Management pathways

Question 1

First line treatment in a 54yo patient with BP over 140/90mmHg.

Answer 1

ACEI/ARB

eg Ramipril/ losartan

Question 2

First line treatment in a 58yo black patient with BP over 140/90mmHg.

Answer 2

CCB

eg Amlodipine

Question 3

Second line of treatment in hypertension

Answer 3

ACEI + CCB

Question 4

Third line of treatment in hypertension

Answer 4

ACEI + CCB + thiazide diuretic

eg bendroflumethiazide

Question 5

Treatment in resistant hypertension

Answer 5

Spironolactone or high dose thiazide

Question 6

Diagnosis pathway in angina

Answer 6

History, ECG, CT coronary angiogram, Perfusion/stress test –> diagnosis

Question 7

First line treatment for angina

Answer 7

B blocker or Amlodipine (CCB)

Question 8

Third line treatment of angina

Answer 8

Add nitrate, Ivabradine, nicorandil

Question 9

First line treatment for heart failure

Answer 9

ACEI + B blocker

Question 10

First line treatment in heart failure if cannot tolerate ACEI

Answer 10

Hydralazine + nitrates

Question 11

Second line in heart failure

Answer 11

Spironolactone ± digoxin

Question 12

Third step in treatment of heart failure to treat symptoms

Answer 12

Thiazide diuretic

Question 13

Third step in treatment of heart failure to prolong survival

Answer 13

Ivabradine

Question 14

Second line treatment in angina

Answer 14

B blocker + CCB