Cardiac

Question 1

How often should a CVD risk be calculated for over 40

Answer 1

Every 5 years

Question 2

What patient are at an increased risk of CVD

Answer 2

Established CVD, CKD, stage 3, albuminurie or familial hypercholesterolaemia

Question 3

What is the CVD risk calculator

Answer 3

Qrisk 2

Question 4

What is heart failure caused by

Answer 4

Structural or functional abnormalities of the gear resulting in reduced cardiac output

Question 5

Symptoms of heart failure

Answer 5

SOB, persistent coughing or wheezing, ankle swelling, reduced exercise tolerance and fatigue

Question 6

What class of diuretics are recommended in heart failure

Answer 6

Loop diuretics- furosemide, bumetanide or torasemide

Question 7

Name the 3 beta blockers that should be used for heart failure

Answer 7

Bisoprolol, carvedilol or nebivolol

Switch patients if they are on another beta blocker

Question 8

Drug treatment for heart failure

Answer 8

ARB/ACE and beta blocker
Add spironolactone
Add ivrabadind or digoxin

Question 9

Heart failure treatment for Afro Caribbean

Answer 9

Hydra lazing and nitrate (isosorbide dinitrate)

Question 10

ARB licensed in heart failure

Answer 10

Candesartan and valsartan

Question 11

Patient on eplerenone and amiodarone

Answer 11

Max dose of eplerenone should be 25mg OF or moderate inhibitor

Question 12

Miss G is a 37-year-old female who has been admitted to hospital following a motorbike accident. She has attained numerous injuries including trauma to her spinal cord but her organ function is normal. Her consultant wishes to initiate her on baclofen. Miss G takes the following drugs: 
Atenolol 25 mg o.d. 
Captopril 25 mg b.d. 
Zonisamide 300 mg o.d. 
Loperamide 2 mg m.d.u.

Which one of the following is the most suitable intervention for Miss G?

No intervention is required
Advise Miss G’s consultant that baclofen enhances the hypotensive effect of captopril and atenolol
Advise Miss G’s carers that baclofen should be administrated at night
Advise Miss G’s consultant that baclofen is contra-indicated in epilepsy
Advise Miss G’s consultant that the use of baclofen with zonisamide is contra-indicated due to an increased risk of Miss G developing hyperthermia.

Answer 12

The correct answer was Advise Miss G’s consultant that baclofen enhances the hypotensive effect of captopril and atenolol

Baclofen increases the hypotensive effects of ACE inhibitors and beta blockers.