cardiology

Question 1

antiplatelet tx

Acute coronary syndrome (medically treated)

Percutaneous coronary intervention

Answer 1

1st line Aspirin (lifelong) & ticagrelor (12 months)
2nd line- If aspirin contraindicated, clopidogrel (lifelong)

1st Aspirin (lifelong) & prasurgrel or ticagrelor (12 months)

2nd - if aspirin contraindicated, clopidogrel (lifelong)

Question 2

hypokalaemia ?
wave sign ecg?

Answer 2

u wave (after t wave)
small t wave
prolonged pr and QT

Question 3

DC cardioverted AF
? how long to anticoagulate after

Answer 3

anticoagulation should be continued even if sinus rhythm is maintained

Question 4

Complete heart block following a MI?

Answer 4

• right coronary artery lesion
• as it supplies the atrioventricular node in the majority

Question 5

AF over 48 hours in young and fit patient ?

Answer 5

• bisoprolol
• 3 weeks anticoagulate
• arrange DC cardiovert
• 4 weeks post anticoag

(if under 48 hours can cardiovert on day)

Question 6

alert + regular narrow QRS tachyarrhytmia tx?

irregular

Answer 6

adenosine
6mg
12mg
18mg then verapamil or bisoprolol

irregular rate controlb blocker

Question 7

alert + tachyarrythmia
regular broad qrs
irregular broad qrs

Answer 7

regular
- amiodarone 300mg

irregular
- eg polymoprhic magnesium sulphate

Question 8

STEMI + PCI can be given in under 120 minutes?

not within 120 mins?

Answer 8

aspirin 300
praugrel
unfractionated heparin + abciximab - bailout glycprotein

fibrinolysis eg streoptokinase or alteplase
ticagrelor after

Question 9

nstemi treatment

Answer 9

• aspirin
• fondaprinux if no immediate pci planned then
• 6 month mortality over 3% then PCI
  ticagrelor and heparin
• if under 3% no PCI - give ticagrelor

Question 10

reduced ejection fraction HF

tx

Answer 10

(normal >55%).

ACE inhibitor /ARB and a beta-blocker
+ if still bad add spironolactone

Question 11

A pansystolic murmur

An ejection systolic murmur is

A continuous ‘machinery’ murmur

A late diastolic murmur

Answer 11

with mitral regurgitation.

with aortic stenosis.

a patent ductus arteriosus.

with mitral stenosis.

Question 12

aortic regurg murmur
signs

Answer 12

early diastolic murmur
collapsing pulse
wide pulse pressure
Quincke’s sign (nailbed pulsation)
De Musset’s sign (head bobbing)

Question 13

bradyarrhytmia tx

Answer 13

1) atropine 500mcg X 6 times (3mg)
2) transcutaenous pacing
3) trnsvenous pacing

Question 14

abdo aneurysm screening Screening

Answer 14

in the UK, all men aged 65 years are offered a single abdominal ultrasound.

Question 15

all patients with peripheral arterial disease should take

Answer 15

clopidogrel and atorvastatin