Cardiology and antiplatelets Flashcards

1
Q

Antiplatelet therapy as secondary prevention for angina? 1st and 2nd line

A

1st line: aspirin 75

2nd line: clopi 75

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anti platelet therapy for Secondary prevention in medically managed ACS

A

12 months of DAPT - aspirin + ticagrelor 90mg BD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Secondary prevention for stroke/TIA

A

clopidogrel alone, lifelong

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Secondary prevention for PVD?

A

clopidgorel alone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ticagrelor vs clopidogrel vs prasugrel vs aspirin - list in order of highest to lowest bleeding risk

A

ticagrelor and prasugrel - higher bleeding risk
clopidogrel
aspirin - lowest bleeding risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pt with PMH of AFib (on apixaban) presents with STEMI, suitable for PCI. what drug treatment would you offer?

If this patient wasn’t on apixaban, what drug treatment would you offer?

A

As well as PCI - give aspirin 300mg STAT + clopidogrel (as on a DOAC) - otherwise give prasugrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

In suspected NSTEMI - what scoring system would you use for risk? what score is deemed low vs medium/high risk

A

GRACE
low risk <=3%
medium high risk >3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acute medical therapy in NSTEMI

A

aspirin 300mg STAT + ticagrelor

BUT if on a DOAC already or high bleeding risk:
aspirin 300mg STAT + clopidogrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Secondary prevention following an MI. in a patient who needs anticoagulation for AF, if they had PCI? if they didn’t have PCI?

A

If they had PCI : clopidogrel for up to 12 months

If they didn’t have PCI: aspirin for up to 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Preferred drug treatment to start in a pt who has had an MI and subsequently developed LVF? when would you start this?

A

MRA eg spironolactone

Start 3-14 days post MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

At what BP is stage 2 hypertension based off avg ABPM?

A

150/95

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Indication for ACEi/ARB as 1st line mx of HTN

A

<55yo or T2DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Indication for CCB as 1st line mx of HTN

A

> 55yo + no T2DM or black

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What clinic BP would you consider commencing antihypertensives without doing ambulatory/home BP monitoring?

A

180/120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

2 types of oesophageal spasm?

A

diffuse (uncoordinated contraction) and nutcracker (coordinated but high amplitude)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ECG changes in hyperkalaemia

A

tented T waves
flatted P waves
QRS broadening
ST depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ECG in hypokalaemia

A

U waves
ST depression
flat T waves

18
Q

ECG in hypercalcemia

A

short QT

19
Q

ECG in hypocalcemia

A

prolonged QT

20
Q

Key ECG feature in hypothermia?

A

J wave (notch at the junction btw QRS and ST segment)

21
Q

CHolestyramine MoA

A

bile acid sequestrant

22
Q

at what age should all DM patients be commenced on a statin

A

40yo

23
Q

alternative to statin recommended for dyslipidaemia

A

ezetimibe

24
Q

what ecg changes would make you suspect posterior STEMI?

A

horizontal ST depression in V1-3

25
Q

what valve problem often arised post MI due to papillary muscle rupture?

A

mitral regurgitation

26
Q

management of angina
- after bB and CCBs, what are the 4 other options?

A

ISMN
nicorandil
ivabradine
ranolazine

27
Q

what is the clinic BP in
stage 1, stage 2 and stage 3 hypertension

A

1) 140/90
2)160/100
3) 180/120

28
Q

at what average home BP would you diagnose stage 2 hypertension

A

> 150/95

(stage 1 is >135/85)

29
Q

Mobitz Type I vs type II

A

Type I - she’s getting later and later
pr interval gradually prolongs until QRS is dropped altogether

type II - just doesn’t turn up at all!
p wave followed by no QRS. PR interval length is constant.

30
Q

Renal causes of Hypertension

A
  • Chronic pyelonephritis
  • Glomerulonephritis
  • Diabetic nephropathy
  • Renal artery stenosis
  • PCKD
31
Q

2 complications of PCI via femoral artery? how do they present?

A

femoral pseudoaneurysm - bruit in femoral mass, reduced pulses in distal limb

retroperitoneal bleed - flank pain and bruising

32
Q

ecg changes in HOCM

A

sinus bradycardia
LVH
right or left axis deviation

33
Q

which cholesterol lowering medication is safe in pregnancy

A

none!

34
Q

ECG finding in brugada syndrome

A

cove shaped ST segment elevation and deep T wave inversion in V1-3

35
Q

which vessels correspond with:
ii, III, aVF
aVL, V5, V6
V1, V2

A

Right : ii III aVF
Left anterior descending: V1, V2
Left circumflex: aVL, V5, V6

36
Q

which pt group is acei/arb 1st line for hypertension

A

<55
or T2DM

37
Q

which lipid lowering therapy predisposes to gallstones?

A

cholestyramine

38
Q

aortic dissection - how does presentation of aortic arch vs descending aorta differ

A

aortic arch –> like MI. note if it affects aortic root can cause MI

descending aorta –> scapular pain

39
Q

what is pulsus paradoxus

A

exaggerated decrease of BP on inspiration

causes –> severe COPD, PE, constrictive pericarditis, tamponade, acute asthma

40
Q

what med do you give after thrombolysis for STEMI

A

heparin infusion

41
Q

in pts post MI, with reduced LVEF, what drug should you start?

A

spironolactone (though this should be started after ACEI/ARB has been established)