Cardiovascular

Question 1

Name the common features of Marfans?

Answer 1

Mitral Valve Prolapse/Stenosis
Aortic Dissection/Aneurysm
Retinal Detachment
Fibriollogen 1 Gene Mutation
Arm Span
Near Sighted
Scoliosis/Sublux Lens
Pectus Excavatum

Question 2

Ventricular Septal Defect what kind of shunt is common? and will any cyanosis occur?

Answer 2

Left to Right Shunt
No Cyanosis

Question 2

Ventricular Septal Defect what type of murmur will be heard?

Answer 2

Pansystolic ejection murmur

Question 3

What happens if a Right to Left shunt occurs in Ventricular Septal Defect?

Answer 3

Cyanosis and Eisenmenger Syndrome21

Question 4

What three conditions does Acute Coronary Syndrome include?

Answer 4

STEMI
NSTEMI
Unstable Angina

Question 5

Name three unmodifiable risk factors for Acute Coronary Syndrome?

Answer 5

• Age
  
  • Male
    Family History

Question 6

Name 5 modifiable risk factors for Acute Coronary Syndrome

Answer 6

• Smoking
  
  • Diabetes
  • Hypertension
  • Hypercholesterolaemia
    Obesity

Question 7

If there are changes in V1-V4 on an ECG which part of the heart is affected?

Answer 7

Anterior - Left Ant Descending

Question 8

If there are changes in II, III and AVF on eCG which part of heart is affected?

Answer 8

Inferior- Right Coronary

Question 9

If there changes in I, V5-6 on ecg which part of heart is affected?

Answer 9

Lateral - Left Circumflex

Question 10

What happens to Troponins in Unstable Angina?

Answer 10

No Cell Death = No Rise in Troponin

Question 11

Aspirin is a potent inhibitor of what?

Answer 11

Platelet thromboxane A2 Production

Question 12

How to treat ACS initially?

Answer 12

Morphine
Oxygen if Sats <94%
Nitrates
Aspirin

Question 13

How to treat a STEMI? (3)

Answer 13

PCI <2 Hours
Aspirin and Clopidogrel or Prasugrel or Ticagrelor
Fibrinolysis

Question 14

PCI for a STEMI has to be carried out within what time?

Answer 14

12 Hours

Question 15

How to risk stratify for a NSTEMI?

Answer 15

Grace

Question 16

What medication can be used for NSTEMI?

Answer 16

Fondaparinux (Antithrombin) 2.5mg

Question 17

What antiplatelet should be used as secondary prevention for ACS? High Risk of Bleed

Answer 17

Clopidogrel

Question 18

What antiplatelet should be used as secondary prevention for ACS? Low Risk of Bleed

Answer 18

Ticagrelor

Question 19

How to work out prognosis for ACS?

Answer 19

Killip Class

Question 20

What medication used for NSTEMI is selective inhibitor of Factor XA?

Answer 20

Fondaparinux

Question 21

Alternative for STEMI when can’t get to cath lab within 2 hours?

Answer 21

Thrombolysis with Tenecteplase up to 12 hours

Question 22

When can thrombolysis as an alternative for stemi treatment be used up to?

Answer 22

12 hours post symptom development

Question 23

Name common risks of thrombolysis? (2)

Answer 23

Bleeding
Do not give if recent stroke/previous intracranial bleed
Severe Hypertension

Question 24

What medication can be used in ACS as an alternative to Beta Blockers?

Answer 24

Calcium Channel Blockers

Question 25

Name a common complication of ACS?

Answer 25

Dresslers Syndrome

Question 26

How to diagnose and treat Dresslers?

Answer 26

Check ESR 1-3 Weeks Post and Treat with NSAIDS

Question 27

Name the common symptoms of Acute Limb Ischemia? (6)

Answer 27

6 P’s
- Pale
- Pulseless
- Painful
- Paralysed
- Paraesthetic
- Perishing with Cold

Question 28

How to diagnose Acute Limb Ischemia (2)

Answer 28

Doppler
Ankle Brachial Pressure index

Question 29

How to treat Acute Limb Ischemia? (3)

Answer 29

Analgesia
IV Unfractioned Heparin
Surgical Embolectomy/Angioplasty

Question 30

5 Major Risk Factors for Aneurysms?

Answer 30

Smoking
Hypertension
Syphillis
Ehler Danlos Type 1
Marfan

Question 31

Who should be screened for Aortic Aneurysms?

Answer 31

Males Age 65 +

Question 32

If someone has an Aorta of 3 to 4.4 Size when to rescan?

Answer 32

Every Year (Small)

Question 33

If someone has an Aorta of 4.5 to 5.4 size when to rescan?

Answer 33

Every 3 Months (Medium)

Question 34

If someone has an Aorta of >5.5 when to rescan?

Answer 34

Refer to Vascular surgery to be seen within 2 weeks