Other

Question 1

CPR - rate of compressions, depth
Has educations around CPR improved mortality in OOHCA?

Answer 1

100-120/min, depth at least 5cm
Education around CPR has not improved mortality in OOHCA

Question 2

AAA - best intervention for reducing aneursym related complications/morbidity

Answer 2

Best evidence for smoking - A/W development AAA, more rapid expansion and more likely to rupture

Question 3

Factors that increase risk of AAA rupture

Answer 3

Diameter >5.5cm
Smoking
Diameter increase >0.5cm in six months
Female

Others: recent surgery, uncontrolled hypertension (inconsistent data regarding HTN, possibly aneursym contour

Question 4

Indications for antibiotic prophylaxis in infective endocarditis

Answer 4

Dental procedures involving gum
Procedures involving respiratory mucosa (incision, biopsy)
Gastrointestinal procedures with high risk of bacteraemia

Question 5

Indications for cardiac transplant

Answer 5

1. Refactory Class III -> IV HF
2. Recurrent refactory ventricular tachyarrhytmias
3. Severe ischaemia not amenable to intervention
4. VO2 max < 14ml/kg/min
5. Congenital heart disease for which no conventional therapy exists or conventional therapy has failed

Question 6

Mechanism of action evolocumab and it’s role

Answer 6

Monoclonal antibody - inhibits PCSK9 -> reduces LDL cholesterol by 60%
FOURIER Trial - when used in combination with statin -> reduced cardiovascular events (death, stroke, MI, unstable angina)

Question 7

Mechanism of action of inclisiran

Answer 7

Inhibits the hepatic synthesis of PCSK9

Other agents used in dyslipidaemia

• Ezetimibe - blocks biliary NPC1L1
• Statin - inhibits the HMG CoA reductase enzyme
• Evolucumab/Alirucumab - monoclonal antibodies that interfere with binding of PCSK9 to the LDL receptor
• Bempedoic acid - prodrug that reduces the production of acetyl CoA in hepatocytes

Question 8

Most important prediposing factor for acute aortic dissection in elderly population

Answer 8

Systemic hypertension