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Question 1

Consequences of MI

Answer 1

heart failure (cannot pump very well)
arrhytmia (dead tissue, get reentrant circuit)
LEFT BUNDLE BRANCH BLOCK (william marrow)

Question 2

Investigations and management MI

Answer 2

• ECG changes –> PCI (completely blocked, stop ischaemia)
• NSTEMI - urgent cath
• negative trop + ecg –> stress test

Question 3

Prinzmetal angina

• treatment
• what causes it

Answer 3

• vasospasm, non-anginal arteries

- treat with CCB

Question 4

Acute management - MONA BASH

Answer 4

Morphine Oxygen Nitrates Aspirin

Beta-Blocker ACE-inhibitor Statin Heparin

beta blockers - prevent arrhythmia from occuring

• STEMI –> PCI
• CABG (3 arteries occluded)
• tpa - if no stent available (within 4hr)

Question 5

Signs of HF

Answer 5

The classic patient is the triad of Exertional Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea. Exertional dyspnea is shortness of breath limiting walking. Orthopnea is shortness of breath that’s worse when lying flat. Paroxysmal Nocturnal Dyspnea is when the patient wakes up in the middle of the night gasping for breath. Because most patients have left and right failure together, rales (fluid on the lungs) may get mixed with peripheral edema and hepatomegaly. Symptoms like an S3 heart sound and Jugular Venous Distension are signs of acute exacerbation.

Question 6

treatment heart failure

Answer 6

Everybody
Salt <2g per day
H2O < 2L per day
ACE-i or ARB (best mortality benefit) Beta-Blocker

Preload (fluid overload)
-furoesemide
-isosorbide dinitrate
dietary modifications

Afterload (BP)
ace
hydralazine
spirinolactone

Question 7

acute exhaserbation - treamnet

Answer 7

NEVER BETA BLOCKER start
LMNOP 
furosemide
morphne
nitrate
oxygen
poisiton

Question 8

Asthma symptoms

Answer 8

wheeze, sob, cough
prolonged expiratory phase
hyperinflated hyperresonant lungs

Question 9

types of thiazide diuretics

Answer 9

Chlorothiazide (Diuril) Chlorthalidone. Hydrochlorothiazide (Microzide)