CARDIOLOGY

Question 1

What are the important points of a cardiac review?

Answer 1

Condition
Last seen
Associated factors: Diabetes, HTN, cholesterol, lifestyle (smoking, obesity, alcohol)
Medication
Plan

Question 2

What investigations point towards ACS cause?

Answer 2

STEMI: Elevated ST and troponins
NSTEMI: ST depression + trops
Unstable Angina: No changes

Question 3

How do you manage MI symptoms acutely

Answer 3

Morphine 10mg IV, repeat after 5 mins
Oxygen
Nitrates 800mcg SL every 5 mins
Aspirin 300mg

Question 4

What constitues definitive MI management?

Answer 4

STEMI…
PCI < 120 mins < Thrombolyse (eg alteplase)

NSTEMI
+ antiplatelet (ticagrelor 180mg OR 300mg clopidogrel)
+ fondapirinux sodium 2.5mg
+ PCI if high GRACE risk within 24 hrs

Question 5

What constitutes secondary prevention of MI

Answer 5

Aspirin 75mg
Anticoag (fondapirinux 2.5mg)
Beta blocker (propranolol 40mg QDS then 80mg BD)

Question 6

How is stable angina managed?

Answer 6

MI prevention: Aspirin 75mg OD + atorvostatin 20mg
Cardiac control:
rate-limiting CCB (verapamil/diltiazem) OR B-blocker
Nifedipine AND Beta blocker

Question 7

How to investigate for heart failure

Answer 7

NT-pro-BNP
TT echo

Question 8

How do you manage acute heart failure?

Answer 8

POUR SOD
POUR away fluids (restrict)
Sit up
Oxygen
Diuretics (40mg furosemide IV)

Question 9

How do you manage chronic heart failure

Answer 9

Bisoprolol 1.25mg + lisinopril 2.5mg
spironolactone