Cardio

Question 1

DVT prophylaxis on flights

Answer 1

Anti-embolism stockings

-no need to give aspirin

Question 2

Causes of Torsades de pointes

Answer 2

Hypomagnesia
Hypokalaemia
Hypothermia

Question 3

Management of torsades de pointes

Answer 3

IV magnesium sulphate

Question 4

Treatment of asymptomatic first degree heart block

Answer 4

No treatment needed

Question 5

Most common congenital heart defect found in adulthood

Answer 5

Atrial septal defect

Question 6

What is bad about having an atrial septal defect in adulthood?

Answer 6

Can allow a clot to pass from the venous system to the left side and cause a stroke

Question 7

How might atrial myxoma present?

Answer 7

Fever of unknown cause

Question 8

Which valve usually affected in endocarditis in drug user?

Answer 8

Tricuspid valve

Question 9

What is takayasu’s areteritis associated with?

Answer 9

Renal artery stenosis

Question 10

DVLA post-MI?

Answer 10

Cannot drive for 4 weeks

if stent inserted I think perhaps 1 week

Question 11

JVP and inspiration?

Answer 11

JVP falls during inspiration

Question 12

Kussmaul’s sign positive?

Answer 12

When the JVP doesn’t fall on inspiration

- seen in constrictive pericarditis

Question 13

Alcohol and warfarin?

Answer 13

Chronic alcoholism increases the metabolism of warfarin

i.e. INR will be low, might have to increase dose

Question 14

Why is leviteracetam good?

Answer 14

Does not have an effect on the cytochrome P450 system

Question 15

When should you take a statin?

Answer 15

Last thing in the evening - majority of cholesterol synthesis takes place at night

Question 16

Inferior MI and aortic regurgitation murmur

Answer 16

Consider proximal aorta dissection

Question 17

Which antibiotic can cause QT prolongation?

Answer 17

Clarithromycin

-long QT can trigger polymorphic ventricular tachycardia

Question 18

What is Sydenham’s chorea?

Answer 18

Complication of Group A -beta haemolytic strep (e.g. rheumatic fever)
Presents with abnormal movements e.g. facial muscles and arm movements

Question 19

This drug commonly causes thrombophlebitis

Answer 19

Amiodarone

Question 20

Half-life of amiodarone?

Answer 20

20-100 days

Question 21

Why can amiodarone cause arrhythmias?

Answer 21

Prolongs QT interval

Question 22

Amiodarone and warfarin?

Answer 22

Amiodarone decreases the metabolism of warfarin

Question 23

What do you need to do when INR <2?

Answer 23

Need immediate anticoagulation e.g. with LMWH

Question 24

What type of diuretic should you use in hypertension?

Answer 24

Should use indapemide instead of thiazide-like diuretics

Question 25

Normal left ventricular ejection fraction?

Answer 25

55-70%

may be reduced in dilated cardiomyopathy

Question 26

What can you measure following acute anaphylaxis?

Answer 26

Can measure serum tryptase

Question 27

How does nicorandil work?

Answer 27

Potassium channel activator

Question 28

Side effects of nicorandil

Answer 28

Headache
Flushing
Anal ulceration

Question 29

Statin monitoring

Answer 29

LFTs at baseline, 3 months and 1 year

Question 30

Which organism causes rheumatic fever?

Answer 30

Strep pyogenes

Question 31

Adenosine half life

Answer 31

10 seconds

Question 32

What helps decide whether glycoprotein IIb/IIIa receptor antagonists should be used?

Answer 32

High GRACE risk score and whether a percutaneous intervention is going to be performed

Question 33

What ECG changes are associated with Wolff-Parkinson white syndrome?

Answer 33

Short PR interval and delta waves

Question 34

CXR finding in coarctation of the aorta?

Answer 34

Rib notching is present in about 70% adults with coarctation of the aorta

Question 35

Investigation essential when investigating PE?

Answer 35

Must do CXR to rule out other pathologies