Week 1 practice questions Flashcards by Morgan Evans

Which of the following is NOT one of the three main “can’t miss” diagnoses for chest pain?
a) MI
b) Dissection
c) PE
d) Pneumothorax

d) Pneumothorax

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Which of the following is defined as spasm of the cardiac arteries?
a) Prinzmetal angina
b) Stable angina
c) Unstable angina
d) Microvascular angina

a) Prinzmetal angina

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Sharp chest pain that worsens with movement is a key symptom of what etiology?
a) MI
b) PE
c) MSK
d) Dissection

c) MSK

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A patient presents to the ED with severe chest pain and tachycardia. You get an EKG and it’s normal. When should you repeat the EKG?
a) 1-5 minutes
b) 10-15 minutes
c) 30-45 minutes
d) 1 hour

b) 10-15 minutes

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All patients undergoing PCI should be pretreated at diagnosis with what therapy/therapies? Select all that apply
a) Anticoagulant
b) Fibrinolytic
c) Dual antiplatelet
d) Antithrombotic

a) Anticoagulant
c) Dual antiplatelet

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A patient presents with chest pain that’s worse when lying supine and relieved by sitting forward. On their EKG, diffuse ST elevation is present. What is the most likely diagnosis?
a) MI
b) PE
c) Unstable angina
d) Prinzmetal angina
e) Pericarditis

e) Pericarditis

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What are the 3 fibrinolytics used for ACS Tx? Select 3
a) Alteplase
b) Reteplase
c) Streptokinase
d) Tenecteplase
e) Urokinase

a) Alteplase
b) Reteplase
d) Tenecteplase
ART

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T/F: Reperfusion with PCI and maximum medical management are both valid methods of Tx for NSTEMI/ unstable angina

True

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What should you NOT give if a pt is headed toward a CABG?
a) Alteplase
b) LMWH
c) Heparin
d) ASA

b) LMWH

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What is the first line Tx for Prinzmetal Angina?
a) Magnesium
b) Diltiazem
c) Alteplase
d) Nitroglycerin

b) Diltiazem

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ASA + clopidogrel or ticagrelor + heparin should be given for what 3 conditions? Select all that apply
a) CAD
b) Stable angina
c) Unstable angina
d) STEMI
e) NSTEMI

c) Unstable angina
d) STEMI
e) NSTEMI

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If a pt is headed for PCI, which antiplatelet should you use?
a) Ticagrelor
b) Clopidogrel
c) None of the above; no P2Y12s allowed!
d) Either of the above

a) Ticagrelor

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Which of the following is NOT a part of Beck’s triad for tamponade?
a) Hypotension
b) Hypertension
c) JVD
d) Muffled heart sounds

b) Hypertension

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A patient has a STEMI and cannot be transferred to a hospital for a PCI for another 9 hours. What should you do?
a) Thrombolytic therapy
b) Fibrinolytic therapy
c) None of the above; anticoagulation and antiplatelets only

a) Thrombolytic therapy

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What do you give within the first day of a STEMI to decrease myocardial oxygen demand and reduce damage?
a) ACEis
b) Statins
c) Beta blockers
d) CCBs

c) Beta blockers

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A patient has an LBBB and NSTEMI. What is the most appropriate course of action?
a) PCI
b) Maximum medical management
c) Either of the above is appropriate

a) PCI

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ST elevation in V1 and depression in V2 is very specific for what?
a) Inferior and right-sided stemi
b) Inferior and lateral stemi
c) Inferior and posterior stemi
d) Anterior and inferior stemi

a) Inferior and right-sided stemi

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Which of the following can be used for a patient with AFIB and HF? Select all that apply
a) Diltiazem
b) Digoxin
c) Verapamil
d) Amiodarone

b) Digoxin
d) Amiodarone

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Which may require a permanent pacemaker?
a) Type 1 AV block
b) Mobitz type 1 AV block
c) Mobitz type 2 AV block
d) All of the above
e) None of the above

c) Mobitz type 2 AV block

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A patient has symptomatic bradycardia but is stable. What do you do?
a) Epinephrine 2-10microgram/min IV
b) Epinephrine 2-10mg/min IV
c) Atropine 1 mg IV push, q 3-5 minutes
d) Atropine 10 mg IV push, q 3-5 minutes
e) Dopamine 5-20 micrograms/kg/min IV

c) Atropine 1 mg IV push, q 3-5 minutes

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A patient has a Mobitz type 2 AV block. How do you Tx?
a) Atropine 1mg bolus q 5 minutes PRN (3mg total dose max) + transcutaneous pacing
b) Atropine 1mg bolus q 5 minutes PRN (3mg total dose max) only
c) Epinephrine 2-10microgram/min IV
d) Transcutaneous pacing only
e) No Tx required

a) Atropine 1mg bolus q 5 minutes PRN (3mg total dose max) + transcutaneous pacing

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T/F: A new LBBB is always concerning, but a new RBBB is not always concerning

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True

Sgarbossa Criteria is used for what?
a) LBBB with Pericarditis
b) RBBB with Unstable angina
c) NSTEMI with Hypertensive crisis
d) STEMI with LBBB
e) STEMI with RBBB

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d) STEMI with LBBB

Anatomic SVT is also known as what?
a) AVNRT
b) AVRT
c) Unstable angina
d) STEMI

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b) AVRT

What should you do for unstable SVT? a) Synchronized cardioversion b) Epinephrine 2-10microgram/min IV c) Adenosine 6mg bolus then flush; at 2 min 12mg bolus then flush d) Atropine 1mg bolus q 5 minutes PRN (3mg total dose max) + transcutaneous pacing

a) Synchronized cardioversion

How should you Tx stable SVT? a) Synchronized cardioversion b) Epinephrine 2-10microgram/min IV c) Adenosine 6mg bolus then flush; at 2 min 12mg bolus then flush d) Atropine 1mg bolus q 5 minutes PRN (3mg total dose max) + transcutaneous pacing

c) Adenosine 6mg bolus then flush; at 2 min 12mg bolus then flush

Which type of WPW should you give adenosine to? a) Orthodromic b) Antidromic c) Both of the above d) Neither of the above; you should give amiodarone

a) Orthodromic

T/F: Brugada syndrome needs to be admitted

False (just needs close oupt followup w cardiologist)

T/F: Vtach has a wide QRS complex

True

A pt with Vtach is hemodynamically stable with a pulse. How do you Tx? a) Synchronized cardioversion 120-200J if biphasic, if monophasic 360 b) Amiodarone, Procainamide, and Sotalol c) Adenosine, Epinephrine, and Propranolol d) Defibrillation, then epinephrine 1.0mg IV, then either amiodarone or lidocaine

b) Amiodarone, Procainamide, and Sotalol

A pt with Vtach is pulseless. How do you Tx? a) Synchronized cardioversion 120-200J if biphasic, if monophasic 360 b) Amiodarone, Procainamide, and Sotalol c) Adenosine, Epinephrine, and Propranolol d) Defibrillation, then epinephrine 1.0mg IV, then either amiodarone or lidocaine

d) Defibrillation, then epinephrine 1.0mg IV, then either amiodarone or lidocaine

Which of the following may be treated with magnesium 2g over 1 min? a) Prinzmetal angina b) Brugada syndrome c) Torsades de pointes d) Vtach e) Vfib

c) Torsades de pointes

How do you Tx Vfib? a) Synchronized cardioversion 120-200J if biphasic, if monophasic 360 b) Defibrillation, then epinephrine 1.0mg IV, then either amiodarone or lidocaine

a) Synchronized cardioversion 120-200J if biphasic, if monophasic 360

Which of the following is NOT one of the big 3 of valvular emergencies? a) Acute aortic regurgitation b) Acute mitral regurgitation c) Acute aortic stenosis d) Acute mitral stenosis

d) Acute mitral stenosis

A patient has acute aortic stenosis. What is the most likely precipitating condition? a) ACS b) Dissection c) CHF d) PE

c) CHF

Which is most specific for CHF? a) Hepatojugular reflux b) JVP c) Pretibial edema d) S3

d) S3 (hepatojugular reflex is most sensitive)

Which is NOT one of the big 3 cause of CHF? a) Ischemia b) Valve disease c) HTN d) MI

d) MI

A patient with a Hx of CHF has a SBP of 160 and is dyspneic. How do you Tx? a) Loop diuretics + CPAP/ BIPAP b) Nitroprusside + CPAP/ BIPAP c) Lasix 40-80mg IV + transdermal low dose nitrates + O2 to 95% d) ACLS d) EKG + slow 250ml of fluid + Norepinephrine 0.05-0.1 mcg/kg/min titrate by increase of 0.02 mcg/kg/min q 5

b) Nitroprusside + CPAP/ BIPAP (same Tx as flash pulmonary edema)

How do you Tx a typical CHF exacerbation? a) Loop diuretics + CPAP/ BIPAP b) Nitroprusside + CPAP/ BIPAP c) Lasix 40-80mg IV + transdermal low dose nitrates + O2 to 95% d) ACLS e) EKG + slow 250ml of fluid + Norepinephrine 0.05-0.1 mcg/kg/min titrate by increase of 0.02 mcg/kg/min q 5

c) Lasix 40-80mg IV + transdermal low dose nitrates + O2 to 95%

Which patient is in cardiogenic shock? a) Typical CHF exacerbation b) Acute hypertensive CHF c) Acute hypotensive CHF d) Acute normotensive CHF

c) Acute hypotensive CHF

What do you do for cardiogenic shock? a) Loop diuretics + CPAP/ BIPAP b) Nitroprusside + CPAP/ BIPAP c) Lasix 40-80mg IV + transdermal low dose nitrates + O2 to 95% d) ACLS e) EKG + slow 250ml of fluid + Norepinephrine 0.05-0.1 mcg/kg/min titrate by increase of 0.02 mcg/kg/min q 5

e) EKG + slow 250ml of fluid + Norepinephrine 0.05-0.1 mcg/kg/min titrate by increase of 0.02 mcg/kg/min q 5

A pt has AFIB with RVR. What do you use for rate control? a) Ibutilide b) Digoxin c) Diltiazem 15-25 mg over 2 min IV infusion at 5-10 mg/hr d) Adenosine 6mg bolus then flush; at 2 min 12mg bolus then flush

c) Diltiazem 15-25 mg over 2 min IV infusion at 5-10 mg/hr

A patient has sharp or stabbing chest pain that radiates and gets a little better leaning forward. This describes what condition? a) STEMI b) Pericarditis c) Myocarditis d) CHF

b) Pericarditis

Diffuse ST elevation, especially in lateral leads, AND no reciprocal depression are typical of what stage of pericarditis? Stage 1 Stage 2 Stage 3 Stage 4

Stage 1

Which of the following pts with pericarditis does NOT need to be admitted? a) Myocarditis b) Effusion c) Uremic pericarditis d) Viral pericarditis

d) Viral pericarditis

What is the best diagnostic tool for pericarditis? a) CT angiography b) Echocardiogram c) X-ray d) EKG e) Arteriogram/angiogram

b) Echocardiogram

A pt has a decrease in systolic pressure more than 10mmHg with inspiration. This is a classic symptom of what? a) AAA b) Dissection c) Cardiac tamponade d) MI

c) Cardiac tamponade

What must be done as soon as aortic dissection is suspected? (hint: it’s also gold standard for AAA) a) CT angiography b) Echocardiogram c) X-ray d) EKG e) Arteriogram/angiogram

a) CT angiography

What two meds should be given to aortic dissection pts? Select all that apply a) Esmolol IV b) Amiodarone IV c) Adenosine IV d) Nicardipine IV

a) Esmolol IV d) Nicardipine IV

A pt has back pain, hypotension, and a pulsatile mass. This describes? a) AAA b) Dissection c) Cardiac tamponade d) MI

a) AAA

Which of the following indicate an ischemic limb that may not be viable? Select two a) Paresthesia b) Poikilothermia c) Paralysis d) Pallor e) Pain

a) Paresthesia c) Paralysis

Most common cause of arterial occlusion causing ischemic limb is what? a) Atherosclerosis b) Thromboembolic event c) Buerger's disease d) Vasculitis

b) Thromboembolic event

What is the gold standard for ischemic limb? a) CT angiography b) Echocardiogram c) X-ray d) EKG e) Arteriogram/angiogram

e) Arteriogram/angiogram

Week 1 practice questions Flashcards

(53 cards)