Name of 3 of 4 indications listed in lecture for treadmill testing
What is Evaluation of intermediate risk chest pain, exercise prescription, perioperative evaluation for non-cardiac surgery, prior to vigorous exercise program for certain high risk patients.
100
A 63-year-old patient presents to your office because of chest pain suggestive of angina. You are considering a stress test to help determine whether the chest pain is due to ischemic heart disease, but she has a heart murmur. Which one of the following valvular heart dysfunctions, if severe, is a contraindication to stress testing?
A. Aortic regurgitation.?B. Aortic stenosis.?C. Mitral regurgitation.?D. Mitral stenosis.?E. Pulmonic stenosis.
A. Aortic Stenosis
100
ST elevations in V2-V5
What is Anterior STEMI
100
Infections contraindicated in treadmill testing
What is myocarditis and pericarditis
100
This should be completed immediately after administration of a shock
What is 2 min chest compressions
200
3 things that should be reported on a treadmill final report
What is ST changes, symptoms, reason for ending test, estimation of exercise capacity, blood pressure reponse, presence and frequency of ectopy, +/- Duke treadmill score
200
Which one of the following statements about medical therapy for aortic stenosis is correct?
A. Angiotensin-converting enzyme inhibitors have been shown to slow progression of stenosis.?
B. Diuretics are first-line therapy when heart failure is present.?
C. No medical therapy is effective for aortic stenosis.?
D. Statins have been shown to slow progression of calcific stenosis.?
E. Vasodilators improve cardiac output and, thus, increase systemic blood
C. No medical management
200
Coronary vessel is thought to be involved with anterior STEMI.
What is Left anterior descending (LAD)
200
Drop in blood pressure that should prompt cessation of treadmill testing
What is 10mmHg
200
3 ACLS signs of instability for tachycardias
What is Ischemic chest pain, altered mental status, hypotension, signs of shock, acute heart failure
300
Definition of abnormal ST segment response to exercise
What is 1.0 mm or > horizontal or downsloping ST dep at
80 msec after J point on 3 consecutive ECG complexes
300
Your patient has a mechanical aortic valve with a relatively low risk of thromboembolic events. Anticoagulation was discontinued for a surgical procedure that is now complete. The surgery was uncomplicated with no bleeding problems. Which one of the following correctly states when warfarin can be restarted, according to the general rule for this situation?
A. Within 24 hours after the procedure.?
B. Approximately 1 week after the procedure.?
C. At the 6-week postoperative evaluation.?
D. 6 months after the procedure.?
E. 1 year after the procedure.
A. Within 24 hours after the procedure
300
Leads which would show an inferior STEMI
What is ST elevation in II, III, aVF
300
Blood pressure limits to consider stopping treadmill testing
What is >250 Systolic and >115 diastolic
300
The 5 H’s of differential diagnosis for cardiac arrest
What is Hypovolemia, hypoxia, hydrogen ion (acidosis), hyper/hypokalemia, hypothermia
400
The Duke treadmill score and category of following patient.
49 yo male who exercised for 12 min with non-limiting chest pain and had 0.5 mm ST depression in lateral leads during recovery.
What is 5.5 (low risk)
400
Which one of the following findings on history and physical examination is the strongest predictor that palpitations are due to a cardiac etiology?
A. Palpitations occur during sleep.?
B. Palpitations occur in short episodes (ie, persisting less than a few minutes).?
C. Regular rapid pounding sensation in the neck.?
D. Known history of cardiac disease.?
E. No history of panic disorder.
C. The likelihood of a cardiac etiology of palpitations is higher when patients experience a regular rapid pounding sensation in the neck
400
Type of STEMI in which nitrates are contraindicated
What is right ventricular STEMI
400
3 EKG findings that are contraindications to treadmill testing.
What is LBBB, high grade atrioventricular blocks, uncontrolled arrythmias with hemodynamic compromise.
400
The first line drug and dosing of unstable bradycardia algorithm
What is Atropine, 0.5mg Q3-5 min (total 3mg)
500
The expected METs for each of the first 3 stages of the Bruce protocol
What is Stage 1 = 5 METS
Stage 2 = 6 - 8 METS
Stage 3 = 8 -10 METS
500
Which one of the following statements is correct about premature ventricular contractions in children without heart disease?
A. For unknown reasons, they occur only in girls.?
B. They are almost never a cause of palpitations.?
C. They are typically associated with chest pain and become more frequent over time.?
D. They are typically not serious and improve spontaneously over time.?
E. They predict subsequent development of early-onset hypertrophic cardiomyopathy.
D. They are typically not serious and improve spontaneously over time.?
500
EKG findings on inferiolateral MI which require consideration for posterior MI
What is Horizontal ST depression in V1-3
Tall, broad R waves (> 30ms) in V2-3
Dominant R wave (R/S ratio > 1) in V2
Upright T waves in V2-3
500
Cutoff for ischemic ST depression in a patient with 1mm of ST depression in lateral leads at baseline
What is 2mm in lateral leads
500
3 indications on ACLS algorithm for amiodarone
What is Refractory VF/VT, stable regular complex tachycardia, stable irregular narrow complex tachycardia