PassMed Errors

Question 1

What caution should be exercised with ACE Inhibitor Treatment initiation?

Answer 1

An increase in serum creatinine up to 30% from baseline is acceptable when initiating ACE inhibitor treatment.

Question 2

How is Diabetes of a Diabetic Patient with ACS managed? (2)

Answer 2

1. Stop Metformin and Gliclazide.

2. Start IV Insulin Infusion.

Question 3

How is Stroke managed in an AF patient? (2)

Answer 3

1. Aspirin Daily.

2. Start anticoagulation after 2 weeks.

Question 4

What is Trifascicular Block? (3)

Answer 4

1. RBBB.
2. 1st Degree HB.
3. Left Anterior/Posterior Hemiblock.

Question 5

Mechanism of Action of Loop Diuretics.

Answer 5

Inhibits the Na-K-Cl Co-Transporter in the Thick Ascending Limb of the Loop of Henle.

Question 6

What medications should be avoided in HOCM?

Answer 6

ACE Inhibitors.

Question 7

What hypertensive medications are avoided in Gout?

Answer 7

Thiazide/Thiazide-Like Diuretics.

Question 8

What electrolyte imbalance is associated with ACE Inhibitors?

Answer 8

Hyperkalaemia.

Question 9

Give an important cause of Torsades de pointes.

Answer 9

Sub-Arachnoid Haemorrhage.

Question 10

Adverse Effect of Loop Diuretics (2).

Answer 10

1. Ototoxicity.

2. Hypocalcaemia.

Question 11

What should electrical cardioversion be synced to?

Answer 11

The R Wave of the QRS Complex to minimise the risk of ventricular fibrillation.

Question 12

What symptomatic medication (out of MONAC) is contraindicated in hypotension + ACS?

Answer 12

GTN - further lowers BP.

Question 13

Adverse Effects of B-Blockers (3).

Answer 13

1. Cold Peripheries.
2. Sexual Dysfunction.
3. Insomnia.

Question 14

Adverse Effect of Amiodarone.

Answer 14

1. Slate-Grey Appearance.

2. Abnormal TFTs.

Question 15

Contraindications of Adenosine (3).

Answer 15

1. Asthma.
2. COPD.
3. Decompensated Heart Failure.
   * Use Verapamil in SVT if Contraindicated.

Question 16

What JVP Waveform is associated with Atrial Fibrillation?
What JVP Waveform is associated with Atrial Contraction against a Closed Tricuspid Valve?
What JVP Waveform is associated with Passive Filling of the Ventricle?

Answer 16

Absent A-Wave.
Cannon A-Wave.
Tricuspid Regurgitation.

Question 17

ALS Important Consideration in Hypothermia.

Answer 17

In cases of hypothermia causing cardiac arrest, defibrillation is less effective and only 3 shocks should be administered before the patient is rewarmed to 30 degrees centigrade.

Question 18

What type of pulse is left-sided heart failure most associated with?

Answer 18

Pulsus Alternans - Alternating Strong and Weak Pulse.

Question 19

Adverse Effect of Nicorandil.

Answer 19

GI Tract Ulcers.

Question 20

Adverse Effects of GTN (3).

Answer 20

1. Hypotension.
2. Bradycardia.
3. Headache.

Question 21

What is Wellen’s Syndrome?

Answer 21

An ECG Pattern caused by high-grade (critical) stenosis of the Left Anterior Descending Coronary Artery.

Question 22

ECG Features of Wellen’s Syndrome (3).

Answer 22

1. Biphasic/Deep T Wave Inversion in V2 and V3.
2. Minimal ST Elevation.
3. No Q Waves.

Question 23

Adverse Effect of Ivabradine.

Answer 23

Visual Disturbances e.g. Phosphenes and Green Luminescence.