Cardiology Arrhythmias

Question 1

What is the therapeutic range of digoxin? Including units

Answer 1

0.7 - 2 ng/mL

Question 2

What are the 5 side effects of amiodarone?

Answer 2

Corneal micro-deposits
Photosensitivity
Thyroid (hypo and hyper)
Pulmonary toxicity
Liver toxicity

Question 3

What are the 5 side effects of amiodarone?

Answer 3

Corneal micro-deposits
Photosensitivity
Thyroid (hypo and hyper)
Pulmonary toxicity
Liver toxicity

Question 4

What are the signs of digoxin toxicity?

Answer 4

Yellow vision
Bradycardia
Confusion
Vomitting
Depression
Dizziness

Question 5

When should a digoxin level be taken?

Answer 5

6-12 hours after dose

Question 6

What is the digoxin antidote?

Answer 6

Digoxin-specific antibody

Question 7

How is QT prolongation treated?

Answer 7

IV magnesium sulfate

Question 8

When is anticoagulation carried out for electrical cardioversion

Answer 8

3 weeks before 4 weeks after

Question 9

How often are amiodarone eye tests

Answer 9

Annual

Question 10

What monitoring is needed for amiodarone

Answer 10

Eye tests
Chest x Ray before starting
LFTs 6 monthly
TFTs 6 monthly
Potassium (u+es) 6 monthly

Question 11

What are the stages of hypertension

Answer 11

Stage 1 - 140/90 - 159/99
Stage 2 - 160/100 - 180/120
Stage 3 - 180/120 >

Question 12

What beta blockers do not cause cold
Extremeties?

Answer 12

Pindolol
Oxprenolol
Acebutanolol
Celiprolol

Question 13

Which beta blockers are cardio selective and best for asthmatics if absolutely necessary?

Answer 13

Bisoprolol
Atenolol
Metoprolol
Acebutanol
Nevivolol

Question 14

Which beta blockers are once daily

Answer 14

Nadolol
Celiprolol
Bisoprolol
Atenolol

Question 15

Which beta blockers do not cross BBB so don’t cause night terrors

Answer 15

Celiprolol
Atenolol
Nadolol
Sotalol

Question 16

What drugs should be stopped in dehydration

Answer 16

DAMN - diuretics, ace I, metformin and NSAIDS

Question 17

Which DOAC needs to be taken with food?

Answer 17

Rivaroxaban

Question 18

What antibiotic can increase INR?

Answer 18

Doxycycline

Question 19

What are the side effects of nitrates

Answer 19

Flushing, falling, dizziness, hypotension, palpitations, syncope

Question 20

How is an ischemic stroke managed ?

Answer 20

300mg aspirin initially
If within 4.5 hours alteplase

Question 21

What medication do we avoid in haemorrhaging stroke

Answer 21

statins

Question 22

How long after an ischemic stroke is a statin started?

Answer 22

48 hours

Question 23

What are clopidogrel side effects

Answer 23

BLED - bruising, leucopenia, erythema multiforme, dyspepsia

Question 24

How long before surgery is clopidogrel stopped?

Answer 24

7 days

Question 25

How many doses of GTN can be given before 999?

Answer 25

3, 5 mins apart

Question 26

When do GTN sublingual tablets expire?

Answer 26

8 weeks after opening

Question 27

How is a nitrate free period maintained ?

Answer 27

Don’t give nitrates 12 hrly

Question 28

In a stemi, how quickly is a PCI needed?

Answer 28

2 hours

Question 29

What 5 meds would someone who has had a heart attack leave hospital on?

Answer 29

DABS - DAPT (aspirin+ticagrelo/clopidogrel/prasugrel)

Question 30

What additional side effect does nicorandil have compared to nitrates?

Answer 30

Ulceration

Question 31

What is the main interaction with nitrates ?

Answer 31

Sildenafil

Question 32

What is the digoxin antidote?

Answer 32

Digoxin specific antibody

Question 33

What is cha2ds2vasc

Answer 33

CCF, hypertension, age 75+ =2, diabetes, stroke/tia =2c age 65-74, sex female

Question 34

What is the nice hypertension pathway?

Answer 34

<55/ diabetes = ARB/ACEI first . >55/Afro = CCB first Then both Then add thiazide like diuretic Then add Alfa or beta blocker if K >4.5 Or spironolactone if K<4.5

Question 35

What are ace inhibitor side effects

Answer 35

HHARDD - hypotension, hepatic failure , angiodema, renal impairment , dry cough, dizziness

Question 36

What is first line for hypertension in pregnancy and second line

Answer 36

Labetolol first Dipyridamole + nifedipine second

Question 37

What MHRA alert is associated with warfarin?

Answer 37

Calciphylaxis / skin reaction

Question 38

What should be done if INR is high?

Answer 38

Major bleed - stop warfarin, IV phytomenandione, dried prothrombin complex Minor bleed INR>8 - IV phytomenandione INR >8 no bleed - oral phyto INR 5-8 minor bleed - IV phyto INR 5-8, no bleed - hold warf for 1-2 doses. Restart when INR <5

Question 39

How is stable angina treated?

Answer 39

CBA - beta blocker first Then CCB Then nitrates / nicorandil / ivabradine / ranolazine

Question 40

What are the 4pillars of Heart failure ?

Answer 40

ACEI / ARB/ ARNI MRA eg epelerone spironolactone SGLT2 eg Dapa

Question 41

Explain the effects of the 3 types of diuretics on U+Es

Answer 41

Loop =decreases all Thiazide = lowers K , lowers NA, lowers Mg, raises Ca k sparing = K increase, Na decrease

Question 42

How long is amiodarone half life?

Answer 42

25 hours ish (long)

Question 43

What should people at risk of pre-eclampsia do?

Answer 43

Aspirin from 12 weeks until birth