Medi 1

Question 1

EBM guidelines for treating hypertension

Answer 1

• People >60, goal for SBP is <150, DBP <90
• People <60, SBP <140, DBP <90
• People >18 w/ CKD <140/90
• People >18 w/ diabetes <140/90

Question 2

In the general non black population, initial antihypertensive tx should include:

Answer 2

A thiazide diuretic
Ca channel blocker
ACE inhibitor
Or Angiotensin Receptor Blocker

Question 3

In the general black population, initial antihypertensive tx should include:

Answer 3

Thiazide diuretic or Ca channel blocker

Question 4

Tx for people >18 w/ CKD and HTN

Answer 4

ACE inhibitor or ARB to improve kidney outcomes

Question 5

Asystole

Answer 5

> 3 sec sinus pause

Question 6

Sick sinus syndrome

Answer 6

Asystole with symptoms

Question 7

Intermittent absent P waves

Answer 7

2nd degree SA block

Question 8

Lack of atrial activity, subsidiary ectopic atrial pacemaker, sinus arrest on ECG

Answer 8

3rd degree SA block

Question 9

Slow sinus response to PACs

Answer 9

1st degree SA block

Question 10

Sinus bradycardia vs. tachycardia

Answer 10

<60

>100

Question 11

Dx and tx of SA node dysfunction

Answer 11

Dx: holter, event recorder, carotid sinus pressure pauses >5sec
Tx: ventricular pacer, AV ventricular pacing

Question 12

AV blocks

2nd degree

Answer 12

Intermittent blocks.
A. Mobitz I (wenkebach): normal QRS, 3:2, 4:3, 5:4 (PR longer longer, longer, drop)-inferior MI, His abnormality, drugs

B. Mobitz II: infra His, wide QRS 2:1, 3:1, 4:1 (PR uniformly long, then drops)

Question 13

Normal PR

Answer 13

0.12-0.2 seconds

Question 14

Tx of bradyarrhythmias

Answer 14

Atropine

Pacemakers

Question 15

____ can’t be seen on an ECG

Answer 15

1st degree SA block

Question 16

AV blocks

1st degree

Answer 16

PR>0.2sec

conducted, but slow

Question 17

AV blocks

3rd degree

Answer 17

Complete block
A. His disease: QRS normal, HR:40-55
B. Infra-His disease: QRS wide, HR<40

Question 18

Treatment for 2nd and 3rd degree AV blocks

Answer 18

Pacemaker

Question 19

Pacemaker syndrome

Answer 19

Syncope
Weakness
Dizziness
Sinus node dysfunction
*prevented by dual chamber pacing maintaining AV synchrony