Medi-misc

Question 1

Anteroseptal wall
Leads
Artery

Answer 1

V1-V6

LAD

Question 2

Lateral wall
Leads
Artery

Answer 2

I, aVL, V5, V6

LCX

Question 3

Posterior wall
Leads
Artery

Answer 3

V1, V2

LCX

Question 4

Inferior wall
Leads
Artery

Answer 4

II, III, aVF

RCA

Question 5

Right ventricular wall
Leads
Artery

Answer 5

RV1-RV6

RCA

Question 6

The ___ feeds the anterior wall and apex of the heart

Answer 6

LAD (and diagonal)

Question 7

The ___ feeds the lateral and part of the posterior wall of the heart (in 15% of people it also supplies all of the inferior wall because it gives rise to the ___)

Answer 7

LCX (and obtuse marginals)

Posterior descending

Question 8

He ___ feeds the inferior wall, RV wall, and SA/AV nodes

Answer 8

RCA

Question 9

Sounds likely to be heard in a STEMI patient

Answer 9

Paradoxically splitting of S2
Apical systolic murmur
S4
Friction rub

Question 10

Stage of MI with tall and narrow T waves?

Answer 10

Early

Question 11

ST depression occurs in leads ___

Answer 11

Facing an ischemic area (1-2 mm lasting 0.08 seconds)

Question 12

Normal values for CO and SVR

Answer 12

4-8 L/min

900-1300 dynes/sec/cm

Question 13

Type of shock:
High CO
low SVR
normal PAOP

Answer 13

Distributive

Question 14

Type of shock:
Low CO
high SVR
high PAOP

Answer 14

Cardiogenic

Question 15

Type of shock:
Low CO
High SVR
Low PAOP

Answer 15

Hypovolemic

Question 16

Type of shock:
Low CO
High SVR
high or normal PAOP

Answer 16

Obstructive

Question 17

Thwart are two of the physiological causes of extracardiac obstructive shock?

Answer 17

Impaired systolic emptying

Impaired diastolic filling

Question 18

Common causes of distributive shock

Answer 18

Anaphylaxis
Shock
Drug overdose
TSS

Question 19

1. What is directly measured by a PA catheter?

2. Indirectly?

Answer 19

1. CVP, PA pressure, PAOP/wedge pressure, CO, SvO2

2. SV, CI, SVR, PVR, Oxygen delivery

Question 20

PAOP reflects pressure in which chamber of the heart?

Answer 20

Left atrium

Question 21

1. What is the drug of choice for septic shock?
2. Medication related shock?
3. Cardiogenic shock?

Answer 21

1. NE (increases BP)
2. Phenylephrine (selective alpha 1 agonist)
3. Dobtamine (increases contractility and CO, vasodilator)

Question 22

1. Best fluid for MVA shock? (Or any trauma)

2. For septic patients?

Answer 22

1. Saline

2. Albumin

Question 23

Colloid is ___

Dosing?

Answer 23

Albumin
HES
Pentastarch
*expensive 
*500-1000 mL of IVS expansion per 1L

Question 24

Crystalloid is ___

Dosing?

Answer 24

Lactated ringers

• cheap, but can give interstitial edema
• 100-200mL IVS expansion per 1L (so less effective than colloid)

Question 25

Normal MAP

Answer 25

70-110 mmHg

Question 26

``` 72 y/o male Left calf claudication with exertion Relieved with rest Predictable after 2 blocks of walking 102 pack year smoker What drug will best reduce risk of CV event ```

Answer 26

Clopidogrel

Question 27

``` 72 y/o male Left calf claudication with exertion Relieved with rest Predictable after 2 blocks 102 pack year smoker Which artery is likely stenosed? ```

Answer 27

Superficial femoral

Question 28

Symmetric and painful dysregulated adipose | Weight loss will not help

Answer 28

Lipedema

Question 29

Virchows triad

Answer 29

Stasis Hypercoagulability Endothelial injury

Question 30

Cirrhosis can cause ___ which leads to pitting edema

Answer 30

Anasarca

Question 31

Which causes of edema are pitting?

Answer 31

Venous HTN Anasarca Lymphedema (non pitting at some stages)

Question 32

Gold standard for dx of DVT?

Answer 32

Venography | -rarely used due to invasiveness

Question 33

What are 2 causes of venous HTN

Answer 33

AV fistula | Thrombophlebitis

Question 34

Filariasis can result in ___ which leads to edema

Answer 34

Lymphedema

Question 35

Venous cath evaluates what?

Answer 35

Venous pressure Right heart pressure CO Possible shunts

Question 36

Which artery is likely responsible if the anterior interventricular sulcus area is not functioning correctly? Posterior IV sulcus?

Answer 36

LAD | RCA