Adult - Cardiology III

Question 1

Does nitroglycerin relieve MI pain?

Answer 1

it has very little effect

Question 2

Does every patient with MI have ECG changes initially?

Answer 2

No - about 30% do not

Question 3

When present, what are the ECG changes of MI?

Answer 3

peaked T waves
elevated ST segment
~ Q wave development

Question 4

ECG changes in I, aVL indicate what MI location?

Answer 4

lateral

Question 5

ECG changes in II, III, aVF indicate what MI location?

Answer 5

inferior

Question 6

ECG changes in V leads,or V3 and V4 indicate what MI location?

Answer 6

anterior

Question 7

Within 4 - 6 hours, what enzymes will be elevated after MI?

Answer 7

Troponin T
Troponin I
CK-MB

(second two are 100% cardio selective)

Question 8

In order, what is acute management of MI?

Answer 8

ASA
nitro
O2

Question 9

What medication may be given for MI pain?

Answer 9

morphine

Question 10

What medication may be given for pulmonary edema in MI?

Answer 10

furosemide (Lasix)

Question 11

If on coumadin, what is theraputic range of INR?

Answer 11

2 - 3 mg/dL

Question 12

What are the coagulation studies?

Answer 12

INR
ACT
APTT
PT
PTT

Question 13

ACT

Answer 13

Activated Coagulation Time

Question 14

PT

Answer 14

Prothrombin Time

Question 15

PTT

Answer 15

Partial Thromboplastin Time

Question 16

What are the indications for clot busting with TPA?

aka pharmacologic revascularization / fibrinolytic

Answer 16

unrelieved chest pain (>30 min and <6 hours)
WITH
ST segment elevation

Question 17

A partial or complete occlusion of a vein by thrombus with secondary inflammation to the wall of the vessel.

Answer 17

venous thrombosis

can be superficial or deep

Question 18

What’s going on in peripheral vascular disease?

Answer 18

decreased blood supply

ARTERIOsclerotic

Question 19

Typical patient with peripheral vascular disease?

Answer 19

40 - 70 year old
smoker
hyperlipidemia
DM

Question 20

Typical initial symptom of peripheral vascular disease?

Answer 20

claudication

Question 21

What are physical findings of peripheral vascular disease?

Answer 21

shiny, hairless skin
dependent rubor
elevational pallor
reduced pulses

Question 22

Diagnositics for peripheral vascular disease?

Answer 22

doppler U/S
ankle-brachial index
arteriography - most definative test

Question 23

Management of peripheral vascular disease?

Answer 23

exercise - 1 hour per day, rest during pain
weight reduction PRN
bypass surgery
amputation

Question 24

Medication management of peripheral vascular disease?

Answer 24

pentoxifylline (Trental)

cilostazol (Pletal)

Question 25

What’s going on in chronic venous insufficiency?

Answer 25

impaired venous return

Question 26

Is chronic venous insufficiency more common in men or women?

Answer 26

women

Question 27

Typical complaint of chronic venous insufficiency?

Answer 27

Lower leg:
ACHING relieved by elevation
EDEMA after prolonged standing
NIGHT CRAMPS

Question 28

Physical findings in chronic venous insufficiency?

Answer 28

brownish discoloration
stasis leg ulcers
dermatitis
cool to touch

Question 29

Diagnostics for chronic venous insufficiency?

Answer 29

clinical picture

Question 30

Management of chronic venous insufficiency?

Answer 30

support stockings
weight loss PRN
treatment of dermatitis or ulcers

Question 31

What is the treatment for acute weeping dermatitis related to chronic venous insufficiency?

Answer 31

wet compresses
hydrocortisone cream

ABT only if clearly infected