Exam (elaborations)
STEP 2 CK FIRST AID RAPID REVIEW
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STEP 2 CK FIRST AID RAPID REVIEW
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STEP 2 CK FIRST AID RAPID REVIEWClassic ECG finding in atrial flutter. - Answers-"Sawtooth" P waves.
Definition of unstable angina. - Answers-Angina is new, is worsening, or occurs at rest.
Antihypertensive for a diabetic patient with proteinuria. - Answers-ACEI.
Beck's triad for cardiac tamponade. - Answers-Hypotension, distant heart sounds, and
JVD.
Drugs that slow AV node transmission. - Answers-β-blockers, digoxin, calcium channel
blockers.
Hypercholesterolemia treatment that leads to flushing and pruritus. - Answers-Niacin.
Treatment for atrial fibrillation and atrial flutter. - Answers-If unstable, cardiovert. If stable
or chronic, rate control with calcium channel blockers or β-blockers.
Treatment for ventricular fibrillation. - Answers-Immediate cardioversion.
Autoimmune complication occurring 2-4 weeks post-MI. - Answers-Dressler's syndrome:
fever, pericarditis, ↑ ESR.
IV drug use with JVD and holosystolic murmur at the left sternal border. Treatment? -
Answers-Treat existing heart failure and replace the tricuspid valve.
Diagnostic test for hypertrophic cardiomyopathy. - Answers-Echocardiogram (showing
thickened left ventricular wall and outflow obstruction).
A fall in systolic BP of > 10 mmHg with inspiration. - Answers-Pulsus paradoxus (seen in
cardiac tamponade).
Classic ECG findings in pericarditis. - Answers-Low-voltage, diffuse ST-segment
elevation.
Definition of hypertension. - Answers-BP > 140/90 on three separate occasions two
weeks apart.
Eight surgically correctable causes of hypertension. - Answers-Renal artery stenosis,
coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's syndrome,
unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism.
Evaluation of a pulsatile abdominal mass and bruit. - Answers-Abdominal ultrasound
and CT.
,Indications for surgical repair of abdominal aortic aneurysm. - Answers-> 5.5 cm, rapidly
enlarging, symptomatic, or ruptured.
Treatment for acute coronary syndrome. - Answers-Morphine, O2, sublingual
nitroglycerin, ASA, IV β-blockers, heparin.
Murmur—hypertrophic obstructive cardiomyopathy (HOCM). - Answers-Systolic ejection
murmur heard along the lateral sternal border that ↑ with Valsalva maneuver and
standing.
Murmur—aortic insufficiency. - Answers-Diastolic, decrescendo, high-pitched, blowing
murmur that is best heard sitting up; ↑ with ↓ preload (handgrip maneuver).
Murmur—aortic stenosis. - Answers-Systolic crescendo/decrescendo murmur that
radiates to the neck; ↑ with ↑ preload (Valsalva maneuver).
Murmur—mitral regurgitation. - Answers-Holosystolic murmur that radiates to the axillae
or carotids.
Murmur—mitral stenosis. - Answers-Diastolic, mid- to late, low-pitched murmur.
What is metabolic syndrome? - Answers-Abdominal obesity, high triglycerides, low HDL,
hypertension, insulin resistance, prothrombotic or proinflammatory states.
Target LDL in a patient with diabetes. - Answers-< 70.
Signs of active ischemia during stress testing. - Answers-Angina, ST-segment changes
on ECG, or ↓ BP.
ECG findings suggesting MI. - Answers-ST-segment elevation (depression means
ischemia), flattened T waves, and Q waves.
Coronary territories in MI. - Answers-Anterior wall (LAD/diagonal), inferior (PDA),
posterior (left circumflex/oblique, RCA/marginal), septum (LAD/diagonal).
A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are
normal. - Answers-Prinzmetal's angina.
Common symptoms associated with silent Mls. - Answers-CHF, shock, and altered
mental status.
The diagnostic test for pulmonary embolism. - Answers-V/Q scan.
An agent that reverses the effects of heparin. - Answers-Protamine.
The coagulation parameter affected by warfarin. - Answers-PT.
, A young patient with a family history of sudden death collapses and dies while
exercising. - Answers-Hypertrophic cardiomyopathy.
Endocarditis prophylaxis regimens. - Answers-Oral surgery—amoxicillin; GI or GU
procedures—ampicillin and gentamicin before and amoxicillin after.
The 6 P's of ischemia due to peripheral vascular disease. - Answers-Pain, pallor,
pulselessness, paralysis, paresthesia, poikilothermia.
Virchow's triad. - Answers-Stasis, hypercoagulability, endothelial damage.
The most common cause of hypertension in young women. The most common cause of
hypertension in young men. - Answers-OCPs. Excessive EtOH.
"Stuck-on" appearance. - Answers-Seborrheic keratosis.
Red plaques with silvery-white scales and sharp margins. - Answers-Psoriasis.
The most common type of skin cancer; the lesion is a pearly-colored papule with a
translucent surface and telangiectasias. - Answers-Basal cell carcinoma.
Honey-crusted lesions. - Answers-Impetigo.
A febrile patient with a history of diabetes presents with a red, swollen, painful lower
extremity. - Answers-Cellulitis.
Pos Nikolsky's sign. - Answers-Pemphigus vulgaris.
Neg Nikolsky's sign. - Answers-Bullous pemphigoid.
A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck.
- Answers-Acanthosis nigricans. Check fasting blood glucose to rule out diabetes.
Dermatomal distribution. - Answers-Varicella zoster.
Flat-topped papules. - Answers-Lichen planus.
Iris-like target lesions. - Answers-Erythema multiforme.
A lesion characteristically occurring in a linear pattern in areas where skin comes into
contact with clothing or jewelry. - Answers-Contact dermatitis.
Presents with a herald patch, Christmas-tree pattern. - Answers-Pityriasis rosea.
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