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Family Medicine I PAEA Blueprint Questions with Correct Answers.
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Family Medicine I PAEA Blueprint Questions with Correct Answers.
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Family Medicine I PAEA Blueprint Questions withCorrect Answers
(Cardiovascular)
1. Angina pectoris
- def
- RFs (worst rf, most modifiable rf)
- pathophys
- pres
- dx
- tx Correct Answer-def: chest discomfort due to myocardial ischemia as
a result of fixed epicardial coronary obstruction
- a complication of CAD usually due to atherosclerosis
RFs:
Worst RF - Diabetes mellitus
Most modifiable - smoking
pathophys: myocardial ischemia (inadequate myocardial tissue
perfusion)
pres: chest pain or discomfort classically described as substernal, poorly
localized, exertional, short in duration exacerbated with activity or stress
and relieved with rest
- <30 minutes, often resolves within 5 min
,- may develop dyspnea, epigastric or shoulder pain instead (F>M,
elderly, diabetics, and obese)
dx: Clinical + testing
1. Ecg - initial test of choice - ST depression classic finding
- resting ecg normal in 50% of cases
2. Stress testing - most important noninvasive testing
3. Coronary angiography - definitive
tx: Typical oupt tx includes 4 drugs -
1/2. Aspirin + Beta-blocker (both decrease mortality),
3. Sublingual short-acting Nitroglycerin prn
4. Daily Statin
Revascularization = definitive
1. Percutaneous transluminal coronary agiography (1 to 2 vessel dz in
nondiabetic
2. Coronary a. bypass graft - left main coronary a. sternosis, 3 vessel dz
(or 2 vessel dz in diabetics)
2. Cardiac basics
a.EKG cheat sheet
,- basic steps in reading ekg Correct Answer-1. Determine rhythm (check
r-r intervals: if <0.12 seconds, regular)
2. Determine rate (regular - 1500/# of small sqaures)
(irregular - number of r waves in 6 second strip x 10)
3. Determine QRS axis
4. Evaluate P waves/PR interval
- Sinus (postive in II,III, avf, and down in aVR), p each P followed by
QRS
- PRI - <.12-.20 seconds>
- atrial enlargement? -
right atrial enlargement = tall P wave in lead II >3mm
Left atrial enlargement = m-shaped p wave in lead II, >.12 seconds
5. Evaluate QRS complex
- narrow v wide (< .12 sec)
- if wide: BBB?
- ventricular hypertrophy?
- pathological q wave?
, 6. Evaluate ST segment
- ST depression or elevation > 1mm in depth/height
7. Evaluate T waves
- inversions/flattening
- QT prolonged?
c. Tachycardia algorithm Correct Answer-
d. Bradycardia algorithm Correct Answer-
e. Sinus tachycardia
- def
- eti
- pres
- dx
- tx Correct Answer-def: Regular cardiac rhythm with hr > 100 bpm
eti: physiologic or pathologic
pathologic - infectious, hypovolemia, cardiac (myocarditis, tamponade,
ACS), respiratory (PE), electrolyte disorders etc.
pres: mc asx
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