Cardiovascular

Question 1

What are the medications for the management of dyslipidaemia

Answer 1

1. High-potency statin
2. Add ezetimibe to reduce LDL
3. Add fenofibrate to reduce triglyceride

Question 2

What statins are recommended for managing dyslipidaemia

Answer 2

Atorvastatin
Rosuvastatin
Simvastatin

Question 3

What statin should be taken at night

Answer 3

Simvastatin

Question 4

List some non-pharmacological management of dyslipidaemia

Answer 4

Smoking
Nutrition
Alcohol
Physical exercise
Weight

Question 5

What is defined as hypertensive

Answer 5

> 140/90mmHg

Question 6

What are some medications that may increase BP

Answer 6

NSAIDs
Stimulants
Corticosteroids

Question 7

What are first-line treatment for HTN

Answer 7

ACEi
“prils”
ramipril, perindopril
ARBs
“sartans”
candesartan, irbesartan, olmesartan
Calcium channel blockers
“pine”
amlodipine, felodipine
Thiazide diuretic for >65yrs old
hydrochlorothiazide, indapamide

Question 8

What are other options to treat HTN

Answer 8

Beta blockers
“olol”
atenolol, bisoprolol
Non-dihydropyridine CCB
diltiazem, veramipil
Alpha agonists/ blockers

Question 9

What medications can be used to prevent angina

Answer 9

Beta blocker or non-dihydropyridine CCB as monotherapy
Dihydropyridine as monotherapy
Dihydropyridine with beta blocker

Question 10

Secondary medications for prevention of angina

Answer 10

Long-acting nitrate
Nicorandil
Short-acting nitrate

Question 11

What medication/s can be used to treat episodes of angina

Answer 11

Short-acting nitrate

Question 12

Initial clinical management of a STEMI/NSTEMI

Answer 12

Aspirin 300mg + GTN spray
IV GTN if indicated plus IV morphine or IV fentanyl for ongoing chest discomfort
Oxygen therapy for patients with oxygen saturation <93%
Beta blockers

Question 13

STEMI management with PCI

Answer 13

Dual antiplatelet therapy
-aspirin with clopidogrel or ticagrelor
Parenteral anticoagulant
-enoxaparin

Question 14

STEMI management with fibrinolytic therapy

Answer 14

Give tenecteplase, alteplase or reteplase
Add DAPT
Add parenteral anticoagulant

Question 15

How do you manage non-ST elevation acute coronary syndrome (NSTEACS)

Answer 15

PCI (preferred) or CABG
DAPT and parenteral anticoagulant with PCI
Fibrinolytic not recommended

Question 16

What can you give patients with post ACS

Answer 16

DAPT - aspirin with clopidogrel for at least 12months
-150mg aspirin indefinitely
Statin
Beta blockers
ACEi/ARBs

Question 17

What is HFrEF

Answer 17

Heart failure with reduced ejection fraction

Question 18

What is HFpEF

Answer 18

Heart failure with preserved ejection fraction

Question 19

How do you manage HFpEF

Answer 19

Diuretic - loop diuretic
Low dose spironolactone

Question 20

How do you manage HFrEF

Answer 20

ACEi/ARB
Add MRA - low dose spironolactone or eplerenone
Add beta blocker if euvolemic
Up titrate to maximum dose tolerated

Change ACEi/ARB to ARNI if LVEF <40%

Question 21

What beta blockers are recommended for HFrEF patients

Answer 21

Bisoprolol
Carvedilol
Metoprolol

Question 22

How do you manage acute rate control for AF

Answer 22

Pharmacological cardioversion
If co-morbidities present, use
Flecainide OR amiodarone

If co-morbidities not present, use
Beta blocker - Metoprolol SR, bisoprolol or carvedilol
Non-dihydropyridine CCB - verapamil or diltiazem

Question 23

How to manage long-term rate control for AF

Answer 23

No co-mobidities
Beta blockers - MBC
Non-DHP CCB
add digoxin or amiodarone if indicated

Co-morbidity present
Beta blockers - MBC
add digoxin or amiodarone if indicated

Question 24

How would you manage rhythm long-term in AF

Answer 24

No co-morbidities
Flecainide or Sotalol
Amiodarone

Co-morbidities
Amiodarone
Add sotalol or BB - MBC

Question 25

What are clinical symptoms of a stroke

Answer 25

Face - dropped Arms - can they lift both arms Speech - slurred? Time

Question 26

How would you manage an ischaemic stroke?

Answer 26

Reperfusion therapy - altepase or tenecteplase if it is within 4.5hrs - add rtPA agent if thrombectomy is indicated Acute antiplatelet therapy - wait 24hrs if the patient is undertaking reperfusion therapy

Question 27

How would you manage a mild ischaemic stroke or high risk TIA?

Answer 27

Acute antiplatelet therapy if they are NOT receiving reperfusion therapy -they should already be on DAPT

Question 28

What medications should a post CVA patient be on

Answer 28

Anti-platelet therapy - lifelong aspirin 100-150mg -clopidogrel 75mg - aspirin with dypyridamole SR 25/200mg If high BP add long term dual therapy - ACEi/diuretic If lipid is high high potency statin

Question 29

What medications can you give a patient with VTE

Answer 29

DOACs or warfarin

Question 30

What medication can you give a patient with DVT or PE

Answer 30

Apixaban or rivaroxaban for 3months if distal DVT 6-12weeks