Passmed Y1-3 Knowledge

Question 1

What is Ticagrelors MOA?

Answer 1

Inhibits ADP binding platelet receptors –> anti-platelet drug

Question 2

What is Heparin’s MOA?

Answer 2

Activates antithrombin III which inhibits factor Xa and IIa

Question 3

What is the MOA of DOACs eg rivaroxaban?

Answer 3

Inhibition of prothrombinase complex bound and clot-associated factor Xa.

Question 4

What is the MOA of aspirin?

Answer 4

Inhibits production of prostaglandins

Question 5

What is the MOA of warfarin?

Answer 5

Inhibits vitamin K epoxide reductase complex 1 (VKORC1)

Question 6

What causes ductus arteriosis closure?

Answer 6

Decreased prostaglandin concentration, due to enhanced clearance because of increased pulmonary flow after the baby is born

Question 7

Which antibiotics can cause torsades de pointes?

Answer 7

Macrolides eg clarithromycin.

Seen: rapid QRS complexes, which appear to be ‘twisting’ around the baseline shown on the ECG.

This condition is associated with a prolonged QT interval.. All other medications do not prolong the QT interval

Question 8

What is the management for torsades de pointes?

Answer 8

IV magnesium sulphate

Question 9

What ECG pathologies does hypokalaemia cause?

Answer 9

U waves
Small or absent T waves (occasionally inversion)
Prolonged PR interval
ST depression
Long QT

Question 10

What does a fourth heart sound suggest?

Answer 10

Directly before S1, always abnormal.

Stiff or hypertrophic ventricle. Turbulent blood flow against a non compliant ventricle

Question 11

Damage to which valve causes left atrial hypertrophy?

Answer 11

Mitral stenosis

Question 12

Damage to which valve causes left ventricular hypertrophy?

Answer 12

Aortic stenosis

Question 13

When prescribing ACEis eg trimethoprim, what blood test should be routinely carried out?

Answer 13

U&E (urea and electrolytes) - monitor potassium

Question 14

What are the features of a first degree heart block?

Answer 14

PR interval > 0.2 seconds

Question 15

What are the features of a second degree heart block (type1)?

Answer 15

(Mobitz I, Wenckebach): progressive prolongation of the PR interval until a dropped beat occurs

Question 16

What are the features of a second degree heart block (type2)?

Answer 16

(Mobitz II): PR interval is constant but the P wave is often not followed by a QRS complex

Question 17

What are the features of a third degree heart block?

Answer 17

No associations between the P waves and QRS complexes

Question 18

What is a common complication of infective endocarditis?

Answer 18

Stroke

Infective endocarditis increases risk of emboli

Question 19

What is the most common cause of bacterial infective endocarditis?

Answer 19

Staph.aureus

Question 20

Where do thiazide diuretics work?

Answer 20

Inhibit sodium reabsorption by blocking the Na+-Cl- symporter at the beginning of the distal convoluted tubule (DCT).

Question 21

What are clopidogrel, prasugrel, ticagrelor and ticlopidine all examples of?

Answer 21

ADP receptor inhibitors (antiplatelets)

Question 22

Where does furosemide act?

Answer 22

Ascending loop of henle

Question 23

What type of drug is furosemide?

Answer 23

Loop diuretic

Question 24

What is the mechanism of carbonic anhydrase inhibitors?

Answer 24

Prevent exchange of luminal Na+ for cellular H+ in the proximal and distal tubules of the nephron

Question 25

What is the mechanism of Amiloride?

Answer 25

Potassium sparing diuretic- inhibits epithelial sodium channels in the cortical collecting ducts

Question 26

What is the mechanism of spironolactone?

Answer 26

Potassium sparing diuretic- inhibits Na+/K+ exchanger in the cortical collecting ducts blocking the action of aldosterone on aldosterone receptors

Question 27

What does concomitant use of amiodarone and erythromycin increase the risk of?

Answer 27

Ventricular arrhythmias