Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

revision > cardio > Flashcards

cardio Flashcards

(78 cards)

Start Studying
1
Q

pathological q waves sign of

A

previous/ resolving MI. indefinite, hours to days

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

causes of ventricular tachycardia

A

hypokalaemia, hypo magnesaemia, (hyperkalaemia can too)

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

torsades de pointe

A

polymorphic VT precipitated by prolonged QT

treat with iv mag sulf

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

verapimil + betablocker

A

contraindicated due to bradycardia

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

management of stable angina

A

-betablocker
-dihydropyridine calcium channel blocker
- both
if not tolerated use:
A long-acting nitrate
Ivabradine
Nicorandil
Ranolazine

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

ivabradine side effects

A

visual disturbances including phosphenes and green luminescence
metabolised by oxidation through cytochrome P450 3A4 (CYP3A4) only. Therefore drugs that induce (e.g rifampicin) or inhibit (e.g erythromycin, itraconazole) CYP3A4, will decrease or increase the plasma concentration

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

INR:

  • following VTE/ AF
  • recurrent VTE
  • when to give vitamin k
A
  • 2.5
  • 3.5
  • 5-8 + bleed or 8+ or major bleed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

management and doses of anaphylaxis

don’t discharge before observation for 6h due to biphasic reaction. can repeat adrenaline every 5 mins

A

Adrenaline Hydrocortisone Chlorphenamine

< 6 months 150 micrograms (0.15ml 1 in 1,000) 25 mg 250 micrograms/kg

6 months - 6 years 150 micrograms (0.15ml 1 in 1,000) 50 mg 2.5 mg

6-12 years 300 micrograms (0.3ml 1 in 1,000) 100 mg 5 mg

Adult and child > 12 years 500 micrograms (0.5ml 1 in 1,000) 200 mg 10 mg

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

ECG features of hypokalaemia

A 
U waves
small or absent T waves (occasionally inversion)
prolong PR interval
ST depression
long QT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

eisenmengers syndrome definition

A

the reversal of a left-to-right shunt in a congenital heart defect due to pulmonary hypertension. This occurs when an uncorrected left-to-right leads to remodeling of the pulmonary microvasculature, eventually causing obstruction to pulmonary blood and pulmonary hypertension.

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

treatment of toursade de pointe

A

iv mag sulf

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

initial management of VF

A

1 shock then 2mins CPR

witnessed VF, up to 3 shocks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

aortic coract associated with

A

Turner’s syndrome
bicuspid aortic valve
berry aneurysms
neurofibromatosis

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

causes of raised BNP

A

heart failure is the most obvious cause of raised BNP levels any cause of left ventricular dysfunction such as myocardial ischaemia or valvular disease may raise levels. Raised levels may also be seen due to reduced excretion in patients with chronic kidney disease.

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

loop diuretics side effects

A 
hypotension
hyponatraemia
hypokalaemia, hypomagnesaemia
hypochloraemic alkalosis
ototoxicity
hypocalcaemia
renal impairment (from dehydration + direct toxic effect)
hyperglycaemia (less common than with thiazides)
gout
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

VT management

A

Drug therapy
amiodarone 300mcg: ideally administered through a central line
lidocaine: use with caution in severe left ventricular impairment
procainamide

Verapamil should NOT be used in VT

If drug therapy fails
electrophysiological study (EPS)
implant able cardioverter-defibrillator (ICD) - this is particularly indicated in patients with significantly impaired LV function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

nitrates contraindicated in

A

aortic stenosis- profound hypotension

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

thiazide diuretics adverse effects

A 
Common adverse effects
dehydration
postural hypotension
hyponatraemia, hypokalaemia, hypercalcaemia*
gout
impaired glucose tolerance
impotence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

dipyridamole MoA

A

Dipyridamole is an antiplatelet mainly used in combination with aspirin after an ischaemic stroke or transient ischaemic attack.

Mechanism of action
inhibits phosphodiesterase, elevating platelet cAMP levels which in turn reduce intracellular calcium levels
other actions include reducing cellular uptake of adenosine and inhibition of thromboxane synthase

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

IE dukes major criteria

A

Pathological criteria

Positive histology or microbiology of pathological material obtained at autopsy or cardiac surgery (valve tissue, vegetations, embolic fragments or intracardiac abscess content)

Major criteria

Positive blood cultures
two positive blood cultures showing typical organisms consistent with infective endocarditis, such as Streptococcus viridans and the HACEK group, or
persistent bacteraemia from two blood cultures taken > 12 hours apart or three or more positive blood cultures where the pathogen is less specific such as Staph aureus and Staph epidermidis, or
positive serology for Coxiella burnetii, Bartonella species or Chlamydia psittaci, or
positive molecular assays for specific gene targets

Evidence of endocardial involvement
positive echocardiogram (oscillating structures, abscess formation, new valvular regurgitation or dehiscence of prosthetic valves), or
new valvular regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ecg changes hypothermia

A 
bradycardia
'J' wave - small hump at the end of the QRS complex
first degree heart block
long QT interval
atrial and ventricular arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

drugs to control rate in AF

A

beta-blockers
calcium channel blockers
digoxin (not considered first-line anymore as they are less effective at controlling the heart rate during exercise. However, they are the preferred choice if the patient has coexistent heart failure)

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

drugs to maintain sinus rhythm in AF

A

sotalol
amiodarone
flecainide
others (less commonly used in UK): disopyramide, dofetilide, procainamide, propafenone, quinidine

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

atorvastatin interacts with

A

macrolides- risk of rhabdomyolsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
when to stop statins
Treatment with statins should be discontinued if serum transaminase concentrations rise to and persist at 3 times the upper limit of the reference range.
26
takayasu features
``` large vessel vasculitis females aorta/ renal artery stenosis systemic features of a vasculitis e.g. malaise, headache unequal blood pressure in the upper limbs carotid bruit intermittent claudication aortic regurgitation (around 20%) ```
27
child pugh scale
liver cirrhosis
28
buergers disease features
small and medium vessel vasculitis that is strongly associated with smoking. Features extremity ischaemia: intermittent claudication, ischaemic ulcers etc superficial thrombophlebitis Raynaud's phenomenon
29
anti coag vs antiplatelet in: - 2ry prevention of MI - 2ry prevention of MI with AF - post ACS/PCI - VTE
- anitplatelet - anticoag monotherapy - 2 antiplatelets and 1 doac - if already on anti P go to anti C, if low HASBLED anti P
30
new onset AF less than 48 hours | more than 48 hourse
dc cardioversion | 3 weeks of anticoagulation first
31
aortic regurge signs
``` Corrigan's - exaggerated carotid pulse Quinke's - nailbed pulsation De Musset's - head nodding Duroziez's - diastolic femoral murmur Traube's - 'pistol shot' femorals ```
32
ECG changes for thrombolysis or percutaneous intervention:
ST elevation of > 2mm (2 small squares) in 2 or more consecutive anterior leads (V1-V6) OR ST elevation of greater than 1mm (1 small square) in greater than 2 consecutive inferior leads (II, III, avF, avL) OR New Left bundle branch block
33
hocm management
``` Amiodarone Beta-blockers or verapamil for symptoms Cardioverter defibrillator Dual chamber pacemaker Endocarditis prophylaxis* ```
34
dilated cardiomyopathy causes
``` Classic causes include alcohol Coxsackie B virus wet beri beri doxorubicin ```
35
amiodarone side effects
``` Bradycardia Hyper/hypothyroidism pulmonary fibrosis/pneumonitis liver fibrosis/hepatitis jaundice taste disturbance persistent slate grey skin discolouration raised serum transaminases nausea constipation (particularly at the start of treatment) ```
36
pulsus paradoxus
greater than normal drop 10mmhg in systolic bp | asthma, cardiac tamponade
37
most common cause of drug induces angioedema
ace inhibitors
38
management of PE
LMWH or heparin initially for 5 days | warfarin within 24h to 3 months
39
tx of SVT
valsalva adenosine 6mg 12mg 12mg electrical cardioversion ablation
40
causes of long qt
congenital: Jervell-Lange-Nielsen syndrome, Romano-Ward syndrome antiarrhythmics: amiodarone, sotalol, class 1a antiarrhythmic drugs tricyclic antidepressants antipsychotics chloroquine terfenadine erythromycin electrolyte: hypocalcaemia, hypokalaemia, hypomagnesaemia myocarditis hypothermia subarachnoid haemorrhage
41
systolic murmur under left clavicle and on back
aortic coarct
42
haemodynamic instability and pain after PCI
urgent CABG
43
3rd heart sound
caused by diastolic filling of the ventricle considered normal if < 30 years old (may persist in women up to 50 years old) heard in left ventricular failure (e.g. dilated cardiomyopathy), constrictive pericarditis (called a pericardial knock) and mitral regurgitation
44
4th heart sound
may be heard in aortic stenosis, HOCM, hypertension caused by atrial contraction against a stiff ventricle therefore coincides with the P wave on ECG in HOCM a double apical impulse may be felt as a result of a palpable S4
45
ix for chronic heart failure
BNP aldosterone antagonists, ACE inhibitors, angiotensin-II receptor antagonists, beta-blockers and diuretics can all falsely lower BNP levels, as can obesity.
46
st elevation without blockage on angiogram
takotsubo
47
mx angina
aspirin and statin gtn spray beta blocker or ccblocker (verapamil/diltiazem) 1st line long acting nitrate 3rd line ivabradine, nicorandil or ranolazine
48
fondaparinux moa
activates antithrombin III
49
pulmonaryy artery pressure, cardiac output and vascular resistance in hypovolaemia cardiogenic shock septic shock
low, low, high (decreased preload) high low, high (hence venodilators for pulmonary oedema) low, high, low (hence vasoconstrictors)
50
wellens sign
deep inverted t waves (critical stenosis of LAD)§
51
marker for second MI in quick succession
CK MB (remains elevated for 3-4 days) trop for 10 days
52
indications for emergency valve replacement
Severe congestive cardiac failure Overwhelming sepsis despite antibiotic therapy (+/- perivalvular abscess, fistulae, perforation) Recurrent embolic episodes despite antibiotic therapy Pregnancy
53
MOA statin
HMG coa reductase inhibitor in hepatic synthesis
54
ix in PE and renal failure
v/q perfusion scan
55
bisferiens pulse
HOCM (happens in subaortic stenosis)
56
drug which only improve mortality in NYHA 3
spironolactone
57
pedunculated mass on echo leading to emboli and AF
atrial myxoma
58
when to stop warfarin before surgery
5 days
59
high grace score- what other drug
abciximab glp3a/2b inhib
60
when not to treat htn
over 80 and low qrisk
61
non cardiac pain but ECG changes - imaging?
coronary ct angio
62
mx of aortic dissection
Type A surgical management, but blood pressure should be controlled to a target systolic of 100-120 mmHg whilst awaiting intervention Type B* conservative management bed rest reduce blood pressure IV labetalol to prevent progression
63
An inferior myocardial infarction and AR murmur should raise suspicion of
ascending aorta dissection rather than an inferior myocardial infarction alone Other features may include pericardial effusion, carotid dissection and absent subclavian pulse.
64
eisenmengers
reversal of left-to-right shunt associated with ventricular septal defects, atrial septal defect and a patent ductus arteriosus.
65
severe mitral stenosis
p mitrale bifid p wave
66
carotid sinus hypersensitivity
ventricular pause of 4 secs, fall in SBP of 10mmhg
67
erythema marginatum
rheumatic fever, sydenha
68
hocm fx
often asymptomatic exertional dyspnoea angina syncope typically following exercise due to subaortic hypertrophy of the ventricular septum, resulting in functional aortic stenosis sudden death (most commonly due to ventricular arrhythmias), arrhythmias, heart failure jerky pulse, large 'a' waves, double apex beat ejection systolic murmur increases with Valsalva manoeuvre and decreases on squatting hypertrophic cardiomyopathy may impair mitral valve closure, thus causing regurgitation
69
statin monitoring
LFTs at 0,3 and 12 months
70
when to operate on aortic stenosis
aortic valve gradient > 40 mmHg or there is evidence of significant left ventricular dysfunction then surgery is sometimes considered in selected asymptomatic patients
71
kussmauls's sign
JVP increase with inspiration, feature of contrictive pericarditis
72
mx of long qt
avo;id drug betablocker icd
73
when to treat HTN
``` stage 1 135/85 and <80 organ damage cvd renal disease diabetes qrisk 10% ``` or <60 or all stage 2
74
cor pulmonale
right heart failure
75
power of defib in VF
150 J
76
bi/trifascicular block
Bifascicular block combination of RBBB with left anterior or posterior hemiblock e.g. RBBB with left axis deviation Trifascicular block features of bifascicular block as above + 1st-degree heart block
77
mx proximal aortic dissection
Proximal aortic dissections are generally managed with surgical aortic root replacement.
78
cha2ds2vasc
``` C Congestive heart failure 1 H Hypertension (or treated hypertension) 1 A2 Age >= 75 years 2 Age 65-74 years 1 D Diabetes 1 S2 Prior Stroke or TIA 2 V Vascular disease (including ischaemic heart disease and peripheral arterial disease) 1 S Sex (female) 1 ```

revision (24 decks)

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