Cardiology

Question 1

Aside from surgical intervention, what management may be used in a STEMI?

Answer 1

Thrombolysis

Question 2

Other than troponin, name cardiac enzymes that are raised in MI

Answer 2

LDH, CK, CK-MB

Question 3

What is seen on ECG a week after MI?

Answer 3

Pathological Q waves, inverted T waves

Question 4

How long is a patient not allowed to drive for after an MI?

Answer 4

4 weeks

Question 5

Complications of coronary angiography

Answer 5

Infection, bleeding, stroke, death, MI, allergy, damage to coronary vessels

Question 6

Exercise and emotions aside, name triggers for angina

Answer 6

Cold weather, lying down, vivid dreams

Question 7

What bloods should you order in angina?

Answer 7

TFTs, Lipids, glucose, U&Es (ACE i), FBCs (anaemia)

Question 8

How does aspirin help in angina?

Answer 8

Inhibits COX, stopping thromboxine production, stopping platelet aggregation

Question 9

Signs of pulmonary oedema on examination

Answer 9

Tachypnoea, tachycardia, raised JVP, fine end-inspiratory crepitations, wheeze, cyanosis, dull percussion

Question 10

Drug that orally raised K+ levels

Answer 10

Sando-K

Question 11

How many seconds is a normal QRS complex?

Answer 11

< 0.12 s (3 squares)

Question 12

What is a capture beat>

Answer 12

Normal QRS complex between VT complexes

Question 13

Which type of arrhythmia is a capture beat seen in?

Answer 13

Ventricular tachycardia

Question 14

Is VT a shockable rhythm?

Answer 14

Yes

Question 15

Oxygen and adrenaline aside, what other drugs may be used in cardiac arrest?

Answer 15

Lidocaine, amiodarone

Question 16

How and where does furosemide act?

Answer 16

Ascending loop of Henle - competitively inhibits the Na-K-Cl 2 transporters

Question 17

What electrolyte disturbance can be caused by ACE inhibitors?

Answer 17

Hyperkalaemia

Question 18

What can be seen on an ophthalmoscope in hypertensive retinopathy?

Answer 18

Cotton wool spots, flame haemorrhages, papiloedoema

Question 19

Signs of hypercholesterolaemia on examination

Answer 19

Xanthelasmata, corneal arcus, tendon xanthoma

Question 20

Causes of AF

Answer 20

Endocarditis, MI, PE, hyperthyroidism, alcohol excess, pneumonia, HF

Question 21

What is seen on ECG in AF?

Answer 21

Irregular QRS complexes, absent P waves

Question 22

What drugs are used in medical cardioversion in AF?

Answer 22

Amiodarone, flecanide

Question 23

What is the acute management of an endocarditis patient?

Answer 23

ABCDE assessment, correct abnormalities

Question 24

Most common cause of infective endocarditis in non-IVDU

Answer 24

Viridans streptococcus

Question 25

Why do we do a urine dip in IE?

Answer 25

To look for microscopic haematuria

Question 26

Long-term drugs used in AF

Answer 26

Beta blocker, CCB, digoxin, warfarin

Question 27

What is seen on ophthalmoscope in IE?

Answer 27

Roth spots

Question 28

What criteria is used to assess the diagnosis of IE?

Answer 28

Duke criteria

Question 29

Signs of aortic regurgitation

Answer 29

Early diastolic murmur, collapsing pulse, wide pulse pressure, displaced apex beat, Austin Flint murmur, head nodding

Question 30

Which valve disease typically causes endocarditis in IVDU?

Answer 30

Tricuspid regurgitation

Question 31

What is the typical causative organism of IE in IVDU

Answer 31

Staphylococcus aureus

Question 32

Investigations in IE

Answer 32

CXR, ECG, urine dip, echocardiogram

Question 33

Causes of endocarditis

Answer 33

IVDU, prosthetic valves, VSD, PDA, mitral / aortic valve disease, coarctation

Question 34

How do we prevent endocarditis in IVDU

Answer 34

Prophylactic antibiotics before invasive procedures

Question 35

Symptoms of angina

Answer 35

Central constricting chest pain, SOB, faint/light-headed