Internal Medicine COMAT Review-293 Questions with Updated Solutions

Internal Medicine COMAT Review-293 Questions with Updated Solutions ECG leads representing anterior wall - CORRECT ANSWER V1-4 (LAD) ECG leads representing the inferior portion of the heart - CORRECT ANSWER II, III, and aVF (right coronary artery) ECG leads representing the lateral myocardial wall - CORRECT ANSWER I, AVL, V5, & V6 When should you consider immediate diagnostic coronary angiography? - CORRECT ANSWER order immediate diagnostic coronary angiography for a STEMI or new-onset Left BBB Another name for angioplasty... - CORRECT ANSWER Primary In an acute inferior wall myocardial infarction, occlusion of which coronary artery is usually implicated? - CORRECT ANSWER Right coronary artery Difference in sounds between COPD and pulmonary edema/interstitial lung disease. - CORRECT ANSWER Wheezing or rhonchi= more suggestive of COPD Crackles= more suggestive of pulmonary edema or interstitial lung disease. Most common cause of an S3 heart sound - CORRECT ANSWER CHF What are S3 heart sounds - CORRECT ANSWER S3 results from increased atrial pressure leading to increased flow rates, as seen in congestive heart failure, which is the most common cause of an S3 heart sound. causes of a mid-systolic non-radiating murmur - CORRECT ANSWER High output states (anemia, fever, thyrotoxicosis, pregnancy). Aortic stenosis (ejecting systolic murmur that radiates to carotids). Aortic sclerosis (valve thickening w/o outflow obstruction). Pulmonic stenosis Hypertrophic cardiomyopathy (consider in younger patients). Where is aortic regurgitation auscultated? - CORRECT ANSWER It's an early DIASTOLIC murmur heard in the 2nd LEFT-upper sternal border.