Complete Answers Emergency Medicine EOR Exam Latest 2023

Complete Answers Emergency Medicine EOR Exam ( Latest 2023)

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All New Q&A in TB - 100% Correct for A++!

1. Dilated Cardiomyopathy: most common cause is . Others?

Answer: alcohol; may also be idiopathic, myocarditis, or drugs (doxorubicin) -

• 1 in 3 cases of heart failure are caused by dilated cardiomyopathy

• What PE and EKG changes are seen with dilated cardiomyopathy?

Answer: PE: S3, JVD, crackles - possible mitral regurg

EKG: nonspecific ST and T wave changes, LBBB

3. Hypertrophic cardiomyopathy: is due to hypertrophy of the . PE re-

veals mitral regurgitation, a heart sound, and prominent left ventricular impulse. EKG reveals LVH

Answer: cardiac septum; S4

4. Restrictive cardiomyopathy: often caused by a process, or post-radi-

ation or post open-heart surgery. What is the most common first symptom?-

Answer: --infiltrative process - amyloidosis, sarcoidosis, and hemochromatosis

-- changes in myocardium --most common first symptom is exertion intolerance and fluid retention, signs of right heart failure

• Atrial fibrillation - regularly irregular - the most common sustained arrhyth-

mia in adults - what three treatments are used? 1 / 4

Answer:

• rate control w BB, CCB, or digoxin
• Anticoagulation w heparin & warfarin
• rhythm control w amiodarone or cardioversion

• Atrial flutter - sawtooth pattern in II, III, aVF - what three treatments are used?

Answer:

• cardioversion if no contraindications
• acute rate control tx w BB, CCB - amiodarone, sotalol, quinidine, or

procainamide

• If site of reentrant is known, catheter ablation

• Multifocal atrial tachycardia - noted in patients with COPD or severe

systemic illness - EKG shows multiple shaped P waves and differing PR intervals. are agents of choice?

Answer: CCB

8. BLOCKS

• =prolonged PR interval
• =progressive increase in PR until Pwave is blocked. 3.

=sudden block in P wave w no change in PR

4. =atrial and ventricular rhythm are independent of each other.: First

degree; Wenckebach Mobitz type I; Mobitz type II, Third degree block

• A may develop after acute MI, PE, aortic stenosis and is due to a

conduction delay in the right or left bundles.: Bundle branch block

• Paroxysmal supraventricular tachycardia is a reentry tachycardia, com-

monly noted in elderly patients with underlying heart disease. What treat- ment may be helpful before using adenosine ie. the drug of choice? 2 / 4

Answer: vagal maneuvers or antianxiety medication

• What are some drugs associated with Torsades de pointes?

Answer: tricyclic an- tidepressants, 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

• 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: 3 / 4

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

17. 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 Hyperten-

sion is defined as greater than .

Answer: 140/90; 160/100

• Hypertension Drug of Choice for

Answer:

angina diabetes hyperlipidemia CHF Previous MI Chronic Renal Failure

Asthma, COPD: 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,

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