Cardiology — Flashcards

Flashcard 181: What is the main mechanism of simvastatin?

Answer: Inhibition of HMG-CoA reductase

Extra: Statins (like simvastatin) competitively inhibit HMG-CoA reductase, the rate-limiting enzyme in hepatic cholesterol synthesis. This leads to an upregulation of LDL receptors on the surface of hepatocytes, increasing the clearance of LDL from the plasma.

Flashcard 182: How do you measure the QT interval on ECG?

Answer: • Time between start of the Q wave and the end of the T wave

Flashcard 183: Adverse effects of Adenosine? 4

Answer: • Chest Pain • Bronchospasm • Transient flushing • Can enhance conduction down accessory pathways, resulting in increased ventricular rate (e.g. WPW syndrome)

Flashcard 184: What does atrial myxoma show on echocardiogram?

Answer: • Pedunculated hetergenous mass

Flashcard 185: if an Angina patient is on monotherapy and cannot tolerate the addition of a calcium channel blocker or a beta-blocker then consider?

Answer: • Long-acting Nitrate (Isosorbide Mononitrate • Ivabradine • Nicorandil • Ranolazine

Flashcard 186: What can cause Sudden Heart Failure, raised JVP, Pulsus parodoxus after recent MI?

Answer: • Left Ventricular Free Wall Rupture *Leakage of blood into the pericardial sac, resulting in cardiac tamponade

Flashcard 187: What are the ECG changes seen with hypercalcaemia?

Answer: • Shortened QT interval

Flashcard 188: What is a classic "sawtooth" sign on ECG?

Answer: • Atrial flutter

Flashcard 189: What is the dose of atorvastatin for secondary prevention?

Answer: 40–80 mg (High-intensity statin)

Flashcard 190: Which antiarrhythmic can cause a grey skin appearance?

Answer: Amiodarone