PINK
What test is used to diagnose arrhythmias such as AF?
Electrocardiogram (ECG)
The goal INR for patients treated with warfarin is what?
2-3
True or False: The mg of warfarin can be determined by knowing the color of the pill, regardless of shape, size, or markings
True
What is paroxysmal AF?
Terminates spontaneously or with intervention within 7 days of onset
What treatment would you give a patient with superficial venous thrombosis? What about patients who cannot get parenteral anticoagulation?
-Fondaparinux 2.5 SubQ daily.
-Rivaroxaban 10 mg PO daily
QB is a 50-year-old white male with a BMI of 30% is admitted to the hospital after experiencing a fall and breaking his leg and will need surgery. PMH includes VTE treatment 3 months ago, hypertension, and diabetes. What modifiable risk factors does QB have? What nonmodifiable risk factors dose QB have?
modifiable: obesity, immobilization, and surgery. Nonmodifiable: age >40 and prior VTE
Patients who have HFrEF undergoing acute rate control should not receive what class of antiarrhythmics?
Non-DHP CCBs
With which anticoagulation therapy would you want to really emphasize consistency of dietary intake with the fictional cartoon character Popeye the Sailor?
Warfarin
When would a patient be contraindicated to receive a Beta Blocker?
Any one of the following: 1st Degree Heart Block, sick sinus syndrome w/out pacemaker, acute decompensated HF
If you were told that no makeup is involved and that their skin color is due to an adverse effect from a medication, what antiarrhythmic would you guess is being prescribed to the Blue Man Group in Vegas?
Amiodarone
Would a HASBLED score of 3 categorize your bleeding risk as low risk, moderate risk, or high risk?
High Risk
What two types of VTE is anticoagulation is preferred over imaging?
Isolated distal DVT with severe symptoms and subsegmental PE with high risk for recurrent VTE.
What problems with DVT and PE would we need to monitor with imaging instead of treating with anticoagulation?
Subsegmental PE and isolated distal DVT
VT is an Asian American female of 72 years old and weighs 78 kg. VT has no past medical history. Vitals: Temp-98°C, HR-78 bpm, RR-1 bpm, BP-117/76 mmHg. VT presents with Dyspnea, chest pain, and wheezing. Imaging tests like CT and chest x-rays show infiltrates. What kind of VTE is VT experiencing?
Patient is experiencing a pulmonary embolism
What trial assessed that a more lenient control of resting heart rate <80bmp is just as effective as a resting heart rate of <110bpm?
RACE II
What is a modifiable risk factor for both AF and VTE?
Obesity
AR is an African American male 76 years old and weighs 113 kg and is getting treated for VTE. AR’s current treatment for VTE is Apixaban 10mg and is on his 4th day of treatment. Looking at his chart you notice that he has a past medical history of COPD, Diabetes, antiphospholipid syndrome, and hyperlipidemia. What do you want to make his VTE treatment?
Overlap apixaban treatment with Warfarin 5 mg PO Daily by two days.
For a patient that needs acute rhythm control in AF w/RVR what is a good medication to use if the patient has structural heart disease?
Amiodarone
VT is an Asian American female of 72 years old and weighs 78 kg. VT has no past medical history. Vitals: Temp-98°C, HR-78 bpm, RR-1 bpm, BP-117/76 mmHg. VT presents with Dyspnea, chest pain, and wheezing. Imaging tests like CT and chest x-rays show infiltrates. VT ends up getting treated with Apixaban 10 mg BID and is on her second day but starts to deteriorate after getting anticoagulation. What kind of therapy do you want to switch VT to?
Alteplase 100 mg IV infused over 2 hours or Tenecteplase 40 mg IV bolus over 5-10 seconds.
What is the pill in the pocket approach for AF? What agents are used?
Treatment option for patients who have infrequent episodes of symptomatic atrial fibrillation with normal LV function, may take single dose of Flecainide 200mg PO <70kg, 300mg PO if >70kg OR Propafenone 400mg PO if <70kg, 600mg PO if >70kg