Archer USMLE step 3 cardiology lecture notes. These lecture notes are samples and are intended for use with Archer video lectures. For video lectures, please log in at http://www.ccsworkshop.com/Pay_Per_View.html

1. Archer online USMLE reviews www.ccsworkshop.com All Rights reserved Archer Slides are intended for use with Archer USMLE step 3 video lectures. Hence, most slides are very brief summaries of the concepts which will be addressed in a detailed way with focus on High-yield concepts in the Video lectures. These slides are only SAMPLES

6. Table 1: Hemodynamic effects of IABP Therapy

42. The PR interval is 388 ms and constant. Each P wave is followed by a QRS complex.

43. Note the progressive lengthening of the PR interval until a P wave is blocked. The PR interval following the blocked P wave is shorter than the one before the blocked P wave. Progressive shortening of the R-R interval is best shown in the 5:4 cycle on the right of the strip

44. P waves are blocked intermittently. The PR interval does not change. Note the wide QRS complexes.

45. No relationship between the atrial and ventricular activity is present. The atrial rhythm is sinus at 90 beats/min. A slight sinus arrhythmia is present. The ventricular rhythm is a wide QRS escape rhythm at 26 beats/min.

46. Test Notes ECG with rhythm strip Essential to define the type and site of the block. Echocardiogram Useful to determine the presence and severity of structural heart disease  evidence of previous MI, hypertensive heart disease, valvular heart disease, and infective endocarditis. Transesophageal echocardiogram is superior to transthoracic echocardiogram in identifying aortic root abscesses and infections involving prosthetic heart valves Serum electrolytes To evaluate for hyperkalemia, especially in patients with kidney disease Cardiac enzymes (creatine kinase, cardiac troponin) Can identify ischemia/infarction or myocarditis as potential causes of AV block Lyme serology Can identify Lyme disease as a potential cause of AV block Serum digoxin level Can identify digitalis toxicity as a potential cause of AV block Thyroid function tests To evaluate for hypothyroidism Blood cultures To evaluate for evidence of bacteremia and possible infective endocarditis ( ? New onset heart block, bbb)

86. An IV drug abuser who recently survived an infective endocarditis episode come to you and says that she cannot give up IVDA but requests you for prophylaxis because she is a high risk for IE as she continues to inject herself putting herself at a risk for bacteremia  what would you do??

94. Lifestyle Modification Approximate SBP Reduction Weight Reduction 5 to 10 mm Hg for every 10kg weight reduction DASH Diet 8 to 14 mm Hg Dietary Sodium Restriction 2 to 8 mm Hg Physical activity 4 to 9 mm hg Moderation of alcohol use 2 to 4 mm hg

118. END!