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Passmed Wrong Qs Notes > Cardio > Flashcards

Cardio Flashcards

1
Q

How to treat 1st episode of AF which presented <48h?

A

Begin anticoagulation, undergo immediate direct current (DC) cardioversion

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2
Q

What medications should be given after MI?

A

dual antiplatelet therapy (aspirin plus a second antiplatelet agent)
ACE inhibitor
beta-blocker
statin

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3
Q

Where do pulse changes happen in aortic dissection?

A
  • weak or absent carotid, brachial, or femoral pulse
  • variation in arm BP
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4
Q

What is given first in to prevent angina attacks, Verapamil or nicorandil?

A

Verapamil (make sure not on beta-blocker) then nicorandil

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5
Q

What is 1st line treatment of aortic stenosis with symptoms?

A

valve replacement

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6
Q

What is needed to make a diagnosis of Takayasu’s arteritis?

A

Magnetic resonance angiography (MRA) or CT angiography (CTA)

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7
Q

What is a side effect of amiodarone?

A

grey skin appearance

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8
Q

What ECG changes are seen in hypothermia?

A

Bradycardia (<60bpm) and not tachycardia
J waves
Prolonged PR, QT and QRS intervals
Shivering artefacts
VT, VF or asystole

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9
Q

How much statin is given for primary and secondary prevention?

A

Primary - 20 mg
Secondary - 80 mg

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10
Q

What is a side effect of beta-blockers?

A

cold peripheries

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11
Q

What only beta-blocker causes long QT syndrome?

A

Sotalol

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12
Q

When do you give ACEi as first line for hypertension?

A

<55Y or T2DM

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13
Q

When do you give CCB as first line for hypertension?

A

> /= 55Y AND not T2DM OR Black African/ Afro-Caribbran ethnicity

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14
Q

When would add a low-dose spironolactone for hypertension?

A
  • Last Line
  • K </= 4.5
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15
Q

When would add an alpha/beta blocker for hypertension?

A
  • Last Line
  • K > 4.5
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16
Q

What is an example of a thiazide LIKE diuretic?

A

indapamide

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17
Q

What is the target INR for patients on warfarin?

A

2.5

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18
Q

What is the target INR for patients on warfarin when thy have emboli/ recurrent venous embolism?

A

3.5

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19
Q

What is an example of a a longer-acting dihydropyridine calcium channel blocker?

A

Amlodipine / modified-release nifedipine

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20
Q

a long-acting nitrate, ivabradine, nicorandil and ranolazine are used for angina when?

A
  • if a patient is on monotherapy and cannot tolerate the addition of a calcium channel blocker or a beta-blocker
  • Specialist medication
21
Q

What is Buerger’s disease (or thromboangiitis obliterans) disease and what is it assoaicted with?

A
  • a small and medium vessel vasculitis
  • causes Raynaud’s phenomenon (discolouration of extremities with cold exposure)
  • extremity ischemia leading to intermittent claudication (pain in legs which occurs during exercise and is relieved by rest)
  • Stringly associated with smoking
22
Q

What are signs of left ventricular aneurysm?

A

Persistent ST elevation following recent MI, no chest pain

23
Q

What are signs of left ventricular free wall rupture?

A

raised JVP, pulsus paradoxus and diminished heart sounds
- Bibasal crackles
- decrease in blood pressure on inspiration

24
Q

What ECG changes does hypercalcaemia cause?

A

shortening of the QT interval

25
Q

How to treat AF?

A

First question: is patient haemodinamically stable?
if no then DC

If yes, Two questions to ask:
i. is patient >65 y/o?
ii. Does patient has history of ischaemic heart disease?

If yes to ANY of the two questions then:
first line Beta Blockers, second line digoxin

If no to BOTH then
First line is fleccanide, second line ameodarone

26
Q

What are signs of hypokalaemia in an ECG?

A

This shows up as T wave flattening or inversion and ST depression. As the severity progresses U waves (small waveform following T wave) and QT prolongation (>450ms) can be seen.

27
Q

Can ACS (unstable angina + ischaemic symptoms) have ecg changes?

A

YES
no elevation in troponins, with or without electrocardiogram changes indicative of ischaemia

28
Q

What murmur is associated with a bicuspid valve?

A

ejection systolic murmur

29
Q

What is the target INR for patients with a mechanical heart valve?

A

3-3.5

30
Q

What is the screening numbers for AAA?

A

<3 = normal
3-4.4 cm = rescan every 12m
4.5-5.4 = Rescan every 3 m
>/= 5.5 = refer within 2 w for vascular surgery for probable intervention

31
Q

When do you give oxygen?

A

O2 < 92%

32
Q

What is trifasicular block?

A

RBBB +left anterior or posterior hemiblock + 1st-degree heart block

33
Q

What is Brugada syndrome?

A

ST segment elevation in leads V1 to V3

34
Q

How many hypertension drugs can be given before you refer to a specialist?

A

4

35
Q

What is the dosage of adrenaline for PEA?

A

1:10000 (1mg)

36
Q

What is the dosage of adrenaline for anaphylaxis?

A

1:1000 (0.5mg)

37
Q

What type of drug is verapamil?

A

CCB

38
Q

If you have a high QRISK3 score with hypertension, what does that mean?

A

That you are at a greater risk of a cardiovascular disease to primary cardiovascular disease prevention should be given e.g. 20mg of statin

39
Q

How does wrafarin affect PT and APTT?

A

Prolonged PT only
2 and 10 are in the common pathway; 7 in extrinsic; 9 in intrinsic
It affects factor 7 the most

40
Q

When do you add ivabradine for angina patients?

A
  • a long acting nitrate
  • if a beta-blocker and dihydropyridine CCB can’t be tolerated
41
Q

How to react first episode of AF which started >48h or uncertain if when started?

A

Rate control drugs e.g. beta-blockers

42
Q

What are examples of rate control drugs for AF?

A
  • Beta blocker
  • CCB
  • Digoxin
43
Q

What are examples of rhythm control drugs for AF?

A
  • beta-blockers
  • dronedarone
  • amiodarone
44
Q

If a patient with AF has a stroke or TIA , what should be given as secondary prevention?

A
  • Warfarin
  • Apixaban
  • direct thrombin
  • factor Xa inhibitor
45
Q

Is the Risk of falls or old age alone is sufficient reasoning to withhold anticoagulation?

A

No

46
Q

What antithrombin therapy is given for a bio prosthetic valve?

A

Aspirin

47
Q

What anti thrombin therapy is given for a mechanical valve?

A

Warfarin and aspirin

48
Q

When do you thrombolyse for PE?

A

Massive PE + hypotension

49
Q

What is first and second line management of SVT (narrow complex)?

A
  • valsalva manoeuvre or carotid sinus massage
  • IV adenosine

Passmed Wrong Qs Notes (20 decks)

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