MRSA

Question 1

treatment for torsades de pointes

Answer 1

haemodynamically stable - IV magnesium sulphate to stabalise the myocardium

haemodynamically unstable - administer 1 synchronised DC

Question 2

origin of wide complex tachycardia

Answer 2

wide complex = ventricular origin

Question 3

causes of polymorphic vs monomorphic wide complex tachycardia

Answer 3

monomorphic - MI
polymorphic - long QT and its causes

Question 4

1st and 2nd line therapy for HF

Answer 4

1t line - betablocker + ACE inhibitor
2nd line - add aldosterone antagonist (spironolactone, eplerone) or SGLT2 if reduced ejection fraction

Question 5

indication for ivabradine 3rd line for HF

Answer 5

sinus rythmn > 75 bpm
LVF < 35%

Question 6

indication for cardiac resynchronisation therapy in HF

Answer 6

widened QRS on ECG

Question 7

indication for sarcutabril-valsatran in HF

Answer 7

if LVF < 35% and symptomatic on ACE/ARB’s
requires ACEi washout period

Question 8

what 2 betablockers are used in HF

Answer 8

carvedilol
bisoprolol

Question 9

peri arrest tachycardia, patient is in shock with BP 70 systolic.
would is the initial management?

Answer 9

synchronised DC cardioversion
up to 3 shocks can be given
once given then follow algorithm for either narrow or braod complex tachycardia

Question 10

what falsly lowers BNP levels

Answer 10

anything that reduces preload therefore reduces atrial stretch/pressure

ACE inhibitors, ARB’s, spironolactone, betablockers, obesity

Question 11

when can you drive after an MI

Answer 11

1 week, no need to inform DVLA