Cards 4

Question 1

Sustained VT must be > how many seconds?

Answer 1

> 30 seconds

Question 2

Amio load

Answer 2

400 mg BID (or TID) x 3 days
400 mg QD x 2 weeks
200 mg QD x 2 weeks

Question 3

NSTEMI observation period

STEMI observation period

Answer 3

NSTEMI
- LHC, no intervention. Heparin 48 hours then d/c
- PCI, 24 hours then d/c

STEMI
- 48 hours observation

Question 4

Priority drug after STEMI (aside from antiplatelet)

Answer 4

BB

Question 5

What is a big hematologic complication after vavle in MAC (transcatheter mitral replacement, LAMPOON trial)

Answer 5

Hemolytic anemia d/t paravalvular leak and shearing of the RBCs

Question 6

1L of fluid = how many kg?

Answer 6

~1kg

Question 7

K+ goal if actively diuresing

Answer 7

> 4

Question 8

Normal cardiac index

Answer 8

2.5-4.2

Question 9

Cardiac index =

Answer 9

CO/BSA

Question 10

Spinal stenosis
Carpal tunnel
Chronically elevated Tn
Large tongue

Answer 10

Amyloid

Question 11

BUN : Cr ratio > 20:1

Answer 11

Pre-renal

Question 12

How do you order diuretics when actively diuresing

Answer 12

Not a scheduled order
Evaluate the patient and place order/dose accordingly

Question 13

Amount of heparin needed for TAVR?
For CABG/SAVR?

Answer 13

~8000
~25-35k

Question 14

Lasix IV to po conversion
What is a good starting dose for diuresing?

Answer 14

IV is ~ double po
Good starting dose is double home dose
(ie pt takes 40 mg po lasix at home, start diuresis at 40 mg IV)

Question 15

Driving restrictions after MI

Answer 15

1 week no driving

Question 16

MI/PCI, pt on DOAC already. Antiplatelet plan?

Answer 16

DAPT + DOAC
After 1 year ASA + DOAC OR DOAC alone
**DOUBLE CHECK THIS

Question 17

Insurance prefers what dose of amio?

Answer 17

200 mg

Question 18

O2 requirement test ofr home needs to be done within how many hours of discharge?

Answer 18

48 hours

Question 19

Mg goal for cardiac patient?

Answer 19

> 2

Question 20

Recurrent pericarditis with effusion, trialed all PO options (NSAIDs, steroids, colchicine). What is another treatement?

Answer 20

Steroid pericardiocentesis

Question 21

Lasix is active for how many hours?

Answer 21

6 hours

Question 22

Therapeutic heparin, weight based heparin is often ordered for

Heparin sub Q is ordered for what and doses how?

Answer 22

ACS, AF

DVT prophylaxis, 5000 TID or BID

Question 23

Transitioning from brillinta to plavix

Answer 23

600 mg plavix 24 hours after last brillinta dose
Then 75 mg plavix QD thereafter

Question 24

ICD indicated in HFrEF

Answer 24

after 3 months of GDMT and EF persistently < 35%

Question 25

Goal net output when actively diuresing

Answer 25

2-3 L

Question 26

What values on the BMP can you evaluate to suggest if you achieved adequate diuresis (ie one you think you are reaching a dry state)

Answer 26

Chloride lowers
Bicarb increases
BUN : Cr > 20-30 : 1

Question 27

What is a good med if BP is slightly low but you want to initiate GDMT for HF?

What if BP high?

Answer 27

Losartan (not very good a lowering BP, so good if BP is already low)

Lisinopril

Question 28

General steroid taper pericarditis (may differ between patients and providers)

Answer 28

Current dose 2 weeks
Reduce dose by 1/2 for 2 weeks
15 mg 3-4 weeks
12.5 mg 2 weeks
10 mg 2 weeks
then decrease by 1 mg every 2 weeks until 0
*Very slow taper to avoid recurrence

Question 29

Options for nausea

Answer 29

1 Zofran (so long as QTc normal)

#2 Compazine (if prolonged QTc)
#3 Scolpomine patch

Question 30

If pt has prolonged QTc, what are 2 options for anti-emetics

Answer 30

Compazine
Scolpomine patch
(Can’t use zofran, may worsen QT)

Question 31

Matolazone proper use?

Answer 31

Associated with significant electrolyte abnormalities
One study showed increased mortality
Try to minimize as much as possible (ie 2-3 days)
Try not to use as outpatient unless absolutely necessary

Question 32

Normal cardiac index scoe

Answer 32

2.5-4.2

Question 33

BB and surgery?

Answer 33

Continue perioperatviely if already on BB
If wanting to start BB for surgery, needs to be started weeks before surgery
DO not add BB (like days before surgery), has been associated with worst outcomes with this use

Question 34

Typical pattern for onset of torsades

Answer 34

PVC on top of T in already bradycardic patient “typical” history

Question 35

Don’t start Jardiance if

Answer 35

For DM if GFR < 30
For HF if GFR < 20

Question 36

Mild versus severe pericardial effusion (measured in diastole)

Answer 36

< 10 mm mild
10-20 mm moderate
> 20 mm severe