Emergency Medicine EOR Exam4 Questions
and Answers Latest 2025 Graded A+
Dilated Cardiomyopathy: most common cause is ____.
Others?
alcohol; may also be idiopathic, myocarditis, or drugs
(doxorubicin) -- 1 in 3 cases of heart failure are caused by dilated
cardiomyopathy
What PE and EKG changes are seen with dilated
cardiomyopathy?
PE: S3, JVD, crackles - possible mitral regurg
EKG: nonspecific ST and T wave changes, LBBB
Hypertrophic cardiomyopathy: is due to hypertrophy of the
_____. PE reveals mitral regurgitation, a ____heart sound,
and prominent left ventricular impulse. EKG reveals LVH
cardiac septum; S4
Restrictive cardiomyopathy: often caused by a ____process,
or post-radiation or post open-heart surgery. What is the
most common first symptom?
--infiltrative process - amyloidosis, sarcoidosis, and
hemochromatosis -- changes in myocardium
--most common first symptom is exertion intolerance and fluid
retention, signs of right heart failure
Atrial fibrillation - regularly irregular - the most common
sustained arrhythmia in adults - what three treatments are
used?
1. rate control w BB, CCB, or digoxin
2. Anticoagulation w heparin & warfarin
3. rhythm control w amiodarone or cardioversion
,Atrial flutter - sawtooth pattern in II, III, aVF - what three
treatments are used?
1. cardioversion if no contraindications
2. acute rate control tx w BB, CCB - amiodarone, sotalol,
quinidine, or procainamide
3. If site of reentrant is known, catheter ablation
Multifocal atrial tachycardia - noted in patients with COPD or
severe systemic illness - EKG shows multiple shaped P
waves and differing PR intervals. ____are agents of choice?
CCB
BLOCKS
1. ____=prolonged PR interval
2.____=progressive increase in PR until Pwave is blocked.
3._____=sudden block in P wave w no change in PR
4._____=atrial and ventricular rhythm are independent of
each other.
First degree; Wenckebach Mobitz type I; Mobitz type II, Third
degree block
A _____may develop after acute MI, PE, aortic stenosis and is
due to a conduction delay in the right or left bundles.
Bundle branch block
Paroxysmal supraventricular tachycardia is a reentry
tachycardia, commonly noted in elderly patients with
underlying heart disease. What treatment may be helpful
before using adenosine ie. the drug of choice?
vagal maneuvers or antianxiety medication
What are some drugs associated with Torsades de pointes?
tricyclic antidepressants, erythromycin, ketoconazole, haloperidol,
cisapride, disopyramide, pentamidine, sotalol, class I anti-
arrhythmics
,CHF - Systolic dysfunction means a problem with the ____.
What drug is contraindicated?
pump; CCB!
CHF - Diastolic dysfunction means a problem with the ____.
compliance or relaxation of the heart during ventricular filling
The ________principle means that as preload increases, the
ventricle is stretched during diastole filling and the ejection
fraction is increased.
Frank-Starling principle
_____is released from cardiac ventricles in response to
increased wall tension.
BNP - B-type natriuretic peptide
What is the pharmacologic therapy for heart failure?
1. diuretics for fluid retention
2. ACEi
3. vasodilators (hydralazine & nitrates)
4. BB for LV dysfunction
5. digitalis to increase cardiac contractility
Functional Classification of Heart Failure:
___-No cardiac symptoms with ordinary activity.
___-Cardiac symptoms w MARKED activity but asymptomatic
at rest
___-Cardiac symptoms w MILD activity but asymptomatic at
rest
___-Cardiac symptoms at rest.
Class I, Class II, Class III, Class IV
Stage 1 Hypertension is defined as greater than ____. Stage 2
Hypertension is defined as greater than ____.
140/90; 160/100
Hypertension Drug of Choice for:
angina
, diabetes
hyperlipidemia
CHF
Previous MI
Chronic Renal Failure
Asthma, COPD
Angina - BB, CCB
Diabetes - ACEi & CCB, avoid diuretics
Hyperlipidemia - ACEi & CCB, avoid diuretics/BB
CHF - diuretics & ACEi, avoid CCB/BB
Previous MI - BB/ACEi
Chronic renal failure - diuretics, CCB
Asthma - diuretics & CCB, avoid BB
Secondary hypertension is HTN due to an ______.
identifiable cause ie. renovascular disease, coarctation of the
aorta, primary aldosteronism, Cushing's, Pheochromocytoma,
OSA, renal parenchymal hypertension
____hypertension is potentially life threatening - HTN plus
rentinopathy, cardiovascular/renal compromise, or
encephalopathy.
Malignant
Malignant hypertension bp? What is the rule of thumb for
lowering?
greater than 220/140; 10% in first hour and 15% for the next 3-12
hours, to normal over next 2 days
What is the agent of choice for BP lowering for patients with
hypertensive encephalopathy, intracranial bleeding, and
heart failure? Use with what for dissecting aneurysm?
nitroprusside; propranolol -- clonidine can also be used but
sedation is common
and Answers Latest 2025 Graded A+
Dilated Cardiomyopathy: most common cause is ____.
Others?
alcohol; may also be idiopathic, myocarditis, or drugs
(doxorubicin) -- 1 in 3 cases of heart failure are caused by dilated
cardiomyopathy
What PE and EKG changes are seen with dilated
cardiomyopathy?
PE: S3, JVD, crackles - possible mitral regurg
EKG: nonspecific ST and T wave changes, LBBB
Hypertrophic cardiomyopathy: is due to hypertrophy of the
_____. PE reveals mitral regurgitation, a ____heart sound,
and prominent left ventricular impulse. EKG reveals LVH
cardiac septum; S4
Restrictive cardiomyopathy: often caused by a ____process,
or post-radiation or post open-heart surgery. What is the
most common first symptom?
--infiltrative process - amyloidosis, sarcoidosis, and
hemochromatosis -- changes in myocardium
--most common first symptom is exertion intolerance and fluid
retention, signs of right heart failure
Atrial fibrillation - regularly irregular - the most common
sustained arrhythmia in adults - what three treatments are
used?
1. rate control w BB, CCB, or digoxin
2. Anticoagulation w heparin & warfarin
3. rhythm control w amiodarone or cardioversion
,Atrial flutter - sawtooth pattern in II, III, aVF - what three
treatments are used?
1. cardioversion if no contraindications
2. acute rate control tx w BB, CCB - amiodarone, sotalol,
quinidine, or procainamide
3. If site of reentrant is known, catheter ablation
Multifocal atrial tachycardia - noted in patients with COPD or
severe systemic illness - EKG shows multiple shaped P
waves and differing PR intervals. ____are agents of choice?
CCB
BLOCKS
1. ____=prolonged PR interval
2.____=progressive increase in PR until Pwave is blocked.
3._____=sudden block in P wave w no change in PR
4._____=atrial and ventricular rhythm are independent of
each other.
First degree; Wenckebach Mobitz type I; Mobitz type II, Third
degree block
A _____may develop after acute MI, PE, aortic stenosis and is
due to a conduction delay in the right or left bundles.
Bundle branch block
Paroxysmal supraventricular tachycardia is a reentry
tachycardia, commonly noted in elderly patients with
underlying heart disease. What treatment may be helpful
before using adenosine ie. the drug of choice?
vagal maneuvers or antianxiety medication
What are some drugs associated with Torsades de pointes?
tricyclic antidepressants, erythromycin, ketoconazole, haloperidol,
cisapride, disopyramide, pentamidine, sotalol, class I anti-
arrhythmics
,CHF - Systolic dysfunction means a problem with the ____.
What drug is contraindicated?
pump; CCB!
CHF - Diastolic dysfunction means a problem with the ____.
compliance or relaxation of the heart during ventricular filling
The ________principle means that as preload increases, the
ventricle is stretched during diastole filling and the ejection
fraction is increased.
Frank-Starling principle
_____is released from cardiac ventricles in response to
increased wall tension.
BNP - B-type natriuretic peptide
What is the pharmacologic therapy for heart failure?
1. diuretics for fluid retention
2. ACEi
3. vasodilators (hydralazine & nitrates)
4. BB for LV dysfunction
5. digitalis to increase cardiac contractility
Functional Classification of Heart Failure:
___-No cardiac symptoms with ordinary activity.
___-Cardiac symptoms w MARKED activity but asymptomatic
at rest
___-Cardiac symptoms w MILD activity but asymptomatic at
rest
___-Cardiac symptoms at rest.
Class I, Class II, Class III, Class IV
Stage 1 Hypertension is defined as greater than ____. Stage 2
Hypertension is defined as greater than ____.
140/90; 160/100
Hypertension Drug of Choice for:
angina
, diabetes
hyperlipidemia
CHF
Previous MI
Chronic Renal Failure
Asthma, COPD
Angina - BB, CCB
Diabetes - ACEi & CCB, avoid diuretics
Hyperlipidemia - ACEi & CCB, avoid diuretics/BB
CHF - diuretics & ACEi, avoid CCB/BB
Previous MI - BB/ACEi
Chronic renal failure - diuretics, CCB
Asthma - diuretics & CCB, avoid BB
Secondary hypertension is HTN due to an ______.
identifiable cause ie. renovascular disease, coarctation of the
aorta, primary aldosteronism, Cushing's, Pheochromocytoma,
OSA, renal parenchymal hypertension
____hypertension is potentially life threatening - HTN plus
rentinopathy, cardiovascular/renal compromise, or
encephalopathy.
Malignant
Malignant hypertension bp? What is the rule of thumb for
lowering?
greater than 220/140; 10% in first hour and 15% for the next 3-12
hours, to normal over next 2 days
What is the agent of choice for BP lowering for patients with
hypertensive encephalopathy, intracranial bleeding, and
heart failure? Use with what for dissecting aneurysm?
nitroprusside; propranolol -- clonidine can also be used but
sedation is common
