Emergency Medicine Exam #8 Questions
and Answers Latest 2025 A+
What are some drugs associated with Torsades de pointes?
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?
pump; CCB!
CHF - Diastolic dysfunction means a problem with the ____.
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.
Frank-Starling principle
_____is released from cardiac ventricles in response to increased wall
tension.
BNP - B-type natriuretic peptide
What is the pharmacologic therapy for heart failure?
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.
Class I, Class II, Class III, Class IV
Stage 1 Hypertension is defined as greater than ____. Stage 2
Hypertension is defined as greater than ____.
140/90; 160/100
,Hypertension Drug of Choice for:
angina
diabetes
hyperlipidemia
CHF
Previous MI
Chronic Renal Failure
Asthma, COPD
Angina - BB, CCB
Diabetes - ACEi & CCB, avoid diuretics
Hyperlipidemia - ACEi & CCB, avoid diuretics/BB
CHF - diuretics & ACEi, avoid CCB/BB
Previous MI - BB/ACEi
Chronic renal failure - diuretics, CCB
Asthma - diuretics & CCB, avoid BB
Secondary hypertension is HTN due to an ______.
identifiable cause ie. renovascular disease, coarctation of the aorta,
primary aldosteronism, Cushing's, Pheochromocytoma, OSA, renal
parenchymal hypertension
____hypertension is potentially life threatening - HTN plus
rentinopathy, cardiovascular/renal compromise, or encephalopathy.
Malignant
Malignant hypertension bp? What is the rule of thumb for lowering?
greater than 220/140; 10% in first hour and 15% for the next 3-12 hours, to
normal over next 2 days
What is the agent of choice for BP lowering for patients with
hypertensive encephalopathy, intracranial bleeding, and heart failure?
Use with what for dissecting aneurysm?
nitroprusside; propranolol -- clonidine can also be used but sedation is
common
Hypotension is defined as a systolic blood pressure less than
_____mm Hg or a decrease from baseline by more than 30mmHg.
What are the 3 treatments for improving blood pressure?
90mmHg;
1. IV Fluids
2. Vasopressors - dopasmine, dobutamine (risk is aggravation of
,arrhythmias and increase myocardial oxygen demand)
3. intra-aortic balloon pump
ST Elevations in II, III, aVF
Inferior MI; right coronary artery
ST Elevations in I, aVL, V4, V5, V6
lateral wall MI, left circumflex artery
ST Elevations in V1, V2, V3, V4, V5
Anterioseptal MI, left anterior descending artery
ST Elevations in V1, V2
posterior wall MI, posterior descending artery
No nitroglycerin in which kind of MI?
inferior
What are the pre hospital treatments for ACS?
MONA; morphine, oxygen, nitroglycerin (0.4mg SL x3 prn), aspirin (325mg)
What two meds should be given to all ACS patients that do not have
contraindications?
BB - unless brady or severe COPD - then do NDCCB (verapamil/diltiazem)
ACEi - if cough, use ARB
What are the adjunctive tx for fibrinolysis or PCI?
1. antiplatelets (ASA, clopidogrel)
2. anticoagulants (UFH, LMWH, DTI, direct factor Xai)
How long should Plavix/Clopidogrel be used for bare metal or drug
eluting stents?
bare metal - 30d-12m
drug eluting - >/=12mon
What meds should a patient go home with after ACS?
Nitroglycerin
BB
ACEi
ASA/Clopidogrel
anticoagulant (up to 8days for LMWH)
aldosterone agonist
statin
LIFESTYLE CHANGES
Cardiac Markers: _____is detectable within 1-2 hours after acute MI.
Duration <1 day. Low specificity.
Myoglobin
, Cardiac Markers: _____is the test of choice and appears 2-6 hours
after MI and stays elevated for 5-10 days.
Troponin
Cardiac Markers: _____appears 3-6 hours after MI and stays elevated
for 2-4 days. Specific to heart muscle.
Creatine kinase Mb
Timeline:
Reperfusion should take place before ___hours of symptom onset.
Door to needle time for fibrinolysis is ____min.
Door to balloon time for PCI is ___min.
12; 30min; 90min
Cardiology
is fun!
What are the treatments for bradyarrhythmias?
atropine, pacing, or epinephrine/dopamine
For synchronized cardioversion, use ____Joules for paroxysmal
supraventricular tachycardia and _____Joules for a fib and VT.
50J, 100J
_____angina is brought on by activity/exercise. ____angina may show
transient ST changes and inverted T waves. ____is pain mainly
occurring at rest due to vasospasm of coronary arteries.
Stable, unstable, prinzmetal/variant (responds well to CCB or nitrates, BB
may exacerbate vasospasm)
_________is considered the gold standad test for aortic dissection
but is also the most invasive of all the radiographic studies. What is
more normally done in the ED?
Aortography; CT with contrast
Aortic dissections - Stanford type A vs. Stanford type B. What's the
difference and which is treated surgically?
Type A - involves ascending aorta - surgical tx!!!
Type B - involves descending aorta - BP control
What is the emergent treatment for arterial embolism/thrombosis
(pain, pallor, pulselessness, paresthesias, paralysis)?
heparin, emergency embolectomy-thrombectomy to restore blood flow
Virchow's Triad for DVT?
venous stasis, endothelial injury, hypercoagulable state
and Answers Latest 2025 A+
What are some drugs associated with Torsades de pointes?
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?
pump; CCB!
CHF - Diastolic dysfunction means a problem with the ____.
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.
Frank-Starling principle
_____is released from cardiac ventricles in response to increased wall
tension.
BNP - B-type natriuretic peptide
What is the pharmacologic therapy for heart failure?
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.
Class I, Class II, Class III, Class IV
Stage 1 Hypertension is defined as greater than ____. Stage 2
Hypertension is defined as greater than ____.
140/90; 160/100
,Hypertension Drug of Choice for:
angina
diabetes
hyperlipidemia
CHF
Previous MI
Chronic Renal Failure
Asthma, COPD
Angina - BB, CCB
Diabetes - ACEi & CCB, avoid diuretics
Hyperlipidemia - ACEi & CCB, avoid diuretics/BB
CHF - diuretics & ACEi, avoid CCB/BB
Previous MI - BB/ACEi
Chronic renal failure - diuretics, CCB
Asthma - diuretics & CCB, avoid BB
Secondary hypertension is HTN due to an ______.
identifiable cause ie. renovascular disease, coarctation of the aorta,
primary aldosteronism, Cushing's, Pheochromocytoma, OSA, renal
parenchymal hypertension
____hypertension is potentially life threatening - HTN plus
rentinopathy, cardiovascular/renal compromise, or encephalopathy.
Malignant
Malignant hypertension bp? What is the rule of thumb for lowering?
greater than 220/140; 10% in first hour and 15% for the next 3-12 hours, to
normal over next 2 days
What is the agent of choice for BP lowering for patients with
hypertensive encephalopathy, intracranial bleeding, and heart failure?
Use with what for dissecting aneurysm?
nitroprusside; propranolol -- clonidine can also be used but sedation is
common
Hypotension is defined as a systolic blood pressure less than
_____mm Hg or a decrease from baseline by more than 30mmHg.
What are the 3 treatments for improving blood pressure?
90mmHg;
1. IV Fluids
2. Vasopressors - dopasmine, dobutamine (risk is aggravation of
,arrhythmias and increase myocardial oxygen demand)
3. intra-aortic balloon pump
ST Elevations in II, III, aVF
Inferior MI; right coronary artery
ST Elevations in I, aVL, V4, V5, V6
lateral wall MI, left circumflex artery
ST Elevations in V1, V2, V3, V4, V5
Anterioseptal MI, left anterior descending artery
ST Elevations in V1, V2
posterior wall MI, posterior descending artery
No nitroglycerin in which kind of MI?
inferior
What are the pre hospital treatments for ACS?
MONA; morphine, oxygen, nitroglycerin (0.4mg SL x3 prn), aspirin (325mg)
What two meds should be given to all ACS patients that do not have
contraindications?
BB - unless brady or severe COPD - then do NDCCB (verapamil/diltiazem)
ACEi - if cough, use ARB
What are the adjunctive tx for fibrinolysis or PCI?
1. antiplatelets (ASA, clopidogrel)
2. anticoagulants (UFH, LMWH, DTI, direct factor Xai)
How long should Plavix/Clopidogrel be used for bare metal or drug
eluting stents?
bare metal - 30d-12m
drug eluting - >/=12mon
What meds should a patient go home with after ACS?
Nitroglycerin
BB
ACEi
ASA/Clopidogrel
anticoagulant (up to 8days for LMWH)
aldosterone agonist
statin
LIFESTYLE CHANGES
Cardiac Markers: _____is detectable within 1-2 hours after acute MI.
Duration <1 day. Low specificity.
Myoglobin
, Cardiac Markers: _____is the test of choice and appears 2-6 hours
after MI and stays elevated for 5-10 days.
Troponin
Cardiac Markers: _____appears 3-6 hours after MI and stays elevated
for 2-4 days. Specific to heart muscle.
Creatine kinase Mb
Timeline:
Reperfusion should take place before ___hours of symptom onset.
Door to needle time for fibrinolysis is ____min.
Door to balloon time for PCI is ___min.
12; 30min; 90min
Cardiology
is fun!
What are the treatments for bradyarrhythmias?
atropine, pacing, or epinephrine/dopamine
For synchronized cardioversion, use ____Joules for paroxysmal
supraventricular tachycardia and _____Joules for a fib and VT.
50J, 100J
_____angina is brought on by activity/exercise. ____angina may show
transient ST changes and inverted T waves. ____is pain mainly
occurring at rest due to vasospasm of coronary arteries.
Stable, unstable, prinzmetal/variant (responds well to CCB or nitrates, BB
may exacerbate vasospasm)
_________is considered the gold standad test for aortic dissection
but is also the most invasive of all the radiographic studies. What is
more normally done in the ED?
Aortography; CT with contrast
Aortic dissections - Stanford type A vs. Stanford type B. What's the
difference and which is treated surgically?
Type A - involves ascending aorta - surgical tx!!!
Type B - involves descending aorta - BP control
What is the emergent treatment for arterial embolism/thrombosis
(pain, pallor, pulselessness, paresthesias, paralysis)?
heparin, emergency embolectomy-thrombectomy to restore blood flow
Virchow's Triad for DVT?
venous stasis, endothelial injury, hypercoagulable state
