Cardio

Question 1

Stable Angina

Answer 1

Symptomatic:

1) GTN spray
2) Anti anginal:
- Beta blocker (propanolol)
- calcium channel blocker (verapamil)
3) Prevention
- aspirin and a statin

Question 2

Immediate ACS management (prehospital)

Answer 2

MONA for unstable angina, STEMI, NSTEMI

Morphine
Oxygen
Nitrates - GTN spray
Aspirin - antiplatelet

Preventative

• Beta blocker (propanolol)
• Ace inhibitor (ramipril)
• Statin (atorvastatin)

Question 3

Pericarditis

Answer 3

NSAID and colchicine
Aspirin and prednisolone may be needed.
Colchicine contraindicated in TB

Question 4

PVD

Answer 4

1) Conservative and lifestyle management.

Statin - atorvastatin
Antiplatelet - Clopidogrel
Thrombolytic - Alteplase

Question 5

DVT/PE

Answer 5

Apixaban first line

LMWH as prevention

Question 6

Cardiac tamponade

Answer 6

Emergency pericardocentesis

Question 7

Pleural effusion

Answer 7

• Chest tube drainage if infected.

- Thoracocentesis

Question 8

STEMI

Answer 8

Immediate aspirin, add ticagrelor if no bleeding risk

If within 12 hours of symptoms, and PCI can be done within 2 hours, PCI.
If PCI not possible, fibrinolysis with alteplase.

ECG after 60-90 mins

Question 9

Hypertension

Answer 9

If less than 55 or T2DM

1) Ramipril or candesartan
2) Ramipril + Amlodipine
3) Ramipril + amlodipine + thiazide diuretic (hydrochlorothiazide)

If black or over 55,

1) Amlodipine
2) Amlodipine + candesartan
3) Amlodipine + candesartan + hyrochlorothiazide

Question 10

Endocarditis

Answer 10

IV antibiotics