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The Holy Grail (Treatments) > Cardio > Flashcards

Flashcards in Cardio Deck (37)
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1
Q

Hypertension <55 year-olds

A
  1. ACE Inhibitors (Ramipril, Lisinopril, Perindopril)
  2. CCBs (Amlodipine, Nifedipine, Verapamil, Diltiazem)
  3. Thiazide Diuretics (Bendroflumethiazide)
  4. Beta-Blockers (Atenolol, Bisoprolol)
    or Alpha-Blockers (Prazosin, Doxazosin)
    or Spironolactone

Exchange ACE Inhibitors for Angiotensin Receptor Blockers (Losartan, Valsartan, Candesartan)

2
Q

Hypertension > 55 year-olds or Black patients

A
  1. CCBs (Amlodipine, Nifedipine, Verapamil, Diltiazem)
  2. ACE Inhibitors (Ramipril, Lisinopril, Perindopril)
  3. Thiazide Diuretics (Bendroflumethiazide)
  4. Beta-Blockers (Atenolol, Bisoprolol)
    or Alpha-Blockers (Prazosin, Doxazosin)
    or Spironolactone

Exchange ACE Inhibitors for Angiotensin Receptor Blockers (Losartan, Valsartan, Candesartan)

3
Q

Targeted additional therapies for Hypertension

A
Angina: BBs and CCBs (never together) 
Heart Failure: BBs and ACE Is 
Diabetic Nephropathy: ACE Is and ARBs
Prostatism: Alpha-Blockers 
Elderly: Thiazide Diuretics
4
Q

Angina

A

ABC BAGS P

Aspirin
B1-Blockers (Atenolol, bisoprolol, metropolol) C
CCBs (Amlodipine, Nifedipine, Felodipine) B
Bypass
Angioplasty
GTN
Statins (if choleosterol >5mm/L)
Potassium Channel Openers (nicorandil, minoxidil)

Unstable: Old ladies are unstable, HAG

  • IV Heparin
  • Aspirin
  • IV GTN

Coronary Artery Spasm:

  • CCBs
  • Isosorbide mononitrate
5
Q

Heart Failure

A

Acute: Remember to be SOFD

  • Sit up
  • Oxygen
  • IV Furosemide
  • IV Diamorphine (not in COPD)

Standard therapy (or previous MI): ABDDS

  • ACEi
  • B-Blockers
  • Diuretics
  • Digoxin
  • Spironolactone

Cor Pulmonale:

  • Diuretics
  • Oxygen

Valvular Disease:
- Surgery

AF:

  • Digoxin
  • DC Cardioversion
6
Q

Acute Pulmonary Oedema

A

Furosemide

7
Q

DVT

A

DVTS happen Lower than the Waist

Anticoagulation:

  • LMWH
  • Warfarin (not in pregnancy)

TED compression stockings

8
Q

Phlegmasia Dolens

DVT caused obstruction of arterial flow due to back pressure created

A

IVC filter through femoral artery which prevents thrombus entering lungs (PE prophylaxis)

  • if long term give anticoagulation (as IVC increases DVT risk)
9
Q

Limb Ischaemia

A sudden lack of blood flow to a limb- causing intermittent claudication, ulcers or gangrene

A

You can’t go skiing in the ALPS if you have limb ischaemia

Anti-platelets
Lifestyle change (stop smoking, exercise more)
PCI or vascular bypass
Statins

10
Q

Abdominal Aortic Aneurysm

Defect in collagen-elastin regulation, causing excessive dilation + increase in abdominal aortic wall stress

A

Endovascular Aneurysm Repair

(Stent inserted via groin and passed up until the weakened part of the artery aneurysm is reached, where it seals off the aneurysm from inside the artery)

11
Q

Varicose Veins

Back pressure due to incompetent valves causes blood to pool in superficial veins

A
Foam sclerotherapy (chemical thrombophlebitis)
Endovenous ablation
Compression stockings
12
Q

Stroke

(Disrupted blood supply to the brain, causing ischaemia and focal neuropathy)

2 Types:

  • Ischaemic: Thrombus (blood clot)
  • Haemorrhagic: Hypoperfusion from bleed (aneurysm)
A

Strokes happen in the brain, must be smart, probably got decent SATS

Ischaemic: SATS

  • Statins
  • Aspirin
  • Thrombolysis (tPA)
  • Supportive

Haemorrhagic:
- supportive

Admit to Stroke Unit obvs
Anti-hypertensives

13
Q

Acute STEMI

A

Patient is probably moaning bc they are having an MI

MONA C 
Morphine (give with anti-emetic) 
Oxygen obviously 
Nitrate
Aspirin 
Clopidogrel 

PCI within 90 mins, or else thrombolysis

Can use:
B1-Blockers (Metroprolol)

14
Q

Post-MI

A
SABA + C 
Statin 
ACEi
Beta Blocker
Aspirin 
\+ Clopidogrel for 4 weeks 

CCBs (Verapamil, Diltiazem) in place of B-Blockers
Warfarin in place of Aspirin & Clopidogrel

15
Q

Supraventricular Arrhythmias

3 Types:

  • AF
  • Atrial Flutter
  • Ectopic Atrial Tachycardia
A
VAV
Vagal manoeuvres (Hold breath, bear down, equalise) 
Carotid massage (usually in children with low stroke risk)
IV adenosine (Anti-arrhythmic) 
IV verapamil (CCB)

Unstable: DC Cardiovert

16
Q

Chronic Arrhythmias

A

Radiofrequency Ablation

Selective cauterisation of cardiac tissue to prevent tachycardia- all anti-arrhythmic drugs must be stopped prior

17
Q

Ventricular Tachycardia

A

Acute (unstable): DC Cardioversion
Paroxysmal (stable): Amiodarone

If unsure if its VT /SVT give Adenosine (Anti-arrhythmic)

18
Q

Atrial Fibrillation

A

ABCDD

  • Amiodarone (Anti-arrhythmic) - rhythm control
  • B1- Blockers (Atenolol, Bisoprolol, Metropolol) - rate
  • CCB (Verapamil, Diltiazem) - rate control
  • Digoxin (Anti-arrhythmic) - rate control
  • DC Cardioversion - rhythm control

Anti-coagulation
Maze procedure

19
Q

Pulseless VT

A

Shock that mofo tf (defibrillation)

20
Q

Ventricular Fibrillation

A

Did someone say clear? SHOCK EM’ (defibrillation)

Consider adenosine if unsure

21
Q

Asystole

A

Patient is fucked

Adrenaline 1mg IV every 3-5 mins following CPR
Atropine
Intubation and IV access

22
Q

Pulseless electrical activity

A

Patient est fuckéd

CPR
IV access for: Atropine, Vasopressin, Adrenaline
Oxygen and intubation
Pray

23
Q

Aortic Stenosis

A

Valve replacement
Balloon valvotomy
TAVI (valve implantation)

24
Q

Mitral Regurgitation

A
Valve replacement
Percutaneous mitral valve repair
Loop Diuretics (Furosemide)
ACE Is (Ramipril, Lisinopril, Perindopril)
Digoxin
Warfarin
25
Q

Mitral Stenosis

A
Valve replacement
Mitral balloon valvuloplasty
Loop Diuretics (Furosemide)
B-Blockers
Digoxin
Warfarin
26
Q

Aortic Regurgitation

A

Valve replacement
ACE Is
ARBs
Diuretics

27
Q

Cardiac Tamponade

A

Pericardialcentesis

28
Q

Cardiomyopathy

A

Treat underlying disease

ACE Is
ARBs
B-Blockers
CCBs
Diuretics
Anti-Arrhythmics (Amiodarone and Digoxin)
29
Q

Coarctation of the Aorta

A

Balloon dilation + stenting

Surgery

30
Q

Pericarditis

A

Supportive (as its viral usually)

Antibiotics for specific bacteria

31
Q

Tetralogy of Fallot

A

Oxygen
Beta-Blocker
Endocarditis prophylaxis
Surgery

32
Q

Myocarditis

(Inflammation of the cardiac muscle) caused by:
Virus

A

Supportive treatment

33
Q

Sinus Bradycardia

(<60bpm)

Caused by:

  • athlete
  • beta-blockers
  • ischaemia (common in inferior STEMIs)
A

Atropine (>600mg)

34
Q

Sinus sick syndrome

SA node dysfunction

A

Pace

35
Q

Torsades de pointes

Looks like Forth-Rail Bridge on an ECG

A

Magnesium Sulphate

36
Q

SVT

A

AdenoSin bc “S”VT

  1. Adenosine
  2. BBs

Unstable: D.C. Cardiovert

37
Q

Aortic Incompetence (if evidence of LV dilation)

A

ACE Is