Cardio

Question 1

Step 2 hypertension

Answer 1

Over 55 and Afro Caribbean - CCB or thiazide

Question 2

Heart failure combination - 1st line

Answer 2

ACE + BB

Question 3

Cholestyramine mechanism of action

Answer 3

Bile acid sequestration which binds to bile acids and promotes hepatic conversion into bile acids.

Question 4

Cholestyramine counselling points

Answer 4

Other drugs should be taken at least 1 hour before or 4-6 hours after bile acid sequestrants.

Question 5

What antifungal does simvastatin interact with?

Answer 5

Miconazole

Question 6

Which antiarrythmic drug does simvastatin interact with?

Answer 6

amiodarone - so atorvastatin would be 1st line instead

Question 7

normal triglyceride level

Answer 7

<1.8mmol/l. fenofibrate to be added if statin does not lower to normal range

Question 8

what to prescribe if someone has tried two statins

Answer 8

colestyramine

Question 9

what would you prescribe if qrisk is 15%

Answer 9

atorvastatin 20mg

Question 10

would you stop simvastatin during pregnancy

Answer 10

yes

Question 11

which macrolide does simvastatin interact with

Answer 11

clarithromycin

Question 12

colestipol counselling point

Answer 12

other medicines to be taken 1 hr before/4hrs after

Question 13

can bumetanide/furosemide be taken in the evening

Answer 13

no

Question 14

which is more potent - bumetanide or furosemide?

Answer 14

bumetanide so give if pt is resistant to furosemide

Question 15

furosemide electrolyte disturbance

Answer 15

hypokalaemia

Question 16

hypokalaemia signs

Answer 16

fatigue, weakness, tiredness

Question 17

salbutamol and furosemide can cause…

Answer 17

hypokalaemia

Question 18

amisulpiride and furosemide can cause…

Answer 18

ventricular arrhythmias

Question 19

inr 8.3, withheld now gums bleeding

Answer 19

give phytomenadione

Question 20

high inr means…

Answer 20

blood is not clotting

Question 21

should diet change with warfarin

Answer 21

no

Question 22

what do you do if inr is high

Answer 22

stop warfarin for 1 day then return to usual 5mg warfarin od recheck inr in 7 days

Question 23

warfarin in end of stage renal causes…

Answer 23

a rash

Question 24

what is the inr target for af pts

Answer 24

2.5

Question 25

tranexamic acid age

Answer 25

18+

Question 26

maximum number of days tranexamic acid can be used

Answer 26

4

Question 27

which drug is given just before pci

Answer 27

prasugrel

Question 28

action required if nstemi pt is taking nifedipine

Answer 28

continue and refer to gp

Question 29

positive d-dimer results means...

Answer 29

LMWH is needed

Question 30

which class has a lower risk of heparin-induced thrombocytopenia?

Answer 30

LMWH

Question 31

list the LMWH

Answer 31

enoxaparin, dalteparin, tinzaparin

Question 32

35 yr old in third trimester with PE, crcl 84...

Answer 32

enoxaparin inj 80mg SC BD

Question 33

enoxaparin side effect...

Answer 33

thrombocytopenia

Question 34

how long is enoxaparin contraindicated for in a stroke

Answer 34

2 months

Question 35

factor xa inhibitors/doacs list

Answer 35

apixaban, rivaroxaban

Question 36

what do you give to someone who travels a lot to prevent a dvt

Answer 36

rivaroxaban

Question 37

which drug do you stop and start after a tia/af

Answer 37

stop clopidogrel, start rivaroxaban

Question 38

dose of rivaroxaban for nstemi and they're taking aspirin

Answer 38

rivaroxaban 2.5mg bd for 12 months

Question 39

tx and dose of dvt/pe

Answer 39

rivaroxaban 15mg bd for first 3 weeks then 20mg od for 3 months, if crcl is 15-49 15mg od

Question 40

Prophylaxis of stroke with AF and one other risk factor (drug&dose)

Answer 40

rivaroxaban 20mg od/apixaban

Question 41

5 apixaban tests

Answer 41

body weight, creatinine, u&e, lfts, fbc

Question 42

initial ischaemic stroke tx and dose

Answer 42

aspirin 300mg od for 2 weeks and antiplatelet

Question 43

aspirin 6 overdose symptoms

Answer 43

hyperventilation, vomiting, tinnitus, deafness, sweating, metabolic acidosis

Question 44

what does not increase risk of haemorrhage with dabigatran

Answer 44

obesity

Question 45

which hyper does amiodarone cause and name symptoms

Answer 45

hyperthyroidism - palpitations, sweating, irritable, weight loss, tired

Question 46

what should you wear with amiodarone

Answer 46

suncream

Question 47

three word symptom caused by amiodarone

Answer 47

toxic epidermal necrolysis

Question 48

amiodarone tests

Answer 48

chest xray, tfts, lfts, potassium

Question 49

which test can amiodarone increase

Answer 49

inr

Question 50

which ccb does amiodarone interact with and what does it cause

Answer 50

diltiazem and bradycardia

Question 51

which antipsychotic does amiodarone interact with and what does it cause

Answer 51

quetiapine and qt prolongation

Question 52

afro Caribbean htn and type 2 diabetes

Answer 52

CCB and ACEi

Question 53

which ccb needs to be the same brand

Answer 53

diltiazem

Question 54

which ccb causes ankle swelling and oedema

Answer 54

amlodipine

Question 55

which ccbs should not be used with bb

Answer 55

verapamil and diltiazem

Question 56

which thiazide won't work for egfr less than 30

Answer 56

bendroflumethazide

Question 57

bendroflumethazide side effects

Answer 57

gout, hyperglycaemia, lithium toxicity, hypokalaemia

Question 58

two things chlorothiazide can increase and two side efffects

Answer 58

urate and glucose, joint pain and swelling

Question 59

As well as htn spironolactone treats...

Answer 59

ascites

Question 60

spironolactone side effects

Answer 60

moobs and hyperkalaemia

Question 61

which electrolyte disturbance is caused by digoxin

Answer 61

hypokalaemia

Question 62

which score is used for AF

Answer 62

chadvasc

Question 63

what is the htn target for diabetics?

Answer 63

130/80

Question 64

which lab test do you check for a cvd?

Answer 64

c-reactive protein

Question 65

if you took digoxin and indapamide together it can cause...

Answer 65

hypokalaemia

Question 66

what should you do if a pt has had a recent fall and hypotension and they take ramipril?

Answer 66

change ramipril

Question 67

what should you do if a pt has high levels of creatinine and takes ramipril?

Answer 67

stop ramipril immediately

Question 68

frequency of pancreatitis with lisinopril

Answer 68

<0.01%

Question 69

what would happen if you drank alcohol with ACEi and doxazosin?

Answer 69

faint

Question 70

what would happen if you took digoxin and bisoprolol?

Answer 70

bradycardia

Question 71

tx for heart failure

Answer 71

ace and bisoprolol

Question 72

beta blockers exacerbate...

Answer 72

asthma

Question 73

side effect of propanalol

Answer 73

fatigue

Question 74

bbs are contraindicated in...

Answer 74

severe peripheral vascular/arterial disease

Question 75

propanalol and adrenaline can cause...

Answer 75

bradycardia

Question 76

which antihypertensive is least likely to cause mouth ulcers?

Answer 76

bbs

Question 77

which two electrolyte disturbance is caused by bb and the se associated?

Answer 77

hypo/hyperglycaemia - tingly

Question 78

se of carvedilol and overdose symptom

Answer 78

anaemia and cardiac arrest

Question 79

do you need to adjust carvedilol in renal impairment?

Answer 79

no

Question 80

which alpha blocker enhances carvedilol

Answer 80

doxazosin

Question 81

nitrates interact with

Answer 81

sildenafil and tadalafil

Question 82

action to be taken if isosorbide mononitrate increased from 40 bd to 60 bd

Answer 82

discuss with gp meds need to be reviewed

Question 83

how long does gtn effect last

Answer 83

20-30 mins

Question 84

apixaban indications

Answer 84

dvt pe prophylaxis of stroke and non-valvular AF

Question 85

gtn indications

Answer 85

angina congestive HF anal fissure

Question 86

spironolactone and ramipril causes...

Answer 86

hyperkalaemia

Question 87

which test should be conducted if myopathy with atorvastatin

Answer 87

creatinine kinase

Question 88

how many compressions and rescue breaths

Answer 88

30 and 2

Question 89

1st line for AF

Answer 89

BB except sotalol

Question 90

dabigatran counselling point

Answer 90

same time each day

Question 91

what to report - pt taking theophylline for first time

Answer 91

vomiting and palpitations

Question 92

typical symptoms of toxicity

Answer 92

nausea and vomiting

Question 93

dabigatran mechanism of action

Answer 93

thrombin inhibitor

Question 94

rate control tx for af

Answer 94

bb(not soltatol) or verapamil/diltiazem