Question Bank

For peripheral arterial disease (PAD), NICE recommends clopidogrel 75mg daily as the first-line antiplatelet agent for the prevention of cardiovascular events. Aspirin is used for coronary artery disease secondary prevention.

For patients of Black African or African Caribbean family origin of any age, or patients over 55 who are not of Black African/Caribbean origin, the first-line treatment for hypertension is a Calcium Channel Blocker (CCB) such as amlodipine.

His CHA2DS2-VASc score is 3 (Age >=75 = 2 points, Diabetes = 1 point). Anticoagulation (DOAC like apixaban) is indicated for men with a score of 1 or more, and recommended for a score of 2 or more; aspirin is no longer used for stroke prevention in AF.

NICE guidelines recommend either a beta-blocker (e.g., atenolol/bisoprolol) or a calcium channel blocker (e.g., diltiazem/verapamil) as first-line treatment for stable angina. Long-acting nitrates and others are reserved for second-line or combination therapy.

The classic ECG findings (short PR interval and delta wave) describe Wolff-Parkinson-White (WPW) syndrome, which is caused by the presence of an accessory conduction pathway known as the Bundle of Kent, bypassing the AV node.

Hypertrophic Cardiomyopathy (HCM) is the most common cause of sudden cardiac death in young athletes. It is typically inherited in an autosomal dominant fashion, usually due to mutations in genes encoding sarcomere proteins (e.g., MYH7 or MYBPC3).

NICE guidelines recommend primary PCI for STEMI if it can be delivered within 120 minutes of the time when fibrinolysis could have been given. Since the PCI centre is only 60 minutes away, it is the preferred reperfusion strategy over fibrinolysis.

Staphylococcus aureus is the most common cause of acute infective endocarditis, particularly in IV drug users. The murmur described is tricuspid regurgitation (right-sided), which is characteristic of endocarditis in this patient group.

NICE recommends an ACE inhibitor and a beta-blocker as first-line treatment for all patients with heart failure with reduced ejection fraction (HFrEF). While furosemide treats symptoms of congestion, it does not improve mortality like beta-blockers do.

In shockable rhythms (VF/Pulseless VT), Resus Council UK guidelines recommend 1mg adrenaline and 300mg amiodarone after the 3rd shock. For non-shockable rhythms, adrenaline is given immediately.