Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 4 General Medicine > AF > Flashcards

AF Flashcards

1
Q

Causes of AF

A 
SMITH
Sepsis 
Mitral regurgitation 
Ischaemic heart disease 
Thyrotoxicosis 
Hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the principles to treating AF

A

rate control
rhythm control
consider anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

AF is the most common important arrhythmia, true or false

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the types of AF

A

permanent - never getting out of it
persistent - succeed in getting out of it
paroxysmal - episodic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

paroxysmal can become persistent

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

once you start the AF journey, you will end up in permanent AF, true or false

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe permanent AF

A

in it
stuck in it
cardiologist will not be able to get you out of it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

if you develop AF at >65yr, most cardiologists will treat it as permanent AF

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

symptoms of permanent AF

A 
asymptomatic 
fatigue 
loss of exercise tolerance 
palpitations 
shortness of breath 
exacerbation of heart failure 
angina if IHD 
stroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

sick sinus syndrome

‘tachy brady’

A

patients can have tachy and brady cardia
tachy - usually AF
brady - other heart rhythms
if brady is profound enough, may get syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

atrial rate of AF

A

300-600bpm

AVN is protective of this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

treatment goals for permanent AF

A

control ventricular rate

  1. B blocker: bisoprolol > atenolol
  2. rate limiting CCB: verapamil, diltiazem
  3. +- digoxin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

bisoprolol indications

A

arrhythmias and HR control
angina
heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

high dose B blockers are used to treat HF?

A

no, high doses can make it worse therefore start it at a very low dose (1.25mg) then add 1.25mg every 2 weeks and build it up very slowly to max tolerated dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

bisoprolol dose for AF

A

5mg to 10mg in 1 step
quicker titration for AF
(not low dose for HF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

if someone is asthmatic, what drug do you use for permanent AF

A

rate limiting CCB
verapamil
diltiazem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

digoxin function

A

acts on ATP Na/K pump at AV node

switches on parasympathetics to slow down the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

in a ‘healthy’ individual, sympathetic drive tends to overcome effect of digoxin

A

yes
exercise/running
digoxin is not good for a young/active person in permanent AF
as does pain, anaemia, HF exacerbation in older patients
therefore treat the cause of the bad HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

dihydropyriDINE CCB examples

A

amloDIPINE

nifeDIPINE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Bisoprolol and verapamil?

A

verapakill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

‘auricular’ appendages

A

extra features on atria of heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Virchows triad

A

hypercoaguability
stasis
endothelial damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

where are you most likely to form a clot in AF

A

left atrial appendage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

perforating lingual artery

A

supplies Broca’s area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
INR target for warfarin
2-3
26
examples of DOACs
edoxiban rivaroxiban apixiban dabigatran
27
DOAC drug of choice for AF
edoxiban
28
DOAC for PE
rivaroxiban
29
DOACs need monitoring blood tests?
No
30
CHA2DS2VASc score
``` congestive heart failure hypertension Age >75 or 65-74 diabetes stroke / TIA vascular disease - MI, PVD Sex category - ignore female risk unless there is another risk ```
31
score of 2 on CHA2DS2VASc score needs anticoagulation
yes
32
indications for warfarin
metallic heart valves | APLS
33
LMWH indications for anticoagulation in AF
when warfarin INR is subtherapeutic | or prior to operation
34
warfarin is teratogenic
yes
35
risk of long term LMWH
osteoporosis
36
what is the HASBLED score
risk of bleeding if you are anticoagulated
37
persistent AF
you're in it and stuck in it unless a cardiologist is successful in getting out of it
38
goal in persistent AF
rhythm control | cardioversion
39
cardioversion in AF
one heart rhythm into another | ie from AF to sinus rhythm
40
types of cardioversion
pharmacological | electrical DC
41
how does DCC work
enough electrical activity to depolarise all heart cells in hope that the SAN reemerged first to restore sinus rhythm put them under GA
42
risk of DCC
arrhythmia: bradycardia, VF | stroke - release of clot from atria
43
within what duration can you attempt cardioversion
<48 hr NICE <24 hr SIGN <12 hr PC
44
class I antiarrhythmic
flecainide
45
class III antiarrhythmic
amiodarone | ami'wonder'one
46
amiodarone is very toxic to the skin, true or false
true extravasation - leaking of fluid can causes severe skin necrosis therefore some units only allow IV amiodarone into a central line
47
what arrhythmias can flecainide cause
VT | atrial flutter
48
what questions do you use to screen whether to use flecainide
are you old >65? | do you have anything else wrong with your heart?
49
management of acute AF in the middle of the night
IV flecainide fast patient in case of anaesthesia LMWH ECG in the morning
50
management of AF >48 hours
start DOAC anticoagulation then 5-6 weeks later you do elective DCC keep them on anticoagulation for 1-6months also consider rate control with B blocker
51
paroxysmal AF is a trouble to treat
yes
52
management goals of paroxysmal AF
maintain sinus rhythm | maintain AF
53
explain maintaining AF in paroxysmal AF
instead of chopping and changing in and out of AF this can be very symptomatic and troublesome, leave them in AF and treat as permanent
54
management of paroxysmal AF in younger patients
antiarrhythmic drugs to stay in sinus rhythm - bisoprolol - flecainide (if not old or has other heart conditions) therefore: low dose of each of these in combination (bisoprolol to protect against flutter and flecainide for AF) - propafinone (Ic and B blocker combo drug) - dronedarone - amiodarone - sotalol (B blocker + amiodarone)
55
side effects of B blockers
cold peripheries poor sleep fatigue
56
digoxin is better for permanent/paroxysmal AF
digoxin is better for permanent AF rather than paroxysmal
57
flecainide can cause atrial flutter
yes | enhances conduction at AVN and can come in with atrial flutter despite AF being controlled
58
what is pill in the pocket
can self administer flecainide within a certain timeframe for paroxysmal AF to avoid long term effects need to try normal therapy first
59
side effects of amiodarone
``` photosensitivity thyroid abnormalities grey waxy complexion irreversible pulmonary fibrosis liver skin necrosis ```
60
non-pharmacological management of paroxysmal AF
venous access catheter - electrical radiofrequency ablation around pulmonary veins RF PVI - pul vein isolation create a burn electrical activity cannot escape cold cryo ablation
61
management of atrial flutter
same as AF
62
atrial flutter caveats
harder to control ventricular rate | more likely to respond to electrical therapy

Year 4 General Medicine (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions