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PassMedicine > Cardiology > Flashcards

Cardiology Flashcards

1
Q

First line management of acute pericarditis?

A

NSAID and colchicine

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2
Q

Most appropriate drug for rate control in AF?

A

Beta blockers e.g. bisoprolol
(Asthma is a contra-indication for beta blockers)

Digoxin if patient has co-existent heart failure

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3
Q

What electrolyte imbalances are important causes of ventricular tachycardia?

A
  • Hypokalaemia

- Hypo-magnesiumaemia

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4
Q

What is the next step when treating someone with SVT after vagal manouvres?

A

Adenosine

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5
Q

What is used to treat Torsades de pointes?

A

IV magnesium sulfate

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6
Q

What medication can be given to patients who require anticoagulation but do not want regular monitoring?

A

DOACs eg. rivaroxaban

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7
Q

How to treat a haemodynamically unstable patient with atrial fibrillation?

A

Immediate electrical cardioversion followed by thromboprophylaxis

(If he was clinically stable and had AF >48 hours then risk of stroke means thromboprophylaxis followed by cardioversion)

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8
Q

Treatment for patients with tachycardia along with signs of shock, myocardial ischaemia or heart failure?

A

Up to three synchronised DC shocks

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9
Q

What are the NICE guideline recommendations for patients with acute phase of an ischaemic stroke with underlying AF?

A

Aspirin 300mg OD for 2 weeks

Then consideration of anticoagulants (warfarin or DOAC) for further stroke prevention) - in the absence of haemorrhagic stroke

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10
Q

Which anti-platelet medications should be given after a stroke?

A

Aspirin 300mg OD for 2 weeks then 75mg clopidogrel OD for life

(Unless patient has indication for anticoagulant e.g. AF)

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11
Q

Initial drug therapy for Afro-Carribean with hypertension?

A

Calcium channel blocker e.g. amlodipine

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12
Q

What is the half-life of adenosine?

A

8-10 seconds

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13
Q

Which antibiotic interacts with warfarin to give a raised INR?

A

Clarithromycin

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14
Q

What investigation is most helpful in diagnosing infective endocarditis?

A

Blood cultures

Set of three cultures

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15
Q

According to NICE guidelines, which medications should a patient be put on following a STEMI?

A
  • Beta blocker
  • ACE inhibitor
  • Dual anti-platelet therapy
  • Statin
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16
Q

What is the next step in management in a STEMI patient who has undergone fibrinolysis with persistent ischaemia?

A

Transfer for PCI

17
Q

Best initial management for a 50-year-old caucasian man with hypertension?

A

Ramipril (ACE inhibitor)

18
Q

What is the main ECG abnormality seen with hypercalcemia?

A

Shortening of the QT interval

19
Q

What is the treatment for sinus bradycardia with adverse features?

A

500mg IV atropine

20
Q

What is the next management step in a patient with suspected PE (due to sore, red calf, post-surgical)? CTPA is negative

A

Proximal leg vein ultrasound

21
Q

What drug do macrolide antibiotics (clarithromycin) interact with?

A

Statins

22
Q

What chemical biomarker is the best for detecting re-infarction?

A

CK-MB

  • Remains elevated for 3-4 days following an MI
  • Troponin may be elevated for 10 days
23
Q

What are the features of Dressler’s syndrome?

A

Dressler’s syndrome = autoimmune reaction to proteins formed in healing post-MI

  • Central, pleuritic chest pain that is worse when lying flat (recurrent pericarditis) and fever
  • Raised ESR
  • Recurrent pleural effusions
  • Treatment with NSAIDs
24
Q

Features of left ventricular free wall rupture following an MI?

A
  • Sudden heart failure
  • Raised JVP
  • Muffled/quiet heart sounds

Free wall rupture due to weakening following MI = tamponade = triad of raised JVP, pulses paradoxus, muffled/quiet heart sounds

25
Q

What class of drugs can be responsible for deterioration in bone health?

A

Loop diuretics e.g. furosemide

- Hypocalcemia is a side effect

26
Q

What electrolyte disturbance is caused by ACE inhibitors?

A

Hyperkalaemia

27
Q

What electrolyte disturbance may be caused by thiazide diuretics?

A

Hypercalcemia

28
Q

Management of STEMI patient if PCI centre is 3 hours away by ambulance?

A

Urgent fibrinolysis

Fibrinolysis should be offered within 12 hours of onset if PCI cannot be delivered within 120 minutes

29
Q

What is the most common cause of mitral stenosis?

A

Rheumatic fever

30
Q

What is the initial management of pulmonary embolism?

A

DOAC

Rivaroxaban

31
Q

What are the anti-platelet choices for NSTEMI?

A
  • Aspirin plus
  • Ticagrelor (if low bleeding risk)
  • Clopidogrel (if high bleeding risk)
32
Q

What complication of an MI is seen in patients who develop acute heart failure with a pan-systolic murmur?

A

Ventricular septal defect

33
Q

In which situations may nitrates be contra-indicated?

A

Hypotension (<90mmHg)

34
Q

Changes in which leads on ECG indicate ischaemic changes in the left circumflex artery?

A

I, aVL, V5-6

35
Q

What is the investigation for stable angina of suspected coronary artery disease aetiology after ECG?

A

Contrast enhanced CT angiography

36
Q

Most common ECG change with pulmonary embolism (PE)?

A

Sinus tachycardia

37
Q

How long before surgery should warfarin be stopped?

A

5 days before surgery

Aim for INR to be <1.5

38
Q

What effect would warfarin have on PT and APTT?

A

Prolonged PT

Normal APTT

PassMedicine (10 decks)

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