2. BAMS Cardiology Flashcards
6 modifiable CVD risk factors
4 irreversible CVD risk factors
CVD prevention involves what two things
Smoking, obesity, stress, diabetes, exercise, hypertension
Sex, age, family history, genes
Lifestyle changes (exercise, weight, stop smoking, drugs) Medical intervention
Give an example of an antiplatelet and how it works
What do anticoagulants do
Give an example of an anticoagulant and how it works
Aspirin - reduces platelet aggregation, preventing blood clot formation
Prevent/slow down clotting, preventing thrombosis or pulmonary embolism formation
Warfarin - inhibits vitamin K-dependent clotting factor synthesis, inhibiting the coagulation cascade, preventing blood clot formation
What are the 2 ways statins can work
Lower lipid content or inhibit cholesterol synthesis in the liver
2 functions of beta-blockers
2 side effects of beta-blockers
Stop arrhythmias, lower heart rate
Block beta-receptors in the lungs (non-selective), prevent heart rate rise (postural hypotension)
2 functions of diuretics
1 side effect of diuretics
Increase salt and water loss, reduce cardiac workload
Xerostomia (dry mouth)
3 functions of nitrates
1 side effect of nitrates
Venodilators, reduce peripheral resistance, dilate coronary arteries
Headaches
Function of Ca-channel blockers and how do they do this
1 side effect of Ca-channel blockers
Lower blood pressure by blocking smooth muscle calcium channels
Gingival hyperplasia
3 functions of ACE inhibitors
2 side effects of ACE inhibitors
2 oral reactions to ACE inhibitors
Block ACE (block Ang I into Ang II), lower blood pressure, reduce salt and water retention
Hypotension, cough
Angio-oedema, lichenoid reactions
Definition of ischaemia
Definition of infarction
Narrowing of BVs, causing inadequate oxygen delivery for tissue needs
Occlusion of BVs, causing no oxygen delivery to tissues, resulting in tissue death
Angina and PVD
What is angina
5 symptoms of angina
3 investigations for angina
Which drug used to treat angina during acute episode in a dental situation
What is involved in angina therapy (4)
Name at least 3 drugs involved in angina therapy/treatment
How is PVD described
What 3 things can PVD cause
Narrowing of one or more coronary arteries, reducing oxygen delivery to the heart
Chest pain, shortness of breath, dizziness, nausea, unusual tiredness
ECG, angiography, echocardiography
GTN - nitrate
Modifying risk factors, aspirin, other drugs
ACE inhibitors, aspirin, beta-blockers, nitrates, Ca-channel blockers, diuretics
Angina of the (lower) limbs
Poor wound infection, tissue necrosis and gangrene
Myocardial Infarction (MI)
5 ways an MI can occur
2 ECG types of MI
4 symptoms of an MI
2 investigations for an MI
4 things you would do if a patient had an MI in your practice
4 components to MI treatment in a hospital
List 4 contraindications to thrombolysis treatment - why is this contraindicated
Name 3 drugs used in secondary prevention of an MI
List 3 complications of an MI
Spontaneous, secondary to ischaemia, sudden death with ischaemia symptoms, MI from PCI, MI from CABG
STEMI, NSTEMI
Chest pain, pain radiates down arm, nausea, shortness of breath, pale, sweaty
ECG, cardiac enzyme (troponin leaks from dead cardiac muscle/tissue)
Call 999, give aspirin (dispersible tablet), give oxygen/loosen clothing, administer analgesia, BLS if required
PCI (stenting/angioplasty), thrombolysis, surgical (CABG), prevent recurrence
Recent surgery, recent injury, severe hypertension, PUD. tPA, involved in thrombolysis, dissolves all blood clots systemically, not just local clots
Beta-blockers, aspirin, ACE inhibitors
Death, arrhythmia, heart failure
Hypertension
What is hypertension
List 5 risk factors associated with hypertension
List 2 symptoms of hypertension
List 3 hypertension investigations
Name 2 things involved in hypertension treatment
List 4 drugs involved in hypertension treatment
A blood pressure greater than 140mmHg systolic over 90mmHg diastolic (140/90)
Age, alcohol, stress, race, obesity
Headaches, TIAs
BP measurement (sphygmomanometer), urinalysis, ultrasound
Modify risk factors, drug treatment (reduce BP to < 140/90)
ACE inhibitors, B-blockers, Ca-channel blockers, (thiazide) diuretics
Heart Failure
Why does heart failure occur
Name two causes of heart failure with diseases associated with each type
Name three types of heart failure
List three symptoms associated with 2 types of heart failure
List 3 drugs used to treat heart failure
List 3 consequences of congestive heart failure
Output of the heart is incapable of meeting tissue demands
High output failure (anaemia, thyrotoxicosis), low output failure (cardiac defect)
Left, right and congestive
Left - lung and systolic effects - shortness of breath, increased HR (tachycardia), hypotension
Right - elevated venous pressure (raised JVP, ascites, swollen ankles)
Diuretics, ACE inhibitors, nitrates
Hypertrophy, oedema, CVC of lungs and liver
Valve disease and Infective Endocarditis
List 3 causes of valve disease
Name one investigation for valve disease
How is valve disease treated
What is infective endocarditis
What two pathogens are commonly associated with infective endocarditis
Congenital abnormality, MI, rheumatic fever
Ultrasound (of heart chambers and valves)
Replacement valve (mechanical or porcine)
Infection of the endocardium, usually valves, caused by microbial colonisation of the thrombi on the endocardial surface
S. aureus and S, viridans
Cyanosis
What is cyanosis
When does cyanosis occur clinically
Name the two types of cyanosis, what tissues they effect, and associated causes
List 5 symptoms of cyanosis
Blue/purple discolouration of the skin/mucous membranes due to low oxygen saturation to surface tissues
When there is > 5g/dl of deoxygenated haemoglobin in the blood
Central (core, lips, tongue - congenital heart disease) and peripheral (extremities - cold environment)
Finger clubbing, blue lips, blue gums, blue skin, blue mucous membranes
