Exam3, CV cases with EKG strips Flashcards
how do you Tx pericarditis
non steroidal anti inflammatory
pleuritic chest pain means what
hurts to breathe
17 y/o male presents for a sports physical. He has a systolic murmur that gets louder when he stands from a squatting position. what is it based on this EKG
left ventricular hypertrophy
congenital- young paitnet, no time to develop HTN, so no aortic stenosis
•23 y/o female presents with left lower quadrant rebound tenderness and appears toxic. The pain began peri-umbilical and has now localized over what is the equivalent to McBurney’s point, but on the left. Her surgeon wants to take her to the OR, but is concerned about her EKG. As the consulting internist clearing her for surgery, what is you recommendation?
EKG shows everything is backwards appearing
dextrocardia
•20 y/o college student comes to the ER after a party where he was observed inhaling large amounts of cocaine. He has retrosternal chest pain that began 50 minutes ago. After reviewing his EKG you recommend which of the following:
massive anterolateral MI
How would you Tx cocaine patient with anterolateral MI
recommend he go to cardiac cath lab
A 55 y/o male dressed as Santa Claus is brought in by the paramedics unresponsive. He was last seen at the Park Meadows Mall toy-store where he was working for the season five hours ago. After you see his EKG you recommend what Tx for what condition
hypothermic.
core re-warming. osborn waves
•A 54 y/o female presents with irritability, says she has trouble concentration and she was in the ER last week with a kidney stone. She has solid lump in the base of her left neck. She had a 30pk/yr history of smoking. What is Dx and EKG look like
hypercalcemia from kidney stones
also from paraneoplastic syndrome
will have shortened QT
•A 66 y/o male, 50 pack-year smoker presents with tearing back pain. He has a widened mediastinum on CXR and a loud murmur of aortic insufficiency. Which EKG could be associated with his condition?
aortic dissection- R. coronary a. so will cause inferioe wall MI
initial approach with aortic dissection and inferioe wall MI
transthoracic ECHO
•A 30 y/o female has palpitations and presents to the emergency room. The ER physician gives her a beta blocker and several days later reads about her in the obituary section of the paper. Which EKG was hers in the ER and why?
Beta blockers contraindicated in WPW syndrome
•50 y/o male has dizziness and passed out. He smokes 2 pks/day for 30 years and is on no medications.
What would you do
pacemaker
•A 28 y/o heroin user begins treatment in a methadone clinic. Three days later he is in the ER unresponsive with EKG showing torsades
What would EKG look like before drugs
Long QT syndrome
What physical findings woul dyou find in someone with long QT
hypocalemia
Trousseau sign- spasm of hand
Chvostek’s- muscle spasms of facial n
•A 62 y/o female had palpitations and was prescribed a medication. She now presents to the emergency room after having passed out and hitting her head. Her EKG is below.
first degree AV block
atenolol
she had supraventricular tachy
•62 y/o male presents with palpitations and lightheadedness. Interpret his EKG:
and Tx
ventricular tachy
Tx with beta blockers, amiodarone, propafenone, Automatic implantable cardio defibrillator
what other meds can be used to treat supraventricular tachy
beta blockers, CCB, digoxin, adenosine, amiodarone
-valsalva maneuver, facial ice bath cardioversion, cardiac ablation, carotid message or pacemaker
72 y/o female presents for a routine physical without complaint. She has hypertension, well controlled on losartan. All of her vital signs are normal. You order a routine EKG.
What is it and tx?
ventricular trigeminy and no Tx
•A 92 y/o demented female is left home alone by her daughter for 30 minutes. The patient thinks her daughter has forgotten to give her medication and takes her lisinopril again. Since she has a very short term memory, she does this several times. Later they bring her to the ER with a complaint of dizziness. Which EKG most likely represents hers and why?
hyperkalemic from ARB action
and really hypotensive
What medication is responsibe for U waves
hypocalcemia, hypomagnesemia
furosemide- loop!
