Cardio

Question 1

What is the most common bacterial cause of IE?

Answer 1

Staph Aureus

Question 2

What is Becks triad and which presentation is it seen in?

Answer 2

Diminished heart sounds, increased JVP and hypotension
Seen in Cardiac tamponade
Treated with pericardiocentesis

Question 3

What is AF treatment pathway?

Answer 3

If haemodynamically unstable- admit urgently
If haemodynamically stable- consider primary care treatment

If haemodynamically stable- beta blockers or rate limiting CCB
CHADSVASC to assess stroke risk and anticoagulate if >2

Question 4

Common ECG changes for PE?

Answer 4

Right heart strain- RBBB, RAD, sinus tachycardia
S1Q3T3 very rare.

Question 5

What are the 6 P’s?

Answer 5

Pale
Painful
Pulseless
Paraesthesia
Perishingly cold
Paralysed

Question 6

What are the 4H’s and 4T’s?

Answer 6

Hypovolaemia
Hypo/hyperkalaemia/metabolic
Hypo/hyperthermia
Hypoxia
Tamponade
Toxins
Thrombosis
Tension pneumothorax

Question 7

What is Brugada syndrome?

Answer 7

Brugada syndrome is known as sudden cardiac death syndrome and is common in the Southeast Asian population, young males.
It is seen on ECG as coved ST elevation and TWI in V1-V3

Question 8

First line treatment for stable angina?

Answer 8

Beta blockers or CCB
2nd line- long acting nitrate, ivabradine, nicorandil, ranolazine

Question 9

What is Wolff-Parkinson White syndrome?

Answer 9

Accessory pathway between atria and ventricles causes ventricle preexcitation.
Seen as delta wave on ECG. Shortened PR interval, widened QRS complex
Small number at risk of sudden cardiac death but very high risk of ventricular arrhythmias.
Usually treated by catheter ablation

Question 10

Are statins safe to use during pregnancy?

Answer 10

No

Question 11

What is the pathognomic ECG change associated with hypothermia?

Answer 11

J waves

Question 12

Why should beta blockers and rate limiting CCBs not be prescribed concurrently?

Answer 12

Due to the increased risk of developing complete heart block

Question 13

What is the common initial management for ACS?

Answer 13

Aspirin 300mg STAT
Oxygen if sats <94%
Morphine if in pain
Nitrates if in pain

Question 14

Which class of drugs are avoided in HOCM?

Answer 14

ACEi
Nitrates
Inotropes

Question 14

What drugs are given as secondary prevention post MI?

Answer 14

DAPT
Beta Blocker
ACEi
Statin

Question 15

What is the second anti-platelet given during ACS alongside aspirin?

Answer 15

If medically managed- ticagrelor for 12 months
If PCI managed- prasugrel or ticagrelor for 12 months

Question 16

What is the most common cause of cardiac arrest following an MI?

Answer 16

VF- also most common cause of death- treated as per the ALS guidelines.

Question 17

Which post MI complication causes left ventricular failure and persistent ST elevation?
Why are patients anticoagulated with this condition?

Answer 17

Left ventricular aneurysm secondary to muscle weakness.
Thrombus may form within the aneurysm and increase stroke risk.

Question 18

Which post MI complication causes acute heart failure symptoms secondary to cardiac tamponade?

Answer 18

Left ventricular free wall rupture.

Question 19

What is electrical alternans?

Answer 19

ECG finding in cardiac tamponade where the QRS complex heights alternate each time

Question 20

Which drug can you not give with clopidogrel?

Answer 20

Omeprazole as it stops the enzyme which converts clopidogrel into its active form