CV 2

Question 1

tachycardia clinical pres
7

Answer 1

1. palpitations
2. syncope
3. lightheadedness
4. dizziness
5. +/- CP
6. hypotension
7. SOB

Question 2

tachycardia - ask about hx of
8

Answer 2

1. infection/illness
2. injury
3. recent bleeding
4. risk factors for internal bleed (PUD)
5. drug/stimulant use
6. exposure to toxins
7. risk factors for dehydration
8. cardiac hx

Question 3

bradycardia - clinical pres
2

Answer 3

HA
hypothermia

Question 4

bradycardia - ask about what hx
2

Answer 4

medications and compliance
exposure to pesticides

Question 5

tachy/brady - img/testing
2

Answer 5

1. ekg
2. consider cxr - pneumothorax, PNA, cardiomegaly/pericardial effusion

Question 6

tachycardia - DD
12

Answer 6

1. MI
2. cardiac tamponade
3. pericardial effusion
4. hypoxia
5. heat stroke
6. acidosis
7. hypovolemia
8. infection/sepsis
9. fever
10. pain
11. hyperthyroid
12. pheochromocytoma

Question 7

bradycardia - DD
7

Answer 7

1. MI
2. increase ICP
3. beta blockers
4. toxicity - cholinergic
5. hypothermia
6. hypothyroid
7. trained athlete

Question 8

sinus tachy tx
3

Answer 8

1. rehydration
2. pain control
3. antipyretics

Question 9

pathologic tachy i.e. PSVT, a fib, a flutter, VT, V fib - tx

Answer 9

ACLS and immediate referral to ER

Question 10

bradycardia - tx

Answer 10

refer to ER is symptomatic or hypotensive

Question 11

tachy/brady- when to refer to ER
4

Answer 11

1. unstable VS
2. high degree AV block
3. cardiac history AND symptomatic
4. new onset a fib or a flutter, wide complex tachy

Question 12

syncope

Answer 12

transient complete or near loss of consciousness w/ spontaneous recovery

Question 13

transient complete or near loss of consciousness w/ spontaneous recovery

Answer 13

syncope

Question 14

vasovagal/reflex syncope may come from
3

Answer 14

1. stressful situation
2. defecation/micturition
3. prolonged standing

Question 15

exertional syncope suggests what

Answer 15

potentially serious CV etiology

Question 16

syncope when lying flat is highly concerning for

Answer 16

dysrhythmia

Question 17

syncope is often preceded by brief what

Answer 17

prodromal symptoms - lightheadedness, nausea, diaphoresis, tunnel vision

Question 18

syncope w/o prodromal sx is concerning for

Answer 18

dysrhythmia

Question 19

syncope red flags
5

Answer 19

1. CP
2. palpitations
3. SOB
4. abd or back pain
5. thunderclap HA

Question 20

syncope take history of
5

Answer 20

1. hx of syncope
2. cardiac disease and associated risk factors
3. antihypertensive and QT prolonging meds
4. in young pts- family hx of sudden cardiac deaths
5. pregnancy

Question 21

syncope PE findings may include
7

Answer 21

1. hypotension
2. bradycardia
3. hypoxia
4. heart murmur
5. abd tenderness
6. neuro deficits
7. lower extremity edema

Question 22

syncope img/testing
5

Answer 22

1. ekg
2. pregnancy test
3. POC glucose
4. consider orthostatic vitals
5. consider CBC/hemoglobin

Question 23

syncope - DD
6

Answer 23

1. cardiac - dysrhythmias, CHF, aortic stenosis, HOCM, PE
2. orthostatic hypotension - hypovolemia, hemorrhage
3. neuro - SAH, seizure
4. ectopic pregnancy
5. ovarian rupture
6. anemia - GIB

Question 24

vasovagal syncope, now well appearing - tx, f/u
3

Answer 24

f/u with PCP
evaluate for concomitant traumatic injuries
treat underlying causes - hypoglycemia, hypovolemia

Question 25

syncope - when to refer to ER 8

Answer 25

1. exertional syncope 2. syncope at rest 3. absence of prodrome 4. recurrent syncope 5. red flag findings 6. advanced age or risk factors for cardiac disease 7. any concern for HF, GIB, PE, aneurysm, abnormal EKG 8. pregnancy w/ concern for ectopic/ovarian rupture