Only $35.99/year

Cardiac OSCE

Terms in this set (36)

Pericarditis (3)
- viral, uremic from CKD
- ibuprofen 600mg TID 1-2 weeks, then decrease by 200 q1-2 weeks PLUS omeprazole 20mg daily PLUS colchicine 0.5 mg BID x3 months

MI (6)
- ASA 325, Atenolol 50, Atorvastatin 40
- Heparin 60 units/kg bolus, f/b 12 units/kg/hr
- Ticagrelor 180mg loading dose, f/b 90mg BID
- NTG 0.3 - 0.6 q5min, max 3
- O2 >94%
- PCI

CHF (5)
- Lisinopril 2.5mg
- Na intake 1.5 g/day
- Carvedilol 3.125 mg BID
- Furosemide 20mg
- Spironolactone 25mg for EF <35%

SVT (5)
- Adenosine 6, 12 ,12
OR
- Diltiazem 0.25 mg/kg IV, f/b 10 mg/hr
OR
- Metoprolol tartrate 5mg q5, max 3
OR
- Amiodarone 150mg IV over 10 min, f/b 1 mg/min over 6 hours
OR
- Synchronized cardioversion (symptomatic, hypotensive)

Afib (5)
- Metoprolol tartrate 2.5-5mg IV max 3, 25mg PO BID
- Rivaroxaban 20mg once daily
OR
- Amiodarone 300mg over 1 hour, f/b 10 mg/hr for 24 hours
- Cardiovert after 3-4 weeks of anticoagulation
- Unstable = DC cardioversion

pVtach/Vfib
- start CPR, put on pads
- Defib w/ 200J
- continue CPR for 2-min
- check rhythm, defib
- CPR 2-min
- Epi 1mg q3-5 min
- start amiodarone 300mg, repeat 150

Bradycardia
- Atropine 1mg q5-15min, Max: 3
- Epi drip: 2-10 mcg/min or Dopamine 5-20 mcg/kg/min
- Transcutaneous pacing (consider sedation)

HTN "decrease risk of mortality & of CV & renal morbidity"
- Lifestyle: <1.5g Na, DASH (8-10 servings fruits/veggies, whole grains, low fat, 30 min mod. activity x5 days/week, red. ETOH)

BP: 130-139/80-89 (Stage 1)
- HCTZ 12.5mg daily
OR
- Lisinopril 10mg daily
OR
- Losartan 25mg daily
OR
- Amlodipine 2.5mg daily

BP: >140/>90 (Stage 2)
- HCTZ 12.5 mg + Lisinopril 10mg

Endocarditis
- 3 sets of blood cx's
- PPx: Amoxicillin 2g PO 30-60 min before procedure (prosthetic heart valves, hx IE, congenital heart dz)
- Vanc, Rocephin, Gentamicin

HLD
- Atorvastatin 40-80mg daily (clinical ASCVD, LDL-c >190, 10-yr risk >20%, DM 40-75)
- Atorvastatin 10-20mg daily (LDL-c >160, FH ASCVD, 10-yr risk >7.5-20%, Age >75, 20-39 w/ DM & RF)

Aortic dissection "BB to achieve HR <60, SBP <120, if BB fails add CCB or Nitroprusside"
- confirmed, acute: Labetalol 1-5mg/min IV, morphine 2mg PRN for pain. IF SBP >120 add diltiazem 0.25 mg/kg IV bolus, f/b 5-10mg/hr
- Type A (involving ascending aorta): open surgery or endovascular stent-graft repair
- Type B (descending aorta, distal to L-subclavian artery): endovascular stent graft repair