Internal Medicine EOR Direct explanations for
better performance.
2nd Degree Heart Block - Mobitz Type II - Answer
2nd Degree Heart Block - Mobitz Type I [Wenchebach] - Answer
Right Bundle Branch Block - Answer
LBBB - Answer
Left Bundle Branch Block - Answer
1st degree heart block - Answer
3rd degree heart block - Answer Ps and Qs don't agree
But occur at regular intervals
Pericarditis ECG - Answer
Which coronary artery is occluded in an inferior wall MI? - Answer Right Coronary
Artery or Right Circumflex Artery
Common adverse effects of thiazide diuretics - Answer Hypokalemia
Hypercalcemia
*Hyperuricemia*
Hyponatremia
Hyperglycemia
Hyperlipidemia
Hypomagnesemia
Common adverse effects of loop diuretics - Answer Hyponatremia
Hypokalemia
Hypersensitivity reactions (sulfa)
Hyperuricemia
Metabolic alkalosis
Ototoxicity
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Hepatic dysfunction based on liver enzymes - Answer
In which leads do you see ST elevations in an inferior wall MI? - Answer II, III, aVF
Which coronary artery is occluded in an anterior wall or septal MI? - Answer Left
Anterior Descending
Which leads do you see ST elevations in a septal MI? - Answer V1-V4, disappearance of
septum Q in leads V5,V6
Which coronary arteries are occluded in a lateral wall MI? - Answer Left circumflex or
obtuse marginal
Which leads do you see ST elevations in a lateral wall MI? - Answer I, aVL, V5, V6
Coronary arteries - Answer
Hypokalemia EKG - Answer
Hyperkalemia EKG - Answer
Hypercalcemia EKG - Answer
Hypocalcemia EKG - Answer
Hypomagnesemia EKG - Answer
Hypermagnesemia EKG - Answer
Does hypernatremia or hyponatremia show EKG changes? - Answer NO
Ventricular Bigeminy - Answer Every other beat is a PVC.
No clinical implications
What is the medication of choice for paroxysmal supraventricular tachycardia? - Answer
Adenosine IV 6 mg
Which patients are candidates for an ICD? - Answer 1) H/o Ventricular tachycardia
2) H/o Ventricular arrhythmia
3) H/o MI
4) CHF (EF </= 35%)
Aortic Stenosis Murmur - Answer Decreases with valsalva and standing.
Increases with squatting.
Heart Murmurs - Answer
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Mitral Stenosis murmur - Answer
What is an Austin Flint murmur? - Answer A murmur due to aortic regurgitation,
originating at the mitral valve when blood enters simultaneously from both the aorta and the left
atrium.
An aortic stenosis murmur results in.... - Answer progressive left ventricular outflow
obstruction
How do you definitively diagnose aortic stenosis? - Answer Echocardiogram (TTE)
Which murmur?
Diastolic murmur
Heart best at apex in L lateral decubitus position with bell
Associated with renal failure and malar rash - Answer Mitral Stenosis
Which murmur?
Pansystolic murmur
Sharp carotid upstroke
Heard best at apex
Radiates to axilla
Left atrial enlargement
Left ventricular hypertrophy - Answer Mitral Regurgitation
Which murmur?
Systolic murmur
Mid-systolic click
Heard best at apex on expiration
Whooping/honking sound
Decreases with squatting [increased preload]
Increases with valsalva or standing [decreased preload] - Answer Mitral Valve Prolapse
Which murmur?
Ejection Systolic murmur
Right Upper Sternal Border radiating to neck
S4
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Narrow pulse pressure
Crescendo-Decrescendo
Heard best in 2nd ICS R sternal edge, on expiration, sitting forward - Answer Aortic
Stenosis
Which murmur?
Diastolic murmur
Traube's sign
What type of murmur is tricuspid stenosis? - Answer Diastolic
What type of murmur is pulmonic stenosis? - Answer Systolic
What is the definition of HFrEF [systolic heart failure]? - Answer Heart failure with LVEF
</= 40%
What is the definition of HFpEF [diastolic heart failure]? - Answer Heart failure with
LVEF > 50%
What are some pharmacologic therapy options for a patient with Stage C HFrEF? - Answer
Routine use:
Diuretic (if has fluid retention)
ACE-I
ARB (if ACE-I intolerant)
Aldosterone receptor antagonists (NYHA class II-IV with LVEF </= 35% or following an acute
MI with LVEF </= 40% w/sx of HF or DM)
Beta blocker
Selected patients:
Hydralazine and isosorbide dinitrate (For African Americans with NYHA class III-IV HFrEF on
GDMT)
Digoxin
Anticoagulants
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