Rosh 6

Question 1

Torsades de Pointes

Treatment is:

Answer 1

Unstable: defibrillation
Stable: intravenous magnesium sulfate and stopping the offending drug

Question 2

MI rx with mortality bennefit

Answer 2

Aspirin, statin, ACE inhibitors, and beta blockers have been shown to have a mortality benefit

Question 3

Anterior wall ST elevation in leads

Answer 3

Anterior wall ST elevation in leads V1 through V4

ST segment elevations > 1 mm in > 2 contiguous leads

Question 4

Inferior wall ST elevation in leads

Answer 4

Inferior wall ST elevation in leads II, III, and AVF

ST segment elevations > 1 mm in > 2 contiguous leads

Question 5

Lateral wall ST elevation in leads

Answer 5

Lateral wall ST elevation in leads I, AVL, V5, and V6

ST segment elevations > 1 mm in > 2 contiguous leads

Question 6

Posterior wall ST depressions _____ and elevations in _____

Answer 6

Posterior wall ST depressions V1 through V3 and elevations in V8 and V9

ST segment elevations > 1 mm in > 2 contiguous leads

Question 7

Inferior ST-Elevation Myocardial Infarction

Answer 7

RCA occlusion
ST elevations: II,III, aVF
RV infarction
ST elevations: V4R and V5R
JVD, hypotension
Rx: IVF, NTG contraindicated

Question 8

Heart Sounds

S1: ____________

Answer 8

mitral and tricuspid valve closure

Question 9

Heart Sounds

S2: ___________

Answer 9

aortic and pulmonary valve closure

Question 10

Heart Sounds

S3: _____________

Answer 10

in early diastole
During rapid ventricular filling phase
Large amount of blood striking a very compliant left ventricle (LV)
Normal in children, pregnant women

Question 11

Heart Sounds

S4 _____________

Answer 11

(“atrial kick”):
Late diastole
Blood flowing against noncompliant LV

Question 12

What is the dosing of atropine?

Answer 12

0.5 mg IV push, which can be repeated every three to five minutes, if needed, to a total dose of 3 mg.