2. Cardiology Flashcards Preview

1. BDS2 BAMS Revision > 2. Cardiology > Flashcards

Flashcards in 2. Cardiology Deck (14):
1

Reversible CVD risk factors (7)
Irreversible CVD risk factors (4)
CVD prevention involves (4)
Features of primary CVD prevention (3)
Difference between primary and secondary prevention
Functions of CV drugs (2)

Modifiable risk factors/lifestyle choices - obesity, diet, smoking, exercise, HTN, diabetes, stress
Genes, FH, sex, age
Lifestyle changes, control cholesterol, lower BP, aspirin
Diet, smoking, exercise
Medical intervention after CVD
Prevent further disease/reduce symptoms

2

Drugs used to prevent IHD (4)
Drugs used to treat IHD (5)

Function of anti platelet drugs and what do they reduce the risk of (2)
Function of anticoagulants and who are they used for
Antiplatelet example (1) and anticoagulant examples (2)
Function of statins (2) and side effects

Antiplatelets, statins, B-blockers, anti-arrhytmics
ACE inhibitors, Ca-channel blockers, diuretics, nitrates, anti-arrhytmics

Reduce platelet aggregation, reduce MI/CVA risk
Prevent/slow down clotting, patients at risk of thrombosis/pulmonary embolism in slow-moving areas
Aspirin; warfarin, heparin
Lower cholesterol/inhibit cholesterol synthesis in liver; myositis drug interactions

3

Function of B-blockers (2)
Side effects of B-blockers (3)

Function of diuretics (3)
Side effects of diuretics (2)

Function of nitrates (2) and types (2)
Side effect of nitrates

Function of Ca-channel blockers (2)
Side effect of Ca-channel blockers

Function of ACE inhibitors (3)
Side effects of ACE inhibitors (2)
Oral reactions of ACE inhibitors (2)

Stop arrhythmias, reduce heart muscle excitation
Prevent HR rise (postural hypotension), reduce heart efficiency, block B-receptors in lungs (asthma issues)

Antihypertensive drugs - increase salt and water loss, reduce plasma volume, reduce cardiac workload
Na/K imbalance, xerostomia

Reduce preload, reduce PR (after load); long/short-acting
Headaches - first-pass inactivation

Reduce BP by blocking smooth muscle Ca channels (some vasodilator peripheral BVs, some slow conduction of pacing impulses on heart muscles)
Gingival hyperplasia

Block Ang I --> Ang II and reduce (aldosterone-dependent) salt and water retention/reabsorption (block vasoconstriction), lower BP
Cough, low BP
Angio-oedema, lichenoid reactions

4

Definition of ischaemia
Definition of infarction
Infarction can lead to (2)
Infarction treatment (2)
Features of TIA (2)

BV narrowing - inadequate oxygen delivery for tissue needs
BV occlusion - no oxygen delivery to tissues. Secondary to ischaemia
Tissue death and loss of function
Reduce necrotic tissue loss, prevent further episode
Mini-stroke - may cause some loss of function, usually <24hrs

5

Angina

Cause/aetiology
Types (2)
Signs and symptoms (7)
Investigations (4)
Treatment (4)
Drugs used to treat (6)
Therapy (2)
What is PVD
Outcomes of PVD (4)

Narrowing and hardening of coronary arteries, reducing blood and oxygen to heart (caused by chemical and mechanical stimulation of sensory nerve endings on coronary vessels and myocardium)

Classical and unstable

Pain on exertion, SoB, chest pain, nausea, tired, dizzy, restless. Usually no signs

ECG, angiography, echocardiography, eliminate other diseases

Reduce afterload and preload, increase oxygen to tissues, vasodilation, reduce attack frequency

Aspirin, diuretics, Ca-channel blockers, ACE inhibitors, B-blockers, nitrates

Surgical - CABG, angioplasty

Claudication of limbs
Limited function, poor wound healing, tissue necrosis, gangrene

6

MI - STEMI and NSTEMI

Signs and symptoms (4)
Investigations (2)
Primary setting treatment (6)
Hospital treatment (5)
Thrombolysis contraindications (7)
MI Complications (5)
Management (2)
Drugs used in management (3)

Pale, nausea, sweaty, chest pain radiating

ECG, cardiac enzymes (troponin leaks from dead cardiac muscle)

999, analgesia, aspirin, oxygen, loosen clothing, BLS

PCI (angioplasty/stenting), thrombolysis (tPA will dissolve all clots), drug treatment, secondary prevention, surgery (CABG)

Injury/surgery, severe HTN, PUD, diabetic eye disease, liver disease, pregnancy

Death, arrhythmias, HF, DVT, embolism

Prevent next MI (modify risk factors) and treat complications

Aspirin, B-blockers, ACE inhibitors

7

Definition of arteriosclerosis
Definition of atherosclerosis
Description of chronic inflammation stage (5)
Description of healing stage (3)
Effects of atherosclerosis (5)
CCS causes (3)
CCS effects (3)
Mechanism leading to HF (5)

Hardening of BV/artery wall, loss of elasticity and flexibility
Changes in BV walls dur to tunica intima

Modifiable risk factors damage endothelial walls --> change surface receptors --> increased lipid permeability --> change in cell adhesion molecules --> monocytes can attach to endothelium and move into BV walls

Proliferation of smooth muscle cells and fibrous tissue growth - growth factors produced, fibrous plaque formed with central mass of liquid and necrotic tissue

Ischaemia, infarction, thrombosis, embolism, chronic periodontitis

Ischaemic heart disease, HTN, valve disease

Hypertrophy, oedema, CVC of lungs and liver

Hypertrophy of myocyte, capillaries don't increase in number, heart heavier, increased metabolic demands --> ischaemia --> myocyte injury --> apoptosis and HF

8

Dental CV drug interactions
Antiplatelets
NSAIDs
Anticoagulants
Ca-channel blockers
Diuretics/B-blockers (2)

Increased bleeding
Mucosal damage
Increased bleeding
Gingival hyperplasia
Xerostomia, increased caries risk

9

Hypertension (HTN)

Definition of high BP and low BP
Target BP and cholesterol
Risk factors (8)
Causes of essential HTN (3)
Signs and symptoms (3)
Investigations (6)
Treatment (3)
Drugs used (4)

>140/90 and <90/60

120/80 and <5mmol/l or reduce by 25%

Age, race, obesity, FH, alcohol, drugs, pregnancy, stress

No triggers, rarely endocrine tumours/renal artery stenosis

None, occasionally headaches, TIAs

Urinalysis, serum biochemistry and lipids, ECG, renal ultrasound

Modify risk factors, drugs, BP <140/90

B-blocker, Ca-channel blocker, thiazide diuretics, ACE inhibitors

10

Heart failure

When does HF occur
Types (2)
Causes (5)
Signs and symptoms - right (4) and left (5)
Treatment - acute/chronic
Drugs used (5)

When heart is incapable of meeting tissue demands

High output (anaemia, thyrotoxicosis), low output (cardiac defect)

Heart muscle disease (MI), pressure overload (HTN), volume overload (mitral/atrial incompetence), arrhythmias (AF), drugs

Right - lung and systolic effects (SoB, increased HR, decreased BP, low volume pulse); left - increased venous pressure (swollen ankles, ascites, increased JVP, tender enlarged liver, poor GI absorption)

Hospitalisation/drugs

Diuretics, ACE inhibitor, nitrates, inotropes (digoxin), stop negative inotropes

11

Valve disease

Causes (4)
Investigation
Treatment
Rheumatic heart disease caused by what reactions
Features of calcific aortic stenosis

Congenital abnormality, MI, rheumatic fever, aortic root dilation

Ultrasound

Replacement valve

Type 2 and 4

Calcification due to tissue inflammation and hyperlipidaemia

12

Cyanosis

Cause
Types (2)
Signs and symptoms (5)

Low oxygen saturation - <5g/dl deoxygenated haemoglobin in blood

Peripheral and central

Blue lips, gums, skin, mucous membranes and finger clubbing

13

Infective endocarditis

Definition
Signs and symptoms (7)
Effects (2)

Infection of endocardium, usually valves, caused by microbial colonisation of thrombi on endocardial surfaces

Fever, heart murmur, embolic phenomena, skin manifestations, splenomegaly, septic complications, mycotic aneurysm

Prolonged antibiotic treatment, cardiac valve damage

14

Arrhythmias

Slow arrhythmias and fast arrhythmias are called
VF definition
VF causes (4)
VF treatment (2)
Asystole definition
AF definition
AF signs and symptoms (6)
AF increases risk of (3)

Brady (heart block - slow - pacemakers treat), tachy

Disorganised ventricular activity; unstable heart activity
MI, electrocution, long QT syndrome, Wolf-Parkinson-White syndrome
AED, CPR

Absence of ventricular contractions lasting longer than the the maximum time for sustainable life (2s)

Rapid irregular beating of the atria

Often none - palpitations, fainting, lightheadedness, SoB, chest pain

CVA, MI, dementia