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Rosh Enp Questions And Answers With Verified Solutions Already Passed!!!!
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Rosh Enp Questions And Answers With Verified Solutions Already Passed!!!!
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Rosh Enp Questions And Answers WithVerified Solutions Already Passed!!!!
Endocarditis most commonly c/b - ANSWER✔✔ IVDA (S. Aureus), Native Valve
(Strep, S. Aureus)
Endocarditis valves involved - ANSWER✔✔ IVDA (tricuspid) Native Valve (Mitral)
Endocarditis Presentation/Physical Exam - ANSWER✔✔ Fever, cough, rash,
myalgias (flu-like symptoms)
Fever
Roth spots
Osler nodes
Murmur
Janeway lesions
Anemia
Nail bed hemorrhages
Emboli
Endocarditis Diagnostic Studies/Management - ANSWER✔✔ ECHO, Blood
Cultures, Duke Criteria/IV Antibiotics
First Degree Heat Block causes - ANSWER✔✔ aging, digitalis, ischemia,
inflammation, cardiomyopathies, beta-blockers
,First Degree Heart Block Features - ANSWER✔✔ P-R interval >0.20 second and
constant. Regular Rhythm
Second Degree Heart Block (Mobitz I/Wenckebach) Features - ANSWER✔✔ P-R
interval progressively lengthening until QRS complex fails to conduct after a P
wave (dropped beat)
The block is almost always within the AV node
Second Degree Heart Block (Mobitz II) Features/Management - ANSWER✔✔ P
waves are normal, QRS complexes usually wide due to concomitant BBB, P-R
interval are always the same duration, there are dropped beats. The block is
below the AV node in the His-Purkinje system. Consider permanent pacemaker
Third Degree Heart Block Causes - ANSWER✔✔ aging, anterior or inferior
infarction, digitalis
Third Degree Heart Block Features/Management - ANSWER✔✔ EKG with regular
P-P and R-R intervals that are UNRELATED to one another (independent beating of
the atria and ventricles)/If symptomatic use atropine, dopamine, temporary
pacing. Definitive treatment is permanent pacemaker
Wolff-Parkinson-White (WPW) Syndrome Cause/Features - ANSWER✔✔
Accessory pathway (bundle of Kent) connecting the atria to the ventricles,
bypassing AV node. EKG with a short P-R interval, wide QRS complex, and slurred
upstroke of QRS (Delta wave)
WPW Syndrome Management - ANSWER✔✔ Procainamide. Definitive treatment
is radiofrequency ablation
, Cardiac Tamponade Presentation - ANSWER✔✔ Dyspnea, chest pain,
hypotension, (Beck Triad) distended neck veins, and muffled heart sounds; pulsus
paradoxus
Cardiac Tamponade Diagnosis/Management - ANSWER✔✔ EKG with low-voltage
QRS and electrical alternans; diastolic collapse of the right ventricle
/Pericardiocentesis, normal saline bolus because patient is preload dependent
Cocaine-Associated Chest Pain c/b - ANSWER✔✔ coronary artery vasospasm
Presentation of Cocaine-Associated Chest Pain - ANSWER✔✔ MI, dysrhythmia,
aortic dissection, myocarditis, stroke
Management of Cocaine-Associated Chest Pain - ANSWER✔✔ NTG, ASA,
benzodiazepines. AVOID beta blockers
HEART Score for Chest Pain Patients in the ED - ANSWER✔✔ Used in patients 21
or older presenting with symptoms suggestive of ACS. Do not use if new ST-
segment elevation>= 1mm or other new EKG changes, hypotension, life
expectancy less than 1 year, or noncardiac med/surg/psych illness determined by
the provider to require admission.
Components of HEART Score Components - ANSWER✔✔ History, EKG, Age, Risk
Factors, Troponin
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