Cardio

Question 1

Work up for MI

Answer 1

Bloods
Cardiac bio makers
ECG
CXR
ECHO
PCI
Coronary perfusion/ CT angio/ Ca score

Question 2

Treatment MI

Answer 2

REPERFUSION- CABG, PCI

Anti-ischaemic: NOM BC
Nitrates, oxygen, morphine, beta, ca
Anti thrombotic- LMWH
Anticoagulant- ASA, clopidogrel
Anti lipid- statins

Question 3

Heart failure investigations

Answer 3

Bloods– esp BNP (100-500)
CXR
ECHO
Coronary angiography

Question 4

HF treatment

Answer 4

Initial- LMNOP
Loop, morphine, nitrates, oxygen, postural

Vasodilators- nitrates and Nesiritide

Anticoagulants- LMWH

Question 5

Non-pharm HF treatment

Answer 5

Fluid and alcohol restriction 
Weight loss and exercise
Devices-- ICD, cardiac catheterization,
Surgery- PCI
Edc- heart failure nurse

Question 6

Differential for MI

Answer 6

PE
AD
GERD
Pericarditis
Pneumonia

Question 7

NYHA HF Classification

Answer 7

1- strenuous
2- ordinary
3- minimal
4- rest

Question 8

ACC Classification

Answer 8

A- high risk no St
B- no sy, yes St
C- sy, St
D- end stage heart failure

Question 9

Classification valvular diseases

Answer 9

Congenital
Infective
Acquired– degenerative or rheumatic

Question 10

Symptoms of IE

Answer 10

Septic emboli
CCF
NEURO- celebrities, mycotic aneurysm, stroke
RENAL- AKI– IC

Question 11

Signs of IE

Answer 11

Fever
Murmur- new or changing
Embolic phenomenon

Question 12

Investigations of IE

Answer 12

Micro- sustained positive blood cultures
Bloods- ESR/CRP, increase WCC, UE, urinalysis 
CXR- HF
ECHO- TOE> TT
Dukes criteria

Question 13

Dukes criteria IE

Answer 13

MAJOR

• positive blood cultures
• ECHO
• new murmur

MINOR

• positive blood cultures
• fever > 38
• embolic
• immunologic
• PRE heart condition

Question 14

Treatment IE prosthetic valve

Answer 14

Vancomycin
Gentamicin
Rifampin

IV 6 weeks

Question 15

Treatment native valve acute

Answer 15

Vancomycin- high dose IV

Gnetamicin- IV 8 hourly

Question 16

Tx subacute IE

Answer 16

Amoxicillin- high dose IV

Gnetamicin- IV 12hrly

Question 17

A fib findings

Answer 17

Irregular QRS 
No P waves 
Atrial rate 400bpm
Ventricular rate varies
Rhythm irregular 
Wavy baseline

Question 18

Investigations a fib

Answer 18

ECG
ECHO
- TT- thrombus, chambers, valvular disease, pulmonary HTN
- TOE- LA thrombi,

Question 19

Rate control a fib

Answer 19

mad d

Metoprolol
Amiodarone
Digoxin
Diltiazem

Question 20

Rhythm control a fib

Answer 20

Sotalol
Dofetilide
Flecainide
Amiodarone
Propafenone
Dronedarone

DCCV, catheter ablation

Question 21

Anticoagulant tx a fib

Answer 21

LMWH- waiting for DCCV
Warfarin- INR 2-3 > 4 weeks
RAD- rivaroxaban, apixaban, dabigatran (if can’t use warfarin)

Question 22

Tx a fib

Answer 22

Rate control
Rhythm control
Anticoagulants

Question 23

CHADS2VAS

Answer 23

Age> 75, stroke/TIA/TE BOTH= 2

2/9--> OAC
CCF
HTN
Age >- 75
Diabetes 
Stroke/TIA/TE
Vascular 
Age 65-74
Sex- female

Question 24

HASBLED score

Answer 24

Age and drugs/alcohol = 2 points 
3/9 
HTN
Abnormal renal / liver 
Stroke
Bleeding
Labile INR
Elderly> 65 
Drugs/ alcohol