Cardiology

Question 1

Heart block (severe) management

Answer 1

1st - atropine 500mcg up to 3mg
2nd - transcutaneous pacing
3rd - isoprenaline/ adrenaline infusion
4th - transvenous pacing (with cardio input)

Question 2

Narrow complex tachycardia (SVT) Mx

Answer 2

if in shock - DC Cardioversion
1st - vagal manoeuvres
2nd - IV Adenosine - 6mg, 12mg, 18mg
3rd - DCCV (If severe)
3rd - rate control B block

Question 3

Complete heart block post MI lesion location

Answer 3

right coronary artery

Question 4

Chronic heart failure Mx

Answer 4

1st - ACEi, B Block
2nd - Aldosterone Ant (spiro)/ ARB/ Hydrazlazine + Nitrate
3rd - Digoxin/ Cardiac resynchronisation
annual influenza, stat pneumococcal

Question 5

Loop diuretics eg Bumetanide SE

Answer 5

ototoxicity

Question 6

Amlodipine SE

Answer 6

flushing, headache, ankle swelling

Question 7

ACS Mx

Answer 7

Aspirin 300mg
O2 if sats <94%
Morphine for pain
Nitrates for pain

Question 8

STEMI Mx

Answer 8

Aspirin 300mg
if <120 mins onset - Prasugrel 10mg + PCI
If >120mins - Fibrinolysis (Fondaparinux) + Ticagrelor

Question 9

Angina Mx

Answer 9

Aspirin, Statin
GTN
1st - B Blocker or CCB (Verapamil/ Diltiazem if monotherapy)
2nd - B Blocker + CCB (Amlodipine if dual therapy)
3rd - Nitrate/ Ivabradine/ Nicorandil (Requires assessment for PCI/ CABG at this stage)

Question 10

Macrolides (Azithromycin) SE

Answer 10

Torsade de pointes (polymorphic VT)

Question 11

Prolonged QT causes

Answer 11

HypoCAL, hypoKAL, hypoMAG
TCA, SSRI
Erythromycin, Clarithromycin, ondansetron, haloperidol, methadone

Question 12

How long to continue anticoagulation post DCCV

Answer 12

lifelong if high risk.
4 weeks if low (CHADVASC <2)

Question 13

Infective endocarditis most common valve affected

Answer 13

tricuspid valve

Question 14

ACEi SE

Answer 14

HyperKAL, dry cough

Question 15

Normal ECG variants in athletes

Answer 15

sinus brady
junctional rhythm
first degree HB
second degree mobitz 1 (wenckebach)

Question 16

hyperkalaemia ECG

Answer 16

tall tented T waves
broad QRS
small P waves

Question 17

hypokalaemia ECG

Answer 17

small/ inverted T waves
U waves (after T wave)
prolonged PR

Question 18

hypercalcaemia ECG

Answer 18

reduced QT

Question 19

hypocalcaemia ECG

Answer 19

prolonged QT

Question 20

digoxin toxicity ECG

Answer 20

ST depression
T wave inversion V5-6

Question 21

Systolic murmurs

Answer 21

ejection - AS
pansystolic - mitral/ tricuspid regurg
late - mitral prolapse

Question 22

Diastolic murmurs

Answer 22

early - aortic regurg
mid/ late - mitral stenosis

Question 23

Stable angina first line Mx (3)

Answer 23

B block
CCB
Gtn