Cardiology

Question 1

How might tricuspid regurgitation manifest?

Answer 1

new pan-systolic murmur, large V waves, and features of pulmonary emboli.

Question 2

What is the mechanism of action of Warfarin?

Answer 2

inhibits epoxide reductase which prevents the reduction of vitamin K to its active hydroquinone form
this in turn acts as a cofactor in the carboxylation of clotting factor II, VII, IX and X (mnemonic = 1972) and protein C.

Question 3

Indications of Warfarin?

Answer 3

1. Mechanical Heart valves - Target INR higher in Mitral than aortic
2. 2nd line after DOACs in Afib - target INR 2.5
3. 2nd line after DOACs in VTE - Target INR 2.5, 3.5 if recurrent

Question 4

Most likely congenital heart defect to be found in adulthood

Answer 4

Atrial septal Defect - Ostium secondum

Question 5

ECG seen in ASD with Ostium secondum

Answer 5

RBBB with right axis deviation

Question 6

Murmur seen in Aortic regurgitation?

Answer 6

Early Diastolic murmur

Question 7

Most appropriate cholesterol management for estabilished CVD patients

Answer 7

Atorvastatin 80mg OD in known IHD, Cerebrovascular or Peripheral vascular disease