Management

Question 1

management for stable angina

Answer 1

All patients= aspirin + statin

Acute attacks= Sublingual glyceryl trinitrate

1st:
-BB or CCB (verapamil or dilttiazem)

2nd:
BB + dihydropyridine CCB (amlodipine)

OR if can’t tolerate BB + CCB:
Use BB or CCB PLUS
-Long acting nitrate
-Ivabradine
-Nicorandil
-Ranolazine

Question 2

young patient, has severe mitral stenosis + needs valve replacement

-which type you choosing?

Answer 2

Mechanical valve
-because they last longer than bioprosthetic valves

Question 3

strong suspiscion of PE but a delay in scan
-what is ur next step management?

Answer 3

Request a CTPA but start rivaroxaban twice daily

Question 4

initial investigation of infective endocarditis?

Answer 4

3 sets of blood cultures, separated by at least 6 hours and taken from different sites BEFORE antibiotics

Echo= imaging of choice

Question 5

most common cause of mitral stenosis

Answer 5

rheumatic fever

Question 6

VF/ pulseless VT treatment

Answer 6

chest compressions to ventilation 30:2

Defib- up to 3 quick successive shocks

after 3 shocks:
adrenaline 1mg
Repeat 1mg every 3-5 mins

amidarone 300mg
further 150mg after 5 shocks

Question 7

AF but CHA2DS2-VASc score of 0
-what do you do next?

Answer 7

ECHOOO
-to exclude valvular heart disease