onlinemeded

Question 1

Why would you not use a drug eluding stent?

Answer 1

unreliable or homeless patient, b/c drug eluding stents require 1 year of clopedigrel
otherwise ALWAYS use drug eluding stents

Question 2

how long do you use clopedigrel in drug eluding stents? bare metal stents?

Answer 2

1 year

1 month

Question 3

after STEMI has been ruled out, what is the next step?

Answer 3

Give ASA

diagnosis with troponins comes AFTER ASA

Question 4

first line treatment for R sided infarct?

Answer 4

fluids

Question 5

What medications are NOT given in R sided infarct & why?

Answer 5

Nitroglycerin & morphine b/c they are venodilators which would decreased preload to R heart, making situation worse

Question 6

What is the limit for transport to PCI center?

Answer 6

60 minutes

Question 7

what is the door to balloon time?

Answer 7

90 minutes

Question 8

In class III heart failure, what medication is added?

Answer 8

spironolactone OR combination hydralazine & isosorbide dinitrate

Question 9

first step in diagnosing HF?

Answer 9

BNP, then echo, then catheterization

Question 10

What can hide HF via BNP?

Answer 10

obesity artificially lowers BNP

Question 11

when do you refer for AICD in HF?

Answer 11

Class I with EF less than 30%

Class II or III with EF less than 35%

Question 12

tx of flash pulmonary edema

Answer 12

IV nitrates

Question 13

What medication in important for long term HF mortality, but reduces EF in acute setting?

Answer 13

beta blockers

Question 14

possible sign of posterior MI?

Answer 14

depression in V1-V4

Question 15

cardiogenic PCWP

Answer 15

greater than 12

Question 16

L atrial enlargement can cause?

Answer 16

atrial fibrillation

Question 17

mitral stenosis sound

Answer 17

opening snap w/diastolic decrescendo murmur

earlier the snap, worse the disease

Question 18

aortic stenosis sound

Answer 18

aortic region, systolic crescendo-decrescendo murmur

Question 19

mitral regurgitation sound

Answer 19

holosystolic murmur radiating to axilla

heard best at apex

Question 20

aortic insufficiency sound

Answer 20

diastolic decrescendo systolic murmur at aortic region

Question 21

valsalva improves which murmurs

Answer 21

MS, AS, MR, AR

Question 22

valsalva worsens which murmurs

Answer 22

HCOM & MVP

Question 23

Leg raise worsens which murmurs

Answer 23

MS, AS, MR, AR

Question 24

Leg raise improves which murmurs

Answer 24

HCOM & MVP

Question 25

HOCM sound

Answer 25

systolic crescendo-decrescendo, young person, improves with increased venous return

Question 26

what patients are most likely to respond to cardioversion?

Answer 26

young with NO structural heart disease

Question 27

when do you get a cardiac MRI?

Answer 27

when sarcoid or hemachromatosis is suspected

Question 28

Beck’s triad

Answer 28

pericardial tamponade:

JVD, hypotension, decreased heart sounds

Question 29

T or F: intubation is dangerous in setting of pericardial tamponade.

Answer 29

T: induction medication decrease preload too much & positive pressure ventilation further reduces preload

Question 30

What antihypertensives cause hypokalemia?

Answer 30

thiazides and loop diuretics

Question 31

What antihypertensives cause hyperkalemia?

Answer 31

ACE-inhibitors

Question 32

tx of A fib in the setting of heart failure?

Answer 32

digoxin or amiodarone

Question 33

when can chest compressions be skipped?

Answer 33

witnessed loss of pulse in shockable rhythm