Cardiology 2 💟

Question 1

Ventricular aneurysm ecg signs

Answer 1

Persistent ST elevation

Question 2

Answer 2

So give dual antiPLT therapy for these patients… especially if drug eluting

Question 3

Nice and can cause flushing. What’s the mode of action of this, and what is the medication to stop it

Answer 3

Due to prostaglandin release, can give a low-dose aspirin if occurs

Question 4

In the setting of syncope, and a likely cardiac origin. What would you do for a patient who is less than 40 years old, and has no structural heart problem. Versus if a patient is older and has maybe a previous MI

Answer 4

The first patient I would do ambulatory ECG. The second patient I would do hospitalisation

Question 5

What arrhythmia is indicative of digoxin toxicity

Answer 5

AV block with atrial tachycardia

Question 6

What is the pathophysiology behind the AV block with atrial tachycardia that we see in dioxin toxicity

Answer 6

AV block is likely due to increase vagal tone. Atrial tachycardia is likely due to increase automaticity

Question 7

What is a sinus pause and sinus arrest. And why do we see this

Answer 7

Sinus pause is a very delayed P-wave. Sinus arrest is a dropped P-wave. These are seen in sick sinus syndrome

Question 8

What is the diagnostic criteria for Kawasaki disease in terms of days

Answer 8

Five or more days of fever plus the at least four of the usual symptoms

Question 9

Clinically, in Kawasaki, what is indicative that the patient has high risk for developing aneurysm

Answer 9

A prolonged fever. For example longer than two weeks

Question 10

Less than 70-year-old patience, with aortic stenosis. Is this senile calcific? Or bicuspid

Answer 10

Less than 70, it’s more likely to be bicuspid cause

Question 11

What is tachycardia induced cardiomyopathy

Answer 11

Patient with sustained tachycardia can get ventricular and atrial dilation, and eventual cardiomyopathy. It is reversible when you do rate and rhythm control

Question 12

Does ischaemic heart disease cause global or segmental hypokinesis

Answer 12

Segmental

Question 13

General side effects for amiodarone

Answer 13

Interstitial pneumonitis, blue grey discolouration of the skin, neuropathy, corneal microdeposits, optic neuropathy, hyper or hypo thyroidism, QT prolongation, bradycardia, heart block

Question 14

Cardiac output in septic shock

Answer 14

Increased at first, and then later decreases

Question 15

The mixed venous return oxygen saturation is usually high in distributive shock. What is the exception to this

Answer 15

Neurogenic

Question 16

Troponin levels following MI. Helpful for re infarction?

Answer 16

Not helpful. Takes about two weeks to lower

Question 17

If somebody has peripheral oedema from CCB is it helpful to have diuretics

Answer 17

No, the mode of action of the oedema is nothing to do with increase volume

Question 18

Atrial fibrillation and patient has no pulse and is in cardiac arrest

Answer 18

This is a pulseless electrical activity

Question 19

Intermittent claudication management ideas

Answer 19

Statin, low-dose aspirin. Supervised exercise program. If persistent can do revascularisation (bypass or stent)

Question 20

Patience post MI, who has structural dysfunction. If the left ejection fraction remained less than 30%, despite medical therapy, what should be done and why

Answer 20

You need to put in an ICD, because they’re at high risk for sudden cardiac death