Cardio

Question 1

Shockable rhythms for cardioversion

Answer 1

Ventricular fibrillation
Ventricular tachycardia

PEA and A systole non shockable

Question 2

Adenosine is used in

Answer 2

Supra ventricular tachycardia

Question 3

Atrial fibrillation RATE control treatment:

Answer 3

First line: metoprolol ( or verapamil)
Second line: digoxin
Also possible option: DC cardioversion

Question 4

Hyperkalaemia treatment

Answer 4

Dextrose/ insulin (drives potassium uptake into cells) + calcium gluconate (stabilise cardiac membrane) + resonium (potassium binder)

Question 5

Atrial fibrillation rhythm control treatment

Answer 5

Verapamil, Sotalol,
Quinine
Flecanide

Question 6

Causes of AF

Answer 6

Pirates
Pulmonary Disease
Ischaemia 
Rheumatic Disease
Anaemia/ Atrial myxoma
Thyrotoxicosis
ETOH
Sepsis 
Chronic AF - HTN, CHF

Question 7

Four commonest precipitatants of CHF

Answer 7

Ischemia
Infection
Arrhythmia
Anaemia

Question 8

Fever with new onset murmur:

Answer 8

Infective endocarditis unless proven otherwise

Question 9

Three commonest pathogens causing IE

Answer 9

Staph Aureus- IVDU and acute
Strep viridans - dental work and subacute
Enterococcus - gastro related

Question 10

IE empirical treatment

Answer 10

Benpen
Flucloxacillin
Gentamicin

Question 11

Signs of congestive heart failure

Answer 11

Gallop rhythm
Elevated JVP
Lung crackles -
Peripheral oedema

Question 12

Chest Pain Red Flag Ddx

Answer 12

PETMAP
Pulmonary embolus
Esophageal rupture
Tamponade
Myocardial infarct
Aortic aneurysm 
Pneumothorax

Question 13

Anacrotic pulse

Answer 13

Slow rising pulse suggesting Aortic stenosis

Loudest on expiration, squatting

Question 14

Pulsus alterans

Answer 14

Alternating weak and strong pulse - suggesting severe chronic heart failure

Question 15

Collapsing pulse

Answer 15

Collapsing water hammer pulse suggests aortic regurgitation. Other signs may include a wide pulse pressure, quincke’s nail bed pulsations, de musset’s head bobbing sign.
Regurgitation heard loudest at left sternal heart border

Question 16

Jerky pulse

Answer 16

HOCM

Question 17

3 signs of HOCM

Answer 17

Harsh ejection systolic murmur
Double apex beat
Jerky pulse

Question 18

Bisferiens pulse

Answer 18

Mixed aortic stenosis and regurgitation

Question 19

Bounding pulse

Answer 19

CO2 narcosis
Sepsis
Liver failure

Question 20

Irregularly irregular

Answer 20

Atrial fibrillation

Question 21

Thready pulse

Answer 21

Barely palpable pulse found in shock

Question 22

Acute management of acute coronary syndrome

Answer 22

DRSABCD ECG TRoPoNin
MONASH- morphine, (oxygen), nitrate, aspirin/clopidogrel, statin, heparin
PCI( within 2 hours if STEMI, within 24 hours if nstemi)
CCU

Question 23

Long term pharmacological management of ACS

Answer 23

SAABC
Statin
ACEi 
Aspirin 
Beta blocker 
Clopidogrel

Question 24

What are the three mortality benefit drugs for CHF?

Answer 24

ACEi
Cardio selective Beta blocker
Spironolactone

Question 25

What are the cardio selective beta blockers ?

Answer 25

Carvedilol Metoprolol -HFPEF Bisoprolol - HFREF

Question 26

5 reversible causes of cardiac arrest | H and T

Answer 26

``` Hypothermia Hyper hypokalaemia High acid Hypovolaemia Hypoxia ``` ``` Toxin Trauma PneumoThorax Thromboembolism Tamponade ```

Question 27

Which arteries and leads are affected in inferior STEMI?

Answer 27

RCA, II, III, aVF

Question 28

Which arteries and leads are affected in anterior STEMI?

Answer 28

LAD, V2, V3, V4, V5

Question 29

Which arteries and leads are affected in lateral STEMI?

Answer 29

LCx, I, aVL, V5,V6