Cardiovascular

Question 1

2 components of ACS

Answer 1

Unstable Angina and MI

Question 2

Main presenting complaint of ACS

Answer 2

Central Crushing Chest Pain

Question 3

ECG signs of STEMI and NSTEMI/Angina

Answer 3

STEMI: Tall T waves first then ST elevations

NSTEMI/Angina: ST depression, T wave inversion

Question 4

Blood marker of MI, where does it come from and when should you measure it?

Answer 4

Troponin - comes from damaged myocardial cells

Available 6-12 hours post MI - peaks at 24

Question 5

MI treatment

Answer 5

MONAC + PCI

Question 6

Difference between stable/unstable angina and MI

Answer 6

MI: Longer than 20 mins and not relieved by GTN
Stable: Comes on during exercise and relieved by rest
Unstable: Comes on at any time, more painful and lasts longer

Question 7

Where does angina type chest pain radiate to?

Answer 7

Jar, Neck and Arm

Question 8

Acute treatment of angina

Answer 8

GTN spray

Question 9

Chronic treatment of angina

Answer 9

Aspirin, Statin and modify risk factors

Question 10

What is the most common sustained cardiac arrhythmia?

Answer 10

Atrial Fibrillation

Question 11

How does AF present

Answer 11

Irregularly Irregular Pulse

Question 12

3 components of AF treatment

Answer 12

Rate control, Rhythm control (Electrical and Chemical) and Thromboprophylaxis

Question 13

Rate control drugs used in AF?

Answer 13

B-blockers and Cardiac Glycosides (Digoxin)

Question 14

Rhythm Control in AF?

Answer 14

Electrical (De-fib) and Chemical (Amiodarone)

Question 15

Thromboprophylaxis drugs used in AF?

Answer 15

Warfarin and Heparin

Question 16

What is the 2nd biggest risk factor for premature death?

Answer 16

Hypertension

Question 17

When do you treat it? (Staging)

Answer 17

Stage 1 = >140/90 - Treat if also end stage organ damage or if Q-risk > 20% - If not then just modify lifestyle
(If Q-risk> 10% then give statin)
Stage 2 = >160/100
Severe = >180/100

Question 18

DVT symptoms

Answer 18

Limb pain, tenderness, heat and swelling

Question 19

Link between DVT and Cellulitis

Answer 19

Can look similar and both can cause/ be caused by each other

Question 20

Investigations for DVT

Answer 20

D-dimer and Doppler study

Question 21

Treatment of DVT

Answer 21

LMWH (Dalteparin)

Question 22

3 Symptoms of LVH

Answer 22

SoB, Fatigue and Pulmonary Oedema

Question 23

Investigations for LVH

Answer 23

ECG, Doppler echo, CXR and B-natriuretic peptide

Question 24

2 Causes of LVH

Answer 24

Coronary Heart Disease and Hypertension

Question 25

Staging by symptoms (1-4)

Answer 25

``` 1 = No symptoms 2= Slight limitation due to symptoms 3= Less than ordinary activity leads to symptoms 4= No activity possible without symptoms ```

Question 26

Acute and Chronic Treatments

Answer 26

Depends on underlying cause - treat hypertension and modify lifestyle factors.

Question 27

Define Congestive Heart Failure

Answer 27

The heart is unable to maintain perfusion of tissues or pump out venous return

Question 28

5 Symptoms of Congestive Heart Failure

Answer 28

Fatigue, SoB, Dizziness, Pulmonary and Peripheral Oedema

Question 29

Heart rate in CHF

Answer 29

Rapid and Irregular

Question 30

3 main causes of CHF

Answer 30

Ischaemic Heart Disease, Hypertension and Dilated Cardiomyopathy

Question 31

4 Investigations fo CHF

Answer 31

CXR, BNP, ECG and Echo

Question 32

Treatment if preserved ejection fractions

Answer 32

Loop diuretics and consider antiplatelet and statin

Question 33

Treatment if reduced ejection fraction

Answer 33

Loop diuretic, ACEi, B-Blocker _ antiplatelet and statin if needed.