The Challenge Cardiology. Week 3

A 34-year-old man presents with chest pain of 4 hours duration, resolved at presentation. He has been smoking marijuana that was laced, which he obtained from an unknown source. His vital signs are temperature 98.6°F, HR 115, RR 20, BP 167/95, O2 Saturation 98% on room air. His physical examination shows pupillary dilation, tachycardia. and diaphoretic skin. His electrocardiogram (EKG) shows ST depressions in V3-V5. Initial troponin level is 0.50 ng per mL. Which of the following is the most appropriate therapy at this time?

Which of the following P2Y12- inhibitors have reversible platelet binding properties?

A 64-year-old woman presents to the emergency department because of increasing shortness of breath and chest pain for 30 minutes. She had a history of hyperlipidemia, type 2 diabetes mellitus, and myocardial infarction. Her temperature is 98.3°F (36.8°C), blood pressure is 110/80 mmHg, pulse is 94/min, respirations are 26/min, and O2 saturation is 89% on room air. ECG shows ST elevation. Which of the following is the next best step in the management of this patient?

A 54-year-old male with a history of pericarditis secondary to squamous cell carcinoma of the lung is brought to the Emergency Department with the complaint of cyanosis, shortness of breath, and dizziness. On examination, his blood pressure is 90/60 mmHg, his pulse is 130 bpm and his respiratory rate is 30 bpm. The jugular vein is distended and central venous pressure is 18 mmHg.

What is the most likely diagnosis?

TW is a 72 yo male (82kg) who presents to the ED complaining of heart palpitations for approximately 2 hours. He said this has happened once before about a year ago, but he didn’t seek care at that time. He as a history of hypertension and hyperlipidemia for which he takes losartan and simvastatin. Upon initial exam his heart rate is 153, BP 141/76, and O2 saturation 98%. His EKG shows atrial fibrillation (AFib) with rapid ventricular response (RVR).

Since you were so helpful earlier, the medical student approaches you to ask about a study they read recently suggesting that magnesium may be useful for AFib RVR and asks you your opinion on the data. Which of the following is the most accurate response?

What should be considered first-line for most non-life-threatening type b aortic dissections?

What is the pharmacology treatment goals for aortic dissection?

How much do patients who use sublingual nitroglycerin prior to ed arrival receive in just one tablet?

What patient population is nicardipine contraindicated in?

The ED provider is deciding on which pharmacological agent to use for hypertensive emergency. Which of the following  is the duration of action for clevidipine?