Cardiology Review(Paramedic)-with100%verified
solutions 2024-2025
, FisdapCardiologyReview(Paramedic)-
with100%verifiedsolutions2024-
2025
Yourespondtoaresidencefora68-year-
oldmalewithnausea,vomiting,andblurredvision.Asyouareassessin
ghim,hetellsyouthathehascongestiveheartfailureandatrialfibrillati
on,andtakesnumerousmedications.Thecardiacmonitorrevealsatri
alfibrillationwithaventricularrateof50beats/
min.WhichofthefollowingmedicationsisMOSTlikelyresponsiblefort
hispatient'sclinicalpresentation?
Digoxin.
Thispatienthasclassicsignsofdigitalistoxicity.Digoxiniscommonlyp
rescribedtopatientswithcongestiveheartfailureandatrialfibrillation
(A-Fib)oratrialflutter(A-
Flutter).Itspositiveinotropiceffectsincreasecardiaccontractilityand
maintaincardiacoutput,whileitsnegativechronotropiceffectscontro
ltheventricularrateoftheA-FiborA-
Flutter.Digitalispreparations(ie,Lanoxin,Digoxin)haveanarrowther
apeuticindex—
thatis,thereisafinelinebetweenatherapeuticandtoxicdose.Youshou
ldsuspectdigitalistoxicityinanypatientwhotakesDigoxinorLanoxina
ndpresentswithcomplaintssuchasnausea,vomiting,abdominalpain
,anorexia,orblurred/
yellowvision.Additionally,virtuallyanycardiacdysrhythmiacanbeca
usedbythetoxiceffectsofdigitalis.Treatmentinvolvestheadministra
tionofDigibind,whichisgivenatthehospital.
Whichofthefollowingisanabsolutecontraindicationforfibrinolyticthe
rapy?
Subduralhematoma3yearsago.
Accordingtocurrentemergencycardiaccare(ECC)guidelines,absolut
econtraindicationsforfibrinolytictherapyincludeANYpriorintracrania
lhemorrhage(ie,subdural,epidural,intracerebralhematoma);known
structuralcerebrovascularlesion(ie,arteriovenousmalformation);kn
ownmalignantintracranialtumor(primaryormetastatic);ischemicstr
okewithinthepast3months,EXCEPTforacuteischemicstrokewithinth
epast3hours;suspectedaorticdissection;activebleedingorbleedingd
isorders(exceptmenses);andsignificantclosedheadtraumaorfacialtr
aumawithinthepast3months.Relativecontraindications(eg,thephysi
,cianmaydeemfibrinolytictherapyappropriateundercertain
, circumstances)include,ahistoryofchronic,severe,poorly-
controlledhypertension;severeuncontrolledhypertensiononprese
ntation(SBP>180mmHgorDBP>110mmHg);ischemicstrokegreat
erthan3monthsago;dementia;traumaticorprolonged(>10minutes
)CPRormajorsurgerywithinthepast3weeks;recent(within2to4week
s)internalbleeding;noncompressiblevascularpunctures;pregnanc
y;priorexposure(>5daysago)orpriorallergicreactiontostreptokina
seoranistreplase;activepepticulcer;andcurrentuseofanticoagulan
ts(ie,Coumadin).
Amiddle-
agedmanpresentswithchestdiscomfort,shortnessofbreath,andnau
sea.Yougivehimsupplementaloxygenandcontinueyourassessment
.AsyourpartnerisattachingtheECGleads,youshould:
Administerupto325mgofaspirin.
Sinceoxygenhasalreadybeenadministeredtothispatientandyourpar
tnerisattachingtheECGleads,youshouldadministeraspirin(160to325
mg,non-enteric-
coated).Earlyadministrationofaspirinhasclearlybeenshowntoreduc
emortalityandmorbidityinpatientsexperiencinganacutecoronarysy
ndrome(ACS).Afterestablishingvascularaccess,youshouldassesshis
vitalsignsandthenadminister0.4mgofnitroglycerin(upto3doses,5mi
nutesapart),providedthathissystolicBPisgreaterthan90mmHg.If3do
sesofnitroglycerinfailtocompletelyrelievehischestdiscomfort,consid
eradministering2to4mgofmorphineIV,providedthathissystolicBPre
mainsabove90mmHg.
WhichofthefollowingECGleadconfigurationsiscorrect?
ToassessleadII,placethenegativeleadontherightarmandthepositivele
adontheleftleg.
AccordingtotheEinthoventriangle,leadIisassessedbyplacingtheneg
ative(white)leadontherightarmandthepositive(red)leadontheleftar
m.LeadIIisassessedbyplacingthenegativeleadontherightarmandthe
positiveleadontheleftleg.LeadIIIisassessedbyplacingthenegativele
adontheleftarmandthepositiveleadontheleftleg.
A61-year-
oldmalepresentswithchestpressurethatwokehimupfromhisnap30m
inutesago.Heisdiaphoretic,anxious,andrateshispainasanan8over10
.Hispastmedicalhistoryissignificantforhypertension,typeIIdiabetes,
andcoronarystentplacement2monthsago.Hetakeslisinopril,Plavix,a
ndGlucophage,andiswearingamedicalalertbracelet
solutions 2024-2025
, FisdapCardiologyReview(Paramedic)-
with100%verifiedsolutions2024-
2025
Yourespondtoaresidencefora68-year-
oldmalewithnausea,vomiting,andblurredvision.Asyouareassessin
ghim,hetellsyouthathehascongestiveheartfailureandatrialfibrillati
on,andtakesnumerousmedications.Thecardiacmonitorrevealsatri
alfibrillationwithaventricularrateof50beats/
min.WhichofthefollowingmedicationsisMOSTlikelyresponsiblefort
hispatient'sclinicalpresentation?
Digoxin.
Thispatienthasclassicsignsofdigitalistoxicity.Digoxiniscommonlyp
rescribedtopatientswithcongestiveheartfailureandatrialfibrillation
(A-Fib)oratrialflutter(A-
Flutter).Itspositiveinotropiceffectsincreasecardiaccontractilityand
maintaincardiacoutput,whileitsnegativechronotropiceffectscontro
ltheventricularrateoftheA-FiborA-
Flutter.Digitalispreparations(ie,Lanoxin,Digoxin)haveanarrowther
apeuticindex—
thatis,thereisafinelinebetweenatherapeuticandtoxicdose.Youshou
ldsuspectdigitalistoxicityinanypatientwhotakesDigoxinorLanoxina
ndpresentswithcomplaintssuchasnausea,vomiting,abdominalpain
,anorexia,orblurred/
yellowvision.Additionally,virtuallyanycardiacdysrhythmiacanbeca
usedbythetoxiceffectsofdigitalis.Treatmentinvolvestheadministra
tionofDigibind,whichisgivenatthehospital.
Whichofthefollowingisanabsolutecontraindicationforfibrinolyticthe
rapy?
Subduralhematoma3yearsago.
Accordingtocurrentemergencycardiaccare(ECC)guidelines,absolut
econtraindicationsforfibrinolytictherapyincludeANYpriorintracrania
lhemorrhage(ie,subdural,epidural,intracerebralhematoma);known
structuralcerebrovascularlesion(ie,arteriovenousmalformation);kn
ownmalignantintracranialtumor(primaryormetastatic);ischemicstr
okewithinthepast3months,EXCEPTforacuteischemicstrokewithinth
epast3hours;suspectedaorticdissection;activebleedingorbleedingd
isorders(exceptmenses);andsignificantclosedheadtraumaorfacialtr
aumawithinthepast3months.Relativecontraindications(eg,thephysi
,cianmaydeemfibrinolytictherapyappropriateundercertain
, circumstances)include,ahistoryofchronic,severe,poorly-
controlledhypertension;severeuncontrolledhypertensiononprese
ntation(SBP>180mmHgorDBP>110mmHg);ischemicstrokegreat
erthan3monthsago;dementia;traumaticorprolonged(>10minutes
)CPRormajorsurgerywithinthepast3weeks;recent(within2to4week
s)internalbleeding;noncompressiblevascularpunctures;pregnanc
y;priorexposure(>5daysago)orpriorallergicreactiontostreptokina
seoranistreplase;activepepticulcer;andcurrentuseofanticoagulan
ts(ie,Coumadin).
Amiddle-
agedmanpresentswithchestdiscomfort,shortnessofbreath,andnau
sea.Yougivehimsupplementaloxygenandcontinueyourassessment
.AsyourpartnerisattachingtheECGleads,youshould:
Administerupto325mgofaspirin.
Sinceoxygenhasalreadybeenadministeredtothispatientandyourpar
tnerisattachingtheECGleads,youshouldadministeraspirin(160to325
mg,non-enteric-
coated).Earlyadministrationofaspirinhasclearlybeenshowntoreduc
emortalityandmorbidityinpatientsexperiencinganacutecoronarysy
ndrome(ACS).Afterestablishingvascularaccess,youshouldassesshis
vitalsignsandthenadminister0.4mgofnitroglycerin(upto3doses,5mi
nutesapart),providedthathissystolicBPisgreaterthan90mmHg.If3do
sesofnitroglycerinfailtocompletelyrelievehischestdiscomfort,consid
eradministering2to4mgofmorphineIV,providedthathissystolicBPre
mainsabove90mmHg.
WhichofthefollowingECGleadconfigurationsiscorrect?
ToassessleadII,placethenegativeleadontherightarmandthepositivele
adontheleftleg.
AccordingtotheEinthoventriangle,leadIisassessedbyplacingtheneg
ative(white)leadontherightarmandthepositive(red)leadontheleftar
m.LeadIIisassessedbyplacingthenegativeleadontherightarmandthe
positiveleadontheleftleg.LeadIIIisassessedbyplacingthenegativele
adontheleftarmandthepositiveleadontheleftleg.
A61-year-
oldmalepresentswithchestpressurethatwokehimupfromhisnap30m
inutesago.Heisdiaphoretic,anxious,andrateshispainasanan8over10
.Hispastmedicalhistoryissignificantforhypertension,typeIIdiabetes,
andcoronarystentplacement2monthsago.Hetakeslisinopril,Plavix,a
ndGlucophage,andiswearingamedicalalertbracelet
