Rosh Review Cardiology

Question 1

Should nitrates be given to a patient with a NSTEMI who has hypotension?

Answer 1

No

Question 2

In what situations should oxygen be administered in patients with non-ST segment elevation myocardial infarction?

Answer 2

If oxygen saturation is < 90% or in the setting of respiratory distress.

Question 3

Patients with NSTEMI and low TIMI score need to be treated with aspirin and a P2Y12 inhibitor and what else?

Answer 3

Anticoagulation:
- Heparin
- Enoxaparin
- Fondaparinux

Question 4

Is tenecteplase used in the management of NSTEMI?

Answer 4

No (due to an increased risk of reinfarction and other complications)

Question 5

Within what timeframe should a patient with an ST elevation myocardial infarction receive percutaneous coronary intervention (PCI) after presenting at a PCI-capable facility?

Answer 5

Within 90 minutes of medical contact.

Question 6

What labs do you need to check for patients on amiodarone?

Answer 6

Thyroid function tests

Question 7

Is there evidence of a benefit of fibrinolytics in NSTEMI?

Answer 7

No

Question 8

What is the most common dysrhythmia that is seen acute myocardial infarction?

Answer 8

Bradycardia

Question 9

What complication is the leading cause of in-hospital death due to acute myocardial infarction?

Answer 9

Cardiac failure

Question 10

What is the immediate treatment for Wolff-Parkinson-White syndrome?

Answer 10

Procainamide

Question 11

Urgent electrical cardioversion followed by catheter ablation should only be done on unstable WPW patients.

True or false?

Answer 11

True

Question 12

What is a common life-threatening dysrhythmia?

Answer 12

Ventricular fibrillation

Question 13

Which class of antihypertensive therapies is most strongly associated with an increased risk of falls?

Answer 13

Vasodilators

Question 14

Is the risk of stroke reduced after ablation of atrial fibrillation?

Answer 14

No

Question 15

Which patients can stop anti-coagulation 2 - 3 months after ablation of atrial fibrillation?

Answer 15

Those with CHADS-VASc score of 0

Question 16

Is aspirin efficacious in preventing thromboembolism in patients with atrial fibrillation?

Answer 16

No

Question 17

What procedural complication should be suspected in a patient with early satiety and nausea after undergoing catheter ablation for atrial fibrillation?

Answer 17

Gastric denervation

Question 18

Patient with recent myocardial infarction develops chest pain and shortness of breath. Physical examination reveals a new harsh holosystolic murmur loudest at the lower left sternal border. A thrill and right ventricular lift are also present. No crackles, rhonchi, or wheezing is appreciated.

Diagnosis?

Answer 18

Rupture of the interventricular septum

Question 19

Infarction of which coronary arteries is most likely to lead to septal rupture?

Answer 19

Right coronary artery and left anterior descending artery.