PAEA EOR IM miss| 62 questions| with complete solutions Clinical Therapeutics, Paroxysmal supraventricular tachycardia (PSVT) Stable Narrow
Complex: - Correct Answer Adenosine
Clinical Therapeutics, Paroxysmal supraventricular tachycardia (PSVT) Stable Wide: - Correct Answer Amiodarone Diagnosis, Acute coronary syndrome: If left coronary artery is ischemic, what are the ECG changes? - Correct Answer ST elevations V5, V6, I and avL Diagnosis, Coarctation of the aorta - Correct Answer o CXR: rib notching, and "3 sign"
- Difference in BP upper and lower extremities
Diagnostic Tests, Coarctation of the aorta - Correct Answer o GOLD: angiogram
o CXR: rib notching, and "3 sign"
Diagnostic Tests Ventricular aneurysm - Correct Answer Initial test is Echo then MRI and/or CT Clinical therapeutics, Constrictive pericarditis - Correct Answer NSAIDs x7-14 days. (sx usually subside within 24h).Clinical therapeutics, Refractory pericarditis - Correct Answer Corticosteroids if symptoms> 48h & refractory to 1st line meds.Health Maintenance, Pancreatitis - Correct Answer Stop ETOH use and/or mange gallstones History and Physical, Aortic dissection - Correct Answer HTN, 50-60yo Intimal wall tear* d/t HTN Intrascapular chest pain, ripping History and Physical, Aortic regurgitation - Correct Answer Blowing diastolic high- pitched decrescendo, murmur located at the LUSB History and Physical, Congestive heart failure - Correct Answer Hx of DM2, meth use, EtOH use, chemo/radiation to chest. PE= dyspneic w/lying flat, multiple pillow prthopnea, ascites, heaptojugular reflex, JVD/distended neck veins, extremity edema, lung sounds will have rales. S3-heart sound Scientific Concepts, Lateral wall MI - Correct Answer Atherosclerosis MC- plaque rupture →thrombosis, EKG: 3-contiguous pathologic Q waves/ST elevations in lateral leads w/ reciprocal changes in inferior leads, usually affects circumflex artery Critical Care : Clinical Therapeutics, Acute angle-closure glaucoma - Correct Answer 2
steps: lower IOP → open the angle (cholinergics)
- 1st line: Acetazolamide (carbonic anhydrase inh.) → or Topical BB (Timolol) 1 / 2
o Then: Miotics/cholenergics (Pilocarpine, Carbachol)
o Definitive: bilateral peripheral iridotomy
Critical Care : Clinical Therapeutics, Hypertensive crisis (emergency) - Correct Answer Labetalol- Decrease BP no more than 25% within 1st hour Critical Care : Clinical Therapeutics, Status epilepticus (sz follow without conscious recovery between) - Correct Answer Lorazepam or Diazepam → Phenytoin → Phenobarbital Critical Care : Diagnosis, Second-degree atrioventricular block - Correct Answer o Mobitz I ECG- progressively elongating PR → dropped QRS
- Mobitz II ECG- constant, prolonged PR complex → dropped QRS
- PE- Becks triad- 1. distant (muffled) heart sounds, 2. ↑ JVP, 3. hypoTN
- Pulsus paradoxus, edema, dyspnea, fatigue
Critical Care : History and Physical, Cardiac (pericardial) tamponade - Correct Answer o Pericardial effusion causing lots of pressure on heart, may be d/t chronic dz
Endocrinology : Clinical Therapeutics, Hypoparathyroidism - Correct Answer Ca+
supplement and Vit. D Endocrinology : Diagnosis, Metabolic syndrome - Correct Answer ATP Ill criteria: at
least 3 of the following 5:
I. ↓HDL: <40 mg/dL in men & <50 mg/dL in women.
2. ↑BP: systolic or mmHg diastolic (or drug tx for HTN).
3. ↑ Fasting TG: mg/dL (or drug tx for high TG).
4. ↑ Fasting blood sugar: 100 mg/dL (or drug treatment for high glucose).
- ↑ Abdominal obesity: waist circumference >40in (men) & >35in (women)
Endocrinology : Diagnosis, Primary aldosteronism - Correct Answer o
Headaches+HYPOKALEMIA:* proximal muscle weakness, polyuria.* fatigue,
constipation, ↓DTR, hypomagnesemia.
- Aldo/reninin ratio >20, plasma aldosterone >20, ↓ renin
- Definitive- Saline infusion test (NO ↑ aldosterone lvls.)
Endocrinology : Diagnostic Studies, Hypothyroidism - Correct Answer ↑ TSH, ↓ T3/T4
Endocrinology : Health Maintenance, Thyroid cancer - Correct Answer Monitor
thyroglobulin lvls Q 6mo after thyroidectomy and monitor calcitonin lvls Gastrointestinal/Nutritional : Clinical Intervention, Hemochromatosis - Correct Answer o Phlebotomy* Qwk until Ø Fe
- → Maintenance phlebotomy Q3-4/years for life.
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