CVS

Question 1

Management of HTN

Answer 1

1. <55 or diabetic: ACEi
   >55 or black: CCB
2. ACEi + CCB
3. • diuretic
4. • a-blocker, b-blocker, vasodilators

Question 2

Causes of hypertension

Answer 2

Primary - essential HTN

Secondary:

Endocrine-
Conns - aldosterone (incr Na reabsorption)
Pheochromocytoma - catecholemines (adrenaline/noradrenaline)
Cushing’s
Acromegaly

Renal-
Renal artery stenosis
Diabetic kidney

Misc-
Pregnancy
Coarctation of aorta
OCP
Sleep apnoea

Question 3

ADRs of thiazides

Answer 3

Erectile dysfunction
Gout
HypoK
Impaired glucose tolerance

Question 4

ADRs of loops

Answer 4

Ototoxic
HypoK
HypoNa

Question 5

DDI of thiazides

Answer 5

Bblockers- increase TAG, Uris acid

Digoxin + steroids - HypoK

Question 6

DDIs of loops

Answer 6

Digoxin and steroids - HypoK

Hypotension

Question 7

ADRs of spironolactone

Answer 7

Gynaecomastia (androgen is cross-reactivity)

HyperK

Question 8

How do you manage high cholesterol?

Answer 8

Statin:
Take OD at night
E.g. Atorvastatin 20-80mg

Question 9

ADRs of statins

Answer 9

Myopathy (increased transaminase, CK)

Arthragia

Question 10

Investigations for HF

Answer 10

1. ECG, BNP, CXR

2. Echo

Question 11

Management of HF

Answer 11

‘UNLOAD (+B)’

Upright
GTN
Lasix (furosemide)
O2
ACEi
Digoxin
B blocker

Implantable devices
Lifestyle

Question 12

NYHA classification of HF

Answer 12

1- no limitation
2- mild limitation
3- marked limitation
4- sx at rest

Question 13

Causes of HF

Answer 13

IHD
Non ischaemic dilated cardiomyopathy 
HTN
Valve disease
Congenital
Pregnancy
Hyperthyroid
AF
Anaemia