SSC cardiology

Question 1

What is first for AF control rate or rhythm?

Answer 1

rate

Question 2

what are the 3 lines of rate control?

Answer 2

1. beta-blocker
2. Ca+ channel blocker (not in heart failure)
3. Digoxin

Question 3

what are the 2 ways of rhythm control?

Answer 3

cardio version and medical control of rhythm

Question 4

When would you perform immediate cardioversion

Answer 4

patient is haemodynamically unstable

Question 5

what are the 2 options for immediate cardioversion?

Answer 5

cardiac defib
or
flecainide/ amiodarone

Question 6

what are the 3 lines of rhythm control?

Answer 6

1. beta-blocker
2. dronedarone
3. amiodarone

Question 7

what is really important to assess someone with afib?

Answer 7

CHA2DS2-VASc score !!
Needs anticoagulation medication

Question 8

what are the options for anticoagulation?

Answer 8

1. DAOCs (apixaban, edoxaban)
2. warfarin

Question 9

what does an angiogram look at?

Answer 9

How the coronary vessels are looking (using dye contrast x-ray)

Question 10

what does an echocardiogram look at?

Answer 10

The structure of the heart and how the valves are working

Question 11

What kind of murmur does aortic stenosis cause

Answer 11

ejection systolic murmur
(classically radiates up to the carotids)

Question 12

what are the 2 main causes of aortic stenosis

Answer 12

calcification- in older patients
bicuspid valve- in younger patients

Question 13

what can you use to increase blood pressure in someone with heart failure but have hypovolimia (can’t use a diuretic first)

Answer 13

+ve catecholamines
eg. adrenaline, noradrenaline, dopamine

Question 14

what are the 4 prognostic treatments for heart failure

Answer 14

1. spironlactone
2. beta-blocker
3. ACEi
4. dapagliflozin (SGLT-2i)

Question 15

why do you use diuretics in heart failure

Answer 15

provides symptomatic relief but doesn’t improve prognostics of disease

Question 16

what is 1st degree heart block

Answer 16

the PR interval is >0.2s

Question 17

What is 2nd degree heart block type 1?

Answer 17

Progressive prolongation of the PR interval until a dropped beat occurs

Question 18

What is 2nd degree heart block type 2?

Answer 18

The PR interval is consistent but the P wave is not always followed by a QRS complex

Question 19

what is 3rd degree heart block?

Answer 19

No association between the P waves and QRS complexes

Question 20

what is the treatment for heart block?

Answer 20

pacemaker

Question 21

causes of heart block

Answer 21

older age
coronary artery disease
cardiomyopathy
sarcoidosis
lyme disease
hyperthyroidism
hyperkalemia

Question 22

What defines a STEMI

Answer 22

chest pain
On ECG- ST elevation is seen
Raised troponin

Question 23

What defines N-STEMI

Answer 23

Chest pain
No ST-elevation on ECG
Raised troponin!!

Question 24

Treatment for MI

Answer 24

MONAC
(Morphine, oxygen, nitrates, aspirin, clopidogrel)

in < than 4hrs after symptoms- PCI
if >4hr after symptoms - thrombolysis