Your 56-year old patient presents with bradycardia with a rate of 55 and first degree AV block. The patient is hemodynamically stable and is not experiencing any syncope or chest pain. History includes previous myocardial infarction. Home medications include beta blockers, daily aspirin. Lab work is non-significant for electrolyte imbalance. You decided to treat this patient for the arrhythmia to prevent future destabilization. From the choices below, which might be the appropriate first measure to consider?
Add digitalis to control the heart rate
Consult cardiologist immediately for guidance
Discontinue Beta Blocker and replace with another therapy if necessary
Your patient is morbidly obese and cannot sit on a bicycle or walk a treadmill. She also has marked and severe emphysema. You need to make an assessment of the risk of significant CAD and your patient’s family says that their relative had their diagnosis based on an ultrasound echocardiography. What facts would influence your decision regarding the family request for echo assessment?
Sensitivity would be increased because of lung disease
Specificity would be increased because of obesity
Sensitivity would be reduced because of obesity and lung disease
Specificity would be reduced because of obesity and lung disease
You are in the clinic with your mentor observing the Echocardiogram exercise test of a 45-year old male that has been experiencing slight chest pressure almost daily during exercise.While observing your patient, your mentor points out that the left ventricle wall is thinning and there is some hyperkinesias of the ventricular wall. From your time in the clinic, you know that this test will be considered to be what type of result?
Your patient is newly diagnosed with persistent Atria Fibrillation. You consider electrocardioversion. Before undergoing this procedure you should order the following examination to assess thrombus risk.
X-Ray of chest
Ultrasound of chest
Tachyarrhythmias cause a drop in commonly blood pressure, cardiac output, syncope, shortness of breath, and chest pain. What phenomenon most often occurs during these arrhythmias to cause these symptoms?
At what age is atria fibrillation most common?
60 years or older
Automaticity is a property common to all cardiac cells. Is this statement true or false?
Your patient has a maximum age-predicted heart rate of 180. During the exercise he reaches a heart rate of 140 and then states he can no longer exercise. You see evidence of ischemic changes on the ECG. This would be predictive of what condition?
Low risk of CAD
You tell a patient that he has a murmur. He says he has been told this before, but wonders what causes the unique sounds of a murmur. Which of the following would be your best option?
Turbulent flow of blood
High pressures caused from HTN
There is no reason, it just happens
Almost always from a sclerotic valve
What is the treatment of choice for uncomplicated community-acquired cystitis?
Any antibiotic will treat this diagnosis
Any patient presenting with symptomatic bradycardia should be referred
to a cardiologist for management. Is this statement true or false?
Encouragement of patients to take effective actions in their own healthcare refers to the concept of:
Physician or provider-driven care
Family care givers
You are considering adding an adjunctive form of testing to detect wall motion abnormalities during the ETT.You select Echocardiography as the added testing. You choose this test because you know that echocardiography does what when added to a standard ETT?
Enhances sensitivity and specificity of CAD detection
Enhances sensitivity while reducing specificity of CAD detection
Enhances specificity while not changing sensitivity of detection for CAD
You like pretty pictures of wall motion
Medicaid is mandated to be provided by each state through federal codes. Each state must offer Medicaid exactly as the federal government prescribes. True or false?
What sexually transmitted disease is most widespread in the USA today?
Your preceptor decides to add Doppler Flow studies to the echocardiogram exercise test for a patient with a recent history of a holistic murmur best auscultated at the left steral boarder. The patient has no history of cardiac surgeries. He asks you what might be the main advantages of adding Doppler Flow for this particular patient. You know from your readings that there are several reasons to add Doppler Flow and below are listed more than one correct reason. Your best response for this specific case, however, would be that Doppler Flow studies would be of what additive value during the echocardiogram study?
Detect and evaluate blood shunting from a septal defect
No advantage is seen for this patient
Gives better screen shots of wall abnormalities
Provides assessment of prosthetic valve function
Sexual partners of a patient with a diagnosed STI should always be examined and treated. Is this statement true or false?
Your patient presents with tachycardia. The QRS is measured at 0.10 seconds. Which of the following tachycardias would be an appropriate conclusion based on this information alone?
Premature junctional contractions
A 65-year old white male arrives in your clinic with general complaints of slight abdominal discomfort. He has a known history of smoking two packs per day for 40 years and hypertension. He also has COPD and has been treated numerous times with oral steroids. You consider several optional diagnoses. Of the ones listed below, which should be included as a potential top suspect in your choice of diagnosis?
Chronic bowel obstruction
Abdominal aortic aneurysm
What are the most common mechanisms to produce cardiac arrhythmias?
Decreased automaticity, triggered activity or reentry
Reentry, electrical dysfunction or activity
Stress, hard work or swimming
Enhanced automaticity, triggered activity or reentry