Cardio Passmed

Question 1

Pericarditis Treatment

Answer 1

1st line = NSAIDs and Colchicine

• mainly managed as outpatients
• if fever and raised troponin manage as inpatient
• treat the underlying cause (eg. infection / autoimmune)

Question 1

Initial / common management of all patients with ACS

Answer 1

MONA

• Morphine - if severe pain
• Oxygen - if sats under 94%
• Nitrates - caution in hypotensive patients
• Aspirin - 300mg Stat.

Question 2

Management of STEMI

Answer 2

1. Aspirin 300mg
2. PCI within 120 mins OR Fibrinolysis if not possible

PCI:
1. give dual anti platelet therapy - Praugrel with the aspirin OR Clopidegrel with the aspirin (if patient is already on anti-coags)
2. RADIAL access - with unfractionated heparin & bailout glycoprotein IIb/IIIa inhibitor
3. Drug eluting stent

Fibrinolysis:
1. Give an antithrombin drug
2. streptokinase / alteplase
3. Repeat the ECG after 60-90 mins to see if the changes have been resolved

Question 3

Acute Heart failure

Answer 3

IV loop diuretics - furesomide / bumetanide

Question 4

1st line investigation for chronic heart failure

Answer 4

all patients should have an N-terminal pro-B-type natriuretic peptide (NT‑proBNP) blood test

Question 5

Infective Endocarditis Management - Native Valve

Answer 5

IV Amoxicillin & Gentamicin FOR 4 WEEKS

(if penicillin allergy replace amoxicillin with vancomycin)

Question 6

Infective endocarditis - prosthetic valve

Answer 6

vancomycin + gentamicin + rifampicin FOR 6 WEEKS