Chapter 2

Question 1

What taken with clopidogrel reduces the antiplatlet effect

Answer 1

Omeprazole (lansoprazole perfectly safe)

Question 2

Why cant you take simvastatin and amlodipine 10mg together

Answer 2

Can cause rhabdomyolysis. Recommeneded that you take amlodipine 5mg

Question 3

Transient ischaemic stroke First line

Answer 3

Dypyridamole MR 200mg BD and aspirin 75mg OD

Question 4

Ischaemic stroke

Answer 4

Clopidogrel 75mg Od

Question 5

Warfarin colours 0.5mg,1mg,3mg and 5mg

Answer 5

White,brown,blue,pink

Question 6

Treating intracerebral haemorrhage you should avoid

Answer 6

Statins, aspirin, and anticoagulants

Question 7

Antiplatelets prevent blood clots in which circulation

Answer 7

Arterial circulation

Question 8

Anticoagulants prevent blood clots in which circulation

Answer 8

In the venous circulation

Question 9

Is aspirin 75mg OD used in primary or secondary prevention

Answer 9

Secondary prevention

Question 10

Step ladder hypertension

Answer 10

1. Ace/arb for under 55 and not AC. Otherwise CCB
2. For under 55 and not AC add a CCB or beta blocker. For AC add ace or arb
3. THIAZIDE LIKE DIURETIC

Question 11

HYPERTENSION STAGES

Answer 11

NORMAL 120/80
STAGE 1 140/90 - TREAT WITH LIFESTYLE ADVICE (SMOKING CESSATION, DIET, EXERCISE)
STAGE 2 160/100
STAGE 3 180/110

Question 12

Which blood pressure medication is indicated for pregnancy

Answer 12

Labetalol. If any side effects like jaundice appear then it must be stopped

Question 13

First line hypertension with diabetes

Answer 13

ACE/ARB regardless of age or race

Question 14

Which medication should be stopped in renal impairment

Answer 14

DAMN ( DIURETICS, ACE/ARB, METFORMIN NSAIDS)

Question 15

Why should ACEi and potassium sparing diuretics not be given together

Answer 15

Increased risk of hyperkalaemia

Question 16

Relationship between hyperkalaemia and hypoglycaemia

Answer 16

Same as the inverse

Question 17

Side effects of dihydropyradrine ccb

Answer 17

Flushing, swelling, headache

Question 18

Chronic heart failure treatments

Answer 18

1st line. Ace/arb and a beta blocker
2nd line. Spironolactone
3rd line. Ivrabadine or digoxin

Question 19

Cholesterol targets

Answer 19

Healthy person total cholestrol - _< 5mmol
High risk total cholesterol - _< 4mmol

Healthy person LDL - _<3mmol
High risk LDL - _<2mmol

> _ 1mmol for HDL ( good cholesterol)

Question 20

How statins work

Answer 20

Work by lowering LDL cholesterol synthesis by the liver via inhivibition of HMG-COA reductase. (Indirectly reduces trigylerides and increases HDL cholesterol)

Question 21

Statins are advised to be taken at which time of day

Answer 21

To be taken at night because that is when LDL synthesis is highest. Apart from Atorvastatin- it is a high intesity

Question 22

Risks of statins

Answer 22

Myopathy

Question 23

Angina prophalaxis

Answer 23

Beta blocker or a dihydropyridine ccb (amlodipine, felodipine)

Second line: combination therapy

Question 24

Using GTN spray

Answer 24

One spray under the tongue and wait 5 mins
Take second dose under the tongue and wait 5 mins
Take third dose under the tongue and wait 5 mins

After three doses call 999

Question 25

Are long acting nitrates taken OD or BD

Answer 25

Long acting nitrates such as mononitrate isosorbide, or isosorbide dinitrate MR are taken BD, as the effects last for 12 hours

Question 26

Stemi and nstemi treatment

Answer 26

Loading dose of Aspirin 300mg chewable or in water with an anticoagulant such as clopidgorel for both. Pain relief should be offered as soon as possible with glyceryl trinitrate (sublingual or buccal). Intravenous opioids such as morphine may also be administered, particularly if acute myocardial infarction (MI) is suspected.

Question 27

What time of day to take diuretics

Answer 27

In the morning to avoid any sleep disturbances

Question 28

What are osmotic diuretics used for and give an example

Answer 28

Used in cerebral oedema and to relieve intracranial pressure. Example is mannitol