort from MI in hospital
Beta blocker increase mortality

Question 6

CHF poor prognostic factors

Answer 6

Inc TropI, SBP<115, Hyponatremia, CAD, inc Creat, low LVEF, Inc BNP, anemia, DM

Question 7

post op pacemaker

Answer 7

RBBB LBBB first degree AV block, age>70, prior heart value surgery

Question 8

ACLS VFib/Vtach

Answer 8

O2/Monitor-
shock 360 monophasic/15-200 biphasic…2 min CPR
shock…cpr 2 min, Epi 1 mg/Vaso 40U q3-5min
shock…..cpr 2min, Amidarone 300 mg, then 150 mg

Question 9

ACLS reversible causes 5 H’s

Answer 9

Hypoxemia, Hypotension, H+ acidosis, hyper/hypokalemia, hypothermia

Question 10

ACLS reversible causes 5 T’s

Answer 10

Tension PTX, Tamponade, Toxin, Thrombosis PE, Thrombosis MI

Question 11

ACLS Asystole/PEA

Answer 11

CPR, Epi, Airway, Reversible causes