CVS

Question 1

For patients with mildly elevated triglycerides of <4mm what treatment can you consider?

Answer 1

standard statins

Question 2

for moderatley elevated triglycerides >4mmol what therapy can you initiate?

Answer 2

fenofibrate, reducing dose with decreasing eGFR
145mg OD (eGFR >60)
96mg (eGFR 20-60)
48mg (eGFR 10-20)

Question 3

Secondary prevention of cardiovascular events includes what medications?

Answer 3

Lipid lowering medications regardless of lipid levels - use high intensity statin.
Antiplatelet agent
ACEI - titrated to max dose tolerated

Question 4

After an ACS event what antiplatelet therapy should be initaiated for seocndary prevention?

Answer 4

Aspirin 100-150mg OD PLUS clopidogrel 75mg OD (or alt) for 12 months, then cease the P2Y12 inhibitor

Question 5

Dores intermittent claudication require DAPT?

Answer 5

NO. Single agent (eTG)

Question 6

After an ACS event your patient is commenced on DAPT, a statin, an ACEI and what else?

Answer 6

Betablocker unless they have decompensated HF, heart block or bradycardia.
Options include:
Atenolol 25-100mg
metoprolol 25-100mg.

Question 7

Post ACS your patient has an EF of <40%, what are the prefered beta blockers in this instance?

Answer 7

bisoprolol 1.25mg OD
carvedilol (weight based dosing)
nebivolol 1.25mg
metoprolol succinate MR 23.75mg OD

start very low go very slow

Question 8

Aldosterone antagonists (MRA) improve survival time and reduce hospitalisations if patient with HFrEF.
Which drugs and dosings do you commence?

Answer 8

spironolactone 25mg OD increasing to 50mg if needed
OE
eplerenone 25mg OD increasing to 50mg if needed

Question 9

You commence spiro for a patient with HFrEF, what can you expect to see on bloods?

Answer 9

A small rise (within normal limits) of potassium.

In those with CKD adding spiro when on an ACE can cause severe hyperkalaemia

Question 10

Anticoags in AF with no inc bleeding risk?

Answer 10

apixaban 5mg BD

Question 11

Anticoags AF with inc bleeding risk (>80, weight <60, creatinine >133 micromol/L)

Answer 11

apixaban 2.5mg BD

Question 12

Anticogs AF with creat cl <30?

Answer 12

CrCl >50nrivaroxaban 20mg OD

if CrCl 15-49 15mg OD

Question 13

RAte cntrol in AF?

Answer 13

Aim <110 bpm

atenolol 25mg OD
metoprolol 25mg OD

Question 14

Rate control in AF when LV dysfunction?

Answer 14

diltiazem or verapamil MR 180mg

Question 15

grade 1 mild HTN

Answer 15

104-159 / 90-99

Question 16

grade 2 mod HTN

Answer 16

160-179 / 100-109

Question 17

grade 3 severe HTN

Answer 17

> 180 / >110

Question 18

management of hypertensive urgency

Answer 18

cardiac monitor
regular obs
medical options:
- amlodipine 5mg stat
- prazocin 2mg stat
- captopril 12.5 mg stat