Rosh 5

Question 1

HCM ECG

Answer 1

deep narrow Q waves in the inferolateral leads
diffuse T wave inversions
LVH

Question 2

RV STEMI Leads

Answer 2

ST elavation in II, III, avf

Question 3

Acute mesenteric ischemia physical exam

Answer 3

sudden-onset severe generalized abdominal pain out of proportion to physical exam.

initial abdominal exam is often nontender or minimally tender, as the peritoneum is not yet irritated.

As bowel ischemia progresses, the intramural intestinal nerves die and the patient’s pain will temporarily resolve- FALSE REASSURANCE

Question 4

What classic ECG finding is associated with severe hypothermia?

Answer 4

Osborn Wave (J Wave).

Question 5

Multifocal Atrial Tachycardia

Answer 5

Associated with patients with COPD and the elderly
Rate will be 100-200 beats/min
PR interval will be differing
Notable feature: At least 3 different P-wave forms
Treatment is to treat the underlying cause, calcium-channel blockers

Question 6

Any medication that slows AV nodal conduction is contraindicated in antidromic WPW.
These can be remembered by the mnemonic “ABCD” which stands for?

Answer 6

adenosine
beta-blockers
calcium channel blockers
digoxin.

Question 7

Which tachydysrhythmia is most commonly seen in Wolff-Parkinson-White syndrome?

Answer 7

Atrioventricular reentrant tachycardia (AVRT).

Question 8

Cardiac Electrical Conduction System pathway

Answer 8

SA node → AV node → bundle of his → bundle branches → purkinje fibers