MCCQE1 INTERNAL MEDICINE EXAM WITH COMPLETE
SOLUTIONS 100% VERIFIED!!!! ALREADY GRADED A+ LATEST
UPDATE!!!
STABLE angina definiton - (ANSWER)substernal "gripping" chest pain or pressure on exertion, relieved w/
rest or NTG
One vessel disease treatment - (ANSWER)Tx β-blocker + aspirin + nitrates
two vessel treatment - (ANSWER)Tx β-blocker + aspirin + nitrates vs PTCA OR CABG
three vessel disease - (ANSWER)Tx CABG
what is involved in a pharmacological stress test - (ANSWER): IV adenosine, dipyridamole, or dobutamine
can stress the heart in place of exercise
The cardiac markers- when do they pick which is most specific? - (ANSWER)CK-MB: peaks in 24 hrs and
lasts 2-3 days, good for recurrence Troponin I: peaks in 24 hrs and lasts 1-2 weeks, most specific
Difference between left-sided and right-sided CHF? - (ANSWER)Left-sided CHF: dyspnea, orthopnea, PND
Right-sided CHF: pitting edema, hepatic congestion, JVD, ascites
NYHA classificaitons in order - (ANSWER)NYHA class I: sx only w/ vigorous activity (e.g. sports) NYHA
class II: sx w/ moderate activity (e.g. stairs)
NYHA class III: sx w/ ADLs NYHA class IV: sx at rest
CHF classes and treatment - (ANSWER)class I → Tx loop diuretic + ACE inhibitor • class II-III → add β-
blocker
• class IV → add digoxin
what is PAC and how do we treat? - (ANSWER)early P wave that looks differently than other P waves, tx
is reassurance
, MCCQE1 INTERNAL MEDICINE EXAM WITH COMPLETE
SOLUTIONS 100% VERIFIED!!!! ALREADY GRADED A+ LATEST
UPDATE!!!
Afib - (ANSWER)acute, stable → anticoagulate + • rate control w/ Ca-blockers
• then cardioversion
MAT - (ANSWER)ooks like AFib but the P waves are variable, need 3 different P waves for dx
ETIOLOGY OF MAT - (ANSWER)Etiology: end-stage COPD (MCC)
wpw, what is the characteristic wave and how do we treat - (ANSWER)"delta wave" reflects accessory
conduction pathway from atria to ventricles, tx is ablation
VTACH TRAETMENT - (ANSWER)Sustained VTach: lasts >30 sec, always symptomatic
Nonsustained VTach: lasts <30 sec, usually asx
Torsades de pointes: rapid, polymorphic VTach due to QT prolongation
sustained → Tx IV amiodarone • nonsustained → reassurance • torsades → Tx IV mag sulfate
VFIB tx - (ANSWER)• Tx immediate defib + CPR, then • continue IV amiodarone
sinus brady tx - (ANSWER)usually insignificant; if sx → Tx • atropine (blocks vagus nerve)
first degree meaning and tx - (ANSWER)PR interval >0.2 .. needs reassurance
DCM management - (ANSWER)echo and CXR to diagnose and tx for CHF AN HEART TXP
SOLUTIONS 100% VERIFIED!!!! ALREADY GRADED A+ LATEST
UPDATE!!!
STABLE angina definiton - (ANSWER)substernal "gripping" chest pain or pressure on exertion, relieved w/
rest or NTG
One vessel disease treatment - (ANSWER)Tx β-blocker + aspirin + nitrates
two vessel treatment - (ANSWER)Tx β-blocker + aspirin + nitrates vs PTCA OR CABG
three vessel disease - (ANSWER)Tx CABG
what is involved in a pharmacological stress test - (ANSWER): IV adenosine, dipyridamole, or dobutamine
can stress the heart in place of exercise
The cardiac markers- when do they pick which is most specific? - (ANSWER)CK-MB: peaks in 24 hrs and
lasts 2-3 days, good for recurrence Troponin I: peaks in 24 hrs and lasts 1-2 weeks, most specific
Difference between left-sided and right-sided CHF? - (ANSWER)Left-sided CHF: dyspnea, orthopnea, PND
Right-sided CHF: pitting edema, hepatic congestion, JVD, ascites
NYHA classificaitons in order - (ANSWER)NYHA class I: sx only w/ vigorous activity (e.g. sports) NYHA
class II: sx w/ moderate activity (e.g. stairs)
NYHA class III: sx w/ ADLs NYHA class IV: sx at rest
CHF classes and treatment - (ANSWER)class I → Tx loop diuretic + ACE inhibitor • class II-III → add β-
blocker
• class IV → add digoxin
what is PAC and how do we treat? - (ANSWER)early P wave that looks differently than other P waves, tx
is reassurance
, MCCQE1 INTERNAL MEDICINE EXAM WITH COMPLETE
SOLUTIONS 100% VERIFIED!!!! ALREADY GRADED A+ LATEST
UPDATE!!!
Afib - (ANSWER)acute, stable → anticoagulate + • rate control w/ Ca-blockers
• then cardioversion
MAT - (ANSWER)ooks like AFib but the P waves are variable, need 3 different P waves for dx
ETIOLOGY OF MAT - (ANSWER)Etiology: end-stage COPD (MCC)
wpw, what is the characteristic wave and how do we treat - (ANSWER)"delta wave" reflects accessory
conduction pathway from atria to ventricles, tx is ablation
VTACH TRAETMENT - (ANSWER)Sustained VTach: lasts >30 sec, always symptomatic
Nonsustained VTach: lasts <30 sec, usually asx
Torsades de pointes: rapid, polymorphic VTach due to QT prolongation
sustained → Tx IV amiodarone • nonsustained → reassurance • torsades → Tx IV mag sulfate
VFIB tx - (ANSWER)• Tx immediate defib + CPR, then • continue IV amiodarone
sinus brady tx - (ANSWER)usually insignificant; if sx → Tx • atropine (blocks vagus nerve)
first degree meaning and tx - (ANSWER)PR interval >0.2 .. needs reassurance
DCM management - (ANSWER)echo and CXR to diagnose and tx for CHF AN HEART TXP
