COMLEX LEVEL 2 Complete (Original) 568
Q&A/ A+ Score Solution.
Pt on statin meds should be monitored for what?
___ w/ statins can increase risk of myositis - Answer: Liver dysfunction. Routinely
monitor AST and ALT
Fibrates (such as gemfibrozil)
Adverse effects of lipid lowering meds
Statins
Niacin
Page 1 of 306
,fibric acid derivatives
Cholestyramine
Ezetimibe - Answer: Elevations of transaminases (liver function tests), myositis
Elevation in glucose and uric acid level, pruritus
Increased risk of myositis when combined with statins
Flatus and abdominal cramping
Well tolerated and nearly useless
Use CCBs (verapamil/diltiazem) in CAD only with
Adverse Effects of CCBs - Answer: • Severe asthma precluding the use of beta
blockers
• Prinzmetal variant angina
• Cocaine-induced chest pain (beta blockers thought to be contraindicated)
• Edema
• Constipation (verapamil most often)
• Heart block (rare)
Page 2 of 306
,Indications for a CABG
Are artery or vein graph better?
___ is the best in acute coronary syndromes, particularly with ST segment
elevation - Answer: • Three vessels with at least 70% stenosis in each vessel
• Left main coronary artery occlusion
• Two-vessel disease in a patient with diabetes
• Persistent symptoms despite maximal medical therapy
Artery graph (last 10 yrs)
Vein graph (last 5 years)
PCI (angioplasty)
What is the S4 sound
What is the S3 sound
What is pulsus pardoxus and what is it associated w/
What is Kussmaul sign
Page 3 of 306
, Increase in wedge pressure is an indication of - Answer: Atrial pumping into a stiff
ventricle
CHF
Decrease in BP >10mmHg on inspiration --> Pericardial tamponade
Inc in jugulovenous pressure on inhalation --> associated w/ constrictive
pericarditis
pulmonary HTN
Leads V2-V4
Leads II, III, AVF
Leads V1, V2
Which is associated w/ worst mortality
Which leads are read backwards? - Answer: anterior wall
Inferior wall
Posterior wall
Page 4 of 306
Q&A/ A+ Score Solution.
Pt on statin meds should be monitored for what?
___ w/ statins can increase risk of myositis - Answer: Liver dysfunction. Routinely
monitor AST and ALT
Fibrates (such as gemfibrozil)
Adverse effects of lipid lowering meds
Statins
Niacin
Page 1 of 306
,fibric acid derivatives
Cholestyramine
Ezetimibe - Answer: Elevations of transaminases (liver function tests), myositis
Elevation in glucose and uric acid level, pruritus
Increased risk of myositis when combined with statins
Flatus and abdominal cramping
Well tolerated and nearly useless
Use CCBs (verapamil/diltiazem) in CAD only with
Adverse Effects of CCBs - Answer: • Severe asthma precluding the use of beta
blockers
• Prinzmetal variant angina
• Cocaine-induced chest pain (beta blockers thought to be contraindicated)
• Edema
• Constipation (verapamil most often)
• Heart block (rare)
Page 2 of 306
,Indications for a CABG
Are artery or vein graph better?
___ is the best in acute coronary syndromes, particularly with ST segment
elevation - Answer: • Three vessels with at least 70% stenosis in each vessel
• Left main coronary artery occlusion
• Two-vessel disease in a patient with diabetes
• Persistent symptoms despite maximal medical therapy
Artery graph (last 10 yrs)
Vein graph (last 5 years)
PCI (angioplasty)
What is the S4 sound
What is the S3 sound
What is pulsus pardoxus and what is it associated w/
What is Kussmaul sign
Page 3 of 306
, Increase in wedge pressure is an indication of - Answer: Atrial pumping into a stiff
ventricle
CHF
Decrease in BP >10mmHg on inspiration --> Pericardial tamponade
Inc in jugulovenous pressure on inhalation --> associated w/ constrictive
pericarditis
pulmonary HTN
Leads V2-V4
Leads II, III, AVF
Leads V1, V2
Which is associated w/ worst mortality
Which leads are read backwards? - Answer: anterior wall
Inferior wall
Posterior wall
Page 4 of 306
