Cardiology 1

Question 1

What cardiac condition produces TH17 which produces mRNA?

Answer 1

Dilated cardiomyopathy

Acute myocarditis

Question 2

DAPT duration for;
BMS?
DES
-Sirolimus
-Paclitaxel

Answer 2

BMS - 3 months minimum
DES - 12 months ideally
-sirolimus - 3 months
-Paclitaxel - 6 months

Question 3

What anti-lipid treatment that increases TGL?

What anti-lipid treatment that increases HDL the most?

Answer 3

Cholestyramine

Gemfibrozil

Question 4

Asymptomatic people without cardiovascular risk - aspirin role?

High lipid, and increased cardiovascular risk - statin role?

Answer 4

NO ROLE

NO ROLE

-except high Ca score > 100

Question 5

Preload and Afterload definition?

Answer 5

Balloon analogy
Preload = end-diastolic pressure of LV/RV = ventricles filling prior to contraction

Afterload = systemic vascular resistance = force ventricles need to eject and overcome to open the aortic valve

Question 6

Ezetimibe MOA?

Answer 6

blocks NPC (cholesterol absorption channel)

Question 7

Target LDL for ;

Established CVD

Answer 7

Established CVD : < 1.8

high risk - < 1.5

Question 8

When use PCSK9 inhibitor (Evolucumab)?

Answer 8

Statin for 12 months + Ezetimibe for 3 months
+ pharmacological management
AND
LDL > 1.8

Question 9

PCSK9 function?

Answer 9

bind to LDLR (receptor) and degrade it so more LDL in circulation

*LDLR binds to LDL and remove it from circulation

Question 10

Familial Hypercholesterolemia -Dutch criteria?

Answer 10

Family hx of Tendon xanthomata/ corneal arcus
Having tendon xanthomata/corneal arcus
Premature CVD
LDL levels high
PCSK9 gene/LDLR mutation

Question 11

Optimal medical therapy for angina?

Answer 11

SABAS

Sublingual nitrates
ACEI  = *LVDF < 40% + CKD/DM
B-blocker = LVDF < 40% + prior MI
Aspirin
Statin

Question 12

LMWH blocks what action?

UFH blocks what action?

Answer 12

FXa

FXa + Thrombin (II)

Question 13

UFH associated with what and how to monitor to prevent it?

Answer 13

HITS - aPTT monitoring

Question 14

Which type of CAD carries worst prognosis?

Answer 14

Left Main CAD

Question 15

What are the complications of PCI?

Answer 15

Cardiogenic shock/ Heart failure - use IABP

Arrhythmias

Question 16

Anticoagulant has least bleeding rate and chance of causing HITS?

Answer 16

Fondaparinux

Question 17

ARNI inhibit nephrolysin via what channel?

Answer 17

LBQ657 = degrades bradykinin = causing vasodilatation, diuresis, relaxation

Question 18

When use ARNI?

Answer 18

EF < 35% + NYHA class II - IV

Question 19

Where is the ‘funny channel’ = IF located?

Answer 19

SA node

Question 20

ICD insertion indications? ( 4 Is)

Answer 20

Ischemic cardiomyopathy
Intractable Ventricular arrhythmias
NYHA II - III
lvEF < 35% despite medical therapy for 3 months

Question 21

CRT indications?

Answer 21

NYHA II - III
lvEF < 35% despite medical therapy for 3 months
QRS > 130 ms + LBBB

Question 22

Heart transplant indications? ( 4 Vs)

Answer 22

Vo2 max < 14
Vascular ischemic - needing inotropes
Ventricular arrhythmias
V-IV NYHA

Question 23

Late complication of heart transplant?

Answer 23

Chronic allograft arteriopathy - hence 6 months routine angiography
-luminal stenosis > 40% - you’re fucked

Question 24

What’s so special about sotagliflozin?

Answer 24

SGLT 1 and 2 inhibitor

can be use in HF - preserved or reduced EF

Question 25

Flecainide cannot be used in those with structural heart disease - why?

Answer 25

Negative inotropic effect

Question 26

ARVD

• best imaging?
• best treatment?
• happens in?

Answer 26

Imaging - MRI - review RV thickness and function

Treatment - B-blockers +/- ICD

Exercise is associated with it

Question 27

Verapamil cannot be used in what condition and why?

Answer 27

VT/ Wide QRS complex

-inhibits Ca2+ entry into L type channel = severe hypotension and cardiac arrest

Question 28

Idiopathic VT causes?

Answer 28

Diastolic Ca overload - delayed after depolarisation

Question 29

SVT in RBBB - what it shows?

Answer 29

SVT with normal RBBB morphology!

Question 30

SVT in LBBB - what it shows?

Answer 30

Small R waves, absence Q waves