Cardiology

Question 1

Which drug (inc. its dose) is given to patients with Q-risk score>10% for primary prevention?

Answer 1

Atorvastatin 20mg

Question 2

Which drug (inc. its dose) is given to patients with known cardiac history for secondary prevention?

Answer 2

Atorvastatin 80mg

Question 3

What is the name given to this abnormally large drop in blood pressure during inspiration?

Answer 3

pulsus paradoxus

Question 4

best diagnostic test for cardiac tamponade

Answer 4

ECHO

Question 5

What is Kussmaul’s sign?

Answer 5

typical of constrictive pericarditis, and is a raised JVP with inspiration

Question 6

Radio-femoral delay occurs in…

Answer 6

Coarctation of aorta

Question 7

raised JVP, muffled heart sounds and pulsus paradoxus is seen in

Answer 7

cardiac tamponade

Question 8

which criteria is used to diagnose infective endocarditis

Answer 8

Duke criteria

Question 9

which pathogen was historically the most common cause of infective endocarditis?

Answer 9

Streptococcus viridans

Question 10

which pathogen is the most common cause of infective endocarditis?

Answer 10

Staph aureus

Question 11

which pathogen is the most common cause of infective endocarditis in pts with prosthetic valves ?

Answer 11

Staphylococcus epidermidis

Question 12

Duke major criteria (at least 2) - 3 things

Answer 12

three or more blood cultures confirming pathogen
positive echocardiogram
new valvular regurgitation

Question 13

Duke minor criteria - 5 things

Answer 13

predisposing heart condition or IVDU
microbiological evidence does not meet major criteria
fever > 38ºC
vascular phenomena: major emboli, splenomegaly, clubbing, splinter haemorrhages, Janeway lesions, petechiae or purpura
immunological phenomena: glomerulonephritis, Osler’s nodes, Roth spots

Question 14

how is type 2 diabetic’s treatment managed in hospital after an ACS event?

Answer 14

Stop their tablets and start IV insulin infusion for tight glycaemic control with blood glucose levels <11 mmol/l

Question 15

what is the gold standard treatment for STEMI?

Answer 15

primary percutaneous coronary intervention (PCI)

Question 16

initial management of ventricular tachycardia in an unstable pt

Answer 16

synchronised cardioversion

Question 17

management of regular broad-complex tachycardia

Answer 17

assume VT

loading dose of amiodarone followed by 24 hour infusion

Question 18

management of polymorphic VT (Torsade de pointes)

Answer 18

IV magnesium

Question 19

management of regular narrow-complex tachycardia

Answer 19

vagal manoeuvres followed by IV adenosine

if above unsuccessful consider diagnosis of atrial flutter and control rate (e.g. Beta-blockers)