Cardio 7

Question 1

Most common cause of death in MI?

Answer 1

Ventricular fibrillation

Question 2

what Ix are essential to investigating PE?

Answer 2

Hx
examination - respiratory and CXR

wells score <4
> d dimer

= CTPA

Question 3

wells score high
CTPA neg for PE
?

Answer 3

consider proximal leg vein uss scan if DVT suspected

Question 4

CTPA or V/Q

when V/Q

Answer 4

renal impairment as contrast in CTPA bad

V/Q better for maternal outcome

V/Q worse for foetus

Question 5

acute pulmonary oedema
Mx?

Answer 5

sit up
Iv loop diuretic

oxygen if need be

vasodilate if need be ; MI/ severe HTN

NIV: resp failure

Question 6

role of beta blockers in HF?

Answer 6

if HR >50 fine to continue

contraindicated in following:

but if HR <50
OR

2/3rd degree Hearrt Block
OR

Shock

Question 7

Pts with acute HF and shock?
Mx

Answer 7

use of inotropic agents: dobutamine

vasopressor
> norepinephrine

mechanical circulatory assistance

Question 8

Stable chest pain
Ix?

Answer 8

CT angiography
2nd line is non invasive functional imaging

> MPS with SPECT

Question 9

Mx of complete Heart Block?

Answer 9

transvenous pacing

Question 10

ORBIT score

Answer 10

haemoglobin

age - 74

bleeding Hx

Renal impairment GFR <60

Treatment with antiplatelets

Question 11

ORBIT score

haemoglobin criteria

Answer 11

<130
<120

haematocrit
<40%
<36%

Question 12

renal impairment ORBIT

Answer 12

<60mL/min

Question 13

high bleeding risk ORBIT?

Answer 13

4-7

8.1 bleeds per 100 patients

Question 14

Nicorandil
S/E

Answer 14

associated with GI ulceration
aphthous ulcers

Question 15

left ventricular strain pattern

Answer 15

t wave inversion in leads V5 and V6

Question 16

long saphenous vein

Answer 16

anterior to medial malleolus

Question 17

severe symptomatic mitral stenosis

Answer 17

mid diastolic murmur

accentuated with pt on left decubitus position

malar rash on cheeks

Question 18

ECG changes from severe mitral stenosis?

Answer 18

left atrial hypertrophy can occur

bifid p wave ; broad notched p waves
in Lead II

= left atrium gives greater contribution to the p wave

Question 19

Orthostatic hypotension

Answer 19

SBP <20

3 minutes

Question 20

ASD

types?

Answer 20

ejection systolic
split S2

ostium secundum
ostium primum

Question 21

most specific ECG finding in pericarditis?

Answer 21

PR depression

Question 22

most common cause of endocarditis?

Answer 22

staph aureus

Question 23

IE in valve surgery ? 2 months

Answer 23

staphylococcus epidermis

Question 24

Ludwig’s angina

Answer 24

non cardiac condition
progressive cellulitis

invades the floor of the mouth and soft tissues of the neck

Question 25

widened mediastinum on CXR?

Answer 25

8.0-8.8 cm at the level of the aortic knob on portable anteroposterior chest films

Question 26

low bleeding risk

medical mx of STEMI

Answer 26

aspirin + ticagrelor
fondaparinux

Question 27

PCI mx of STEMI
low bleeding risk

Answer 27

loading dose of 300mg aspirin

+ prasugrel

unfractionated heparin and fondaprinux

Question 28

QT interval

Answer 28

time between start of Q wave and end of T wave

> 430ms
450ms

Question 29

biventricular failure implies?

Answer 29

failure of both ventricles

Land R

Question 30

heart failure with reduced ejection fraction

Answer 30

systolic dysfunction left ventricle is not able to pump blood out effectively

> outflow problem
musculature problem

dilated cardiomyopathy / IHD

Question 31

Diastolic dysfunction

Answer 31

HOCM

preserved ejection fraction

Question 32

p450 inducers which cause INR to fall?

Answer 32

phenytoin
rifampicin
carbamazepine

Question 33

p450 inhibitor which causes INR to increase= increased bleeding risk

Answer 33

clarithromycin
allopurinol

amiodarone
SSRI

Question 34

how to spot pacemaker on an ECG

Answer 34

long straight lines preceding QRS complexes

Question 35

long QT syndrome

Answer 35

inherited delayed repolarization of ventricles

loss of function/ blockage of K+ channels