A 55-year-old man has suffered an extensive anterior myocardial infarction (MI) but has recovered well in the hospital. His pre-discharge echocardiogram shows him to have a reduced ejection fraction of 35%. He has no dyspnoea, residual chest pain or significant oedema.
Which is the single correct combination of drugs that he should be taking on discharge from the hospital?
Which statement accurately describes chest pain?
A 35-year-old woman visits her doctor for a check-up. She is worried about her risk of developing cardiovascular disease after hearing about a family member’s recent diagnosis.
Which of the following factors would most significantly increase her risk of cardiovascular disease?
A 70-year-old man is diagnosed with chronic stable angina at his Cardiology Clinic appointment. He has normal left ventricular function on echocardiogram. He presents to his General Practitioner to discuss treatment options. He has no significant medical history or regular medication but is an ex-smoker who quit 20 years ago. On examination, his blood pressure is 120/76 mmHg and his heart rate is 70 bpm.
Which of the following medications is the single most appropriate first therapy for symptom control?
A 63-year-old man has been feeling ill for 2 weeks with fatigue, loss of appetite, and night sweats. During examination, he has a temperature of 38.5oC and a loud mid-systolic ejection murmur in the second right intercostal space with a palpable thrill. What is the most appropriate intervention for this man?
What factors in a patient’s medical record could potentially elevate natriuretic peptide levels (such as NT-proBNP) that are utilized to evaluate possible heart failure?
A 55-year-old gentleman has uncontrolled hypertension. He is currently taking a calcium antagonist and an ACE inhibitor.
His U&Es are shown below. You would like to start a diuretic.
Serum sodium 140 mmol/L (137-144)
Serum potassium 4.1 mmol/L (3.5-4.9)
Urea 5.0 mmol/L (2.5-7.5)
Creatinine 60 µmol/L (60-110)
According to the latest NICE guidance, which one would be your first choice?
A 7-year-old girl has coarctation of the aorta. She was diagnosed six weeks ago. She needs to have a dental filling.
Which one of the following is correct?
A 65-year-old Afro-Caribbean woman has a blood pressure of 150/96 mmHg on ambulatory blood pressure testing.
She has no heart murmurs and her chest is clear. Past medical history includes asthma and chronic lymphoedema of the legs.
As per the latest NICE guidance on hypertension (NG136), what would be the most suitable approach to manage her blood pressure in this situation?
A 58-year-old African gentleman is seen by his GP at a first visit registration medical.
He is completely asymptomatic but his blood pressure measures 150/95 mmHg, then 148/90 mmHg and 155/98 mmHg on two further visits a few weeks apart. He is not taking any medication currently.
What is the next best treatment option for this gentleman?