Cardiovascular

Question 1

Aortic Regurgitation

Answer 1

ACE Inhibitors

Question 2

Supraventricular Tachycardia

Answer 2

Adenosine
Beta-blockers
Unstable SVT -DC cardiovert

Question 3

Torsades de Pointes

Type of ventricular tachycardia

Answer 3

Magnesium Sulphate

Question 4

Sinus Sick Syndrome (SA node dysfunction)

Answer 4

Pacing

Question 5

Sinus Bradycardia (<60bpm)

Answer 5

Common in inferior STEMIs

Atropine (>600mg)

Question 6

Myocarditis

Answer 6

Supportive Treatment

Question 7

Tetralogy of Fallot

Answer 7

Oxygen
Beta-blockers
Endocarditis
Prophylaxis
Surgery

Question 8

Pericarditis

Answer 8

Supportive for viral causes

Antibiotics for specific bacterial cases

Question 9

Coarctation of the aorta

Answer 9

Balloon dilation

Stenting surgery

Question 10

Cardiomyopathy

Answer 10

Treat underlying cause
ACE Inhibitors
Angiotensin II receptor antagonist
Beta blockers
Calcium channel blockers
Diuretics
Anti-arrhythmic
Amiodarone and digoxin

Question 11

Cardiac Tamponade

Answer 11

Pericardialcentesis

Question 12

Aortic Regurgitation

Answer 12

Valve replacement
ACE Inhibitors
Angiotensin II receptor Antagonist
Diuretics

Question 13

Mitral Stenosis

Answer 13

Valve replacement
Mitral ballon valvuloplasty
Loop diuretics (Furosemide)
Beta-blockers
Digoxin
Warfarin

Question 14

Mitral Regurgitation

Answer 14

Valve replacement
Percutaneous mitral valve repair
Loop diuretics (furosemide)
ACE Inhibitors (Ramipril, Lisinopril, Perindopril)
Digoxin
Warfarin

Question 15

Aortic Stenosis

Answer 15

Valve replacement
Ballon valvotomy
TAVI (valve implantation)

Question 16

Pulseless electrical activity

Answer 16

Resuscitation
CPR
Atropine
Vasopressin
Adrenaline
Oxygen and intubation

Question 17

Asystole

Answer 17

Adrenaline 1mg IV
Every 3-5mins following CPR
Atropine
Intubation and IV access

Question 18

Ventricular Fibrillation

Answer 18

Defibrillation shock
Adrenaline
Consider adenosine

Question 19

Pulseless VT

Answer 19

Defibrillation shock

Question 20

Atrial Fibrillation

Answer 20

ABCDD
Amiodarone (anti-arrhythmic) rhythm
B1 beta blockers (bisoprolol) rate
Calcium channel blockers (verapamil) rate
Digoxin (anti-arrhythmic) rate
DC Cardioversion- rhythm
Anti-coagulation
Maze procedure

Question 21

Ventricular Tachycardia

Answer 21

Acute (unstable)= DC cardioversion
Paroxysmal (stable)=amiodarone

If unsure between VT and SVT give adenosine (anti-arrhythmic)

Question 22

Chronic Arrhythmias

Answer 22

Radiofrequency ablation which is a selective cauterisation of cardiac tissue to prevent tachycardia

Question 23

Supraventricular Arrhythmias

A. Fib, Atrial flutter, ectopic atrial tachycardia

Answer 23

VAV
Vagal manoeuvres and carotid massage
Adenosine IV
Verapamil IV

Unstable- DC Cardiovert

Question 24

Acute STEMI

Answer 24

MONA C
Morphine + anti-emetic
Oxygen
Nitrate
Aspirin (300mg)
Clopidogrel

PCI within 90mins, not possible= thrombolysis

Question 25

Post MI

Answer 25

``` SABA + C Statin ACE Inhibitor Beta-blocker Aspirin +Clopidogrel for 4 weeks ``` Calcium channel blockers can be used instead of BB and warfarin instead of aspirin

Question 26

Stroke

Answer 26

``` Ischaemic (blood clot) SATS Statins Aspirin Thrombolysis (tPA) Supportive ``` Haemorrhagic (aneurysm) Supportive Refer to stroke unit Anti-hypertensives

Question 27

Varicose Veins

Answer 27

``` Foam sclerotherapy (chemical thrombophlebitis) Endovenous ablation Compression stockings ```

Question 28

AAA

Answer 28

Endovascular Aneurysm Repair Stent passed through artery in groin, seals off aneurysm from inside artery)

Question 29

Limb Ischaemia

Answer 29

ALPS Anti-platelets Lifestyle change (stop smoking, exercise more) PCI or vascular bypass Statins

Question 30

``` Phlegmasia Dolens (DVT obstruction) ```

Answer 30

ICV filter through femoral artery which prevents thrombus entering lungs (PE prophylaxis) Long term-anticoagulations

Question 31

DVT

Answer 31

Anticoagulation with Low weight molecular heparin Warfarin (but not in pregnancy) TED compression stockings

Question 32

Acute pulmonary oedema

Answer 32

Furosemide

Question 33

Heart failure

Answer 33

``` Acute- take a SMINT Sit up + give oxygen Morphine IV diuretic (furosemide) Nitrate (GTN Spray) Tailor further management ``` ``` Standard therapy- DABS and digoxin Diuretic ACE inhibitor Beta blocker Spironolactone ```

Question 34

Heart failure- Cor Pulmonale

Answer 34

Diuretics + Oxygen

Question 35

Heart Failure- Vascular disease

Answer 35

Surgery

Question 36

Heart Failure- A. Fib

Answer 36

Digoxin | DC Cardioversion

Question 37

Angina

Answer 37

ABC BAGS P Aspirin B1 blockers Ca channel blockers By pass Angioplasty GTNs Statins (if cholesterol >5mm/l) Potassium channel openers (nicorandil, minoxidil)

Question 38

Unstable Angina

Answer 38

HAG Heparin IV Aspirin GTN IV

Question 39

Coronary Artery Spasm

Answer 39

Ca channel blockers | Isosorbide mononitrate

Question 40

Hypertension <55 yrs old

Answer 40

Step 1: ACE Inhibitors Step 2: Ca channel blockers Step 3: Thiazide diuretics Step 4: Beta blockers or alpha blockers or spironolactone Exchange ACE for ARB

Question 41

Hypertension >55 yrs + Afro-Caribbean

Answer 41

Step 1: Ca channel blocker Step 2: ACE Inhibitors Step 3: Thiazide diuretics Step 4: Beta blockers or alpha blockers or spironolactone Exchange ACE for ARB

Question 42

Hypertension with secondary disease

Answer 42

Angina: Beta blockers and ca channel blockers never together Heart failure: Beta blockers and ACE Inhibitors Diabetic nephropathy: ACE and ARBs Prostatism: alpha blockers Elderly: Thiazide diuretics