PAEA EMERGENCY MEDICINE EOR FINAL
PAPER COMPLETE QUESTIONS WITH
CORRECT ANSWERS ALREADY PASSED
●● What PE and EKG changes are seen with dilated cardiomyopathy?
Answer: PE: S3, JVD, crackles - possible mitral regurg
EKG: nonspecific ST and T wave changes, LBBB
●● Hypertrophic cardiomyopathy: is due to hypertrophy of the _____.
PE reveals mitral regurgitation, a ____heart sound, and prominent left
ventricular impulse. EKG reveals LVH
Answer: cardiac septum; S4
●● Restrictive cardiomyopathy: often caused by a ____process, or post-
radiation or post open-heart surgery. What is the most common first
symptom?
Answer: --infiltrative process - amyloidosis, sarcoidosis, and
hemochromatosis -- changes in myocardium
--most common first symptom is exertion intolerance and fluid retention,
signs of right heart failure
●● Atrial fibrillation - regularly irregular - the most common sustained
arrhythmia in adults - what three treatments are used?
,Answer: 1. rate control w BB, CCB, or digoxin
2. Anticoagulation w heparin & warfarin
3. rhythm control w amiodarone or cardioversion
●● Atrial flutter - sawtooth pattern in II, III, aVF - what three treatments
are used?
Answer: 1. cardioversion if no contraindications
2. acute rate control tx w BB, CCB - amiodarone, sotalol, quinidine, or
procainamide
3. If site of reentrant is known, catheter ablation
●● Multifocal atrial tachycardia - noted in patients with COPD or severe
systemic illness - EKG shows multiple shaped P waves and differing PR
intervals. ____are agents of choice?
Answer: CCB
●● BLOCKS
1. ____=prolonged PR interval
2.____=progressive increase in PR until Pwave is blocked.
3._____=sudden block in P wave w no change in PR
4._____=atrial and ventricular rhythm are independent of each other.
Answer: First degree; Wenckebach Mobitz type I; Mobitz type II, Third
degree block
,●● A _____may develop after acute MI, PE, aortic stenosis and is due to
a conduction delay in the right or left bundles.
Answer: Bundle branch block
●● Paroxysmal supraventricular tachycardia is a reentry tachycardia,
commonly noted in elderly patients with underlying heart disease. What
treatment may be helpful before using adenosine ie. the drug of choice?
Answer: vagal maneuvers or antianxiety medication
●● What are some drugs associated with Torsades de pointes?
Answer: tricyclic antidepressants, erythromycin, ketoconazole,
haloperidol, cisapride, disopyramide, pentamidine, sotalol, class I anti-
arrhythmics
●● CHF - Systolic dysfunction means a problem with the ____. What
drug is contraindicated?
Answer: pump; CCB!
●● CHF - Diastolic dysfunction means a problem with the ____.
Answer: compliance or relaxation of the heart during ventricular filling
●● The ________principle means that as preload increases, the ventricle
is stretched during diastole filling and the ejection fraction is increased.
, Answer: Frank-Starling principle
●● _____is released from cardiac ventricles in response to increased
wall tension.
Answer: BNP - B-type natriuretic peptide
●● What is the pharmacologic therapy for heart failure?
Answer: 1. diuretics for fluid retention
2. ACEi
3. vasodilators (hydralazine & nitrates)
4. BB for LV dysfunction
5. digitalis to increase cardiac contractility
●● Functional Classification of Heart Failure:
___-No cardiac symptoms with ordinary activity.
___-Cardiac symptoms w MARKED activity but asymptomatic at rest
___-Cardiac symptoms w MILD activity but asymptomatic at rest
___-Cardiac symptoms at rest.
Answer: Class I, Class II, Class III, Class IV
●● Stage 1 Hypertension is defined as greater than ____. Stage 2
Hypertension is defined as greater than ____.
Answer: 140/90; 160/100
PAPER COMPLETE QUESTIONS WITH
CORRECT ANSWERS ALREADY PASSED
●● What PE and EKG changes are seen with dilated cardiomyopathy?
Answer: PE: S3, JVD, crackles - possible mitral regurg
EKG: nonspecific ST and T wave changes, LBBB
●● Hypertrophic cardiomyopathy: is due to hypertrophy of the _____.
PE reveals mitral regurgitation, a ____heart sound, and prominent left
ventricular impulse. EKG reveals LVH
Answer: cardiac septum; S4
●● Restrictive cardiomyopathy: often caused by a ____process, or post-
radiation or post open-heart surgery. What is the most common first
symptom?
Answer: --infiltrative process - amyloidosis, sarcoidosis, and
hemochromatosis -- changes in myocardium
--most common first symptom is exertion intolerance and fluid retention,
signs of right heart failure
●● Atrial fibrillation - regularly irregular - the most common sustained
arrhythmia in adults - what three treatments are used?
,Answer: 1. rate control w BB, CCB, or digoxin
2. Anticoagulation w heparin & warfarin
3. rhythm control w amiodarone or cardioversion
●● Atrial flutter - sawtooth pattern in II, III, aVF - what three treatments
are used?
Answer: 1. cardioversion if no contraindications
2. acute rate control tx w BB, CCB - amiodarone, sotalol, quinidine, or
procainamide
3. If site of reentrant is known, catheter ablation
●● Multifocal atrial tachycardia - noted in patients with COPD or severe
systemic illness - EKG shows multiple shaped P waves and differing PR
intervals. ____are agents of choice?
Answer: CCB
●● BLOCKS
1. ____=prolonged PR interval
2.____=progressive increase in PR until Pwave is blocked.
3._____=sudden block in P wave w no change in PR
4._____=atrial and ventricular rhythm are independent of each other.
Answer: First degree; Wenckebach Mobitz type I; Mobitz type II, Third
degree block
,●● A _____may develop after acute MI, PE, aortic stenosis and is due to
a conduction delay in the right or left bundles.
Answer: Bundle branch block
●● Paroxysmal supraventricular tachycardia is a reentry tachycardia,
commonly noted in elderly patients with underlying heart disease. What
treatment may be helpful before using adenosine ie. the drug of choice?
Answer: vagal maneuvers or antianxiety medication
●● What are some drugs associated with Torsades de pointes?
Answer: tricyclic antidepressants, erythromycin, ketoconazole,
haloperidol, cisapride, disopyramide, pentamidine, sotalol, class I anti-
arrhythmics
●● CHF - Systolic dysfunction means a problem with the ____. What
drug is contraindicated?
Answer: pump; CCB!
●● CHF - Diastolic dysfunction means a problem with the ____.
Answer: compliance or relaxation of the heart during ventricular filling
●● The ________principle means that as preload increases, the ventricle
is stretched during diastole filling and the ejection fraction is increased.
, Answer: Frank-Starling principle
●● _____is released from cardiac ventricles in response to increased
wall tension.
Answer: BNP - B-type natriuretic peptide
●● What is the pharmacologic therapy for heart failure?
Answer: 1. diuretics for fluid retention
2. ACEi
3. vasodilators (hydralazine & nitrates)
4. BB for LV dysfunction
5. digitalis to increase cardiac contractility
●● Functional Classification of Heart Failure:
___-No cardiac symptoms with ordinary activity.
___-Cardiac symptoms w MARKED activity but asymptomatic at rest
___-Cardiac symptoms w MILD activity but asymptomatic at rest
___-Cardiac symptoms at rest.
Answer: Class I, Class II, Class III, Class IV
●● Stage 1 Hypertension is defined as greater than ____. Stage 2
Hypertension is defined as greater than ____.
Answer: 140/90; 160/100
