Misc

Question 1

Anticoagulation in AF scoring

Answer 1

CHADSVASC

C Congestive heart failure 1 
H Hypertension (or treated hypertension) 1 
A2 Age >= 75 years 2 
 Age 65-74 years 1 
D Diabetes 1 
S2 Prior Stroke or TIA 2 
V Vascular disease (including ischaemic heart disease and peripheral arterial disease) 1 
S Sex (female) 1 

0 No treatment
1 Males: Consider anticoagulation
Females: No treatment (this is because their score of 1 is only reached due to their gender)
2 or more Offer anticoagulation

Question 2

Bleeding risk score in anticoagulation

Answer 2

H Hypertension, uncontrolled, systolic BP > 160 mmHg 1
A Abnormal renal function (dialysis or creatinine > 200)
Or
Abnormal liver function (cirrhosis, bilirubin > 2 times normal, ALT/AST/ALP > 3 times normal 1 for any renal abnormalities

1 for any liver abnormalities
S Stroke, history of 1
B Bleeding, history of bleeding or tendency to bleed 1
L Labile INRs (unstable/high INRs, time in therapeutic range < 60%) 1
E Elderly (> 65 years) 1
D Drugs Predisposing to Bleeding (Antiplatelet agents, NSAIDs)
Or
Alcohol Use (>8 drinks/week) 1 for drugs

1 for alcohol

Question 3

Long QTc drugs

Answer 3

• amiodarone, sotalol, class 1a antiarrhythmic drugs
• tricyclic antidepressants, selective serotonin reuptake inhibitors (especially citalopram)
• methadone
• chloroquine
• terfenadine**
• erythromycin
• haloperidol