Cardio

Question 1

which part of the nephron does furosemide act in

Answer 1

ascending loop of henle

Question 2

loop diuretics mechanism

Answer 2

prevents reabsorption of sodium, water, chloride and potassium in the ascending loop of henle

Question 3

3 contraindications of furosemide

Answer 3

hyponatraemia, hypokalaemia

anuria

Question 4

Side effect of furosemide, bendroflumethiazide, spironoactone

1 specific one in spirnolactone

Answer 4

postural hypotension in all

gynaecomastia in spirinolactone

Question 5

which diuretic can cause gynaecomastia

Answer 5

spironolactone (potassium sparing)

Question 6

4 contraindications of bendroflumethiazide

Answer 6

Addison’s

hyponatraemia

hypokalaemia

pregnancy

Question 7

which diuretic is the least contraindicated in pregnancy

Answer 7

furosemide

Question 8

which part of the nephron does bendroflumethiazide act on

Answer 8

distal convoluted tubule

Question 9

mechanism of spirinolactone

Answer 9

potassium sparing diuretic

aldosterone antagonist

so promotes excretion of sodium but sparing of potassium

works in the collecting duct

Question 10

which part of the nephron does spirinolactone act on

Answer 10

collecting duct

Question 11

what are 2 unlicensed indications of spirinolactone

Answer 11

acne in women

hirtuism

(aldosterone antagonist)

Question 12

3 contraindications of spirinolactone

Answer 12

Addison’s

hyperkalaemia

anuria

Question 13

mechanism of atenolol

Answer 13

beta blocker

stops noradrenaline binding to beta 1 receptor (competitive inhibition)

causes negative ionotropic and chronotropic effects

decreased heart rate and strength of contraction

Question 14

3 contraindications of atenolol

Answer 14

COPD/ asthma

bradycardia

pheochromocytoma

Question 15

2 side effects of atenolol

Answer 15

cold peripheries

hypotensive symptoms

Question 16

complication risk of atenolol

Answer 16

increases risk of T2DM

Question 17

main side effect of ramipril

Answer 17

dry cough

Question 18

2 contraindications of ramipril

Answer 18

angiodema

pregnancy

Question 19

what drug do you not give ramipril with

Answer 19

renin inhibitor e.g. Aliskeren

Question 20

mechanism of amlodipine

Answer 20

calcium channel blocker

relaxes vascular smooth muscle cells

no chrono/ionotropic action, just reduces blood pressure

Question 21

3 contraindications of amlodipine

Answer 21

stenosis

cariogenic shock

unstable angina

Question 22

what drug do you not give amlodipine with

Answer 22

other calcium channel blockers

Question 23

3 side effects of amlodipine (one main one)

Answer 23

leg swelling/ oedema

drowsy

flushing

Question 24

mechanism of losartan

Answer 24

angiotensin 2 receptor blocker (ARB)

acts on blood vessels directly to block angiotensin 2 receptor

decreases blood pressure

Question 25

non cardiac indication of losartan

Answer 25

diabetic nephropathy

Question 26

when do you give losartan in heart failure

Answer 26

when ramipril is contraindicated

Question 27

2 side effects of losartan (one causes the other)

Answer 27

hyperkalaemia leading to: muscle cramps

Question 28

mechanism of isosorbide mononitrate

Answer 28

donates Nitric Oxide (NO) to smooth muscle cells causing them to relax

Question 29

which drug do you not give isosorbide mononitrate with

Answer 29

Viagra (Sildenafil)

Question 30

mechanism of digoxin

Answer 30

cardiac glycoside inhibits sodium absorption increasing intracellular calcium decreases conduction, positively ionotropic causes strong, slow heart beats

Question 31

when do you give digoxin in heart failure and other indication

Answer 31

sedentary old people can give in AF

Question 32

mechanism of amiodarone

Answer 32

class 3 antiarrythmic potassium channel blocker prevents depolarisation leading to a Lower heart rate

Question 33

when is amiodarone given

Answer 33

in severe arrythmias in hospital/ under close supervision by specialists e.g. severe AF, Wolff-Parkinson-White Syndrome

Question 34

5 contraindications of amiodarone

Answer 34

brachycardia hypotension heart failure thyroid dysfunction (usually hypothyroid) pregnancy

Question 35

4 side effects of amiodarone

Answer 35

hypothyroidism (and actually hyperthyroid but less common) prolonged QT interval Photosensitivity Vision changes

Question 36

aspirin mechanism

Answer 36

antiplatelet stops prostaglandin synthesis which stops platelet aggregation

Question 37

2 side effects of aspirin

Answer 37

dyspepsia bleeding same as clopidogrel

Question 38

mechanism of clopidogrel

Answer 38

antiplatelet competitively inhibits ADP receptors on platelets leading to less aggregation

Question 39

2 side effects of clopidogrel

Answer 39

dyspepsia bleeding same as aspirin

Question 40

Enoxaparin mechanism

Answer 40

LMWH inhibits factor 10a converting prothrombin into thrombin stopping the coagulation cascade

Question 41

what drug anticoagulant do you give to pregnant women having a DVT

Answer 41

enoxaparin (LMWH)

Question 42

2 side effects of enoxaparin

Answer 42

bleeding increased liver enzymes

Question 43

TPA mechanims

Answer 43

thrombolytic drug binds directly to blood clot and breaks down the fibrin matrix

Question 44

3 indications of TPA

Answer 44

acute MI (?) massive PE with haemodynamic instability stroke if given in 4 hours

Question 45

3 side effects of TPA

Answer 45

bleeding angina hypotension

Question 46

warfarin mechanism

Answer 46

anticoagulant blocks vitamin K enzyme inhibiting factors 2,7,9,10

Question 47

3 contraindications of warfarin

Answer 47

pregnancy (1st and 3rd trimesters) bleeding post-surgery with bleeding risk

Question 48

3 side effects of warfarin

Answer 48

bleeding mild rash hair loss

Question 49

rivaroxaban mechanism

Answer 49

DOAC inhibits factor 10a converting prothrombin into thrombin

Question 50

one contraindication of rivaroxaban

Answer 50

anti-phospholipid syndrome

Question 51

3 side effects of rivaroxaban

Answer 51

iron deficiency anaemia dizziness GI upset

Question 52

simvastatin mechanism

Answer 52

inhibits HMG COA reductase stopping cholesterol synthesis

Question 53

contraindication of simvastatin

Answer 53

pregnancy/ lactation

Question 54

3 side effects of simvastatin (one main one)

Answer 54

muscle weakness constipation sometimes causes increased liver enzymes so check LFTs beforehand