Treatment For Acute Mi

Question 1

Ejection systolic murmur heard loudest in the aortic area radiating to the carotids

Answer 1

Aortic stenosis

Question 2

Mid diastolic murmur heard best with the bell of the stethoscope at the apex with the patient in left lateral position

Answer 2

Mitral stenosis

Question 3

Pansystolic murmur loudest at the apex of the heart radiating to the axilla

Answer 3

Mitral regurgitation

Question 4

Early diastolic murmur the best at the left fourth intercostal space with a patient sat forward in expo

Answer 4

Aortic regurgitation

Question 5

What is hocm
What is treatment
What drugs avoid

Answer 5

Hypertrophic obstructive cardiomegaly 
Management
Amiodarone
Beta-blockers or verapamil for symptoms
Cardioverter defibrillator
Dual chamber pacemaker
Endocarditis prophylaxis*
Avoid-  nitrates , acei, inotropes

Question 6

S v t management

Answer 6

Acute management
vagal manoeuvres: e.g. Valsalva manoeuvre
intravenous adenosine 6mg → 12mg → 12mg: contraindicated in asthmatics - verapamil is a preferable option
electrical cardioversion

Question 7

Bradycardia tree,met

Answer 7

1st atropine

2nd is extermal pacing

Question 8

Who should get a statin

Answer 8

All people with established cardiovascular disease (stroke, TIA, ischaemic heart disease, peripheral
Anyon with a 10-year cardiovascular risk >= 10%
patients with type 2 diabetes mellitus should now be assessed using QRISK2 like other patients are, to determine whether they should be started on statins
patients with type 1 diabetes mellitus who were diagnosed more than 10 years ago OR are aged over 40 OR have established nephropathy

Statins should be taken at night as this is when the majority of cholesterol synthesis takes place. This is especially true for simvastatin which has a shorter half-life than other statins