Cardiology & Cardiac MCQs

 A patient on the medical floor is found to be bradycardic and it is decided to pace him. You are not able to get hold of the cardiologist. You decide to insert the pacing lead. What is the ideal location for the catheter tip for temporary transvenous pacemaker- see image?

A

B

C

D

E

https://youtu.be/KdCTRdUetOM

Cardiac & Cardlology MCQs

 You are called to the ED where a patient is unresponsive with a BP of 69/40. His ECG is shown. What is the next step in his management?

a. Load with digoxin 1 mg followed by 0.25 mg IV qd

b. Administer amiodarone IV

c. Cardiovert at 360 joules using a monophasic device

d. Cardiovert at 120-200 joules using a biphasic device

e. Defibrillate at 360 joules

https://youtu.be/KdCTRdUetOM

Cardiology and Cardiac MCQs

 A 67 yo complains of palpitations on day 1 after thyroid surgery. His vitals are stable and his ECG is shown below. What treatment is not useful for treating the below arrhythmia?

a. Beta blocker

b. Antiarrhythmic like ibutilide

c. Calcium channel blocker

d. Adenosine

e. Warfarin

f. Catheter ablation

1. Initiate A-V nodal blockade with ß-adrenergic or calcium channel blockers or procainamide.  

2. These medications slow the ventricular response by slowing conduction in the AV node. In general, beta blockers are used for rate control.

3. Overall, atrial flutter should be managed in the same way as atrial fibrillation. Because both rhythms can lead to the formation of a blood clot in the atrium, individuals with atrial flutter usually require some form of anticoagulation or antiplatelet agent. 

4. Both rhythms can be associated with dangerously fast heart rates and thus require medication to control the heart rate (such as beta blockers or calcium channel blockers) and/or rhythm control with class III antiarrhythmics (such as ibutilide or dofetilide). However, atrial flutter is more resistant to correction with such medications than atrial fibrillation.

https://youtu.be/KdCTRdUetOM

Cardiology & Cardiac MCQs

 Q2. What drug would you use to treat this rhythm in a patient with lung disease?

a. Adenosine

b. Beta blocker

c. Digoxin

d. Verapamil

e. Amiodarone 

https://youtu.be/KdCTRdUetOM

Cardiac and Cardiology MCQs

 Q1. You are most likely to see the below rhythm in which population? (hint different P wave morphology)

a. Rheumatic fever

b. Coronary artery disease

c. COPD

d. Congenital heart disease

e. Hypertension 

https://youtu.be/KdCTRdUetOM