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Cardiology: Key Information > 4th Year Extra bits > Flashcards

4th Year Extra bits Flashcards

(52 cards)

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1
Q

what is the QRISK2 score?

A

scoring system used to assess risk of CVD

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2
Q

who should get their QRISK2 score done?

A

84 years and younger
diabetics
renal disease?

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3
Q

hypertension management pathway

A
  • ACEI/ ARB or CCB
  • ACEI/ARB + CCB
  • ACEI/ARB + CCB + thiazide-like diuretic
  • K+ >4.5mmol/l beta or alpha blocker, if K+ <4.5mmol/L spironolactone
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4
Q

lifestyle management in hypertension

A 
low salt diet
reduce caffeine
stop smoking
reduce alcohol
diet
exercise
weight loss
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5
Q

management of malignant hypertension

A

IV labetalol/ GTN

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6
Q

presentation of malignant hypertension

A 
men in 5th decade
HA
vomiting
visual disturbance
convulsions
papilloedema
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7
Q

in hypertension and diabetes what is first line management for all regardless of age?

A

ACEI/ ARB

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8
Q

what QRISK2 score should atorvastatin 20mg be started?

A

10% or greater

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9
Q

what dose of atorvastatin should be started in QRISK 10% or greater in those with CVD?

A

80mg

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10
Q

monitoring when starting statins?

A

recheck lipid level at 3 months to check for >40% reduction

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11
Q

what to do if >40% reduction not achieved?

A

check compliance
diet advice/ lifestyle
increase dose (80mg is max)

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12
Q

what is normal lipid level?

A

<10mmol/L

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13
Q

who should be offered atorvastatin 20mg?

A

type 1 diabetics
CKD
CVD
check QRISK2 in type 2

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14
Q

warnings to give when starting statins?

A

grapefruit juice interaction
muscle pain prior to starting
if muscle pains develop seek medical advice

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15
Q

when are statins CI?

A

pregnancy

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16
Q

what are Osler’s nodes?

A

tender on ends of fingers and toes

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17
Q

what are Janeway lesions?

A

non-tender lesions on palms and soles

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18
Q

Duke’s criteria for endocardtiis diagnosis

A

2 major, 1 major + 3 minor, or 5 minor for diagnosis
 Major= blood culture positive for typical organism or persistently positive and evidence of endocardial involvement
 Minor= fever, previous heart condition or IVDU, immunological phenomena, vascular phenomena or positive blood culture with atypical bacteria.

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19
Q

immunological phenomena in endocarditis

A 
Osler’s
Roth
GN
clubbing
petechiae
arthralgia
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20
Q

vascular phenomena in endocarditis

A 
mycotic aneurysms
janeway
septic emboli
intracranial haemorrhage
visceral infarct
splinter haemorrhages
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21
Q

grading angina

Study These Flashcards
A 
I = angina on strenuous or prolonged exertion
II = slight limitation in ordinary activity, angina in moderate activity
III = marked limitation of ordinary, angina on mild
IV = unable to carry out activities without angina, may occur at rest
22
Q

what is decubitus angina?

Study These Flashcards
A

precipitated by lying flat

23
Q

what is variant/prinzmental angina?

Study These Flashcards
A

coronary artery spasm

24
Q

management of ischaemic stroke

Study These Flashcards
A

thrombolysis within 4.5 hours of onset
thrombectomy within 6 hours (or 24 if limited infarct core volume)
aspirin 300mg for 2 weeks (+ PPI if needed)

25
dosage of aspirin in MI
300mg
26
management of MI
MONA +C/T (clopidogrel if high risk of bleeding, ticagrelor if no risk) PCI within 12 hours + 120 minutes (72 hours if NSTEMI or unstable angina) thrombolysis if >120 minutes
27
long-term management post-MI
``` aspirin (lifelong+ PPI if needed, if sensitivity give clopidogrel) beta blocker (12 months, unless reduce LVEF then lifelong) ACEI/ ARB (check renal function before and 1-2 weeks after) statin (life-long, started within 48 hours) ```
28
what is Beck's triad?
muffled heart sounds low BP raised JVP seen in pericardial effusion
29
who always gets ACEI first line for BP no matter ethnicity or age?
diabetics
30
management of acute heart failure
IV loop | additions= oxygen, nitrates, CPAP, dobutamine, NE
31
management of chronic heart failure
first line= ACEI + beta blocker 2nd= spironolactone 3rd= digoxin/ ivabradine/ enestero
32
bradycardia management
atropine 500mcg IV | pacing
33
a wave in JVP
atrial contraction
34
x waves in JVP
relaxation of atria
35
c wave in JVP
systolic contraction
36
v wave in JVP
right atrium fills with blood
37
y wave in JVP
tricuspid valve opens
38
indications for CABG
``` severe angina unresponsive to medical therapy marked ST depression on exercise ECG left main stem stenosis severe triple vessel disease angina with left ventricular dysfunction ```
39
indications for temporary pacing
unstable bradycardia not responding to atropine post-anterior MI with heart block trifascicular block prior to surgery
40
management of warfarin in bleeding
- Major bleeding= stop warfarin, give vit K 5mg IV and prothrombin complex concentrate - INR >8.0 minor bleeding/ no bleeding= stop warfarin, give IV vit K 1-3mg, repeat if still high after 24 hours. Restart warfarin when INR <5 - INR 5-8 minor bleeding= stop warfarin, give IV vit K 1-3mg and restart when <5.0 - INR 5-8 no bleeding= withhold 1 or 2 doses, reduce maintenance dose
41
when is valve replacement indicated?
symptomatic | gradient >40mmHg
42
constrictive pericarditis sign?
Kussmaul's sign (raised JVP that does not fall with inspiration
43
what to do if the cardiac arrest if witnessed on monitor?
3 successive shocks then CPR
44
MI medically treatment instead of PCI/ thrombolysis
aspirin + ticagrelor + fondaparinux (+ nitrates if BP good)
45
who should be offered atorvastatin 20mg?
QRISK2 score >10% | if already CVD give 80mg
46
when to recheck lipids after starting a statin?
3 months later aiming for >40% reduction (if not chat about lifestyle and consider dose increase - max is 80mg)
47
who should be considered for 20mg statins without lipid check?
diabetics | CKD
48
warnings in statin use?
grapefruit juice | muscle pain - doctor + check CK
49
what are statins CI in?
pregnancy
50
timing for PCI
2hours
51
long-term management of MI
``` aspirin (+ PPI - if cannot tolerate use clopidogrel) beta blocker (metoprolol) for 12 months, if LVEF then lifelong ACEI/ARB (check renal function before and 1-2 weeks later) statin lifelong ```
52
rate control CCB (dipyramindaole??)
verapamil | nifedipine

Cardiology: Key Information (42 decks)

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