Cardiology 2

Question 1

First line treatment in heart failure with reduced ejection fraction

Answer 1

Beta blockers and ACE inhibitors

Question 2

Treatment in Prinzmetal angina

Answer 2

Felodipine - dihydropyridine calcium channel blocker

Question 3

medication to avoid in HOCM

Answer 3

ACE inhibitors

Question 4

management of angina

Answer 4

Bisoprolol, GTN, Aspirin, Atorvastatin

Question 5

Management of stable angina guidelines

Answer 5

Aspirin, statin, b-blockers, c-blockers (verapamil or diltiazem if mono therapy) , glyceryl trinitrite, or isosorbide mononitrate , nicorandil, ivabradine

Question 6

medications causing of prolonged qt interval

Answer 6

• Antiarrhythmics: Amiodarone, sotalol, quinidine
• Antibiotics: Macrolides, fluoroquinolones
• Antidepressants: TCAs, SSRIs (e.g., citalopram)
• Antipsychotics: Haloperidol, quetiapine, ziprasidone
• Antiemetics: Ondansetron, domperidone
• Methadone (opioid)

Question 7

drug induced gynaecomastia

Answer 7

Digoxin

Question 8

Management of heart failure

Answer 8

First line - Ace inhibitors and beta blockers
Second line - aldosterone inhibitors ( spironolactone, eplerenone) , SGLT2 - inhibitors
Third line - Ivabradine if hr >75bpm , sacubitril - valsartan, Digoxin, hydralazine in combination with nitrates.

Question 9

Anticoagulation post valve replacement surgery

Answer 9

Bioprosthetic - Aspirin
Mechanical - Warfarin + Aspirin

Question 10

Aortic dissection management

Answer 10

type A - ascending aorta - control BP (IV labetalol) + surgery
type B - descending aorta - control BP(IV labetalol)

Question 11

Treatment of bradycardia

Answer 11

Atropine 500mcg first line txt. atropine up to 3mg
Transcutaneous pacing
Isoprenaline/adrenaline

Question 12

Mechanism of action of ACEi

Answer 12

low levels angiotensin 2, which causes vasodilation
e.g efferent arteriole in the glomerulus - vasodilation , decrease intraglomerular pressure

Question 13

Management in ventricular tachycardia

Answer 13

No adverse signs - 2g magnesium , amiodarone, lidocaine , procainamide.

Adverse sign (chest pain, shock, heart failure, syncope) - electrical cardioversion

Question 14

STEMI management

Answer 14

Fibrinolysis (alteplase) within 12 hours of onset, if no PCI centre within 120mins.

Question 15

STEMI secondary prevention

Answer 15

Dual anti-platelet therapy for 12 months, Statin, ACEi, B-blocker

Question 16

Ventricular tachycardia

Answer 16

Verapamil is contraindicated