CVRN STANDARD EXAMS ANSWERS AND
QUESTIONS SET A+
✔✔hypomagnesemia EKG - ✔✔Moderate- wide QRS
Severe-prolonged PR, QRS/QT widened,
broad-flat T wave
Associated with Torsades de Pointes
✔✔tacrolimus - ✔✔immunosuppressive macrolide antibioitc
can cause nephrotoxicity with elevated BUN and creatinine, hyperkalemia, insomnia,
and malaise
used instead of cyclosporine because it is generally well tolerated and effective for
rescue therapy during cardiac rejection
✔✔cyclosporine AEs - ✔✔hypertension
facial dysmorphism
✔✔corticosteroid AEs - ✔✔hypertension
hirsutism
acne
✔✔aortic stenosis - ✔✔syncope associated with exertional exercise due to reduced
cerebral blood flow because peripheral dilation without increased CO
✔✔dissecting descending aortic aneurysm - ✔✔severe knife-like pain posteriorly
between the scapulae, nausea, and vomiting (cold and clammy)
✔✔Dissection of ascending thoracic aorta - ✔✔pain is in the anterior chest
✔✔Digitoxin toxicity - ✔✔Common cause of junctional rhythm
, levels normally 0.5-2 ng/ml
fatigue, lethargy, depression, nausea and vomiting
AV or SA block, new ventricular dysrhythmias or tachycardia
treatment: digoxin immune FAB (Digibind)
✔✔Pacemaker post-op - ✔✔hiccups indicate pacemaker lead has become dislodged
and is causing phrenic nerve or muscle stimulation
other complications - Infection, bleeding, hematoma, puncture of subclavian vein,,
hemothorax, irritation of the ventricular wall, cardiac tamponade
✔✔thrombolytic contraindications - ✔✔aortic aneurysm
hemorrhagic stroke
recent surgery
bleeding
history of stroke within 2 months
sever HTN uncontrolled (>180)
possibly:
pregnancy, pericarditis, endocarditis
>75 years old
✔✔Cardioversion prep - ✔✔- anticoagulation >3 weeks before procedure
- hold digoxin for >48hrs
- antiarrhythmics possible to slow the HR
- fast before cardioversion so possible reduction/skip of insulin dose
✔✔dobutamine - ✔✔used to treat heart failure and low cardiac output.
especially after cardiac surgery
✔✔dopamine - ✔✔used to treat shock and hypotension for patients requiring volume
resuscitation
✔✔isoproterenol - ✔✔stimulates the heart in patients with severe bradycardia
✔✔learning materials - ✔✔should be at 6th grade level
✔✔Warfarin contraindications - ✔✔caffeinated beverages may increase the effects of
warfarin
Vitamin K foods may decrease warfarin effect
QUESTIONS SET A+
✔✔hypomagnesemia EKG - ✔✔Moderate- wide QRS
Severe-prolonged PR, QRS/QT widened,
broad-flat T wave
Associated with Torsades de Pointes
✔✔tacrolimus - ✔✔immunosuppressive macrolide antibioitc
can cause nephrotoxicity with elevated BUN and creatinine, hyperkalemia, insomnia,
and malaise
used instead of cyclosporine because it is generally well tolerated and effective for
rescue therapy during cardiac rejection
✔✔cyclosporine AEs - ✔✔hypertension
facial dysmorphism
✔✔corticosteroid AEs - ✔✔hypertension
hirsutism
acne
✔✔aortic stenosis - ✔✔syncope associated with exertional exercise due to reduced
cerebral blood flow because peripheral dilation without increased CO
✔✔dissecting descending aortic aneurysm - ✔✔severe knife-like pain posteriorly
between the scapulae, nausea, and vomiting (cold and clammy)
✔✔Dissection of ascending thoracic aorta - ✔✔pain is in the anterior chest
✔✔Digitoxin toxicity - ✔✔Common cause of junctional rhythm
, levels normally 0.5-2 ng/ml
fatigue, lethargy, depression, nausea and vomiting
AV or SA block, new ventricular dysrhythmias or tachycardia
treatment: digoxin immune FAB (Digibind)
✔✔Pacemaker post-op - ✔✔hiccups indicate pacemaker lead has become dislodged
and is causing phrenic nerve or muscle stimulation
other complications - Infection, bleeding, hematoma, puncture of subclavian vein,,
hemothorax, irritation of the ventricular wall, cardiac tamponade
✔✔thrombolytic contraindications - ✔✔aortic aneurysm
hemorrhagic stroke
recent surgery
bleeding
history of stroke within 2 months
sever HTN uncontrolled (>180)
possibly:
pregnancy, pericarditis, endocarditis
>75 years old
✔✔Cardioversion prep - ✔✔- anticoagulation >3 weeks before procedure
- hold digoxin for >48hrs
- antiarrhythmics possible to slow the HR
- fast before cardioversion so possible reduction/skip of insulin dose
✔✔dobutamine - ✔✔used to treat heart failure and low cardiac output.
especially after cardiac surgery
✔✔dopamine - ✔✔used to treat shock and hypotension for patients requiring volume
resuscitation
✔✔isoproterenol - ✔✔stimulates the heart in patients with severe bradycardia
✔✔learning materials - ✔✔should be at 6th grade level
✔✔Warfarin contraindications - ✔✔caffeinated beverages may increase the effects of
warfarin
Vitamin K foods may decrease warfarin effect
