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+--- Thread: cardio q - maddymami (/showthread.php?tid=405472)
cardio q - maddymami - ArchivalUser - 04-29-2009
A 26-year-old man is brought to the emergency department complaining of chest pressure radiating to his left arm and jaw. The pain is constant in nature and started while he was at an œafter-hours dance club. He has no previous history of heart trouble, has never been hospitalized, and has no family history of myocardial infarction. Examination reveals a diaphoretic, anxious young man in mild discomfort. His pupils are widely dilated and he is tachycardic, but otherwise he has a normal exam. Cardiac enzymes reveal changes consistent with a myocardial infarction. An electrocardiogram shows ST segment depression in the lateral leads. The intern on call gives morphine, oxygen, a nitroglycerin drip, aspirin, intravenous metoprolol, and lovastatin. Shortly thereafter the patient complains of worsening substernal pressure. He is watched in the emergency room, where repeated blood pressure checks show elevated systolic blood pressures of 180 to 220 mm Hg. The patient acutely decompensates and is intubated and transferred to the intensive care unit. Which of the following may have prevented this patient™s decompensation?
A. Administration of immediate thrombolytic therapy after EKG and enzyme results
B. Immediate administration of phentolamine after worsening pain and hypertension
C. Increased dose of intravenous beta-blocker to reduce blood pressure
D. Not giving lovastatin in the acute setting of myocardial infarction
E. Stopping nitroglycerin and giving a bolus of normal saline
0 - ArchivalUser - 04-29-2009
B
seems like metoprolol was given to this cocaine induced MI causing alpha receptors medicated severe vasoconstriction - BP shot up!
0 - ArchivalUser - 04-29-2009
bbb
0 - ArchivalUser - 04-29-2009
bbbbbbbb
0 - ArchivalUser - 04-29-2009
hi stefan78 where have you been?, good to see u
have you took the test yet??
0 - ArchivalUser - 04-29-2009
i am fine
no i could not give time to study...was busy with some non imp stuff!!
how are you saboo
0 - ArchivalUser - 04-29-2009
i am fine
took my test in dec failed with 72% ahhh
reading again taking in july,
review all the material again this time more focus on ccs, reading conrad fisher im book just ordered
i enjoyed your post and qu!!!
0 - ArchivalUser - 04-29-2009
BB?
0 - ArchivalUser - 04-29-2009
young patinet with mi suspect coaiane inducend mi,give iv pentolamine and iv ntg