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Clinical Years / Progress Test > Cardio > Flashcards

Cardio Flashcards

1
Q

what is first line for bradycardia?
if fails?

A

atropine
then external pacing

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2
Q

what is radio-femoral delay associated with?

A

coarctation of the aorta

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3
Q

what rhythms are shockable? what drug is given with them

A

VT and VF
give amiodorone 300mg after 3 shocks
CPR 30:2 for 2 minutes between shocks

Give adrenaline 1mg after compressions have restarted after 3rd shock if no response

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4
Q

what rhythms are non-shockable? how do you manage

A

asystole/pulseless electrical activity
CPR 30:2
give adrenaline 1mg asap then every 3-5 minutes

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5
Q

management for SVT

A

vagal manoevres then adenosine - 6mg then 12mg then 18mg escalating if unsuccessful
if still uncontrolled cardioversion

note adenoids contraindicated in asthmatics

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6
Q

what is the most common cause of mitral stenosis

A

rheumatic fever

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7
Q

what ECG abnoramlity can hypokalaemia cause?

A

broad complex ventricular tachycardia

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8
Q

management of an unstable tachyarrhythmia

A

DC cardioversion if systolic BP <90mmHg

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9
Q

acute HF treatment

A

oral then IV furosemide
if not responding then CPAP

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10
Q

reversible causes of cardiac arrest

A

Hypothermia
Hypoxia
Hypovolaemia
Hypokalaemia/hyperkalaemia/hypoglycaemia

Tension pneumothorax
Tamponade
Toxins
Thrombosis

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11
Q

CHADSVASC

A

CHF
Hypertension
Age (1 for >65, 2 for> 75)
Diabetes
Stroke/TIA/thromboembolism (2)
Vascular disease
Sex (1 for female)

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12
Q

treatment of pericarditis

A

NSAIDs
aspirin

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13
Q

cardiac tamponade signs

A

becks triad
raised JVP
low BP
muffled heart sounds

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14
Q

What precipitates digoxin toxicity

A

Hypokalaemia
Other factors; age, renal failure, myocardial ischaemia, other electrolyte abnormalities

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15
Q

Statins
- contraindications
- when to take
- doses

A

Contraindicated in pregnancy and if taking a macro life antibiotic (clarithromycin, erythromycin)
Take in the evening if od
Atorvastatin 20mg for primary prevention
Atorvastatin 80mg for secondary prevention

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16
Q

When is aspirin used in IHD

A

All patients without contraindications

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17
Q

how does bifasicular block appear on ECG

A

RBBB with left axis deviation

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18
Q

how does wolf Parkinson white appear on ECG

A

re-entry tachycardia caused by the presence of an accessory pathway- commonly presents supraventricular tachycardia.
ECG changes include a short PR interval along with wide QRS complexes with a slurred upstroke (delta wave)

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19
Q

Hypertrophic Obstructive CardioMyopathy

A

an inherited cardiac condition which is a cause of sudden death in young people

symptoms if present:
exertional dyspnoea
angina
syncope

signs:
ejection systolic murmur
S4 heart sound
LVH on ECG

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20
Q

coarctation of the aorta + features

A

congenital narrowing of the descending aorta

infancy: heart failure
adult: hypertension
radio-femoral delay
mid systolic murmur, maximal over back
apical click from the aortic valve
notching of the inferior border of the ribs

21
Q

associated conditions of coarctation of the aorta

A

Turner’s syndrome
bicuspid aortic valve
berry aneurysms
neurofibromatosis

22
Q

what valve does infective endocarditis most likely affect

A

tricuspid valve

23
Q

Arrhythmogenic right ventricular cardiomyopathy

A

inherited CVD that may present with syncope or sudden cardiac death

second most common after HOCM

causes T wave inversion v1-v3

24
Q

what is the main cause of mitral stenosis

A

rheumatic fever

25
Q

mitral stenosis symptoms

A

dyspnoea
haemoptysis
mid late diastolic murmur
malar flush
AF secondary to increased left atrial pressure

26
Q

adrenaline in ALS

A

adrenaline 1 mg as soon as possible for non-shockable rhythms

during a VF/VT cardiac arrest, adrenaline 1 mg is given once chest compressions have restarted after the third shock

repeat adrenaline 1mg every 3-5 minutes whilst ALS continues

27
Q

amiodarone in ALS

A

amiodarone 300 mg should be given to patients who are in VF/pulseless VT after 3 shocks have been administered

a further dose of amiodarone 150 mg should be given to patients who are in VF/pulseless VT after 5 shocks have been administered

28
Q

tachyarrhythmia; systolic BP<90mmHg

A

DC cardio version

29
Q

antiplatelet therapy before PCI

A

dual antiplatelet therapy prior to PCI (aspirin + another)

Prasugrel is offered if the patient is not taking an oral anticoagulant, whereas clopidogrel is offered if they are

30
Q

persistent ST elevation with no chest pain after an MI

A

left ventricular aneurysm

31
Q

statin major drug interaction

A

erythromycin/clarithromycin - contraindicated together

note statins also contraindicated in pregnancy

32
Q

drug treatment of a VT

A

amiodarone ideally via a central line

33
Q

Kussmaul’s sign

A

JVP rise on inspiration
associated with constrictive pericarditis

34
Q

secondary prevention after developing cardiovascular disease

A

4As

Aspirin
Atorvastatin
Atenolol or other beta-blocker
ACEi

35
Q

PCI in STEMI

A

within 120 minutes symptom onset

dual anti-platelet before - aspirin + prasguel/clopidogrel if already anti-coagulated

unfractioned heparin during PCI

36
Q

fibrinolysis in STEMI

A

done if >120 minutes

add another anti-thrombin drug

37
Q

NSTEMI management

A

Aspirin 300mg
Fondaparinux if no immediate PCI planned

Low risk GRACE score - give ticagrelor

High risk GRACE score - offer immediately if unstable, within 24 hours if not
give unfractioned heparin + ticagrelor/prasugrel

also consider coronary angiography

38
Q

heart failure first line drug management - reduced ejection fraction

A

ACE inhibitor + beta blocker

generally one started at a time

39
Q

2nd line HF treatment

A

add aldosterone antagonist e.g. spironolactone

note ACEi + spironolactone has risk of hyperkalaemia

40
Q

vaccinations HF

A

one off pneumococcal

annual flu

41
Q

treatment torsades de point

A

IV magnesium sulphate

42
Q

antiplatelets in medically treated ACS

A

aspirin lifelong and ticagrelor 12 months

if aspirin contraindicated, clopidogrel lifelong

43
Q

antiplatelets if PCI was used for ACS

A

aspirin lifelong + prasurgrel/ticagrelor 12 months

if aspirin contraindicated, clopidogrel lifelong

44
Q

antiplatelets TIA / stroke

A

clopidogrel lifelong

2nd line aspirin +dipyridamole

45
Q

antiplatelets peripheral artery disease

A

clopidogrel lifelong

2nd line aspirin lifelong

46
Q

management cardiac tamponade

A

urgent pericardiocentesis

47
Q

atrial septal defect murmur

A

ejection systolic

48
Q

hypercalcaemia main abnormality on ECG

A

shortening of QT interval

Clinical Years / Progress Test (24 decks)

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