Emergency Medicine EOR Exam with precise
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detailed answers |
Dilated |Cardiomyopathy: |most |common |cause |is |____. |Others? |- |CORRECT |ANSWER💢✔alcohol; |may |
also |be |idiopathic, |myocarditis, |or |drugs |(doxorubicin) |-- |1 |in |3 |cases |of |heart |failure |are |caused |by |
dilated |cardiomyopathy
What |PE |and |EKG |changes |are |seen |with |dilated |cardiomyopathy? |- |CORRECT |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 |- |CORRECT |
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? |- |CORRECT |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? |- |CORRECT |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? |- |CORRECT |
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? |- |CORRECT |
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. |- |CORRECT |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. |- |CORRECT |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? |- |CORRECT |ANSWER💢✔vagal |maneuvers |or |antianxiety |medication
What |are |some |drugs |associated |with |Torsades |de |pointes? |- |CORRECT |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? |- |CORRECT |
ANSWER💢✔pump; |CCB!
CHF |- |Diastolic |dysfunction |means |a |problem |with |the |____. |- |CORRECT |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. |- |CORRECT |ANSWER💢✔Frank-Starling |principle
_____is |released |from |cardiac |ventricles |in |response |to |increased |wall |tension. |- |CORRECT |
ANSWER💢✔BNP |- |B-type |natriuretic |peptide
,What |is |the |pharmacologic |therapy |for |heart |failure? |- |CORRECT |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. |- |CORRECT |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 |____. |- |CORRECT |ANSWER💢✔140/90; |160/100
Hypertension |Drug |of |Choice |for:
angina
diabetes
hyperlipidemia
CHF
Previous |MI
Chronic |Renal |Failure
Asthma, |COPD |- |CORRECT |ANSWER💢✔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 |______. |- |CORRECT |ANSWER💢✔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. |- |CORRECT |ANSWER💢✔Malignant
Malignant |hypertension |bp? |What |is |the |rule |of |thumb |for |lowering? |- |CORRECT |ANSWER💢✔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? |- |CORRECT |
ANSWER💢✔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? |- |
CORRECT |ANSWER💢✔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 |- |CORRECT |ANSWER💢✔Inferior |MI; |right |coronary |artery
ST |Elevations |in |I, |aVL, |V4, |V5, |V6 |- |CORRECT |ANSWER💢✔lateral |wall |MI, |left |circumflex |artery
ST |Elevations |in |V1, |V2, |V3, |V4, |V5 |- |CORRECT |ANSWER💢✔Anterioseptal |MI, |left |anterior |descending
|artery
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detailed answers |
Dilated |Cardiomyopathy: |most |common |cause |is |____. |Others? |- |CORRECT |ANSWER💢✔alcohol; |may |
also |be |idiopathic, |myocarditis, |or |drugs |(doxorubicin) |-- |1 |in |3 |cases |of |heart |failure |are |caused |by |
dilated |cardiomyopathy
What |PE |and |EKG |changes |are |seen |with |dilated |cardiomyopathy? |- |CORRECT |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 |- |CORRECT |
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? |- |CORRECT |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? |- |CORRECT |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? |- |CORRECT |
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? |- |CORRECT |
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. |- |CORRECT |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. |- |CORRECT |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? |- |CORRECT |ANSWER💢✔vagal |maneuvers |or |antianxiety |medication
What |are |some |drugs |associated |with |Torsades |de |pointes? |- |CORRECT |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? |- |CORRECT |
ANSWER💢✔pump; |CCB!
CHF |- |Diastolic |dysfunction |means |a |problem |with |the |____. |- |CORRECT |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. |- |CORRECT |ANSWER💢✔Frank-Starling |principle
_____is |released |from |cardiac |ventricles |in |response |to |increased |wall |tension. |- |CORRECT |
ANSWER💢✔BNP |- |B-type |natriuretic |peptide
,What |is |the |pharmacologic |therapy |for |heart |failure? |- |CORRECT |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. |- |CORRECT |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 |____. |- |CORRECT |ANSWER💢✔140/90; |160/100
Hypertension |Drug |of |Choice |for:
angina
diabetes
hyperlipidemia
CHF
Previous |MI
Chronic |Renal |Failure
Asthma, |COPD |- |CORRECT |ANSWER💢✔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 |______. |- |CORRECT |ANSWER💢✔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. |- |CORRECT |ANSWER💢✔Malignant
Malignant |hypertension |bp? |What |is |the |rule |of |thumb |for |lowering? |- |CORRECT |ANSWER💢✔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? |- |CORRECT |
ANSWER💢✔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? |- |
CORRECT |ANSWER💢✔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 |- |CORRECT |ANSWER💢✔Inferior |MI; |right |coronary |artery
ST |Elevations |in |I, |aVL, |V4, |V5, |V6 |- |CORRECT |ANSWER💢✔lateral |wall |MI, |left |circumflex |artery
ST |Elevations |in |V1, |V2, |V3, |V4, |V5 |- |CORRECT |ANSWER💢✔Anterioseptal |MI, |left |anterior |descending
|artery
