EMERGENCY MEDICINE EOR EXAM LATEST -

EMERGENCY MEDICINE EOR EXAM LATEST -

50 QUESTIONS AND CORRECT

DETAILED ANSWERS (VERIFIED ANSWERS ) |

ALREADY GRADED A+

Paroxysmal supraventricular tachycardia is a reentry tachycardia, commonly noted in elderly patients with underlying heart disease. What treatment may be helpful before using adenosine ie. the drug of choice? - ANSWER- vagal maneuvers or antianxiety medication

What are some drugs associated with Torsades de pointes? - ANSWER- tricyclic antidepressants, erythromycin, ketoconazole, haloperidol, cisapride, disopyramide, pentamidine, sotalol, class I anti-arrhythmics

CHF - Systolic dysfunction means a problem with the ____. What drug is contraindicated? - ANSWER- pump; CCB!

CHF - Diastolic dysfunction means a problem with the ____. - ANSWER- compliance or relaxation of the heart during ventricular filling

The ________principle means that as preload increases, the ventricle is stretched during diastole filling and the ejection fraction is increased. - ANSWER- Frank-Starling principle

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_____is released from cardiac ventricles in response to increased wall tension. - ANSWER- BNP - B-type natriuretic peptide

What is the pharmacologic therapy for heart failure? - ANSWER- 1.diuretics for fluid retention

• ACEi
• vasodilators (hydralazine & nitrates)
• BB for LV dysfunction
• digitalis to increase cardiac contractility

Functional Classification of Heart Failure:

___-No cardiac symptoms with ordinary activity.___-Cardiac symptoms w MARKED activity but asymptomatic at rest ___-Cardiac symptoms w MILD activity but asymptomatic at rest ___-Cardiac symptoms at rest. - ANSWER- Class I, Class II, Class III, Class IV

Stage 1 Hypertension is defined as greater than ____. Stage 2 Hypertension is defined as greater than ____. - ANSWER- 140/90;

160/100

Hypertension Drug of Choice for:

angina diabetes hyperlipidemia 2 / 4

CHF Previous MI Chronic Renal Failure Asthma, COPD - ANSWER- Angina - BB, CCB Diabetes - ACEi & CCB, avoid diuretics Hyperlipidemia - ACEi & CCB, avoid diuretics/BB CHF - diuretics & ACEi, avoid CCB/BB Previous MI - BB/ACEi Chronic renal failure - diuretics, CCB Asthma - diuretics & CCB, avoid BB

Secondary hypertension is HTN due to an ______. - ANSWER- identifiable cause ie. renovascular disease, coarctation of the aorta, primary aldosteronism, Cushing's, Pheochromocytoma, OSA, renal parenchymal hypertension

____hypertension is potentially life threatening - HTN plus rentinopathy, cardiovascular/renal compromise, or encephalopathy. - ANSWER- Malignant

Malignant hypertension bp? What is the rule of thumb for lowering? - ANSWER- greater than 220/140; 10% in first hour and 15% for the next 3-12 hours, to normal over next 2 days

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What is the agent of choice for BP lowering for patients with hypertensive encephalopathy, intracranial bleeding, and heart failure?Use with what for dissecting aneurysm? - ANSWER- nitroprusside; propranolol -- clonidine can also be used but sedation is common

Hypotension is defined as a systolic blood pressure less than _____mm Hg or a decrease from baseline by more than 30mmHg. What are the 3 treatments for improving blood pressure? - ANSWER- 90mmHg;

• IV Fluids
• Vasopressors - dopasmine, dobutamine (risk is aggravation of

arrhythmias and increase myocardial oxygen demand)

• intra-aortic balloon pump

ST Elevations in II, III, aVF - ANSWER- Inferior MI; right coronary artery

ST Elevations in I, aVL, V4, V5, V6 - ANSWER- lateral wall MI, left circumflex artery

ST Elevations in V1, V2, V3, V4, V5 - ANSWER- Anterioseptal MI, left anterior descending artery

ST Elevations in V1, V2 - ANSWER- posterior wall MI, posterior descending artery

No nitroglycerin in which kind of MI? - ANSWER- inferior

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