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Flashcards in As it says on the tin Deck (95):
1

What is a high blood pressure reading

140/90

2

Stage 1 hypertension reading

140/90

3

Stage 2 hypertension reading

160/100

4

Stage 3 hypertension reading

180/110

5

Malignant hypertension reading

Diastolic over 130

6

Risk factors for hypertension

Familial, obesity, dyslipidaemia, stress excess alcohol, smoking and high salt

7

4 examples of secondary hypertension

Cushings syndrome, conn's syndrome, phaeochromocytoma and renal disease

8

What will be seen in urine test in hypertension

Protein and blood

9

What will be seen on fundoscopy in hypertension

Retinopathy

10

What will be seen on ECG in hypertension

Ventricular hypertrophy

11

What is needed for diagnosis of hypertension

ABPM/HBPM

12

Describe ABPM

2 readings per hour for 14 hours, average to diagnose/not diagnose

13

Describe HBPM

2 consecutive measurements (while sitting) 1 minute apart. Do this twice daily for 4-7 days. Ignore first day and average rest to diagnose/not diagnose

14

1st step in treatment (non pharmacological) in hypertension

Lifestyle (BMI of 18.5<25, 150 minutes of exercise per week and <6g of salt per day)

15

1st step in pharmacological treatment in hypertension

<55 year=ACEi. >55 years or black=Calcium channel blocker.

16

2nd step in pharmacological treatment in hypertension

ACEi and C

17

3rd step in pharmacological treatment in hypertension

A, C and Diuretic

18

4th step in pharmacological treatment in hypertension

A, beta blocker, C and D

19

What is target BP of someone over 80

150/90

20

Who should ACEi and ARBs be avoided in

Pregnant women

21

Describe the pain in angina

Tight chest pain, typically on exertion, radiating to the jaw, arms and/or back

22

Describe stable angina

Relieved by rest

23

Describe unstable angina

Not relieved by rest

24

ECG investigation in angina

ST depression in unstable and stable, ST elevation in vasospastic

25

Management for angina symptoms and >90% CVD risk

Managed for stable angina

26

Investigation for angina symptoms and >61% CVD risk

Catheter angiography

27

Investigation for angina symptoms and >30% CVD risk

Functional testing (stress-tests)

28

Investigation for angina symptoms and >10% CVD risk

CT angiography

29

1st line pharmacological treatment for angina

Short acting nitrate (GTN)

30

Secondary prevention pharmacological for angina

ACEi and aspirin

31

2nd line pharmacological treatment for angina

Beta blockers OR rate limiting calcium channel blocker (verapamil

32

3rd line pharmacological treatment for angina

Beta blocker and amlodipine

33

4th line pharmacological treatment for angina

Isosorbide mononitrate, ivabradine or nicorandil

34

ECG findings in NSTEMI

ST depression, T wave inversion and pathological Q waves

35

When do troponins start to elevate

4 hours after MI and last for 7 days

36

When does CK elevate

Takes 24 hours to peak

37

How to tell apart NSTEMI and unstable angina

Does not usually elevate troponins and does not usually have changes on ECG

38

Treatment for low risk NSTEMI

MONAC

39

What do if there is potential for further occlusion

Urgent angiography with potentially a PCI

40

ECG findings in STEMI

ST elevation, T wave inversion and pathological q waves

41

Inferior MI leads

2, 3 and aVF

42

Anterior MI leads

V2-V5

43

Lateral MI leads

aVL, V5-V6

44

Anterolateral MI leads

aVL, V4-V6 and 1

45

Anteroseptal MI leads

V1-V3

46

What bloods should be obtained in MI

Troponins, CKs, electrolytes and lipids

47

How long should after an MI should a PCI be carried out

90 minutes

48

What should be performed if PCI is unavailable

Thrombolysis

49

What does thrombolysis consist of

Streptokinase and aspirin

50

What sputum can be present in heart failure

Pink frothy sputum

51

CXR on heart failure

Cardiomegaly, pulmonary congestion/oedema, kerley B lines

52

ECG on heart failure

Ischaemia, hypertension and arrhythmias

53

Pharmacological treatment for heart failure

Diuretics, ACEi, ARBs, beta blockers, spirnolactone and digoxin in progressed disease

54

What is a brief description of an arrhythmia

Abnormality in cardiac rhythm

55

What 5 categories can arrhythmias be put into

Tachycardia, bradycardia, supra-ventricular, ventricular and AV nodal

56

Three main causes of arrhythmias

Altered automiticity, triggered activity and re-entry circuit (accessory pathway)

57

5 standard investigations for arrhythmias

ECG, CXR, echo, event recorder and EP study

58

What is gold standard treatment for arrhythmias

Radiofrequency ablation

59

What drugs must be stopped before radiofrequency ablation and when

Anti-arrhythmic drugs 3-5 days before procedure

60

What is cardioversion used for

To get back to sinus rhythm

61

What anti-arrhythmic drugs are used for rhythm control

1 and 3

62

What anti-arrhythmic drugs are used in rate control

2 and 4

63

Examples of class 1 anti-arrhythmics

Flecainide and lignocaine

64

Examples of class 2 anti-arrhythmics

Atenolol and propanolol

65

Examples of class 3 anti-arrhythmics

Amiodarone and sotalol

66

Examples of class 4 anti-arrhythmics

Verapamil and dlitiazem

67

Describe sinus bradycardia

Heart rate of less than 60 with a regular rhythm.

68

Intrinsic mechanisms of sinus bradycardia

Ischaemia/infarction and fibrosis of atrium/SA node (sick sinus syndrome)

69

Extrinsic mechanisms of sinus bradycardia

Hypo-thermia/thyroidism and betablockers/verapamil

70

Treatment for sinus bradycardia

Pacing and anticoagulation

71

Where are the two most common locations in heart block

AV node (AV block) and the lower bundle of his/purkinge fibres (bundle branch block)

72

What is 1st degree heart block

Prolonged PR interval (>0.22)

73

what are the two subtypes of 2nd degree heart block

Mobitz type 1 and mobitz type 2

74

Describe mobitz 1

Progressive PR prolongation and then a dropped QRS complex

75

Describe mobitz 2

Dropped QRS complex with no PR prolongation

76

Complete heart block

Dissociation between P wave and QRS complex (lonely P waves)

77

ECG of right bundle branch block

Deep S waves in 1 and V6 and tall R wave in V1

78

ECG of left bundle branch block

Deep S wave in V1 and tall R waves in 1 and V6

79

Treatment for heart block

IV atropine and temporary or permanent pacing

80

3 types of AFib

Paroxysmal, persistent and permanent

81

Describe paroxysmal AF

Lasts less than 48 hours

82

Describe persistent AF

Longer than 48 but can be cardioverted

83

Describe permanent AF

Unable to be converted back to sinus rhythm

84

Treatment of acute AF

Rate control using drugs, cardioversion and anticoagulation

85

2 methods of rhythm control in AF

Cardioversion and class 1+3 anti-arrhythmics

86

The system used to indicate if anti coagulation is necessary in an AF patient

CHA2DS2VAS

87

What does CHA2DS2VAS stand for

Congestive heart failure=1 points
Hypertension=1 point
Age over 75=2 points
Diabetes mellitus=1 point
Previous stroke, TIA or thromboembolism=2 points
Vascular disease=1 point
Age 65-74=1 point
Sex=Female (1 point)

88

3 drugs in rate control for AF

Digoxin, beta blockers and verapamil

89

ECG in atrial flutter

Saw tooth baseline

90

Treatment for atrial flutter

Electrical cardioversion, radiofrequency ablation and class 3 anti-arrhythmis

91

Symptoms/signs of ventricular tachycardia

Dizziness, hypotension and cardiac arrest

92

What is torsades de pointes

Broad polymorphic QRS complexes

93

ECG of normal ventricular tachycardia

Broad monomorphic QRS complexes

94

Treatment of haemodynamically unstable ventricular tachycardia

DC cardioversion

95

Treatment of pulse less ventricular tachycardia

Defibrillation