OME - Day 1

Question 1

What are the four medications everyone with CAD should be on?

Answer 1

Aspirin, Statin, Ace-inhibitor, and Beta-blocker

Question 2

What class of medication prevents death in the first 24 hours post MI?

Answer 2

Beta Blockers

Question 3

You want a stress test, but the patient has heart failure, so what kind of stress test do you do?

Answer 3

Nuclear

Question 4

You want a stress test, but the person has ANY reason they can’t walk. What kind of stress test do you do?

Answer 4

Pharmacologic stress test

Question 5

A cath is performed and there’s 3 vessel disease. What’s the next step?

Answer 5

CABG

Question 6

What’s the magic time where you give tPA rather than transport for PCI in STEMI?

Answer 6

60 minutes

Question 7

You want a stress test, but the patient has a history of a CABG, so what kind of stress test do you do?

Answer 7

Nuclear

Question 8

A person calls EMS with chest pain and known coronary artery disease; what’s the first step?

Answer 8

Nitro (not aspirin)

Question 9

A person comes into the ED with chest pain; what do you give them first?

Answer 9

Aspirin (not nitro)

Question 10

A cath is performed and the LAD and left circumflex are blocked. What’s the next step?

Answer 10

CABG

Question 11

Dyspnea on exertion, worsening orthopnea, paroxysmal nocturnal dyspnea - diagnosis?

Answer 11

Congestive Heart Failure

Question 12

What medication do you give if there’s volume overload in a CHF patient?

Answer 12

Loop diuretics (IV in exacerbation, PO if not exacerbated)

Question 13

At what ejection fraction should someone be considered for AICD placement?

Answer 13

EF < 35% (and Stages I-III)

Question 14

You suspect CHF exacerbation;

what’s the first step?

Answer 14

ECG (to rule out arrhythmia and infarction)

Question 15

You suspect CHF;

what blood test do you get?

Answer 15

BNP (Brain natriuretic peptide)

Question 16

You suspect CHF;

which imaging do you order?

Answer 16

2D Echo aka Echocardiogram

Question 17

A pregnant woman has a rumbling systolic murmur with an opening snap. Diagnosis?

Answer 17

Mitral valve prolapse

Question 18

Crescendo-Decrescendo Murmur right sternal border?

Answer 18

Aortic Stenosis

Question 19

First line treatment for mitral stenosis?

Answer 19

Balloon Valvotomy

Question 20

Old man passes out while shoveling snow; what’s the most likely murmur?

Answer 20

Aortic Stenosis

Question 21

Septic Shock from Aortic Insufficiency gets?

Answer 21

Intra-Aortic Balloon Pump

Question 22

Teenager who gets profound dyspnea while playing a sport, diagnosis?

Answer 22

Hypertrophic Obstructive Cardiomyopathy

Question 23

Treatment for Hypertrophic Obstructive Cardiomyopathy?

Answer 23

Beta-blockers (avoid exercise, avoid dehydration)

Question 24

What test do you do before replacing the aortic valve?

Answer 24

Left Heart Cath (you may need a CABG)

Question 25

You diagnose mitral valve regurgitation; what’s the most likely cause?

Answer 25

Papillary Muscle rupture

Question 26

Diagnosis for Asymmetric Hypertrophy of the septum

Answer 26

HOCM

Question 27

Treatment for dilated cardiomyopathy?

Answer 27

Beta-blockers, Ace-inhibitors, and Diuretics

(treat it like systolic dysfunction)

Question 28

How do you treat a restrictive cardiomyopathy?

Answer 28

Beta-blockers (diastolic failure)