A 66-year-old female complains of dizziness, fatigue, and shortness of breath. Her EKG is below. What is your working diagnosis? What immediate treatment is indicated?
Question 1 A 66-year-old female complains of dizziness, fatigue, and shortness of breath. Her EKG is below. What is your working diagnosis? What immediate treatment is indicated?
Question 2 What is the difference in dihydropyridine and non-dihydropyridine calcium channel blockers? What conditions are they used to treat?
Question 3 A 63-year-old female has been successfully cardioverted and is now on amiodarone for rhythm maintenance. The patient is on the following medications:
Warfarin 10 mg po daily
Lisinopril 20 mg po daily
Amiodarone 400 mg po daily
Prilosec 20 mg po daily
Digoxin 4250 mcg po daily
What interactions are possible and how would you monitor and adjust for them.
Question 4 A 59-year-old male complains of dizziness, palpitations, weakness, and chest tightness. These symptoms have occurred a couple times a day for the last seven days. EKG shows atrial fibrillation with rapid ventricular response. His blood pressure varies with readings of 90/42 to 120/66. Heart rate ranges from 150—210. The decision is made to cardiovert the patient. Prior to the procedure, what testing is essential to complete?
Question 5 A 52-year-old male is found unresponsive. His EKG is above.
What is your working diagnosis of this EKG? What initial treatment would be indicated?
Question 6 A 79-year-old male with a history of atrial fibrillation is taking the following medications:
Brilenta 60 mg po bid
Lisinopril 20 mg po daily
Amiodarone 400 mg po daily
Prilosec 20 mg po daily
Daily labs for this patient show:
Sodium 137
Potassium 4.2
Creatinine 0.9
BUN 22
Alkaline phosphatase: 202
ALT 60
AST 44
What medication could cause these lab results?
Question 7 A 58-year-old male complains of a galloping heart rate and shortness of breath. Vital signs are BP 110/74, P 156, RR 22 Oxygen sat is 96%. Continuous EKG monitoring identifies periods of sinus tachycardia as well as episodes of atrial fibrillation. Laboratory results for this patient show:
Hemoglobin 13.3 g/dl
Hematocrit 39%
WBC 8.7
Platelets 172,000
Sodium 140
Potassium 3.7
TSH 0.0 mIU/L
T4 3 mg/dl
T3 6.6 pg/ml
What is your working diagnosis and what two initial medications would you prescribe for this patient?
Question 8 What is your interpretation of this 12-lead EKG?
Question 9 What is your interpretation of this 12-lead EKG?
What initial treatment is indicated?
Question 10 Mrs. Franklin is a 68-year-old woman with long-standing, persistent AF being managed with rhythm control on dofetilide. She also has type 2 diabetes mellitus (T2DM), hypertension, and a myocardial infarction 3 years ago. She also takes an 81 mg aspirin every day.
Based on her CHADS2 score and HAS-BLED score, would you recommend starting her on anticoagulation?
What data would help you explain why this is important preventative step for the patient?
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