pretest

Question 1

. Common causes of cardiogenic shock

include

Answer 1

acute MI, pulmonary embolism, COPD exacerbation, and pneumonia

Question 2

occurs after an acute spinal cord injury, which disrupts
sympathetic innervation resulting in hypotension and bradycardia. Anaphylactic
shock

Answer 2

neurogenic shock

Question 3

supraventricular tachycardia

Answer 3

narrow complex regular tachycardia

caused by a reentry or an ectopic pacemaker in areas of the heart above the bundle of His, usually the atria

Question 4

First-line treatment for a patient with stable SVT is ?

Answer 4

vagal maneuvers- bear down, include carotid sinus massage (after auscultating for carotid bruits) and facial immersion in cold water.

If vagal maneuvers fail, the next step is adenosine

Question 5

originates from ectopic
ventricular pacemakers and is usually a regular rhythm with rate greater
than 100 beats per minute and wide QRS complexes.

Answer 5

Ventricular tachycardia (VT)

Question 6

Ventricular tachycardia treatment unstable

Answer 6

In unstable pts, synchronized cardioversion

Question 7

Ventricular tachycardia treatment stable

Answer 7

1st line- Amiodarone 150-mg IV over 10 minutes

Question 8

Drugs that can be given thru endotracheal tube

Answer 8

naloxone, atropine, versed, epinephrine, and lidocaine

mnemonic NAVEL.

Question 9

Unstable A-Fib treatment

Answer 9

cardioversion

Question 10

Cardioversion vs defibrillation

Answer 10

Cardioversion is performed with organized cardiac electrical activity with pulses

defibrillation is performed on patients without pulses

Question 11

The key step when cardioverting is to activate the synchronization mode and confirm the presence of ?

Answer 11

sync markers on the R waves
prior to delivering electrical energy.

machine ids R waves and wont deliver electrical energy during it

Question 12

pulseless electrical activity (PEA)

Answer 12

cardiac electrical activity but no detectable pulses

Question 13

patients with ESR have ↑ risk of hyperkalemia –> PEA

_____ should be given first to stabilize the cardiac membranes

Answer 13

calcium gluconate

Question 14

Biphasic defibrillation

Answer 14

delivers a charge in one direction for
1/2 of shock, then opposite direction for the second 1/2.

significantly↓ energy for defibrillation and ↓ the risk of myocardial damage.

Question 15

________ is never recommended for asystole.

Answer 15

Defibrillation

Question 16

A common cause of asystole is

Answer 16

a disconnected lead or malfunctioning equipment
confirm asystole by switching to
another lead on the cardiac monitor

Question 17

The appropriate treatment for asystole includes

Answer 17

CPR
epinephrine every 3 to 5 minutes
atropine every 3 to 5 minutes

Question 18

no relationship between the P waves and QRS complexes

Answer 18

3rd degree block

Question 19

First-degree AV block

Answer 19

PR interval > 0.20 seconds

Every P wave is still followed by a QRS complex (1:1 conduction).

Question 20

all forms of shock attempt to compensate for hypotension with tachycardia except for

Answer 20

neurogenic

Question 21

_________ is the 1st line for second-degree, Mobitz I AV block.

Answer 21

Atropine

majority respond without further treatment needed

Question 22

Mobitz I is commonly seen with

Answer 22

acute inferior MI
digoxin toxicity
myocarditis
post-cardiac surgery

Question 23

Administration of _________ has been shown to decrease runs of torsades

Answer 23

magnesium sulfate

Question 24

Beta Blocker antidote

Answer 24

glucagon

thought to work through a separate
receptor that is not blocked by β-adrenergic antagonists, ultimately ↑ inotropy and chronotropy

Question 25

specific ultrasound signs for tamponade

Answer 25

right atrial and ventricular collapse

pericardial effusion

Question 26

ST segment elevation in leads II, III, and aVF indicating the patient is having?

Answer 26

an inferior wall MI

Question 27

Cushing reflex

Answer 27

hypertension, bradycardia, and respiratory depression

in 1/3 of patients with a potentially lethal ↑ ICP

Question 28

Naloxone serious side effects

Answer 28

↑ HR
v-fib 
cardiac arrest 
sz
comma 

*So use some caution in AMS–> look for pinpoint pupils, etc

Question 29

alcohol withdrawal seizures may occur anywhere from _______ after cessation

Answer 29

6 to 48 hours

Question 30

hypertensive encephalopathy

Answer 30

• rapid ↑ BP accompanied by neurologic changes
• systolic BP > 220 mmHg
• diastolic BP > 110 mmHg
• pressure should only be ↓ 20% -30% in the 1st hour.

Question 31

hypertensive encephalopathy s/s

Answer 31

severe HA, NVD, AMS, sz, blindness

Question 32

If a patient is symptomatic from hyponatremia use hypertonic saline (3%) to raise the serum sodium to ______

Answer 32

serum sodium to 120 mEq/L

Question 33

DTs usually occur _____ after alcohol cessation

Answer 33

48-72 hours

Question 34

Neuroleptic malignant syndrome rx

Answer 34

• Dantrolene

- AMS, hyperthermia, and muscle rigidity

Question 35

classic triad of Wernicke encephalopathy:

Answer 35

confusion, ataxia, and ophthalmoplegia

Question 36

ETOH withdrawal with hallucination but no sz

Answer 36

alcoholic hallucinosis

Question 37

CNS effects of cocaine ( autonomic and CNS hyperactivity, agitation, paranoia) are managed with ___________

Answer 37

benzodiazepines