Cardiac Medicine sub-specialty Certification - CMC

Lateral EKG leads Inferior EKG Leads Anterior EKG Leads Cardiac Tamponade s/s AAA s/s pneumothorax DKA HHS I, aVL, V5, V6 Left circumflex II, III, aVF Right coronary artery V1, V2, V3, V4 Left anterior descending artery JVD, narrow pulse pressure, hypoTN (Beck's Triad) pulsus paradoxus (SBP descrase 20mmHg on inspiration) unrelenting chest/abd pain through to back, S/sx: Simple- mild distress, asymmetric chest wall, vauge SOB, chest pain Tension - cyanosis, absent sounds on affected side, decreased wall movement, chest pain. tracheal shift toward unaffect- ed side Tx: simple- no tx, possible chest tube Tension - needle decompression prior to chest tube Dx: hyperglycemia, ketonuria/ketone- mia, metabolic acidosis. [BG 300, ketones present, pH7.30 and bircarb 15] Tx: 3-6 liters NS or 1/2 NS (D5 1/2 when BG250). IV insulin (decrease BG ~100 q1-2h) Hyperglycemia w/o ketosis (enough in- sulin to prevent ketosis, not enough to prevent hyperglycemia) Typically dehydrated, PPP, n/v, lethar- gic/coma, tachy, hypoTN, glycosuria