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Holy Grail Docs > Revision Powerpoint Cardio > Flashcards

Revision Powerpoint Cardio Flashcards

1
Q

general rules for endocarditis antibiotics?

A

needs high dose (IV)
long course (4-6 weeks)
bactericidal
synergistic effect of combination

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2
Q

what organisms cause native valve endocarditis?

A

staph aureus (most common)
strep viridans
enterococcus
staph epidermidis

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3
Q

what organisms cause endocarditis in IV drug users?

A

staph aureus

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4
Q

what organisms cause prosthetic valve endocarditis?

A

staph epidermidis

staph aureus

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5
Q

endocarditis after dentist?

A

strep viridans

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6
Q

endocarditis after line insertion?

A

staph epidermidis

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7
Q

treatment for prosthetic valve endocarditis?

A

vancomycin
rifampicin
gentamicin
valve replacement usually needed

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8
Q

normal P wave?

A

0.0-0.1 secs

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9
Q

normal QRS?

A

<0.1

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10
Q

PR interval?

A

AV node delay

0.12-0.2 secs

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11
Q

QT interval?

A

diastole

0.36-0.44 secs)

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12
Q

where is angiotensinogen produced?

A

liver

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13
Q

where is renin produced?

A

kidney

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14
Q

where is ACE produced?

A

lung surface

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15
Q

how do thiazide diuretics work?

A

reduce blood volume by increasing Na, Cl and H2O excretion

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16
Q

side effects of thiazide diuretics?

A

hypokalaemia

electrolyte disturbance

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17
Q

how do beta blockers work?

A

reduce sympathetic activity, reducing CO, reducing renin release from kidney

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18
Q

beta blocker side effects?

A

cold peripheries
asthma
fatigue

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19
Q

how do CCBs work?

A

block L type calcium channels, reducing Ca2+ entry into vascular smooth muscle, reducing contraction

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20
Q

side effects of CCBs?

A

ankle oedema

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21
Q

how do alpha blockers work?

A

block alpha 1 adrenoceptors causing vasodilation

reduces sympathetic transmission

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22
Q

side effects of alpha blockers?

A

dizziness

confusion

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23
Q

what is stage 1 hypertension?

A

BP > 14/90 in clinic
OR
ABPM average of 135/85

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24
Q

what is stage 2 hypertension?

A

clinic BP > 160/100
OR
ABPM average >150/95

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25
Q

causes of left sided heart failure?

A

ischaemid heart disease
cardiomyopathy
valvular disease

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26
Q

symptoms of left sided heart failure

A

dyspnoea on exertion/rest
orthopnoea
paroxysmal nocturnal dyspnoea
pink frothy sputum

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27
Q

signs of left heart failure?

A

tachycardia
fine crepatations
pleural effusion
S3 (gallop rhythm - S3 + tachycardia)

28
Q

heart failure on CXR?

A

cardiomegaly
bat wing shadows (esp. lower zones)
interstitial fluid

29
Q

right heart failure is usually 2ndary to left, true or false?

A

true

30
Q

what can cause primary right heart failure?

A

cor pulmonale

congenital heart disease

31
Q

symptoms of right heart failure?

A

body oedema

32
Q

signs of right heart failure?

A 
oedema
elevated JVP
hepatomegaly
ascites
CXR
33
Q

when are thiazide diuretics used for heart failure?

A

mild CCF only

loop diuretics more commonly used (furosemide)

34
Q

what is the main side effect of furosemide and how is this counteracted?

A 
hypokalaemia
coincidental drugs (ACE and spironolactone) help retain and normalise K
35
Q

what drugs are used in heart failure?

A 
diuretics
spironolactone
ACE inhibitors
Beta blockers
Ivabradine
Digoxin
36
Q

what are the initial risks of Beta blockers in HF?

A

hypotension

worsening dyspnoea

37
Q

what kind of drug is spironolactone?

A

aldosterone receptor antagonist

38
Q

side effects of spironolactone?

A

hyperkalaemia
renal dysfunction
gynaecomastia

39
Q

what does ivabradine do and when is it used for HF?

A

slows HR

only used if HR fast despite B blockers

40
Q

what is the sign of digoxin poisoning?

A

yellow vision

41
Q

signs of patent foramen ovale?

A

machine like murmur

42
Q

how is a patent foramen ovale diagnosed and treated?

A

ECHO, Doppler US

treated with surgery

43
Q

signs of patent ductus arteriosus?

A

laboured breathing

44
Q

how is a PDA treated?

A

NSAIDs

45
Q

signs of persistant pulmonary hypertension of the newborn?

A 
sick at birth or in hrs following
cyanosis
tachycardia
low blood sats on high flow O2
pre and post ductal saturations
46
Q

how is persistent pulmonary hypertension of the newborn treated?

A

nitric oxide

47
Q

what are the signs of duct dependant circulation (DDC-also known as patent ductus arteriosus)?

A

present at 3-5 days

suddenly pale, tachypnoeic and distressed

48
Q

how is DDC treated?

A

IVPGE2

prostaglandin E2 - keeps duct open until surgery as baby is dependant on open duct

49
Q

what is the main use for antiplatelets?

A

arterial thrombosis

50
Q

how does aspirin work?

A

irreversibly blocks COX in platelets preventing TXA2 synthesis
also blocks COX in endothelial cells inhibiting production of antithrombotic prostaglandin I2

51
Q

side effect of aspirin?

A

GI bleeding

ulceration

52
Q

how does clopidogrel work?

A

links to P2Y12 receptor via disulphide bridge producing irreversible inhibition
(usually used when aspirin allergic or alongside aspirin)

53
Q

how does tirofiban work?

A

binds to factor IIb/IIIa

prevents MI in high risk unstable angina

54
Q

what are anticoagulants mainly used for?

A

venous thrombosis

55
Q

how does warfarin work?

A

inhibits Vit K reductase preventing conversion of epoxide to active hydroquinone
inactivates factors II, Vii, IX and X

56
Q

how does rivaroxiban work?

A

direct thrombin inhibitor

factor Xa inhibitor

57
Q

how does LMWH work?

A

inhibits Xa

not thrombin IIa

58
Q

4 Hs and 4 Ts of reversible causes of cardiac arrest?

A 
Hypothermia
Hyperkalaemia/hypokalaemia
Hypovolaemia
Hypoxia
Tamponade
Tension pneumothorax
Thromboembolism
Toxin
59
Q

saddle shaped ST elevation?

A

pericarditis

60
Q

continuous machine like murmur?

A

PDA

61
Q

diminished or absent lower limb pulses?

A

coarctation of aorta

62
Q

radio-femoral delay?

A

coarctation of aorta

63
Q

slow rising pulse?

A

aortic stenosis

64
Q

collapsing pulse?

A

aortic regurgitation

65
Q

JVP rising on inspiration?

A

cardiac tamponade or constrictive pericarditis

66
Q

tapping apex beat, loud S1?

A

mitral stenosis

67
Q

drug causing gout?

A

thiazide diuretics

Holy Grail Docs (39 decks)

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