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Cardiovascular REVISION > All of cardio > Flashcards

All of cardio Flashcards

1
Q

Treatment of cardiac tamponade as a complication of an MI

A

Pericardial aspiration

Surgery

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2
Q

What does the valsalva manoeuvre active

A

aortic baroreceptors

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3
Q

What is the funny current?

A

The decreased K+ efflux superimposed upon a Na+ influx

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4
Q

If is mediated by

A

hyperpolarisation

HCN channels

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5
Q

What does a block of HCN channels cause?

A

a decrease in the slope of the pacemaker potential, therefore a reduction of heart rate

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6
Q

What is Atropine

A

a competitive inhibitor of acetylcholine, used in extreme Bradycardia to speed up the heart rate

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7
Q

Invabradine

A

selective blocker of HCN channels, used to slow down the heart rate in angina

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8
Q

Sacroplasmic recticulum

A

calcium store

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9
Q

CICR

A

calcium induced calcium release

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10
Q

Refractory period

A

a period immediately following stimulation, nerve muscle is unresponsive

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11
Q

What does a long refractory period prevent

A

tectonic contraction

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12
Q

What are the segments of heart muscle

A

Actin and myosin

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13
Q

What is the role of calcium in cardiac muscle contraction

A

Ca2+ is required to bind with troponium, pulling troponium-tropomyosin complex aside

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14
Q

What is bound to actin to prevent muscle contraction

A

tropomyosin

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15
Q

Define Preload

A

Pressure exerted on the muscle fibres in the ventricles of the heart at the end of diastole

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16
Q

Frank Starling’s Law of the Heart

A

SV vs EDV

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17
Q

Afterload

A

the resistance into which the heart is pumping

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18
Q

Length of diastole

A

0.5 s

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19
Q

Length of systole

A

0.3 s

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20
Q

How to calculate the HR from an ECG

A

300/no. of large square between each R wave
OR
if irregular

Count the number of QRS complexes in 30 large squares, and multiply by 10

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21
Q

How much is a small box and a large box worth on an ECG

A
  1. 04 seconds - small box

0. 2 seconds - large box

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22
Q

Anteroseptal MI (STEMI)

A

ST elevation in chest leads V1-V4

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23
Q

Inferior MI (STEMI)

A

ST elevation in limb leads II, III, aVF

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24
Q

Anterolateral MI (STEMI)

A

ST elevation in V4-V6, I, aVL (affects LAD or circumflex)

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25
Lateral MI (STEMI)
ST elevation in I, aVL +/- V5-V6
26
Posterior MI (STEMI)
Tall R waves, V1-V2
27
What is the short term regulation of blood volume and MABP?
baroreceptors
28
What is the long term regulation of blood volume and MABP?
hormones and BV
29
MABP equation
CO x TPR
30
What is released in response to significant atrial distension
ANP
31
ANP
decreasing renin release
32
What is the parasympathetic relationship with cAMP
decreased cAMP
33
What is the effect of parasympathetic stimulation opening GIRK channels
opening GIRK channels causes hyperpolarisation
34
Adrenaline is used for
Cardiac arrest and ALS IV | Anaphylactic shock IM
35
Dobutamine is used for
Acute, but reversible, heart failure | e.g. following cardiac surgery, cardiogenic/septic shock
36
What type of drug is propanolol
non selective B-ADR
37
Examples of B1-selective ADR
atenolol, bisoprolol, metoprolol
38
Example of a non-selective and partial agonist B-ADR
Alprenolol
39
What is carvedilol
B-ADR antagonist used to treat mild to moderate heart failure start low, increase slow
40
Adverse affects of B-ADR Antagonist
``` Bronchospasm in asthmatics Aggravation of cardiac patients Bradycardia Hypoglycaemia - diabetics Fatigue Cold extremities ```
41
What is the drug used for bradycardia following an MI in incremental doses and what is this dose and what is the alternative medication?
Atropine 300-600 mg Glycopyronium
42
Why don't you ever use B blockers and calcium antagonist
B blockers are decreasing rate Calcium channel blockers are decreasing force therefore together they could cause serious heart bradycardia
43
What is the B-ADR antagonist used primarily for thyrotoxicosis
Propanolol
44
What is digoxin
a cardiac glycoside that increasing cardiac contractibility | use in Heart failure
45
Digoxin and dobuatmine are examples of
positive inotropic drugs
46
Affect of inotropic drugs on ventricular function curve
upward and leftward shift
47
How does digoxin work
digoxin binds to the alpha subunit of the potassium sodium ATPase, prevent the efflux of calcium
48
How can affects of digoxin be dangerously enhanced
low plasma potassium | low therapeutic concentration
49
Indirect effects of digoxin include
increases vagal activity slows SA node discharge slows AV node conduction
50
Digoxin S.E
Heart block Arrhythmias Toxicity
51
Digoxin toxicity
``` yellow-green blurry vision N/V bradycardia heart block ventricular arrhythmias ```
52
What is Levosemendan
calcium sensitiser
53
What drug binds to tropnium C sensitising it to action of calcium
Levosemendan
54
When do we use Levosemendan
Acute DECOMPENSATED HF | causes vasodilation - reduces after load - reduces cardiac output
55
A cardiac drug that inhibits PDE in cardiac and smooth muscle cells
Amrinone
56
Use and unwanted effects of Amrinone
IV in acute HF | worsens survival in arrhythmias
57
What is the most important vasodilator that comes from the endothelium
Nitric Oxide
58
Use of nitric oxides in angina
benefit due to increasing the myocardial oxygen requirement by i) decreasing the preload ii) decreasing the after load and iii) improving perfusion to the ischaemic zone
59
When do we use Organic nitrates
Angina | Acute Coronary Syndrome (ACS)
60
Short acting tablet or spray used for rapid effect before exception in ANGINA
Glyceryl trinitrate
61
Glyceryl trinitrate in ACS
IV infusion (+aspirin)
62
Longer acting NO used in prophylaxis of angins
Isosorbide mononitrate
63
S.E. of Nitritic Oxides
Diminished effects Postural hypotension Initial headaches
64
Examples of endothelin antagonists used in pulmonary hypertension
bostentan | ambrisentan
65
Don't use ACEI or ARBs in
PREGNANCY
66
S.E. include dry cough and initial hypotension
ACEI - lisinopril
67
Calcium antagonists that act on cardiac L-type channels
verapamil
68
Dihydropyradmines used in patients with heart failure
amlodipine
69
S.E. of L-type calcium antagonists
``` excessive vasodilation .. hypotension dizziness ankle oedema flushing ```
70
Examples of potassium channel openers
Minoxidil | Nicorandil
71
Last resort of sever hypertension
minoxidil
72
Used in untreatable angina
nicorandil
73
alpha-1 receptor antagonists
pazosin | doxazosin
74
Thiazide diuretics
mild acts on distal tubule BENZOFLUMETHIAZIDE treats - mild HF, hypertension, resistant oedema
75
Loop diuretics
stronger acts on the loop of Henle FUROSEMIDE treats - Acute Pulmonary Oedema and Chronic HF
76
Resistance to blood flow is inversely proportional to the radius of the blood vessel to the power of
4
77
Bradykinin
vasodilatory adgent
78
Sympathetic nerve stimulation shift the Frank-Stringling curve to the
left
79
Where is the needle inserted in pericardial centesis
infrasternal angle, directed superoposteriorly
80
Anti-hypertensive drugs
``` Diuretics B-blockers ACEI ARBs Calcium channel antagonists Alpha blockers ```
81
Anti-anginal
``` B-blockers Nitrates Calcium channel antagonists Potassium channel blockers - Nicorandil Ivabradine Ranolazine ```
82
Anti-thrombotic
Aspirin Clopidogrel Prasugrel Ticgrelor
83
Anti-coagulatants
Warfare, heparin, rivaroxaban, dabigatran
84
Fibrinolitics
Streptokinase, PA
85
S.E. of diuretics
``` hypokalaemia arrhythmia hyperglycaemia increased uric acid impotence ```
86
ACE S.E.
Cough renal dysfunction angioedema
87
Anti platelet S.E.
Haemorrhage Peptic ulcer --> haemorrhage aspirin sensitivity - asthma
88
Blocks clotting factors 2, 7, 9, 10 and can be reversed by the use of vitamin K
Warfarin
89
Factor X inhibtor
Rivaroxaban
90
Factor IIa inhibitor
Dabigatram
91
Avoid streptokinase in
``` recent haemorrhage traum bleeding tendencies severe diabetic retinopathy peptic ulcer ```
92
Block HMG-CoA reductase
Statins
93
Statin S.E.
myopathy | renal failure
94
What group of drugs is bezafibrate from
fibrates

Cardiovascular REVISION (5 decks)

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