Importantish things maybe..

Question 1

What MUST be considered in every patient with acute onset of chest pain.

Answer 1

BIG 6

Question 2

What are the “Big 6”

Answer 2

1) Tension Pneumothorax/Pneumothorax.
2) Acute Myocardial Infarction/Unstable Angina
3) Pericardial Tamponade
4) Pulmonary Embolism (PE)
5) Esophageal Rupture
6) Aortic Dissection/Rupture

Question 3

What is becks triad indicative of?

Answer 3

Pericardial Tamponade

Question 4

What is becks triad?

Answer 4

• Muffled heart sounds
• Jugular venous distension
• Hypotension unresponsive to fluid challenge

Question 5

Presence of at least one of Virchow’s triad is indicative of what?

Answer 5

DVT

Question 6

What is Virchow’s Triad

Answer 6

(a) Venous stasis
(b) Hypercoagulable state
(c) Injury to vessel wall

Question 7

Unstable is defined as what?

Answer 7

(1 Changes in mental status.
(2 Ischemic chest discomfort.
(3 Hypotension
(4 Signs of shock.
(5 Acute heart failure.

Question 8

During the ACLS protocol, following second round of medications to evaluate the causes of cardiac arrest what are you going to be looking for or at?

Answer 8

H’s and T’s

Question 9

what are the H’s and T’s

There are 11 of them….

Answer 9

1) Hypovolemia
2) Hypoxemia
3) Hydrogen ion excess (acidosis)
4) Hyper-/hypokalemia
5) Hypothermia
6) Hyper-/hypoglycemia
7) Tamponade
8) Tension Pneumothorax
9) Thrombosis (pulmonary embolism)
10) Thrombosis (myocardial infarction)
11) Toxins

Question 10

How do you tell the difference between Hypertensive emergency vs Hypertensive urgency

Answer 10

Signs of END ORGAN DAMAGE

Question 11

What are the signs of END ORGAN DAMAGE

Answer 11

1) Hypertensive encephalopathy (mental status changes, confusion, headache).
2) Intracranial hemorrhage
3) Ischemic stroke
4) Hypertensive nephropathy (proteinuria, hematuria, and
progressive kidney dysfunction).
5) Unstable angina, AMI, CHF, or Aortic dissection
6) Pulmonary edema

Question 12

ANY new heart murmur with a fever is WHAT until proven otherwise?

Answer 12

Endocarditis

Question 13

What does S-3 sound represent?

Answer 13

early diastole

Volume overload

Question 14

What does S-4 Sound represent

Answer 14

ventricular filling from atrial kick

Question 15

Loud S2 suggests

Answer 15

hypertension, valve disorder, stenosis, or fluid

Question 16

Loud S1 suggests

Answer 16

increased blood velocity, mitral stenosis, heart block,

hypertension, or calcification of mitral valve

Question 17

What would you see from a PE of Acute Arterial Occlusion of a Limb

Answer 17

Six P’s

Question 18

are the six 6 P’s in regards to severe arterial ischemia

Answer 18

1) Pain
2) Pallor (or mottled with delayed capillary filling)
3) Poikilothermia (coolness)
4) Pulselessness
5) Paresthesia
6) Paralysis

Question 19

On an EKG
What is alternating amplitude in the precordial leads, meaning that every other QRS complex has reduced amplitude alternating with increased amplitude.

Answer 19

Electrical Alternans