Acute Medical Presentations — Flashcards

Flashcard 61: What are important questions to ask in a Falls History? 9

Answer: • Where was the patient when they fell? • When did they fall? • Did anyone else see the fall? (collateral) • What happened? Any associated features before/during/after • Why do you think they fell? • Have they fallen before? • Systems review • PMH (balance/gait/sight) • Social Hx

Flashcard 62: What is the first-line management of SVT?

Answer: 1. Vagal maneuvers (e.g., Valsalva maneuver or unilateral carotid sinus massage) 2. Adenosine (if vagal maneuvers fail)

Extra: In unstable patients (hypotension, heart failure, ischemia), the first-line management is synchronized DC cardioversion.

Flashcard 63: What MI presents with tall R waves V1-2

Answer: • Posterior MI

Flashcard 64: Difference between presentation of Myocarditis and Pericarditis?

Answer: • **Pericarditis:** Pleuritic chest pain (relieved by sitting forward), pericardial friction rub, and diffuse ST-elevation on ECG. • **Myocarditis:** Features of heart failure (dyspnea, edema), arrhythmias, and **elevated cardiac enzymes (Troponin)** with global/regional wall motion abnormalities on Echo.

Extra: Clinical Note: In practice, these often overlap as **myopericarditis**. The presence of elevated troponins or new ventricular dysfunction (HF symptoms) is the key clinical indicator that the myocardium is involved, rather than just the pericardial sac.

Flashcard 65: Normal QRS duration?

Answer: • 0.8 - 0.12 seconds

Flashcard 66: Management for Broad-complex tachycardia?

Answer: • If unstable (shock, syncope, MI): Synchronized DC cardioversion\n• If stable: IV Amiodarone (300mg over 20-60 mins)

Flashcard 67: Persistent ST elevation following a recent MI, but without ongoing chest pain, is most suggestive of:

Answer: Left Ventricular Aneurysm (Post-MI)

Extra: Persistent ST elevation (>2 weeks post-MI) in the absence of chest pain is most characteristic of a left ventricular aneurysm. This is often associated with a 'squared-off' appearance of the ST segments and Q-waves in the affected leads.

Flashcard 68: What is contraindicated in VT?

Answer: • Verapamil

Flashcard 69: What is the appropriate treatment for Torsades de Pointes?

Answer: • IV magnesium sulfate

Flashcard 70: What can reduce BNP levels?

Answer: • ACE inhibitors • ARBs • Diuretics