The Crushing Weight of Clin Med
Antihypertensive that works on arteries and veins quickly by breaking down into nitric oxide causing vasodilation.
SODIUM NITROPRUSSIDE
*SECRETE DOUBLE JEOPARDY* 😁
A massive pulmonary embolism, pericardial tamponade, tension pneumothorax, and aortic dissection are all common causes of what type of shock?
Obstructive Shock
HF with a preserve ejection fraction EF > 50%
- diastolic dysfunction occurs as the ventricle becomes thickened or less compliant
HFpEF
Which murmur is associated with the Graham-Stell murmur?
Pulmonic Regurgitation
Graham-Stell Murmur: brief decrescendo early diastolic murmur at LSB w/ full inspiration
What are the Black Box Warnings for Clozapine (Clozaril)?
- 100 pts for each named
1. Agranulocytosis
2. Myocarditis
3. Elderly pts w/ dementia
4. Seizures
5. Orthostatic hypotension
What could happen if Lasix IV is pushed too quickly?
OTOTOXICITY
- esp if used in combination w/ aminoglycosides
How should you treat infective endocarditis to provide appropriate coverage pending a definitive dx?
Vancomycin 1g q12h
+ Ceftriaxone 2g q24h
NYHA HF Classification where the patient shows marked limitation of physical activity; Comfortable at rest, but less than ordinary activity causes symptoms
Class III
What is the MCC of Mitral Stenosis?
Rheumatic heart disease
A model of interaction where it is assumed that the provider knows best and the pt is expected to comply.
Paternalistic Model
*SECRET DOUBLE JEOPARDY*
2nd or 3rd degree heart block is contraindicated in which antihypertensive medications?
Beta-Blockers
CCBs: Non-pines
A 65-year-old man presents with chest pain, dyspnea, JVD, and hypotension. He sustained blunt chest trauma from a motor vehicle accident one hour prior to arrival. EKG shows electrical alternans. What is most likely the diagnosis?
Cardiac Tamponade
Pink frothy sputum is primarily associated with what condition?
Left-sided heart failure
*DOUBLE JEOPARDY*
What is the MCC of restrictive cardiomyopathy?
Amyloidosis
What is the therapeutic window for lithium?
0.6-1.2 mmol/L
Same as serum Cr!
Niacin can cause adverse effects such as intense flushing and itching of the face, head, and neck. How can this be prevented?
Using the Modified Duke's Criteria, what major/minor combination is required for a dx of infective endocarditis?
- 2 MAJOR
- 1 MAJOR + 3 minor
- 5 minor
AHA/ACC HF staging where the patient has refractory heart failure requiring specialized interventions
Stage D
A 62 yo male with h/o HTN presents to the office with worsening fatigue and SOB with exercise over the past 2 months. He occasionally has accompanied chest pain that is improved with rest. Physical exam reveals a forceful apical pulse as well as a high-pitched blowing diastolic murmur best heard at the LSB. EKG shows some evidence of LVH but no ST-segment elevation or T wave inversions. What is the most likely dx?
Aortic Regurgitation
Aside from depression and anxiety, SNRIs can also be used for what?
Neuropathic pain
A pt comes to your office and complains that the new HTN medication his doctor prescribed has done nothing for his HTN. Being the clever PA you are, you double-check his med list and see he has been taking Calcium and Vitamin D supplements. What are your next steps?
Calcium and Vit D can reduce the effectiveness of CCBs >> just increase his CCB dose
Which type of shock is the ONLY shock in which large amounts of fluid aren't given?
What do you use instead?
Cardiogenic Shock
Inotropic support: Dobutamine (+inotrope), Epi (+ inotrope and vasoconstrictor), or Amrinone (+inotrope)
Intraaortic balloon pump support
Treat the underlying cause: MI, cardiomyopathy, etc
Right-sided HF caused by chronic lung disease, pulmonary HTN, chronic hypoxemia, resulting in RV dysfunction
Cor pulmonale
A 72 yo pt with a h/o HTN comes to the ER due to worsening episodes of dyspnea after walking to his mailbox. He also reports chest pain and syncope. Upon auscultation, you hear a harsh, rumbling murmur that increases in intensity when you ask them to lean forward. You have also noticed a weak, delayed carotid pulse. EKG shows LVH. What do you suspect is the MCC of this murmur?
Degenerative calcification of the aortic valve
What is the most crucial component to include in the interview for all pts with mental health complaints?
ALWAYS ASK ABOUT SUICIDAL AND HOMICIDAL IDEATION
- crucial to r/o potential harm to others or the pt