passmed misc

Question 1

if thrombolysis given, repeat ECG…

Answer 1

60-90mins

if ST elevation persists patient should be urgently transferred for PCI

Question 2

electorlyte disturbance. -thiaze

Answer 2

hypercalcamia

Question 3

warfarin - PT and APTT

Answer 3

prolonged PT

normal APPT

Question 4

hypercalcaemia ECG change

Answer 4

short QT

Question 5

loop diurecitcs - effect on potassium

Answer 5

hypokalaemia

Question 6

additional Ix if someone has strep bovis IE

Answer 6

colonoscopy

Question 7

Kussmuals Sign

Answer 7

JVP rises with inspiration –> contrictive pericarditis

Question 8

malignant htn

Answer 8

> 180/120
symptomatic

caused by fibroid necrosis
end organ damage - IC haemorrhage, AKI, aortic dissection q

Question 9

malignant htn Mx

Answer 9

controll drop in BP to ~160/100 over 24hrs

uncontrolled drop in BP can lead to ischaemic stroke due to poor cerebral autoregulation and perfusion

Question 10

which anti-hypertensive can cause leg swelling

Answer 10

CCBs

Question 11

causes of high output cardiac failure

Answer 11

anaemia 
AV malformation 
thyrotoxicosis
Paget's 
pregnancy 
thiamine deficiency

Question 12

amyloidosis - heart failure and sign on ECHO

Answer 12

amyloidosis can cause restrictive heart failure

myocardium has sparkling appearance on ECHO

Question 13

when are nitrates contraindicated

Answer 13

hypotension

Question 14

statin + erythomicin/clarithromycin

Answer 14

drug interaction

Question 15

what medication is contraindicated in hypertrophic obstructive cardiomyopathy

Answer 15

ACEI

Question 16

ruptured interventricular septum

Answer 16

pt with LAD MI at risk
haemodynamic instabilisty
harsh holosystolic murmur

Question 17

rupture left ventricular free wall

Answer 17

leads to haemoperidcardium –> cardiac tamponade

hypotension, raised JVP, muffled heart sounds