Answer and Explanation 5

5.  The correct answer is C.  Alcohol use is not identified as a risk factor in CAD.  In fact, it has been show when used in moderation to be helpful.  Diabetes, hyperlipidemia, and tobacco abuse are all recognized as major risk factors for CAD.

Question 5

 5.  Which of the following is not recognized as a recognized risk factor for coronary artery disease (CAD)?

A.  Diabetes Mellitus

B.  Hyperlipidemia

C.  Alcohol Use

D.  Tobacco Abuse

Answer and Explanation 4

4.  Choice C is the correct answer.  This EKG shows A-Fib with RVR.  It has an irregularly irregular pattern.  Cardioversion should not be considered immediately because the patients blood pressure is normal.  Adenosine is helpful for SVT and really does not show efficacy in A Fib with RVR.  Therefore the correct answer is C.

Question 4

4.  Which of the following actions is most appropriate treatment given the EKG below and knowing your patients blood pressure is 170/96 ?

A.  Adenosine 12 mg IV

B.  Adenosine 6 mg IV

C. Cardizem 15 mg IV bolus, followed by a drip

 

D.  Stat Cardioversion at 150 joules

Answer and Explanation 3

3.  Choice D is correct.  By definition of the Wells criteria the patient with cancer does not put the patient in a low risk population so a D-Dimer would not be helpful.  A VQ scan would not be the best test because the ventilation portion may be obscured by the pneumonia and lung cancer and will likely yield inconclusive results.  Selective pulmonary angiography could give you the diagnosis but is quite invasive and the procedure could have some complications.  Therefore the correct answer is D.

Question 3

 3.  Which of the of following is the best test to screen a 53 year old patient with lung cancer and pneumonia that has pleuritic chest pain and shortness of breath for a pulmonary embolus?

A.   D-Dimer

B.  VQ Scan

C.  Selective pulmonary angiography

D.  CTA of Chest with IV contrast

Answer and Explanation 2

2.  Choice A is correct.  In cases of new onset Left Bundle Branch Block in patients with chest pain you have to treat this as a ST elevation MI.  Cardiology should be consulted immediately and the patient should be evaluated for cardiac catheterization.  ST Depression is just indicative of ischemia no matter if it is in all leads or just the anterior lateral leads.  Another possibility with ST depression in all leads is an evolving pericarditis.  Flipping of the axis in lead AVR could mean lead reversal.