Valvular, Arrhythmia

Question 1

Flecainide, Amiodarone, Propafenone, and Verapamil cause this effect to digoxin level?

Answer 1

These can INCREASE the digoxin level.

Question 2

What is the first line treatment for Lyme carditis?

Answer 2

IV ceftriaxone for 3 weeks for Lyme carditis.

Doxy is the first line treatment for early Lyme disease

Question 3

What is the most common cardiac rhythm documented with out of hospital sudden cardiac death resuscitated, within 4 minutes after arrest?

Answer 3

Ventricular Fibrillation

Question 4

Does digoxin work better to control rate at rest or with exercise?

Answer 4

With REST.

Question 5

Which laboratory test is the most helpful to confirm symptoms concerning for carcinoid tumor?

Answer 5

Urinary 5-HIAA

Question 6

Which of the Class I antiarrhyhmic subtypes have the most potent sodium channel blocking effect?

Answer 6

The Class IC agents have the most potent sodium channel blocking effect (e.x. Flecainide)
C are the Chief, Champion, Coolest, Crowning

(the least potent are the 1B’s - bogus, blah, bummer, bad, beastly. like lidocaine )

Question 7

Which of the Class I antiarrhyhmic subtypes have the least potent sodium channel blocking effect?

Answer 7

The least potent sodium channel blocking effect are the 1B’s
= bogus, blah, bummer, bad, beastly. (ex. like lidocaine )

Question 8

Congenital Deafness, Syncope, Long QT.

What disorder?

Answer 8

Jervell and Lange-Nielsen Syndrome
Autosomal Recessive.
Long QT and congenital sensorineural deafness.
Associated with mutations in KCNQ1(LQT1) or KCNE1(LQT5) which encode the alpha and beta subunits of the slowly acting component of the outward rectifying potassium current (IKs); these proteins also are required to produce endolymph– which explains the deafness.

Question 9

A mutation in either KCNQ1(LQT1) or KCNE1(LQT5) which encode the alpha and beta subunits of the slowly acting component of the outward rectifying potassium current (IKs) causes this syndrome with primary 2 clinical symptoms?

Answer 9

Condition is Jervell and Lange-Nielsen Syndrome

Congenital Deafness
Long QT

Long QT and congenital sensorineural deafness.
Associated with mutations in KCNQ1(LQT1) or KCNE1(LQT5) which encode the alpha and beta subunits of the slowly acting component of the outward rectifying potassium current (IKs); these proteins also are required to produce endolymph– which explains the deafness.