USMLE Forum Archives - USMLE Step 2 CK - atrial fibrillation
atrial fibrillation
ysemak - 01-26-10 17:31
A 65-y/old male with a history of chronic atrial fibrillation is referred to you for evaluation before surgery. He has a history of hypertension and hypercholesterolemia. He has normal cardiac function otherwise with a normal ejection fraction and no valvular disease. Which of the following options would be appropriate for this patient?
ysemak - 01-26-10 17:31
A 65-y/old male with a history of chronic atrial fibrillation is referred to you for evaluation before surgery. He has a history of hypertension and hypercholesterolemia. He has normal cardiac function otherwise with a normal ejection fraction and no valvular disease. Which of the following options would be appropriate for this patient?
The correct answer and explanation will be available after you answer.
Page 1
#1
Re: atrial fibrillation conym5 - 01-27-10 22:38 My answer is: a.
a. Anticoagulate the patient with warfarin and allow him to stay in atrial fibrillation.
chronic AFIb should be treated with anticoagulation first, then control the heart rate..
#9
Re: atrial fibrillation drravindramegha - 02-07-10 07:53 My answer is: b.
there is no any sign of thrombosis,
so prophylaxis with aspirin is better option up to my knowledge.
#27
Re: atrial fibrillation mtniharika - 04-30-10 08:05 My answer is: d.
d. Strongly suggest cardioversion to this patient since sustained normal sinus rhythm yields the best long-term outcomes.
#28
Re: atrial fibrillation babbu5508 - 05-21-10 14:00 My answer is: b.
history of chronic atrial fibrillation is referred to you for evaluation before surgery..normal ejection fraction and no valvular disease. Place the patient on aspirin and allow him to stay in atrial fibrillation.
#29
Re: atrial fibrillation babbu5508 - 05-21-10 14:02 but how far is anticoagulatio preferred before surgery??
#37
Re: atrial fibrillation babbu5508 - 09-30-10 16:38 Outcomes of patients in atrial fibrillation who are rate-controlled and anticoagulated are actually better than are the outcomes in those in whom normal sinus rhythm is maintained using antiarrhythmics..good point to remember
#39
Re: atrial fibrillation paperp - 10-19-10 15:14 my initial thinking was that because the pt was going in for surgery - anticoagulation would not be appropriate... however i realize that the reason why d is incorrect is because it is RATE control that shows improved mortality and not Rhythm control.
http://enotes.tripod.com/Afib_rate2010.pdf
For afib first try meds; if unstable (which this patient is not) then cardiovert...
anticoagulate 3mos prior to cardiovert
can't find anything on the idea that the patient is better being left in a-fib
#53
Re: atrial fibrillation sudha2015 - 04-16-11 11:15 chronic atrial fibrillation is referred to you for evaluation before surgery. He has a history of hypertension and hypercholesterolemia. He has normal cardiac function otherwise with a normal ejection fraction and no valvular disease. Which of the following options would be appropriate for this patient?
a. Anticoagulate the patient with warfarin and allow him to stay in atrial fibrillation
#54
Re: atrial fibrillation babbu5508 - 04-30-11 15:02 chronic atrial fibrillation is referred to you for evaluation before surgery. He has a history of hypertension and hypercholesterolemia. He has normal cardiac function otherwise with a normal ejection fraction and no valvular disease. Which of the following options would be appropriate for this patient?
a. Anticoagulate the patient with warfarin and allow him to stay in atrial fibrillation
#64
Re: atrial fibrillation mathewjm - 06-11-11 15:07 This is not right. This patient has ONE risk factor being HTN thus he should be placed on ASA not warfarin
#66
Re: atrial fibrillation ankit0503 - 06-18-11 02:46 My answer is: a.
thats the best I can think of.
#68
Re: atrial fibrillation dinmenace - 06-19-11 18:12 My answer is: a.
In AF, the normal electrical impulses that are generated by the sinoatrial node are overwhelmed by disorganized electrical impulses that originate in the atria and pulmonary veins, leading to conduction of irregular impulses to the ventricles that generate the heartbeat.
Page 1