Cardiovascular

Question 1

A fib with stable v/s and LV dysfunction. Tx of choice? CIx?

Answer 1

Tx of choice : beta blocker metoproplol CIx : CCB, flecainide

Question 2

WPW syndrome, palpitation, wide QRS tachycardia, stable v/s Dx and Tx? what drug is contraindicated in WPW syndrome?

Answer 2

ventricular tachycardia

amiodarone if stable

adenosin, digoxin, CCB (verapamil), b-blocker all contraindicated in WPW syndrome

Question 3

MI, thrombolysis, discharge with what medicine?

Answer 3

STATIN, ASPIRIN, clopidogrel (or tigaglerol) for all ACS patients (regardless of whether revascularization was performed) + beta blocker if LV dysfuntion present + ACE i if DM present

Question 4

peripheral artierial disease no sign of acute critical limb ischemia what medicine to take?

Answer 4

ACEi statin

Question 5

hemorrhage class I - IV class I class II class III class IV

Answer 5

class I : <15% blood loss, normal V/S, UO class II : 15-30% (750-1500ml) blood loss, pulse 100-120, normal BP, RR 20-30, UO 20-30ml/h class III : 30-40% (1500-2000ml) blood loss, pulse >120, low BP, RR 30-40, UO 5-15ml/h class IV : > 40% (>2000ml) pulse >140, low BP, negligible UO, lethargic mental

Question 6

a. fib how to decide on the anticoagulant therapy?

Answer 6

CHA2DS2-VASc C Congestive heart disease H HTN A2 Age> 75 D DM S2 Stroke Hx V vascular disease A age 65-74 Sc Sex category - female 0 : no anticoagulation 1 : anti platelet 2 : anti coagulation

Question 7

Digoxin induced ECG changes? (4 benign changes)

Answer 7

1. T-wave change (flattening, inversion) 2. QT interval shortening 3. Scooped appearance of ST segment with ST segment depression 4. increased amplitude of U wave

Question 8

PSVT

two drugs?

Answer 8

adenosine

verapamil

Question 9

anticoaluation management for a patient receiving scheduled cardioversion for a. fib?

Answer 9

warfarin 4 weeks before and after cardioversion

Question 10

chest pain, dyspnea, normal CXR

describe the abnormality in ECG and Dx

Answer 10

S1Q3T3

R/O pulmonary embolism

Question 11

the best indicator for myocardial re-infarction?

Answer 11

CK-MB elevation

(it has a short half life)

Question 12

acute cardiogenic pulmonary edema

Tx?

Answer 12

LMNO

loop diuretics

morphine

nitrates

oxygen