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1
Q

if someone has an NSTEMI and <3% GRACE score what medications should they receive? what if they have bleeding risk

A

ASPIRIN 300mg +Ticagrelor

Clopidogrel if bleeding risk

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2
Q

ECG findings in posterior MI

A

horizontal ST depression
tall, broad R waves
upright T waves
dominant R wave in V1/2

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3
Q

how does a left ventriuclar aneurysm presetn post MI and ehat are ECG findings

A

NO PAIN
signs of HF eg dyspnoea, bibasal crackles rasied JVP
ECG - persistent ST elevation

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4
Q

treatment of neurogenic shock

A

vasoconstrictors - spinal cord transection casues peripheral vasodilaion

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5
Q

prophylaxis of variceal rebleed

A

propanolol

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6
Q

what drug is used in hypercholesterolaemia in people who dont tolerate statins

A

ezetimibe

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7
Q

features of takayasu arteritis

A

headache malaise, unequal BP in arms, aortic regurgitation, claudication on exertion

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8
Q

what is pulsus paradoxus and when is it seen

A

decrease in pulse pressure during insp
asthmas

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9
Q

what is romano ward syndrome ?

A

auto dom congenital long QT syndrome

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10
Q

Pericarditis ECG findings

A

st elevation and pr depression

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11
Q

what antibiotic can prolong the QT

A

tetrayclines

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12
Q

does warfarin affect the PT or APTT

A

PT

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13
Q

ank spond x-ray findings

A

subchondral erosions, sclerosis
and squaring of lumbar vertebrae

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14
Q

maagement ofpancreatic pseudo cyst

A

conservatively - 50% reslove in 3 months

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15
Q

what type of colostomy is placed in an emergency sigmoid persoration

A

end colostomy - hartmanns procedure

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16
Q

treatment of intrapartum GABHS

A

IV benpen

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17
Q

what is osteomalacia

A

softening of the bones secondary to low vitamin D levels

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18
Q

MI of what region causes AV nodal block

A

inferior

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19
Q

biochemical findings in osteomalacia

A

low calcium
low phosphate
high ALP
high PTH

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20
Q

what is th emost reliable test to confirm ovulation

A

day 21 progesterone

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21
Q

treatmet of pneumothorax< 2cm

A

if SOB > need asp
if aymp - discahrge

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22
Q

biochemistry in oesteogenesis imperfecta

A

normal CA, P04, ALP and PTH

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23
Q

what medication is used for people wiht systemic scleorsis with renal crisis

A

ACEI

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24
Q

tx of torsades

A

iv magnesium sulphate

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25
Q

what size of aorta is classed an aneurysmal

A

> 3cm

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26
Q

management of AAA depending on size

A

3cm- 4.5 = rescan every 12 month
4.5-5.5cm - -rescan every 3month
.5.5cm or rapidly enlarging eg> 1cm/ yr- refer urgent 2 week referral

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27
Q

diagnosis of AAA rupture

A

theatre straight away if unstable
CTA if stable

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28
Q

types of arotic dissection

A

type A -ascending
`type b - descending

29
Q

investigations in arotci dissection and when used

A

CXR - widened mediastinum
CT -stable
TOE - unstable

30
Q

mangemenet of differeretn arotic dissections

A

type A Ascending - emergecny Surgical (TEVAR)
TyPE B - Iv labetalol and conservative

31
Q

STEMI ECG changes

A

increase in 1mm on limb leads
increase of 2mm on chest
new LBBB

32
Q

what classically precipitates digoxin toxicity

A

hypokalaemia

33
Q

classical causes fo SVT

A

AVNRT - most common
AVRT eg WPW

34
Q

what to give in SVT if allergic to adenosine

A

verapamil

35
Q

what is PR prolongation classed as

A

> 0.2

36
Q

mobitzII

A

P’s not always followed by QRS

37
Q

after TIA or Stroke folllowign AF when should anticoagulation begine

A

TIA - immediately
Stroke - 2 weeks

38
Q

options for chemical cardioversion

A

flecanide and amiodarone (if structural heart disease)

39
Q

what should be given alongside cardioversion if presenting <48 hours

A

heparin

40
Q

how long shoud a patient be anticoaged for prior to cardioversion

A

3weeks

41
Q

how long shoudl a patient be anticoaged for prior to ablation

A

4 weeks

42
Q

what electrolyte disturbances cause long QT

A

hypokalaemia
hypocalcaemia
hypomagnesium

43
Q

difference between paroxysmal and persistent AF

A

paroxsymal <48 hours
peristenet >48hrs and can be cardioverted

44
Q

what must be done in AF if CHADVASC says no anticoag

A

must do echo to exclude valvular disease

45
Q

when is S3 heard

A

left ventricular failure (e.g. dilated cardiomyopathy, HF), constrictive pericarditis
mitral regurg

46
Q

are innocent murmurs sys or diastolic

A

always systolic

47
Q

regurgitation murmurs tend to have what sound

A

blowing

48
Q

management of mitral stenosis

A

aymp - monitor
symp -perc balloom valvotomy

49
Q

management of mitra regurg

A

medical - nitrates diuretics Hf meds
severe - pig/artificial valve replacement

50
Q

management of aaortic stenosis

A

aymp - monitor if >40mmhg then replace
symp - AVR

51
Q

aortic regurg mangeemnt

A

medical
aymp with LV dys or symp = AVR

52
Q

most common endocarditis organism forllowin gsurgery/indwellign lines

A

staph epidermidis

53
Q

enodcarditis organims assoc with colorectal cancer

A

strep bovis

54
Q

how far apart do cultures need to be in infective endocarditis and how many

A

2 >12 hrs apart
3 cultures fi less specific organism eg staph aureus/epidermidis

55
Q

how to diagnse brugada syndrome

A

give flecanide if ECG gets worse then brugada (ST elevation in leads V1-3 and t wave inversion )

56
Q

treatment of brugadas

A

ICD

57
Q

ECG changes seen in brugada

A

TS elevation and RBBB in V1,2,3

58
Q

mutation in HOCM

A

β-myosin heavy chain protein or myosin-binding protein C

59
Q

characteristic biopsy findings in HOCM

A

myofibrillar hypertrophy with chaotic and disorganized fashion myocytes (‘disarray’) and fibrosis on biopsy

60
Q

what movements alter murmur in HOCM

A

decrease with squatting increase with valsalva

61
Q

echo findings in HOCM

A

MR SAM ASH
mitral regurg
sys anterior mitral valve leaflet
asyym hypertrophy

62
Q

cancer assoc with Acanthosis nigricans

A

gastrointestinal cancer

63
Q

what overdose causes tinnitus

A

aspirin

64
Q

mist common casue of neutropenic sepsis

A

staph epidermidis

65
Q

what size of DCIS warrants mastectoym

A

> 4cm

66
Q

symptoms of myocarditis

A

chest pain , SOB, arrhythmia

67
Q

what test must all pericarditis patients have

A

TTE

68
Q

what test is used to monitor LMWH

A

anti-Xa activity

random (19 decks)

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