Cardiology

Question 1

Antibiotics that can cause torsades des pointes?

Answer 1

Macrolides: Clarythromycin

Question 2

Side effects of GTN?

Answer 2

Hypotension, (reflex) tachycardia, headaches.

Question 3

First-line treatment for regular broad complex tachycardias without adverse features:

Answer 3

IV amiodarone

Question 4

2 meds for orthostatic hypotension:

Answer 4

Fludrocortisone and midodrine

Question 5

Early diastolic murmur, 2nd right intercostal space, wide pulse pressure, head bobbing, collapsing pulse, hyperdinamic apex:

Answer 5

Aortic regurgitation

Question 6

Management for heart failure on patient with optimal medical therapy, low EF and wide WRS > 120 ms:

Answer 6

Cardiac resynchronisation therapy

Question 7

Monitoring of patients taking amiodarone prior to and every 6 months:

Answer 7

Prior to: TFT, LFT, U&E, CXR (pulmonary fibrosis, pneumonitis).
6 months: TFT, LFT

Question 8

Treatment for aortic stenosis in a fit >65 years old?

Answer 8

Bioprosthetic valve replacement, does not need long-term anticoagulation, better hemodynamic properties and lower risk of thromboembolic complication.

Question 9

Treatment for aortic stenosis in a fit young person?

Answer 9

Mechanical valve replacement, lasts longer but requires long-term anticoagulation

Question 10

2 beta-blockers that reduce mortality in heart failure?

Answer 10

Bisoprolol and carvedilol

Question 11

First and second-line meds for heart failure with reduced EF?

Answer 11

ACEIs + BB.
2nd: aldosterone antagonist: spironolactone or eplerenone

Question 12

Thiazide diuretics electrolyte side effects:

Answer 12

hyponatraemia and hypokalaemia

Question 13

Statins contraindications:

Answer 13

Macrolides, pregnancy

Question 14

Treatment for chronic heart failure + atrial fibrillation:

Answer 14

Digoxin

Question 15

Stable AF treatment if <48 h:

Answer 15

Rate or rhytm control

Question 16

Stable AF treatment if >48 h:

Answer 16

First rate control, then anticoagulate for 3 weeks, then electrical cardioversion, then anticoagulation for 4 weeks at least.

Question 17

ACS anti-platelet therapy:

Answer 17

Aspirin + ticagrelor/prasugrel. Stop 2nd anti-platelet after 12 months.

Question 18

Strong suspicion of PE but a delay in the scan:

Answer 18

Treatment dose DOACs

Question 19

Acute pulmonary oedema and hypotension after postero-inferior MI, early-mid-pan systolic murmur?

Answer 19

Acute mitral regurgitation

Question 20

Infective endocarditis in intravenous drug users most commonly affects which valve?

Answer 20

Tricuspid

Question 21

First-line for reducing stroke risk?

Answer 21

DOACs

Question 22

Most common cause of death following a MI

Answer 22

Cardiac arrest due to VF

Question 23

When to stop ACEIs regarding renal function?

Answer 23

Cr increase 30% or eGFR decrease 25%

Question 24

Drug contraindicated in VT, HF and with BB:

Answer 24

Verapamil, can cause cardiac arrest

Question 25

MI secondary prevention:

Answer 25

TABAS: Ticagrelor, ACEI, BB, Aspirin, Statins

Question 26

Drugs that have shown to reduce mortality in patients with left ventricular failure:

Answer 26

ACEIs/ARBs, BBs, Aldosterone antagonists, hydralazine and nitrates

Question 27

Persistent ST elevation, with tiredness and breathlessness after MI:

Answer 27

Left ventricular aneurysm

Question 28

Diastolic murmur loudest over the apex, may cause AF:

Answer 28

Mitral stenosis

Question 29

Bradycardia/heart block after MI, area of myocardium and branch most likely to be affected?

Answer 29

Inferior, right coronary (supplies AV node)

Question 30

Antibiotic to avoid in long QT syndrome?

Answer 30

Erythromycin

Question 31

First-line anti-anginal for stable angina

Answer 31

BB or CCB (verapamil or diltiazem as monotherapy, amlodipine or nifedipine with BBs)

Question 32

ECG features of LBBB:

Answer 32

Downward QRS in V1. LBBB is always pathological, when there are symptoms of MI it may be anterior MI

Question 33

Features of venous ulcer and treatment:

Answer 33

Superior to medial malleolus and hyperpigmentation, compression bandaging

Question 34

When to offer anti hipertensive drugs for diabetic patients?

Answer 34

Clinic blood pressure over 140/90mmHg, or an average home reading over 135/85mmHg

Question 35

Tx for peripheral arterial disease:

Answer 35

Clopidogrel and atorvastatin

Question 36

Anti-hypertensive med that can cause angioedema?

Answer 36

ACEIs

Question 37

Early diastolic murmur loudest when leaning forward or on expiration, signs like pulsating nailbed and carotid pulsation and hyperdinamic apex:

Answer 37

Aortic regurgitation