Angina

Question 1

Define Angina

Answer 1

Question 2

What is the management plan for stable angina?

Answer 2

Question 3

How does unstable angina present?

Answer 3

Question 4

What is Prinz metal angina?

Answer 4

Angina caused by narrowing or occlusion of the proximal coronary artery due to spasm, in which pain is experienced at rest rather than activity (commonly seen in women, Ptx presenting with migraine)

Question 5

What are the three types of angina that can be seen clinically?

Answer 5

Question 6

How does Stable Angina present?

Answer 6

Question 7

What are factors that make diagnosis of stable angina less likely:

Answer 7

Question 8

How is diagnosis confirmed for stable angina?

Answer 8

ECG

Question 12

Ptx presents with acute attacks of stable angina, what is the first line management for this patient type?

Answer 12

GTN (can be used a preventative too)

Question 13

For long term prevention of chest pain for patient with stable angina what is the first line therapy?

Answer 13

Question 14

For long term prevention of chest pain for patient with stable angina what is given if beta-blocker is contraindicated in Ptx?

Answer 14

Question 15

Mr. Smith complains of chest pain on exertion, which is relieved with rest. He reports experiencing these symptoms for the past six months, with increasing frequency. He has decompensated heart failure, COPD and now has been diagnosed for angina. He has had a history of bronchospasm in the past when on propranolol. What is the therapy of choice ?

Answer 15

Amlodipine

Question 16

If patient fails with beta blocker alone to control symptoms of stable Angina what is the next intervention according to NICE?

Answer 16

Question 17

If patient has failed on beta blocker, CCB intervention what is the next line of treatment?

Answer 17

A long-acting nitrate, ivabradine, nicorandil, or ranolazine, should also be considered as monotherapy in patients who cannot tolerate beta-blockers and calcium-channel blockers, if both are contraindicated, or when they both fail to adequately control angina symptoms.

Question 18

44) Care home that you service has taken on a new patient and wants your advice on times to
administer their meds, one of the meds is isosorbide mononitrate 10mg BD, which is the most
appropriate administration times for this med?
A 8am and 12pm
B 8am and 2pm
C 8am and 4pm
D 8am and 6pm
E 8am and 8pm

Answer 18

c
There is a drug free period at night to prevent resistance to nitrates. You are to leave a 6-8 hours hour gap according to NHS England.

Question 19

45) 21 male, was diagnosed with iron-deficiency anaemia 1 year ago due to a poor diet, he was
prescribed ferrous sulphate 200mg tabs 1 TDS and given a repeat script, he improved his diet and
after 4 months of treatment his iron stores were replenished and his Hb levels were within range,
today 8 months later he has presented with another prescription for ferrous sulphate 200mg 1 TDS,
which of the following is the most appropriate reason for contacting the doctor?
A dose too high
B dose too low
C duration of treatment too long
D inappropriate dose regimen
E inappropriate formulation

Answer 19

C
Oral iron therapy is often required for at least 3 to 6 months to replete iron stores and normalize ferritin levels, although more time may be required depending upon the severity of IDA and ongoing losses

Question 20

47) 80 female, has been taking morphine sulphate 10mg MR capsules for 7 days, she has become
constipated so her GP has prescribed senna 7.5mg at night, she would like to know senna onset of
action?
A 30-60 mins
B 1-2 hours
C 8-12 hours
D 1-2 days
E 3-5 days

Answer 20

C

Question 21

52) 62 female, prescribed alendronic acid tabs at dose of 70mg once weekly, she has never taken
this before so would like to know how to most effectively take the tablet, which is most appropriate
advice to give on how to take it?
A swallow whole with a full glass of water, remain upright for at least 30 mins after taking
B swallow whole with a full glass of water, take at least 10 mins before breakfast
C tablets can be halved or crushed, take 30 mins before food and other meds
D take at least 30 mins before breakfast and remain upright for at least 1 hour after taking
E take at least 1 hour before any other oral med

Answer 21

A