By Adam Rosh, Stephen Menlove

"This is a superb evaluate of emergency medication in easy-to-read case-based questions that offer readers with adequate details to appreciate the most important recommendations of prognosis and administration within the emergency setting."--Doody's overview carrier. . "I came across all the inquiries to be in real USMLE kind, the content material to be totally actual and updated, adn the measure of complexity to be acceptable for 3rd and fourth yr scientific scholars. it's the top assessment textual content that i have ever reviewed."--Michael Curley, clinical scholar, college of Wisconsin institution of medication and Public overall healthiness. . this can be the easiest question-and-answer overview for emergency drugs questions about the USMLE Step 2 and shelf checks. Reader will locate 500 board-format questions, whole with causes of either right and mistaken solutions. All questions were reviewed by way of scientific scholars to make sure they appropriately mirror the examination experience.. . Features:. 500 USMLE-type questions, solutions, and motives. motives for correct and flawed solutions. pursuits what you really want to understand. pupil confirmed and reviewed (20081118)

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35. The answer is b. ) Long QT syndrome (LQTS) is a congenital disorder characterized by a prolongation of the QT interval on ECG and a propensity to ventricular tachydysrhythmias, which may lead to syncope, cardiac arrest, or sudden death in otherwise healthy individuals. The QT interval on the ECG, measured from the beginning of the QRS complex to the end of the T wave, represents the duration of activation and recovery of the ventricular myocardium. In general, heart rate corrected QTc values above 440 msec are considered abnormal.

It is also used to anticoagulate stable patients who have been in atrial fibrillation for longer than 48 hours and are going to be pharmacologically or electrically cardioverted. Cardioversion of atrial fibrillation (if longer than 48 hours) carries the risk of thromboembolism. 17. The answer is d. ) This patient has decompensated heart failure (CHF) with pulmonary edema. Nitroglycerin is the most effective and most rapid means of reducing preload in a patient with CHF. Nitrates decrease myocardial preload and, to a lesser extent afterload.

The answer is e. ) The classic triad of aortic stenosis is dyspnea, chest pain, and exertional syncope. Syncope is a result of either inadequate cerebral perfusion or occasional dysrhythmias. The classic auscultory finding is a harsh systolic ejection murmur that is best heard in the second right intercostal space with radiation to the carotid arteries. Syncope in the setting of a new systolic murmur always should raise the suspicion for aortic stenosis as the etiology. The ECG usually reveals left ventricular hypertrophy.

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