GenMed CBE Formative - Palpitations

Question 1

Answer 1

CVS - Sweating, chest pain, light-headed/dizziness, syncope, pulse irregularity
Psych (Anxiety) - Chest tightness, sweaty palms, sleep disturbances
Endocrine (Hyperthryoidism) - Weight loss, heat intolerance, goitre, fine tremor

Question 2

Answer 2

• Afebrile - infectious cause unlikely
• O2 sats low but not terrible
• PR>100bpm therefore tachycardic
• Irregularly irregular PR = Atrial fibrillation
• Very high BP = Hypertensive cardiac remodelling = heart failure & retinopathy & nephropathy
• RR = normal
• JVP not elevated
• Displaced apex beat = cardiomegaly
• Heart mumur = mitral valve regurgitation
• Bibasal crackles & pitting oedema = congestive heart failure
• Abdo = NAD
• Distal pulses present = No VAD

Question 3

Answer 3

Question 4

Her ECG is shown, what is her rhythm? (1 mark)

Answer 4

Question 5

Answer 5

Question 6

Answer 6

Question 7

Answer 7

Yes (1 mark)

Question 8

Question 8 - List 4 circumstances where you should advise against anticoagulation. (2 marks)

Answer 8

1. Recent bleeding
2. Alcoholism/liver disease
3. Known coagulation defects
4. Multiple/frequent falls
5. Dementia
6. Poor compliance

(0.5 marks each to a max 2 marks)

Question 9

Answer 9

Explanation in plain language of TIA/ stroke risk. (1 mark)