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Step 3 > Inservice Deck 1 - CV and ENT > Flashcards

Inservice Deck 1 - CV and ENT Flashcards

1
Q

Immediate tx for unstable patient with pulses?

A

synchronized cardioversion @ 100J

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2
Q

procainamide - 2 main indications

4 stopping points

A

WPW and VTach

Hypotension
Resolution of arrhythmia
QRS widening > 50% original
Max dose reached (17 mg/kg)

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3
Q

Hepatojugular reflux indicates?

A

right sided heart failure

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4
Q

What do you think of with electrical alternans?

A

cardiac tamponade (pericardial effusion)

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5
Q

Best way to visualize the vegetations in endocarditis?

A

TEE

gold std - tissue biopsy

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6
Q

most useful test for endocarditis?

A

blood cxs x 3, taken 1 hour apart

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7
Q

Number 1 complication of endocarditis?

A

CHF

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8
Q

Most sensitive CXR finding in aortic dissection?

A

widened mediastinum

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9
Q

Sudden onset of sharp chest pain and back pain, syncope, or stroke-like symptoms think?

A

aortic dissection

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10
Q

initial treatment for hemodynamically stable patient with prolonged qt who develops tachyarrhythmia

A

mg

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11
Q

normally functioning pacemaker fails to pace, most likely cause

A

oversensing

  • pacemaker senses external stimuli as atria/vent contraction
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12
Q

ekg in pericarditis will most commonly show ST elevations and what else?

A

PR depression

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13
Q

tx for patient with ST elevations in II, III, and aVF who develop hypotension?

A

IV fluid bolus

  • inferior MI think right ventricle involved
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14
Q

most common sign in patient with myocarditis?

A

tachycardia

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15
Q

most specific sign in acute CHF?

A

S3

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16
Q

Patient had MI 2 months ago and has EKG with persistent ST elevation. What is the diagnosis?

A

ventricular aneurysm

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17
Q

tx for asymptomatic patient with PVCs?

A

observe / DC if incidental finding

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18
Q

10 year old has signs and symptoms of CHF as well as HTN and unequal pulses. Most likely cause?

A

coarctation of the aorta

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19
Q

dialysis patient presents with dyspnea. You press on his AV gract and the pulse drops from 130-90. What does this indicate?

A

high output failure

Branham sign - may occur when > 20% of cardiac output is diverted through the access

20
Q

Disposition for patient with abd pain and 7 cm pulsatile mass?

A

operating room

  • no CT, ruptured AAA
21
Q

What are the contraindications to thrombolytics in patients with ACS?

A

TPA IS BAD

T - trauma
P - pericarditis
A - active internal bleeding
I - intracranial pathology/tumor
S - stroke - hemorrhagic or recent ischemic (6 months)
B - BP uncontrolled, 180 or above SBP or 11 DBP
A - allergic to med
D - dissection (suspected)
22
Q

what ST/T ratio can distinguish benign early repolarization from pericarditis?

A

ST/T < 0.25 in benign early repol

23
Q

Female with palpitations and mid systolic click has what diagnosis?

A

mitral valve prolapse

24
Q

most common cause of dysr4hythmia in cardiac transplant patient?

A

rejection

25
Q

patient s/p cardiac transplant has bradycardia. WHat med will not be effective? why not?

A

atropine - denervated vagal nerve

26
Q

Next test to order on 65 year old male with HTN, left flank/back pain, and trace hematuria?

A

abd ultrasound - r/o AAA

27
Q

What tx is indicated for patient with unstable angina allergic to ASA?

A

clopidogrel

28
Q

patient with transvenous pacer has pacer spikes with LBBB pattern on EKG. WHat does this signify?

A

functioning normally

29
Q

a magnet placed over a pacemaker has what effect?

A

causes it to fire at a fixed rate

30
Q

30 year old male presents after syncopal event with EKG showing ST elevatioin in V1-V3 with a RBBB without reciprocal depressions. Most likely diagnosis?

A

brugada syndrome

tx - refer for EPS study

31
Q

What is the best tooth transplant medium? what if not available?

A

Hank’s balanced salt solution

  • milk
  • saline
  • intraoral

hanks - isotonic calcium containing cell culture medium

32
Q

bad breath and bad gums?

A

ANUG

acute necrotizing ulcerative gingivitis

33
Q

What is the diagnosis and inital source that caused an abnl swelling in submandibular region with tongue deviated upward?

A

ludwig’s angina

odontogenic - caused from an abscess of the mandibular molars

34
Q

Organism that causes malignant otitis externa?

A

pseudomonas - classically in diabetics

35
Q

Common source of posterior epistaxis?

A

sphenopalatine artery

36
Q

patients most at risk for posterior bleeds?

A

elderly with coag

37
Q

diabetic presents with facial pain, unilateral facial swelling over the mandible, fever, trismus, purulent discharge from stetson’s duct has what?

A

suppurative parotitis

Cause - bact = staph viral = mumps

tx - abx, sialogogues

38
Q

patient has acute onset of tinnitus hearing loss and vertigo, N/V, and nystagmus that is fatigable. No recent URI and has had multiple previous episodes. Diagnosis?

A

meniere’s disease

39
Q

child has been coughing since playing with legos. What test is needed?

A

bronchoscopy after CXR

40
Q

Diagnosis and tx for baby with infection of lacrimal sac?

A

dacryocystitis

tx - topical and systemic abx, ophtho consult, warm compresses

41
Q

3 year old immigrant with multipe episodes of paroxysms of coughing. Dx and tx?

A

pertussis

tx - erythromycin or other macrolide

42
Q

are systemic abx indicated for most patients with dry socket

A

NO!

tx - nerve block, irrigate, eugenol, +/- gelfoam

43
Q

What infection is of concern in diabetic febrile who develops black sputum?

A

mucormycosis

44
Q

what is the disposition and tx for a febrile patient who presents with posterior auricular pain and tenderness to touch

A

mastoiditis

tx - admit with IV abx

45
Q

most common organism in otitis media?

A

strep pneumo

46
Q

most common complication of AOM?

A

tympanic membrane perforation

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