Angina and ACS

Question 1

First line for long-term management of stable angina?

Answer 1

Beta blocker or NDHP CCBs

Question 2

________, a drug used in treatment of angina, can cause ulceration

Answer 2

Nicorandil

Question 3

What is used in the initial management of STEMI/NSTEMI (4 points)

Answer 3

Oxygen if hypoxic

Nitrates

Opioids (anti-emetics to prevent N&V)

Aspirin and Clopidogrel

Question 4

True or false: Isosorbide mononitrate (ISMN) can be sold over the counter

Answer 4

TRUE

It is a P medicine!

Question 5

What should be added to a beta blocker if symptoms of angina persist/worsen despite treatment

Answer 5

A long acting DHP CCB

Question 6

What are the long acting dihydropyridine CCBs

3 points

Answer 6

Amlodipine
MR nifedipine
MR felodipine

Question 7

Symptoms of (typical) stable angina ?
(3 points)

Answer 7

1. Pain that is worse on exertion
2. Constricting pain in the: front of the chest/ neck/ shoulders/ jaw/ arms
3. Relieved by rest (or GTN) within 5 minutes

Question 8

What additional symptoms could you expect in atypical stable angina
(3 points)

Answer 8

One or more of the following:

1. GI discomfort
2. Breathlessness
3. Nausea

Question 9

If both CCBs and Beta blockers are CI or not tolerated, what are the treatment options for angina
(4 points)

Answer 9

1) Nicorandil
2) Long acting nitrates e.g. ISMN
3) Ivabradine
4) Ranolazine

Question 10

When should a patient with angina be advised to call 999 during an acute episode?

Answer 10

If no improvement after 2 doses of sublingual GTN (5 minutes apart)