Atrial Fibrillation Management Quiz
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Questions and Answers

What is the recommended treatment for a patient with acute limb ischemia due to atrial fibrillation?

  • Flecainide
  • Warfarin
  • Embolectomy (correct)
  • Aspirin

    • In the CHADS2 scoring system, how many points are assigned for a history of stroke or TIA?

  • 1 point
  • 2 points (correct)
  • 3 points
  • 0 points

    • When should aspirin be administered according to the CHADS2 score?

  • Only when the patient is asymptomatic
  • If the score is 0 or 1 (correct)
  • If the score is 2 or more
  • For all AF patients

    • Which medication is typically not used as a first-line treatment for rhythm control in atrial fibrillation?

    <p>Warfarin</p> Signup and view all the answers

    For a patient with atrial fibrillation and hemodynamic instability, which intervention is indicated?

    <p>Electrical cardioversion</p> Signup and view all the answers

    Which of the following conditions is NOT a component of the CHADS2 score?

    <p>Chronic lung disease</p> Signup and view all the answers

    What is the primary reason for prescribing warfarin over aspirin in atrial fibrillation?

    <p>Warfarin prevents thromboembolic events more effectively for high-risk patients</p> Signup and view all the answers

    In patients with atrial fibrillation, what is the standard procedure before considering rhythm control?

    <p>Initiate rate control</p> Signup and view all the answers

    What is the most common cause of pericarditis in a patient with rheumatoid arthritis?

    <p>Viral infection</p> Signup and view all the answers

    Which clinical feature is characteristic of uremic pericarditis?

    <p>High levels of creatinine and BUN</p> Signup and view all the answers

    What is the recommended initial treatment for pericarditis?

    <p>NSAIDs and colchicine</p> Signup and view all the answers

    Which type of pericarditis occurs as a reaction to myocardial infarction?

    <p>Dressler syndrome</p> Signup and view all the answers

    What is the next best step in diagnosing pericarditis after an ECG?

    <p>Echocardiography</p> Signup and view all the answers

    What condition may be confused with chronic constrictive pericarditis?

    <p>Tamponade</p> Signup and view all the answers

    Which of the following statements about fibrinous pericarditis is true?

    <p>It can occur shortly after a myocardial infarction.</p> Signup and view all the answers

    What is a classic infectious cause of chronic constrictive pericarditis?

    <p>Tuberculosis</p> Signup and view all the answers

    What is the heart rate threshold that characterizes rapid ventricular response in atrial flutter?

    <p>Above 150 bpm</p> Signup and view all the answers

    Which characteristic appearance do atrial flutter waves display on an ECG?

    <p>Classic sawtooth</p> Signup and view all the answers

    What distinguishes ventricular tachycardia (VT) from supraventricular tachycardia (SVT) on an ECG?

    <p>VT has wide complexes</p> Signup and view all the answers

    What is the first step in treating supraventricular tachycardia (SVT) in a stable patient?

    <p>Carotid massage</p> Signup and view all the answers

    When should direct current cardioversion be considered for a patient with ventricular tachycardia?

    <p>If the patient is in coma or has low blood pressure</p> Signup and view all the answers

    What is the characteristic QRS duration in ventricular tachycardia?

    <p>More than 120 ms</p> Signup and view all the answers

    Which of the following is not a typical treatment for premature ventricular complexes (PVCs)?

    <p>Amiodarone</p> Signup and view all the answers

    Which of the following statements is true regarding the complexes seen in supraventricular tachycardia (SVT)?

    <p>They resemble needle shapes</p> Signup and view all the answers

    What condition is characterized by pulmonary arteriovenous fistula leading to high-output failure?

    <p>Hereditary hemorrhagic telangiectasia</p> Signup and view all the answers

    What is the first step in managing a patient suspected of having paroxysmal atrial fibrillation after presenting with a TIA?

    <p>Holter monitor</p> Signup and view all the answers

    What characteristic pattern is observed in the ECG of a patient with atrial fibrillation?

    <p>Irregularly irregular rhythm with absent P-waves</p> Signup and view all the answers

    In patients over 75 years old with atrial fibrillation, which potential complication should be primarily considered?

    <p>Stroke or TIA</p> Signup and view all the answers

    If a patient with atrial fibrillation presents with severe abdominal pain, what diagnosis should be suspected?

    <p>Acute mesenteric ischemia</p> Signup and view all the answers

    What is the next best step after diagnosing atrial fibrillation with an ECG?

    <p>Perform echocardiography</p> Signup and view all the answers

    In which condition can intraosseous arteriovenous fistulae occur?

    <p>Paget's disease</p> Signup and view all the answers

    Which feature is typical of an ECG showing atrial fibrillation?

    <p>Random and irregular QRS complexes</p> Signup and view all the answers

    What does ST-elevation in leads II, III, and aVF primarily indicate?

    <p>Inferior MI possibly involving the right coronary artery</p> Signup and view all the answers

    Which artery supplies the apex of the heart?

    <p>Left anterior descending artery</p> Signup and view all the answers

    What is indicated by ST-elevations in leads V1-V3?

    <p>Anterior MI</p> Signup and view all the answers

    In a patient with inferior MI and left-dominant circulation, which sequence is expected for vascular supply?

    <p>Left main coronary à left circumflex à PDA</p> Signup and view all the answers

    Which condition is characterized by a new-onset systolic murmur following an MI?

    <p>Mitral regurgitation</p> Signup and view all the answers

    What arrhythmia is the most common cause of death following an MI?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    What do Q waves on an ECG typically indicate?

    <p>Old myocardial infarction history</p> Signup and view all the answers

    Which statement regarding arrhythmias post-MI is accurate?

    <p>Fibrosis of myocardium increases risk of future arrhythmias</p> Signup and view all the answers

    What is the first treatment given for a myocardial infarction (MI)?

    <p>Aspirin</p> Signup and view all the answers

    Which of the following statements is true regarding myocardial infarction and its complications?

    <p>MI can cause coagulative necrosis of the myocardium.</p> Signup and view all the answers

    What change in hemodynamics is expected during cardiogenic shock due to myocardial infarction?

    <p>Decreased cardiac output and increased PCWP</p> Signup and view all the answers

    Which medication is typically administered after aspirin in patients with acute coronary syndrome?

    <p>Clopidogrel</p> Signup and view all the answers

    What is a contraindication for the use of nitrates in MI management?

    <p>Right-sided MI</p> Signup and view all the answers

    What finding is typically observed on the ECG for ST-Elevation Myocardial Infarction (STEMI)?

    <p>Diffuse ST-elevations in all leads</p> Signup and view all the answers

    How does a patient with pericarditis typically present regarding pain?

    <p>Pain that is relieved by sitting upright</p> Signup and view all the answers

    Which of the following conditions can lead to serous pericarditis?

    <p>Cocaine use</p> Signup and view all the answers

    Study Notes

    Pulmonary Arteriovenous Fistula

    • A diagnosis often associated with hereditary hemorrhagic telangiectasia
    • Characterized by red dots on the tongue, mouth, or fingers
    • May also present in Paget's disease (intraosseous AV fistulae)

    Atrial Fibrillation (AF)

    • Irregularly irregular rhythm, absent P-waves
    • Important due to potential for thrombus formation in the left atrium
    • Can lead to various embolic events (stroke, TIA, retinal artery occlusion, mesenteric ischemia, limb ischemia)
    • Often paroxysmal (comes and goes)
    • Older patients (especially over 75) are more frequently affected
    • Normal blood pressure is a key clue in the vignette for AF in older patients
    • If an older patient presents with typical AF symptoms, but has normal blood pressure and sinus rhythm on ECG, a Holter monitor is the next best step to assess for paroxysmal AF
    • Echocardiography is next after diagnosis to visualize the LA mural thrombus
    • Patients with abdominal pain in the setting of AF or hyperthyroidism should raise suspicion for acute mesenteric ischemia; mesenteric angiography would be the next step in evaluation
    • Management involves rate control (e.g., metoprolol, verapamil) before potentially considering rhythm control
    • Aspirin or warfarin is used depending on the CHADS2 score (CHF, HTN, Age 75+, Diabetes, Stroke/TIA)

    Atrial Flutter

    • Characterized by sawtooth pattern on ECG
    • Low yield for USMLE

    Ventricular Tachycardia (VT)

    • Wide-complex QRS complexes (>120 ms) are a hallmark
    • Significantly higher yield for 2CK

    Supraventricular Tachycardia (SVT)

    • Narrow-complex QRS complexes
    • Management: carotid massage, adenosine

    Premature Ventricular Complexes (PVCs)

    • Wide-complex, premature beats originating from ventricles
    • Not typically treated

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    Cardiovascular Third Degree PDF

    Description

    Test your knowledge on the management of atrial fibrillation, including treatment options, the CHADS2 scoring system, and specific medication uses. This quiz covers critical interventions and considerations for patients at risk of complications related to atrial fibrillation.

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