You have a patient with a mechanical mitral valve being treated with Coumadin for anticoagulation, what is their goal INR?
2.5-3.5
100
Which of the following explains the most common pathophysiology of acute ST elevation MI
a. Plaque rupture in coronary artery leading to transmural occlusion
b. Thromboembolus formed in atrium due to a-fib becoming lodged in coronary artery
c. Coronary vasospasm
d. Coronary dissection from increased blood pressure
What medication is often used for treatment of hemodynamically stable ventricular tachycardia
Amiodarone Bolus + drip
200
A 19 year old male comes into your office after passing out suddenly during a rugby match. You note a systolic murmur along the right and left sternal borders. What techniques can you utilize to support your most likely diagnosis
Accentuate murmur: Valsalva
Lessen murmur: Squat down
HOCM murmur
300
Which Beta Blockers have mortality benefit and are indicated for heart failure with reduced ejection fraction?
Metoprolol (succinate), Carvedilol, Bisoprolol
300
ST Elevations in V1 and V2 signify occlusion of which coronary artery?
Patient's with a left anterior fasicular block will have what changes on axis
300
You and your patient with atrial fibrillation decide to schedule electrical cardioversion to restores sinus rhythm. What are two ways to prevent the risk of thrombo-embolization after conversion
Anticoagulate for 4 weeks prior to cardioversion or TEE cardioversion
300
You are listening to a murmur on a patient with aortic stenosis. How might this affect the sound of S2?
Paradoxical splitting
400
This electrolyte abnormality can increase the risk of Digoxin toxicity
Hypokalemia
400
A patient receives a drug eluting stent, what are two medications that are crucial to maintaining a patent stent
In a patient with fever, new murmur, and shortness of breath in whom you suspect endocarditis, what are two important questions to ask them about to support your diagnosis?
IV drug abuse
Recent dental procedures
History of valve replacement
500
You are seeing a patient in the office who will be started on amiodarone for prevention of ventricular arrhythmia. What laboratory work should be checked prior to initiation and periodically
Thyroid function tests, LFT's, PFT's, opthalmic exams
500
A 40 year old male comes in to the ED anxious and complaining of chest pain after snorting cocaine 1 hour ago. ECG shows ST elevation in V1, V2 with ST depressions in I and aVL. Vital signs: BP 168/90, HR 110, RR 22, O2 92% Which medication that is often given in ACS should be avoided in this patient
Beta blockers
500
What is the normal QRS duration? PR duration?
120 ms, 200 ms
500
You have a patient in a-fib with rapid ventricular response with rates 120-150 with BP of 88/45 and appears very lethargic, what is the appropriate treatment at this time
D/C cardioversion
500
How does a right bundle branch block affect the timing of A2 and P2
S2 splitting, P2 occurs later due to prolonged RV depolarization