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Cards EKG changes Flashcards

1
Q

Which EKG change is commonly seen in an acute myocardial infarction (MI)?
A. ST-segment elevation
B. T-wave inversion
C. Q waves
D. All of the above

A

D. All of the above

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2
Q

What is the significance of Q waves on an EKG?
A. Indicates atrial enlargement
B. Suggests past myocardial infarction
C. Normal finding in young adults
D. Reflects electrolyte imbalance

A

B. Suggests past myocardial infarction

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3
Q

What does ST-segment elevation on an EKG indicate?
A. Normal cardiac function
B. Myocardial ischemia
C. Myocardial injury
D. Hyperkalemia

A

C. Myocardial injury

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4
Q

Which coronary artery is typically involved in an inferior MI?
A. Left anterior descending artery
B. Left circumflex artery
C. Right coronary artery
D. Left main coronary artery

A

C. Right coronary artery

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5
Q

Which EKG leads show changes in an anterior MI?
A. Leads II, III, aVF
B. Leads V1-V4
C. Leads I, aVL, V5-V6
D. Leads aVR, V1-V2

A

B. Leads V1-V4

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6
Q

Which EKG finding is often seen in posterior MI?
A. ST-segment elevation in V1-V4
B. T-wave inversion in II, III, aVF
C. R wave greater than S wave in V1-V2
D. Q waves in leads I and aVL

A

C. R wave greater than S wave in V1-V2

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6
Q

Which EKG finding suggests myocardial ischemia?
A. ST-segment elevation
B. T-wave inversion
C. Q waves
D. ST-segment depression

A

B. T-wave inversion

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6
Q

. What is the typical EKG finding in variant (Prinzmetal) angina during an episode?
A. ST-segment elevation
B. ST-segment depression
C. T-wave inversion
D. Q waves

A

A. ST-segment elevation

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7
Q

. Which EKG finding indicates transmural infarction?
A. ST-segment depression
B. T-wave inversion
C. Significant Q waves
D. Hyperacute T waves

A

C. Significant Q waves

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8
Q

. What is the purpose of using beta-blockers in ACS management?
A. Increase heart rate
B. Decrease myocardial oxygen demand
C. Raise blood pressure
D. Lower cholesterol levels

A

B. Decrease myocardial oxygen demand

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9
Q

Which symptom is often associated with acute coronary syndrome (ACS)?
A. Sharp, stabbing chest pain
B. Gradual onset of dull, heavy chest pain
C. Intermittent shooting pain in the arm
D. Localized tenderness over the ribs

A

B. Gradual onset of dull, heavy chest pain

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10
Q

. Which medication class is often used for long-term prevention of recurrent ACS?
A. Antibiotics
B. Antiplatelets
C. Antihistamines
D. Antacids

A

B. Antiplatelets

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11
Q

ST-segment depression
T-wave inversion
No significant Q wave

A

NSTEMI

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12
Q

ST-segment elevation
T-wave inversion
Significant Q wave

A

STEMI

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13
Q

T-wave inversion

A

Ischemia

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14
Q

ST-segment elevation

A

injury

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15
Q

Significant Q-wave

A

infarction

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16
Q

Anterior MI ECG changes

A

seen in lead V1-V4

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17
Q

Anterolateral MI EGG changes

A

seen in
I, aVL
V4
V6

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18
Q

Anteroseptal MI EGG changes

A

seen in V1, V2

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19
Q

Inferior MI

A

seen in II, III, aVF

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20
Q

Posterior MI

A

seen in V1–V3

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21
Q

Lateral MI

A

seen in
I, aVL
V5
,V6

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22
Q

For the diagnosis of endocarditis to be made, the following must be present:

A

Two major criteria, OR
* One major criterion and three minor criteria, OR
* Five minor criteria

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23
Q

Major criteria for endocarditis diagnosis

A

Two separate positive blood cultures with microorganisms typical for infective endocarditis
(viridans streptococci, streptococcus bovis, HACEK group, staphylococcus aureus,
enterococci)

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24
Q

Minor criteria for diagnosis of endocarditis

A

Echocardiographic evidence of endocardial involvement (typical valvular lesions:
vegetations, abscess, or partial dehiscence of a prosthetic valve)
Predisposition: predisposing heart condition or IV drug use
Temperature above 38°C
Vascular phenomena: major arterial emboli, septic pulmonary infarcts, mycotic aneurysm,
intracranial haemorrhage, conjunctival haemorrhage, Janeway lesions
Immunological phenomena: glomerulonephritis, Osler nodes, Roth spots, rheumatoid
factor
Microbiological evidence: positive blood culture but not meeting major criterion, or
serologic evidence of active infection with organism consistent with infective endocarditis

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25
Q

Endocarditis may present with several skin manifestations. Which of the following are included?
A. Petechia, splinter hemorrhage, Janeway spots, and Osler’s nodes
B. Eczema, psoriasis, hives, and blisters
C. Acne, rosacea, and dermatitis
D. Vitiligo, melasma, and warts

A
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26
Q

Which ocular signs can be seen in endocarditis?
A. Roth spots and petechial hemorrhage
B. Conjunctivitis and photophobia
C. Blurred vision and dry eyes
D. Retinal detachment and cataracts

A

A. Roth spots and petechial hemorrhage

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27
Q

Which pulmonary symptoms might a patient with endocarditis exhibit?
A. Pleuritic chest pain, cough, and shortness of breath
B. Asthma, wheezing, and rapid breathing
C. Chest tightness, cyanosis, and hemoptysis
D. Bronchitis, chronic obstructive pulmonary disease (COPD), and apnea

A

A. Pleuritic chest pain, cough, and shortness of breath

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28
Q

Which central nervous system (CNS) symptoms are indicative of endocarditis?
A. Headache, confusion, and meningitis
B. Dizziness, vertigo, and balance issues
C. Tremors, weakness, and neuropathy
D. Memory loss, disorientation, and agitation

A

A. Headache, confusion, and meningitis

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28
Q

Gastrointestinal symptoms of endocarditis include:
A. Nausea, vomiting, and weight loss
B. Diarrhea, constipation, and bloating
C. Heartburn, acid reflux, and indigestion
D. Abdominal distension and flatulence

A

A. Nausea, vomiting, and weight loss

29
Q

What renal symptoms might you observe in a patient with endocarditis?
A. Flank pain, hematuria, and pyuria
B. Increased urine output and dehydration
C. Urinary incontinence and urgency
D. Kidney stones and frequent urination

A

A. Flank pain, hematuria, and pyuria

30
Q

A new or increased intensity of an old heart murmur is a cardiovascular sign of endocarditis. Which additional cardiovascular symptom may also be present?
A. High blood pressure
B. Chest pain
C. Rapid heart rate
D. Arrhythmia

A

B. Chest pain

31
Q

Which of the following general symptoms are commonly associated with endocarditis?
A. Fever, chills, and fatigue
B. Joint pain and muscle weakness
C. Rash and itching
D. Numbness and tingling

A

A. Fever, chills, and fatigue

32
Q

Which gastrointestinal procedure can be a risk factor for endocarditis?
A. Barium enema
B. Drinking plenty of water
C. Avoiding dairy products
D. Taking over-the-counter antacid

A

A. Barium enema

32
Q

Which of the following respiratory procedures poses a risk for endocarditis?
A. Rigid bronchoscopy
B. Deep breathing exercises
C. Using a nebulizer
D. Taking antihistamines

A

A. Rigid bronchoscopy

33
Q

What type of genitourinary infection can lead to an increased risk of endocarditis?
A. Urinary tract infection (UTI)
B. Athlete’s foot
C. Ear infection
D. Sinus infection

A

A. Urinary tract

34
Q

Which skin condition is NOT a risk factor for endocarditis?
A. Trauma
B. Abscesses and lesions
C. Eczema
D. Puncture site from IV injection

A

C. Eczema

35
Q

What type of cardiac procedure can increase the risk of developing endocarditis?
A. Cardiac surgery
B. Electrocardiogram (EKG)
C. Blood pressure monitoring
D. Wearing a heart rate monitor

A

A. Cardiac surgery

36
Q

Which of the following procedures is a risk factor for endocarditis in the gastrointestinal category?
A. Colonoscopy and endoscopy
B. Appendectomy and cholecystectomy
C. Hemorrhoidectomy and gastrectomy
D. Taking antacids and probiotics

A

A. Colonoscopy and endoscopy

37
Q

Which of the following is NOT a risk factor for endocarditis related to genitourinary procedures?
A. Urinary catheterization
B. Prostatectomy
C. Endometrial infections
D. Regular urination

A

D. Regular urination

38
Q

What gastrointestinal procedures are associated with a higher risk of endocarditis?
A. Esophageal dilation and barium enema
B. Taking probiotics and eating a high-fiber diet
C. Drinking plenty of water and avoiding spicy foods
D. Regular bowel movements and using laxatives

A

A. Esophageal dilation and barium enema

39
Q

Which respiratory procedures can increase the risk of endocarditis?
A. Rigid bronchoscopy and nasotracheal suctioning
B. Deep breathing exercises and using a humidifier
C. Taking allergy medications and avoiding pollutants
D. Using inhalers and nasal sprays

A

A. Rigid bronchoscopy and nasotracheal suctioning

40
Q

Cardiac and vascular risk factors for endocarditis include which of the following?
A. Cardiac surgery and IV drug use
B. High cholesterol and hypertension
C. Obesity and sedentary lifestyle
D. Regular exercise and a healthy diet

A

A. Cardiac surgery and IV drug use

41
Q

Which skin conditions or procedures can contribute to the development of endocarditis?
A. Puncture site from IV injections and lacerations
B. Sunburn and insect bites
C. Dry skin and eczema
D. Acne and rosacea

A

A. Puncture site from IV injections and lacerations

42
Q

risk for endocarditis
A. Tooth extraction and periodontal surgery
B. Brushing teeth and using mouthwash
C. Dental flossing and using fluoride toothpaste
D. Drinking hot beverages and eating spicy food

A

A. Tooth extraction and periodontal surgery

43
Q

What genitourinary procedures are risk factors for endocarditis, especially in the presence of a urinary tract infection?
A. Urinary catheterization and dilation of strictures
B. Drinking plenty of water and frequent urination
C. Use of antiseptic wipes and regular bathing
D. Wearing loose-fitting clothing and cotton underwear

A

A. Urinary catheterization and dilation of strictures

44
Q

When diagnosing endocarditis, which echocardiogram method provides a more detailed view of the heart valves and is often preferred?
A. Transthoracic echocardiogram (TTE)
B. Transesophageal echocardiogram (TEE)
C. Stress echocardiogram
D. Doppler echocardiogram

A

B. Transesophageal echocardiogram (TEE)

45
Q

Diagnostics for endocarditis

A
  • ESR/CRP
  • Urinalysis
  • CBC/WBC
  • Baseline EKG
  • CXR
  • Echocardiogram
  • Transthoracic vs. transesophageal
46
Q

For a diagnosis of endocarditis to be made, which combination of criteria is NOT sufficient according to the Modified Duke criteria?
A. One major criterion and three minor criteria
B. Two major criteria
C. Five minor criteria
D. One major criterion and two minor criteria

A

D. One major criterion and two minor criteria

47
Q

Which of the following is NOT part of the Modified Duke criteria for diagnosing endocarditis?
A. Predisposition such as predisposing heart condition or IV drug use
B. Rheumatoid arthritis
C. Vascular phenomena such as major arterial emboli
D. Temperature above 38°C

A

B. Rheumatoid arthritis

48
Q

Which microorganism is typical for infective endocarditis and is part of the major criteria for the Modified Duke criteria?
A. Escherichia coli
B. Staphylococcus aureus
C. Pseudomonas aeruginosa
D. Candida albicans

A

B. Staphylococcus aureus

48
Q

Which of the following is considered an immunological phenomenon, a minor criterion, in the diagnosis of endocarditis?
A. Major arterial emboli
B. Intracranial hemorrhage
C. Glomerulonephritis
D. Janeway lesions

A

C. Glomerulonephritis

48
Q

Which of the following vascular phenomena is considered a minor criterion in the Modified Duke criteria for endocarditis?
A. Glomerulonephritis
B. Janeway lesions
C. Positive blood culture
D. Vegetations on echocardiogram

A

B. Janeway lesions

48
Q

What is required to meet the microbiological evidence minor criterion for endocarditis in the Modified Duke criteria?
A. Two separate positive blood cultures with typical microorganisms
B. Positive blood culture but not meeting primary criterion
C. Echocardiographic evidence of endocardial involvement
D. Temperature above 38°C

A

B. Positive blood culture but not meeting primary criterion

48
Q

Which combination is sufficient to diagnose endocarditis using the Modified Duke criteria?
A. Two minor criteria and one major criterion
B. One major criterion and three minor criteria
C. Three major criteria
D. Four minor criteria

A

B. One major criterion and three minor criteria

49
Q

Which of the following is a minor criterion for diagnosing endocarditis according to the Modified Duke criteria?
A. Two separate positive blood cultures with typical microorganisms
B. Echocardiographic evidence of endocardial involvement
C. Positive blood culture not meeting major criterion
D. Abscess formation on the valve

A

C. Positive blood culture not meeting major criterion

50
Q

How many major criteria are required for a definitive diagnosis of endocarditis according to the Modified Duke criteria?
A. One
B. Two
C. Three
D. Five

A

B. Two

51
Q

Which of the following is considered a major criterion for the diagnosis of endocarditis according to the Modified Duke criteria?
A. Temperature above 38°C
B. Positive blood culture for typical microorganisms
C. Presence of Osler nodes
D. Positive rheumatoid factor

A

B. Positive blood culture for typical microorganisms

52
Q

For patients with a penicillin allergy, which antibiotic and route can be used for infective endocarditis prophylaxis?
A. Cefazolin oral
B. Ampicillin IV
C. Ceftriaxone IM or IV
D. Amoxicillin oral

A

C. Ceftriaxone IM or IV

53
Q

Which of the following conditions is NOT considered a high-risk factor for requiring infective endocarditis prophylaxis?
A. Complex cyanotic congenital heart disease
B. Previous history of infective endocarditis
C. Hypertension
D. Cardiac valvulopathy in a transplanted heart

A

C. Hypertension

53
Q

Which antibiotic is NOT recommended for penicillin-allergic patients as prophylaxis for infective endocarditis?
A. Clindamycin
B. Azithromycin
C. Amoxicillin
D. Cephalexin

A

C. Amoxicillin

54
Q

Which of the following patients should receive antibiotic prophylaxis for infective endocarditis?
A. Patients with hypertension undergoing dental procedures
B. Patients with prosthetic heart valves undergoing invasive respiratory tract procedures
C. Patients with diabetes undergoing routine blood tests
D. Patients with asthma undergoing minor skin surgery

A

B. Patients with prosthetic heart valves undergoing invasive respiratory tract procedures

54
Q

What is the recommended antibiotic prophylaxis for an adult patient without a penicillin allergy undergoing a dental procedure involving the gingival tissues?
A. Clindamycin oral 600 mg
B. Amoxicillin oral 2 g
C. Azithromycin oral 500 mg
D. Cephalexin oral 2 g

A

B. Amoxicillin oral 2 g

54
Q

Which antibiotic is recommended for prophylaxis in penicillin-allergic patients undergoing procedures that perforate the oral mucosa?
A. Amoxicillin
B. Ampicillin
C. Clindamycin
D. Cefazolin

A

C. Clindamycin

55
Q
A
56
Q

Which high-risk patient group should receive antibiotic prophylaxis before undergoing an invasive respiratory tract procedure involving biopsy?
A. Patients with a history of pneumonia
B. Patients with prosthetic heart valves
C. Patients with diabetes
D. Patients with asthma

A

B. Patients with prosthetic heart valves

57
Q

What is the empiric antibiotic treatment for infective endocarditis in patients with prosthetic valves?
A. Vancomycin IV
B. Vancomycin IV plus rifampin
C. Ampicillin/sulbactam (Unasyn) plus an aminoglycoside
D. vancomycin IV or ampicillin/sulbactam (Unasyn) plus an
aminoglycoside (plus rifampin in patients with prosthetic valves)

A

D. vancomycin IV or ampicillin/sulbactam (Unasyn) plus an
aminoglycoside (plus rifampin in patients with prosthetic valves)

58
Q

How long is the IV antibiotic treatment course for Staphylococcus aureus or coagulase-negative Staphylococcus in infective endocarditis?
A. 1–2 weeks
B. 2–4 weeks
C. 4–6 weeks
D. 6–8 weeks

A

B. 2–4 weeks

59
Q

Which of the following antibiotics can be used alone or in combination for a 2–4 week IV treatment course for Staphylococcus aureus infective endocarditis?
A. Vancomycin, penicillin G, ceftriaxone
B. Ampicillin, streptomycin, ceftriaxone
C. Vancomycin, gentamycin, rifampin
D. Penicillin G, gentamycin, rifampin

A

A. Vancomycin, penicillin G, ceftriaxone

60
Q

What combination of antibiotics is recommended for Enterococcus infective endocarditis?
A. Vancomycin and gentamycin
B. Vancomycin and rifampin
C. Penicillin G and ceftriaxone
D. Ampicillin and ceftriaxone

A

A. Vancomycin and gentamycin

61
Q

ST depressions in leads V1-V3 indicate which type of heart attack?
A. Inferior wall heart attack
B. Lateral wall heart attack
C. Posterior wall heart attack
D. Anterior wall heart attack

A

C. Posterior wall heart attack

62
Q

Which leads coincide with an anterior wall heart attack?
A. Leads II, III, and aVF
B. Leads V1-V3
C. Leads I, aVL, and V5-V6
D. Leads V3-V4

A

D. Leads V3-V4

63
Q

In a posterior wall heart attack, which leads show ST depressions?
A. Leads V3-V4
B. Leads V1-V3
C. Leads I, aVL, and V5-V6
D. Leads II, III, and aVF

A

B. Leads V1-V3

64
Q

Which EKG leads coincide with a lateral wall heart attack?
A. Leads I, aVL, and V5-V6
B. Leads II, III, and aVF
C. Leads V1-V3
D. Leads V3-V4

A

A. Leads I, aVL, and V5-V6

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