Step Up Cardrio

Question 1

ECG finding of Anterior Infarct

Answer 1

ST elevation V1-V4

Q waves V1-V4

Question 2

ECG findings in Posterior Infarct

Answer 2

ST depression V1 and V2

Upright and big T waves in V1 and V2

Question 3

ECG findings in Lateral infarct

Answer 3

Q waves in I and aVL

Question 4

ECG findings in Inferior infarct

Answer 4

qQ waves in II, III and aVF

Question 5

ST depression indicates what?

Answer 5

subendocardial injury

Question 6

ST elevation indicates what?

Answer 6

transmural injury

Question 7

When is troponin I falsely elevated?

Answer 7

Renal failure patients

Question 8

How soon after MI do troponins increase?

Answer 8

3-5 hours

Question 9

When do troponins peak after MI

Answer 9

24-48 hours

Question 10

What is the most common cause of death in first days after MI?

Answer 10

VT arrythmia of Vfib

Question 11

How can you detect a recurrent heart infarction?

Answer 11

CK-MB re-elevation after 36-48 hours or repeat ST elevation within 24 hours

Question 12

What is Dressler’s Syndrome

Answer 12

Acute pericarditis, fever, malaise, luekocytoss and pleuritis weeks to months after MI

Question 13

What is treatment of Dressler’s Syndrome

Answer 13

Aspirin first line. NSAIDs second line.

Question 14

What does echo show in diastolic dysfunction?

Answer 14

impaired LV relaxation

Question 15

Where is S3 heard best

Answer 15

apex

Question 16

Where is S4 heard best

Answer 16

left sternal border

Question 17

When is BNP released from ventricles?

Answer 17

In response to ventricular volume expansion and pressure overload

Question 18

What drugs lower mortality in CHF?

Answer 18

ACE inhibitors
B-blockers (carvedilol and metorprolol)
Spironolactone (aldosterone inhib)
Hydarlazine + nitrate

Question 19

What are signs of Digitalis toxicity?

Answer 19

Afib, AV block, N/V, anorexia, visual changes, disorientation

Question 20

What drugs lower mortality after acute MI?

Answer 20

Aspirin
B-blockers
ACE inhbitors

Question 21

What is the significance of Premature atrial complexes?

Answer 21

Can be precursor of ischemia in a diseased heart, otherwise found in 50% of normal hearts and of no significance

Question 22

What is seen on EKG in premature atrial complexes?

Answer 22

P-wave weirdness because originate in atria and not in sinus node

Question 23

What is seen on EKG in premature ventricular complexes?

Answer 23

Wide bizarre QRS due to slow conduction through ventricle. Missing P waves because they are buried in widened QRS

Question 24

What is treatment of hemodynamically unstable Afib?

Answer 24

Electrical cardioversion to sinus rhythm immediately

Question 25

Where are saw tooth Aflutter waves found?

Answer 25

II, III, aVF

Question 26

What does EKG of Paroxysmal Supraventricular Tachycardia look like?

Answer 26

narrow QRS with p waves buried in QRS because of short circuit and rapid conduction

Question 27

What does wolf parkinson white EKG look like?

Answer 27

``` narrow complex tachycardia short PT interval delta wave (upward deflection before QRS) ```

Question 28

What is the medical treatment of WPW?

Answer 28

Procainamide or Qunidine

Question 29

What is the medical treatment for sustained ventricular tachycardia?

Answer 29

IV amiodorane IV procainamide IV sotalol

Question 30

What increases systolic ejection murmur of hypertrophic cardiomyopathy?

Answer 30

Valsalva and Standing (decreases LV size and increases outflow obstruction)

Question 31

What decreases systolic ejection murmur of hypertrophic cardiomyopathy?

Answer 31

Handgrip (increases systemic resistance leading to decreased gradient across aortic valve) Squatting, lying down, straight leg raise (decrease outflow obstruction)