Frequently asked Qs from Cardiology in MRCP(UK) Part 1

Cardiology is a very important speciality for both Part 1 and 2 exam so my suggestion is to understand it very well.
I will summarize some important concepts most frequently asked in Part 1 examination.

1. STEMI and NSTEMI (ACS) are highly important .
They may give you a scenerio of acute myocardial infarction and will ask the are of myocardium involved such as left ventricle (LAD) IN case of anterior lead involvement   , inferior wall and SA node in case of II ,III and aVF leads etc.
Know the anatomy well.coz definitely there is one or 2 qs based on it will be in your exam.

2.how long you should give clopodogrel after drug eluting stent insertion.

3.how frequent restenosis and rethromnosis occurs ( after PCI and stenting)n patient with diabetes and without diabetes. ( very common scenerio in MRCP)

4. Learn in and out of CHF. You should be familiar with NYHA classification and must know when to add beta blocker or spironolactone in a CHF patient.its another sure shot for your exam.

5.you must know your antiarrhythmics and their side effects.
One fav question is a patient was started on Amiodarone for ventricular tachycardia and now after 2 years he complains that his skin color turned Grey----- photo toxicity of amiodarone

They may ask pt now complains the sweling around thyroid and palpitation---hyperthyroidism induced by Amiodarone as amiodarone has iodine(2/3 rd of its constituent)

Beta blockers side effect are also commonly asked .

They also trick you sometime by asking that a first trimester pt with PSVT is concern about aadenosine use on pregnancy --- reassure her that its very safe in pregnancy.

6.ACE inhibitors are very frequently asked may be becuse Diabetic Nephropathy is very imp in Uk and western hemisphere.
Read NICE guidelines about when to stop  Ace inhibitors in case of increase cr level( if cr increses more than 30 percent).

Dont give Ace inh in pregnant and bilateral renostenosis.

7.dont treat CHB by any active intervention if its occurred after INF WALL MI as its gonna resolve once we take care the MI  by eithe PCI OR Thrombolytics. But if its ant wall mi or lateral wall then go ahead with transvenous pacemaker as a bridging therapy of permanent pacemaker.

8.remember when to treat ectopic beats and when to reassure.Mrcp loves this

9.DVLA guidelines , specially post CABG , Post Pci , post STEMI

10.you may get ECG findings such as AVNT,PSVT,WPW, TORSADE.DE.POINTES etc and they may ask the treatment .( you dont get actual ecg picture but findings)

11. Treatment of hypertension In pregnancy is also a biggie.

12. Aortic dissection and whether to do surgical or medical management ? Stanford Type A vs Type B.

13.cholesterol embolism post Angigraphy is also commonly featured.

14.Blind treatment Aka empirical Tx of Subacute bacterial endocarditis I.e
Iv Benzyl penicillin plus gentamicin .
Don't jump to vancomycin until they specifically tell you its staphylococcus aureus. ( yes my friend I know you will say you need to add rifampicin with Vanco, thank you Genius)

15.transesophageal echo vs  blood culture in SABE .

16.do always transthoracic Echo in case of HOCM , Transesophageal is not very ideal in case of ventricular pathology.

17.Brugada syndrome and arrhytmogenic ventricular dysplasia along with Long Qt syndrome is also good to have a a quick look.

18.Digoxin side effects.

19.Management of Afib is almost sure qs .you must know when to cardiovert .

20.duration of Warfarin use in various cardiovascular problems most imp one is DVT  .learn It well.

21.learn ACLS guideline and various mode of Adrenaline administration such as iv vs io.
We always get some tricku qs based on ACLS guidelines such as what to do after 2 cycle of cpr , when to give Amiodarone , what should be concentration of Adrenaline , what should be mode of cardioversion ie synchronised vs asynchronised.
There will be 1 qs from this topic.
You dont have to remember the dosage so relax!

22.indication of ICD is also some times asked such as a pt with Hocm has non sustained arrhytmia or he was placed on beta blocker but he is having frquent syncope .what should be next step in management?

23.indications of pacemaker insertion .

24. When to treat aortic stenosis vs when to just observe .
Remember aymptomatic AS should always be treated  with valvuloplasty no matter what is his aortic pressure gradient .

25.takayasu arteritis and kawasaki disease are favorite vascular disease of MRCP 1 .also syphilitic aortitis is sometimes been asked.