cardiology

Question 1

give some examples of direct oral anticoagulants

Answer 1

apixiban
dabigatran
rivaroxaban
inhibit thrombin and Xa

Question 2

what are DOACs used for?

Answer 2

direct oral anticoagulants used for extended thromboprophylaxis and treating AF and DVT, contraindicated in pregnancy.

Question 3

what can cause right to left shunt?

Answer 3

truncus arteriosus
transposition of great vessels
tricsupid atresia
tetralogy of Fallot

Question 4

what is Mobitz type 1?

Answer 4

2nd degree heart block where progressive lenthening of PR interval until a beat is dropped. Due to inferior MI, AVN damage

Question 5

what is Mobitz type 2?

Answer 5

second degree heart block where pr interval is constant and it’s the QRS complex that’s dropped, failure of conduction through His Purkinje, due to anterior MI.

Question 6

what is the difference between AF and atrial flutter

Answer 6

AF is disorganised firing irregularly irregular, with flutter there’s a re-entrant loop in the right atrium, it’s irregular

Question 7

list the risk factors of IHD

Answer 7

hypertension
lack of physical exercise
low fruit and veg intake
abdominal obesity
smoking
male
stress
alcohol consumption
ApoB/ApoI index

Question 8

what are the 3 main symptoms of heart failure?

Answer 8

breathlessness
fluid retention-oedema
fatigue

Question 9

what would you give to a black man or over 55 year old with hypertension?

Answer 9

calcium channel blocker, otherwise ACEi

Question 10

give some signs of peripheral vascular disease

Answer 10

absent pulses
atrophic skin
punched out ulcers
prolonged capillary refill

Question 11

give some causes of hypertension

Answer 11

renal artery stenosis
Cushing’s
Conn’s
phaechromocytoma, of the adrenal medulla

Question 12

give some ECG features of pericarditis

Answer 12

widespread saddle shaped ST elevation

PR depression

Question 13

what are the ECG features of LV hypertrophy

Answer 13

increased R waves in the left side leads I V4-6, aVL

Question 14

what bacteria commonly cause IE?

Answer 14

Strep viridans

Strep pneumoniae

Question 15

give some causes of bradycardia

Answer 15

raised ICP
drugs Beta blockers, digoxin
cholestatic jaundice
hypothyroidism
acute ischaemia of SAN

Question 16

what causes first degree heart block?

Answer 16

myocarditis

hypokalaemia

Question 17

what are the features of WPW?

Answer 17

shortened PR interval
delta wave
narrow QRS

Question 18

give some causes of AF

Answer 18

hypertension
hyperthyroidism
coronary artery disease

Question 19

what drug is given to manage AVNRT or AVRT?

Answer 19

iv adenosine

Question 20

what is the difference between first and second degree heart block?

Answer 20

in first degree, every p wave is also with a QRS complex, but in second degree, some QRS are lost

Question 21

what is Wolff Parkinson White syndrome?

Answer 21

congenital AVNRT

Question 22

how does hypertension lead to heart failure?

Answer 22

increased venous return leads to increased diastolic volume leads to increased preload

Question 23

what might a patient be offered if they have a high pre-test probability?

Answer 23

invasive angiography

Question 24

give some examples of GPII/IIIa inhibitors

Answer 24

tirofiban, abciximab, eptifibatide

Question 25

what are the 5 ps?

Answer 25

``` the symptoms of acute limb ischaemia pain pallor parasthesia paralysis perishingly cold ```

Question 26

what is the Fontaine classification

Answer 26

``` severity of peripheral arterial disease I asymptomatic II intermittent claudication III nocturnal or rest pain IV necrosis/gangrene ```

Question 27

what is ABPI

Answer 27

ankle brachial pressure index

Question 28

define shock

Answer 28

when the cardiovascular system cannot supply adequate substrate for aerobic respiration to occur

Question 29

what is tetralogy of Fallot?

Answer 29

VSD pulmonary stenosis right ventricular hypertrophy overriding aorta

Question 30

what kind of atrial septal defect is associated with AV valve defects?

Answer 30

ostium priumum

Question 31

give an example of a condition that causes right axis deviation

Answer 31

atrial septal defect

Question 32

which structural heart defect may follow an MI?

Answer 32

ventricular septal

Question 33

what is the treatment for tetralogy of Fallot?

Answer 33

If having a hypoxic spell then knee chest position, O2, morphine then long term beta blockers

Question 34

what is ventricular aneurysm?

Answer 34

where the wall of the ventricle bulges due to cell death from myocardial infarction

Question 35

what does heparin do?

Answer 35

activates antithrombin so less thrombin and factor Xa

Question 36

where is most sodium reabsorbed

Answer 36

proximal convoluted tubule

Question 37

where to thiazides work?

Answer 37

distal convoluted tubule bendroflumethiazide

Question 38

examples of loop diuretics

Answer 38

furosemide | bumetanide

Question 39

example of thiazide

Answer 39

bendroflumethiazide

Question 40

side effect of loop diuretic

Answer 40

AKI, gout, hypokalaemia

Question 41

side effect thiazide

Answer 41

hypokalaemia, alkalosis

Question 42

spironolactone side effect

Answer 42

hyperkalaemia, loss of libido

Question 43

how is preload reduced

Answer 43

vasodilation

Question 44

how is after load reduced

Answer 44

arteriodilation

Question 45

calcium channel blocker used for antihypertension

Answer 45

amlodipine

Question 46

inferior ECG leads

Answer 46

II III aVF

Question 47

anterior ECG leads

Answer 47

V2-V4

Question 48

what is the name of the PTH similar hormone?

Answer 48

parathyroid related protein

Question 49

what can be offered for angina in someone who cannot tolerate calcium channel blockers?

Answer 49

nicorandil (a potassium channel activator)

Question 50

what can be offered for angina in someone who cannot tolerate beta blockers?

Answer 50

ivabradine

Question 51

what drugs should be offered following an MI

Answer 51

``` ACEi anticoagulants (aspirin/NOAC) antiplatelets (clopi/tica/praus) beta blocker statin CCB ```

Question 52

in physiology where is hydrostatic pressure>(colloid osmotic and interstitial pressure)

Answer 52

across the arteries

Question 53

causes of non pitting oedema

Answer 53

``` thyroid disease (if widespread hypo) radiation surgery tumour filaria ```