cardiology

Question 1

what are the 4 main causes of cardiac tamponade

Question 2

ECG features of hypokalaemia

Answer 2

small or absent T waves (occasionally inversion)
prolong PR interval
ST depression
long QT

Question 3

when is nitrates contraindicated

Answer 3

severe hypotension- go into shock

Question 4

what is the management for STEMI if PPCI cannot be done within 120 mins (and sx onset <12h)

Answer 4

IV fibrinolysis (IV alteplase)

Question 5

management of Heart failure

Question 5

what is the next step of Mx if in AF chadvasc score is 0 (or 1 in F)

Answer 5

echo to rule out valvular disease (which in combination with AF is an absolute indication for anticoagulation)

Question 5

which artery supplies inferior wall of heart?

Answer 5

RCA

Question 6

what can be given alongside MOAN for acute MI to counteract emetic effects of opiates?

Answer 6

Intravenous Metoclopramide 10mg

Question 7

which artery supplies anterior/ anteriolateral wall of heart?

Answer 7

LAD

Question 8

which artery supplies lateral and posterior wall of heart?

Answer 8

LCA

Question 9

what would be ECG changes in isolated posterior MI?

Answer 9

prominent R in V1 and V2

Question 10

what is the medication is needed when a pt is discharged who had an MI?

Answer 10

1. DUAT: clopidogrel 75mg OD, aspirin 300mg OD (could also be ticagrelor 90 mg bd or prasugrel 10 mg od which are stronger antiplatelets)
2. bisoprolol 10mg OD
3. Ramipril 10mg OD
4. atorvastatin 80mg OD

Question 11

NICE guidelines for secondary prevention of MI

Answer 11

all patients should be offered an ACEi, dual antiplatelet therapy, a beta-blocker and a statin.