Cardiology and Respiratory

Question 1

Adenosine use?

Answer 1

used to terminate supraventricular tachycardias

Question 2

Adverse effects of adenosine

Answer 2

chest pain, bronchospasm, transient flushing, can enhance conduction down accessory pathways

Question 3

Treatment of COPD

Answer 3

SABA / SAMA

if asthmatic features, then add LABA + ICS if no asthmatic features, LABA + LAMA then SABA PRN, LABA + LAMA + ICS

Question 4

Treatment for acute pericarditis

Answer 4

NSAID (ibuprofen) + colchicine

Question 5

Secondary prevention for MI

Answer 5

6A's:
aspirin 75mg daily
another antiplatelet: clopidogrel
atorvastatin 80mg daily
ACEi 
Atenolol (or another beta blocker)
aldosterone antagonist (for those with heart failure)

Question 6

What should be given to AF patients 2 weeks after stoke?

Answer 6

warfarin or direct antithrombin Xa inhibitor

Question 6

What should be given to AF patients 2 weeks after stoke?

Answer 6

warfarin or direct antithrombin Xa inhibitor

Question 7

Bradycardia managemment?

Answer 7

Atropine 500mcg IV
Atropine up to maximum of 3mg
Transcutaneous pacing
Isoprenaline / adrenaline infusion

Question 8

Wellen’s syndrome?

Answer 8

Previous history of angina, deep T wave inversion or biphasic T waves in V2-3 = critical stenosis of LAD artery

Question 9

Heart failure treatment?

Answer 9

ACEi and beta blocker

Question 10

Acute bronchitis treatment?

Answer 10

Doxycyline

Question 11

Infective exacerbation of COPD antibiotic choice?

Answer 11

amoxicillin, clarithromycin or doxycycline

Question 12

What medications are used for pharmacological cardioversion in new onset AF?

Answer 12

flecainide or amiodarone if no structural heard disease

amiodarone if structural heart disease

Question 13

Management of minor bleeding with INR>8 on warfarin:

Answer 13

Stop warfarin
IV vitamin K 1-3mg
repeat dose after 24 hours if INR still high
restart warfarin when INR <5

Question 14

Management of patient if INR > 8 with no bleeding:

Answer 14

stop warfarin
vitamin K by mouth
repeat if INR too high after 24 hours
restart when INR <5

Question 15

Management of patient if INR 5-8 with no bleeding

Answer 15

withhold 1-2 doses of warfarin

reduce subsequent maintenance dose

Question 15

Management of patient if INR 5-8 with no bleeding

Answer 15

withhold 1-2 doses of warfarin

reduce subsequent maintenance dose