Miscellaneous

Question 1

Tachycardic septic shock pressor

Answer 1

Vasopressin/phenylephrine instead of norepinephrine

Question 2

LV hypertrophy and renal dysfunction

Answer 2

Fabry disease, diagnose with genetic testing

Question 3

CPR in a patient with VF or pulseless ventricular tachycardia (VT)

Answer 3

epinephrine 1 mg should be given intravenously every 3-5 min after the second shock. Amiodarone 300 mg or lidocaine 1-1.5 mg/kg may be given IV or IO after the third shock.

Question 4

> 60% survival and with favorable neurologic outcomes for out of hospital arrests

Answer 4

early defib

Question 5

low PA sat + low PCWP

Answer 5

cardiogenic+ distributive shock

Question 6

increased survival rate in cardiac arrest.
decreased survival.

Answer 6

in hospital arrest (25%).

older age (especially >85 years of age), a history of cancer, nonshockable rhythm, unwitnessed arrest, and a pH <7.2

Question 7

Mechanical ventilation: optimize oxygen and carbon dioxide.
Increase oxygenation by.
Decrease CO2 by (paCO2 35-45)

Answer 7

increasing PEEP or increasing the FiO2 with a goal SpO2 of 92-98%.
Increasing the tidal volume and/or increasing the set respiratory rate.

Question 8

ARDS management

Answer 8

TV 6-8 L
Prone

Question 9

For each minute that cardiopulmonary resuscitation (CPR) and defibrillation are delayed

Answer 9

survival is reduced by 10%

Question 10

first thing that should be done when finding an unresponsive, pulseless individual

Answer 10

call for help

Question 11

Risk factors for central sleep apnea.

Risk factors for OSA.

Answer 11

male sex, advanced age, atrial fibrillation, and hypocapnia.
advanced age and an increasing body mass index.

Question 12

history of pregnancy-related hypertension, diabetes mellitus, preterm birth, placental abruption, and stillbirth increases future CV disease

Answer 12

by twofold

Question 13

sports physical

Answer 13

standardized history questionnaire

Question 14

Antifungals, dilt and verap inhibit CYP3A4

Answer 14

Increased levels of cyclosporine and tacrolimus which in turn can increase levels of statins

Question 15

Pre op AS

Answer 15

if suspected moderate or greater valvular stenosis or regurgitation, get echo if none in the past year; or 2) a significant change in clinical status or physical examination since the last evaluation (Class I indication).

Question 16

P2Y12 choice

Answer 16

Ticagrelor for ACS.
Plavix for non ACS such as stable angina.
No prasugrel if h/o stroke or >75 yo.

Question 17

women with mechanical valves during pregnancy

Answer 17

first trimester: warfarin okay if <5 mg/day.
second and third: warfarin okay at whatever dose.
36 weeks: enoxaparin or unfractionated heparin, monitor therapeutic levels with factor Xa

Question 18

severe features of pre-eclampsia.

Answer 18

systolic BP ≥160 mm Hg or diastolic BP ≥110 mm Hg or evidence of significant end-organ dysfunction.
VAGINAL DELIVERY!!!!!!

Question 19

Targeted temperature management (with target 32-36°C) is for

Answer 19

survivors of cardiac arrest (both shockable and nonshockable) who are comatose (GCS ≤8) following resuscitation.

Question 20

Cath post arrest

Answer 20

only for STE

Question 21

persistent or worsening hypotension or shock after blunt trauma

Answer 21

TTE even if initial FAST is negative

Question 22

asymptomatic severe MS preggo

Answer 22

valvuloplasty before preggo

Question 23

Preggo antihtn

Answer 23

labetalol, nifedipine, alpha methyldopa, furosemide to <150/90

Question 24

2nd trimester CO and SVR

Answer 24

increase in CO and decrease in SVR.

Question 25

Treatment of central sleep apnea in HF

Answer 25

CPAP-> supplemental oxygen.
Adaptive servoventilation is CI, increases mortality.

Question 26

Markedly elevated RAP=.
Biventricular support

Answer 26

Right heart failure.
venoarterial extracorporeal membrane oxygenation (ECMO).
venovenous ECMO only supports right heart.