MCCQE1 Internal Medicine (A+ Graded Already)

STABLE angina definiton correct answers substernal "gripping" chest pain or pressure on exertion, relieved w/ rest or NTG One vessel disease treatment correct answers Tx β-blocker + aspirin + nitrates two vessel treatment correct answers Tx β-blocker + aspirin + nitrates vs PTCA OR CABG three vessel disease correct answers Tx CABG what is involved in a pharmacological stress test correct answers : IV adenosine, dipyridamole, or dobutamine can stress the heart in place of exercise The cardiac markers- when do they pick which is most specific? correct answers 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? correct answers Left-sided CHF: dyspnea, orthopnea, PND Right-sided CHF: pitting edema, hepatic congestion, JVD, ascites NYHA classificaitons in order correct answers 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 correct answers 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? correct answers early P wave that looks differently than other P waves, tx is reassurance Afib correct answers acute, stable → anticoagulate + • rate control w/ Ca-blockers • then cardioversion MAT correct answers ooks like AFib but the P waves are variable, need 3 different P waves for dx ETIOLOGY OF MAT correct answers Etiology: end-stage COPD (MCC) wpw, what is the characteristic wave and how do we treat correct answers "delta wave" reflects accessory conduction pathway from atria to ventricles, tx is ablation VTACH TRAETMENT correct answers Sustained VTach: lasts 30 sec, always symptomatic Nonsustained VTach: lasts 30 sec, usually asx