Cardiology

Question 1

What is 1st degree HB?

Answer 1

Lengthening of PR interval >200ms (5 small sq)

Question 2

Treatment for 1st degree HB?

Answer 2

Does not req treatment

Question 3

Causes of 1st degree HB

Answer 3

Increased fitness
Inferior MI
Electrolyte disturbance
Normal variant

Question 4

Types of 2nd degree HB?

Answer 4

Mobitz 1 (wencheback)
Mobitz 2

Question 5

What is Mobitz 1?

Answer 5

Gradual prolongation of PR interval until QRS is dropped

PR interval is longest before dropped beat and shortest after

Question 6

Causes of mobitz 1 (wenchebach)

Answer 6

Drugs: b-blockers, amiodarone, CCB, digoxin
Increased vagal tone (athletes)
Inferior MI

Question 7

How do we treat mobitz 1 (wenchebach)?

Answer 7

Usually benign - low risk of progress to CHB
In asymptomatic patient no treatment needed
Symptomatic pts tend to respond to atropine

Question 8

What is Mobitz II?

Answer 8

Randomly dropped QRS
No progressive prolongation of PR int
P waves constant

Question 9

Aortic regurg features?

Answer 9

Early diastolic murmur

Loudest in expiration and leaning forward

Question 10

Mitral stenosis features?

Answer 10

Mid systolic murmur

Loudest in expiration and LL position

Question 11

Aortic stenosis sound and radiation??

Answer 11

Ejection systolic

Radiates to carotids

Question 12

Mitral regurg sound and radiation?

Answer 12

Pan-systolic

Radiates to axilla

Question 13

When do we offer anti-hypertensive treatment for HTN?

Answer 13

Persistent stage 2 (160/100). Before this, lifestyle changes

Offer to those with stage 1 with evidence of end-organ damage

Question 14

Adult with HTN and T2D, what HTN med?

Answer 14

ACEi/ARB

add CCB/thiazide

Question 15

<55 white, what HTN med?

Answer 15

ACEi/ARB

add CCB/thiazide

Question 16

> 55 white what HTN med?

Answer 16

CCB

add ACE/ARB/thiazide

Question 17

any age african/caribbean, what HTN med?

Answer 17

CCB

Add ACE/ARB/Thiazide

Question 18

Investigating PE

Answer 18

1) Hx
2) exam
3) CXR
4) Wells score “likely” do a CTPA, “unlikely” do D-dimer
If there is delay with CTPA, begin LMWH

Question 19

Treatment after PE?

Answer 19

Give LMWH
Begin Warfarin with 24h
Continue warfarin for 3m if provoked
Beyond 3m if unprovoked

Question 20

What can a broad complex tachycardia be?

Answer 20

SVT or VT

in periarrest situ, assume it is VT

Question 21

How do we treat VT?

Answer 21

Amiodarone
lidocaine
if there are adverse signs (hypotensive, chest pain, HF, syncope), or these fail:
DC cardioversion