Pass Medicine Flashcards
When starting ramipril, what is an acceptable increase in creatinine from baseline?
30%
What are the common side effects of amiodarone? (10)
Bradycardia Hyper/hypothyroidism Pulmonary fibrosis/pneumonitis Liver fibrosis/hepatitis Jaundice Taste disturbance Persistent slate grey skin discolouration Raised serum transaminases Nausea Constipation (particularly at the start of treatment)
What is the first line investigation for a patient with suspected stable angina?
Contrast-enhanced CT coronary angiogram
What is hypertrophic obstructive cardiomyopathy (HOCM)?
HOCM is an autosomal dominant disorder that is a cause of sudden death in young people
Unexplained syncope is one of the indicators that sudden death may occur
What is the management of hypertrophic obstructive cardiomyopathy? (5)
Amiodarone Beta-blockers or verapamil for symptoms Cardioverter defibrillator Dual chamber pacemaker Endocarditis prophylaxis
What ECG changes are seen in hypercalcaemia?
Shortening of the QT interval
Osborne (J) waves may also be seen in more severe cases
Management for patient with K+ >6 on ACEi
Prompt cessation of ACEi
Orthostatic Hypotension
Drop in SBP of at least 20 mmHg and/or
Drop in DBP of at least 10 mmHg after 3 minutes of standing
Management of a patient having major bleed on warfain
Stop warfarin
Give 5mg vit k IV
Give prothrombin complex concentrate
When is oral vitamin K indicated?
INR > 8 in the absence of bleed
What is used to reverse a DOAC?
Idarucizumab
What is the approximate half-life of adenosine?
10 seconds
Drugs that reduce mortality in HF
ACE-inhibitors Beta-blockers Angiotensin receptor blockers Aldosterone antagonists Hydralazine and nitrates
How many shocks can be given in cardiac arrest caused by hypothermia?
3 shocks until the patient is rewarmed to 30 degrees
PE + Hypotension treatment
Thrombolyse - Alteplase
Links to Streptococcus viridans
Classically linked to poor dental hygiene or following a dental procedure
Links to Streptococcus bovis
most commonly linked with colorectal cancer
Coxiella burnetti
Causes Q fever, an infection caught most commonly from farm animals. So, consider in any farmer or abattoir worker
Staphylococcus epidermis
most commonly associated with patients who have undergone previous prosthetic valve surgery
Most common cause of infective endocarditis
Staph Aureus
Features of HYPOKALEMIA on ECG
U waves (small deflection following T wave) Small or absent T waves Prolonged PR interval ST depression Long QT
What is a Q wave?
Small deflection following T wave
Usually same direction as T
Best seen in V2 and V3
Investigation of choice for suspected PE + renal impairment
Ventilation perfusion scan
First line management of acute pericarditis
NSAID and Colchicine
What is pulsus paradoxus?
Abnormally large drop in BP during inspiration
Associated with Cardiac Tamponade
What is Kussmauls sign
Raised JVP with inspiration
Associated with constrictive pericarditis
Condition associated with radio-femoral delay
Coarctation of the aorta
