Pasmeds

Question 1

The expression of what substance is increased on endothelial cells after damage or oxidative stress

Answer 1

Vascular cell adhesion molecule 1
Binds to molecules on lymphocytes , monocytes and eosinophils to cause adhesion of these molecules to the endothelium

Question 2

Does angina have infarction

Answer 2

No only ischaemia

Question 3

What acute coronary syndrome has total occlusion

Answer 3

STEMI

Question 4

SOCRATES

Answer 4

Site - central , left sister
Onset - sudden
Character - crushing
Radiation - left arm, neck and jaw
Associated symptoms - nausea, sweating , sob, clammy
Time- constant
Exacerbating / relieving - worsened by exercise better with gtn spray
Severity - often very severe

Question 5

In what patients is no pain common for acs

Answer 5

Elderly
Diabetics

Question 6

central crushing chest pain in a young patient with no cv risk factors or history

Answer 6

costochondritis

Question 7

what medications carry a risk of heart block

Answer 7

beta blockers

Question 8

When giving a combination of beta blockers and calcium channel blockers what is impoprtant

Answer 8

the latter is a dihydrpiridine

Question 9

what is a contraindication to doing a ct coronary angiography

Answer 9

renal impairments

Question 10

what conditions are needed for a patient with a stemi to have a pci

Answer 10

12hrs of symptom onset and 2 hours at hospital

Question 11

ECG findings for STEMI

Answer 11

-ST-segment elevation > 1 mm in 2 contiguous limb leads OR > 2 mm in 2 contiguous chest leads; and
– NEW ONSET LEFT BUNDLE BRANCH BLOCK
-Hyperacute T-waves

Question 12

Protective feature of aaa

Answer 12

Patients with dm

Question 13

what would you see on ecg for aortic stenosis

Answer 13

Increased QRS complex voltage
Left axis deviation
Poor R-wave progression

Question 14

Summary of mitral regurgitation

Answer 14

Pan systolic murmur radiates to apex
best heard 5th ic
S1 may be quiet

Question 15

summary of aortic stenosis

Answer 15

• systolic ejection murmur radiates to carotid
• 2nd IC
• sOFT S2 SOUND

Question 16

Summary of aortic regurgitation

Answer 16

• wide pulse pressure
• collapsing pulse
• early diastolic murmur
• IE mxc

Question 17

most common cause of aortic regurgitation

Answer 17

infective endocarditis

Question 18

what connective tissue disorder is aortic regurgitation commonly associated with

Answer 18

marfans

Question 19

CHADVASC2 SCORE

Answer 19

C: 1 point for congestive cardiac failure.
H: 1 point for hypertension.
A2: 2 points if the patient is aged 75 or over.
D: 1 point if the patient has diabetes mellitus.
S2: 2 points if the patient has previously had a stroke or transient ischaemic attack (TIA).
V: 1 point if the patient has known vascular disease.
A: 1 point if the patient is aged 65-74.
Sc: 1 point if the patient is female

Question 20

what is a common cause of afib

Answer 20

holiday heart syndrome - due to excess alcohol intake

Question 21

Why would you choose DCCV over oral beta blockers in afib

Answer 21

• dccv if patient is haemodynamically unstable

Question 22

patients with a high chadvasc2 score should be anti coagulated with ?

Answer 22

novel oral anti coagultant

Question 23

no contraindication of beta blockers, haemodynically stable patient should be started with ……. for AF

Answer 23

BISOPROLOL

Question 24

first line therapy for atrial flutter in haemodynamically stable px

Answer 24

AV node blocking agents
oral verapamil

Question 25

slurred upstroke of qrs complex suggests

Answer 25

Wolff parkinson white syndrome

Question 26

common presentation of wolff parkinson white syndrome

Answer 26

Young patient with flutters and palpitations ECH shows sloped qrs complex

Question 27

what medications can cause long qt syndrome

Answer 27

Amiodarone, Tricyclic Antidepressents Antibiotics, Fluconazole, Erythromycin, Metoclopramide, Quinidine, Haloperidol, Ondansetron, SSRIs

Question 28

What alzheimer drug can lead to third degree heart block

Answer 28

Donepzil

Question 29

Main difference between mobitz 1 and 2

Answer 29

Type 1 prolongation of pr until it drops Type 2 constant pr and p waves that are not often followed by qrs

Question 30

Inheritance pattern for HOCM

Answer 30

Autosomal dominant

Question 31

Typical presentation of HOCM

Answer 31

Young patient with syncope and chest palpitations , a parent died at a young age

Question 32

What causes the ductus arteriosus to close

Answer 32

Decreased levels of prostaglandins

Question 33

Egg on side CXR would indicate

Answer 33

Transposition of the great arteries

Question 34

most common organism to cause infective endocarditis

Answer 34

s aureus

Question 35

most common complication of IE and how it would show on ecg

Answer 35

S aureus prolonged pr interva;

Question 36

St segment elevation in what leads what show lad occlusion

Answer 36

V1-V4

Question 37

Common complication of pericarditis

Answer 37

Pericardial effusion

Question 38

Chest pain relieved by sitting up and worse when lying down

Answer 38

Pericarditis

Question 39

Name 4 defects in tetraology of fallot

Answer 39

- overriding aorta - pulmonary stenosis - right ventricular hypertrophy - ventricular septal defect

Question 40

causes of secondary hypertension

Answer 40

- phaeochromocytoma - hyperaldosteronism - stress - renal artery stenosis - preeclampsia

Question 41

what is kussmaul's sign

Answer 41

jugular venous pulse rises with inspiration.

Question 42

patients with turners syndrome have htn due to ....?

Answer 42

Coarctation of the aorta distal to the left subclavian artery

Question 43

fine bibasal crackles and a displaced apex beat are indicative of ?

Answer 43

Pulmonary oedema in HF

Question 44

wells score

Answer 44

risk of dvt

Question 45

ANN ARBOR staging ?

Answer 45

lymphoma staging

Question 46

dukes criteria

Answer 46

IE likelihood