Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 PT > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What is the dose of adrenaline for children and adults in CARDIAC ARREST?

A

Child
10micrograms every 3-5mins
1:10,000

Adult
1mg every 3-5
1:10,000

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

How do you treat an overdose of apixaban or rivaroxaban (DOACs)?

A

Andexanet alfa

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

What are the vitamin K clotting factors?

A

2, 7, 9 and 10

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

What is the Bainbridge reflex?

A

Pee more and tachycardia to push fluid out

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

What time during the day should you give statins?

A

in the evening as they make you tired

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

What drug can you not give to patients who have mechanical heart valves? What do you use instead?

A

DOACs as could cause stroke + bleeding

USE WARFARIN

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

What is the major haemorrhage protocol?

A

2222

get blood pack:
X4 Blood, X4 FFP

take U+E, FBC, Crossmatch, PT, APTT, Fibrinogen, ABG, Calcium, Lactate

1:1
blood : FFP

1g Tranexamic Acid over 10 minutes, then 1g over 8 hours

give vitK for warfarinised patients

prevent hypothermia: bear hugger blankets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would you diagnose a carotid bruit and what could it indicate?

A

using a doppler ultrasoundcould lead to a clot in the carotid artery –> stroke

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

What is the antidote for heparin?

A

Protamine sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you treat hypertension?

A

any ACE inhib e.g. ramipril or ARB e.g. losartan (with or without diabetes)

but if 55 or over, OR!!! Black African/African-Caribbean, NOT WITH DIABETES, first line is a calcium-channel blocker e.g. verapamil or amlodipine

if Black and T2 diabetes = losartan

-if already on ACE and calcium channel blocker ADD a thiazide LIKE (NOT BENZTHIAZIDE)
-if still not working and potassium is more than 4.5 then add an alpha or beta blocker and if it’s lower than 4.5 give spironolactone

Remember that calcium channel blockers cannot be used in heart failure apart from amlodipine

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

What CHADS-VASc score indicates use of oral anticoagulants?

A

2 or more

(Age or stroke gives a score of 2, everything else scores 1)

congestive heart failure, hypertension, age (more than or equal to 75 would give a score of 2), diabetes, stroke, vascular disease, age normal (65-74), sex (women score 1)

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

When would you give a blood transfusion?

A

if Hb is 70g/L or below

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

How do statins work and when do you need to stop them?

A

Inhibiting cholesterol synthesis.

STOP them when macrolide abx have started e.g. clarithromycin

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

How do you treat acute atrial fibrillation?

A

IN THIS ORDER:

rhythm control = DC cardioversion (first line only if symptoms less than 48 hrs or on anticoags)

Stroke control = DOAC’s !!! e.g. apixaban if CHADVASC score 2 for 4 weeks or for a minimum of 3 weeks before the cardioversion or transoesophageal echo instead of the 3 weeks anti-coag

rate control = beta blocker OR calcium channel blocker e.g. diltiazem, digoxin

if already on a beta blocker and need another rate control:
-Amiodarone (especially if they have heart disease)
-Flecainide

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

How do you reverse warfarin?

A

Reversal in 1 hr: give PCC (prothrombin complex concentrates)

-only use fresh frozen plasma if PCC is not available

-give IV vitamin K with the PCC/FFP as well

reversal in 4-24 hours: IV or oral Vit K

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is endocarditis/criteria to diagnose?

A

DUKE’s CRITERIA

infection of the inner lining of the heart (the endocardium)–> flu/infection like symptoms, chest pain when breathing

fever and a new murmur
janeway lesions

THREE sets of blood cultures

treatment:
normal valve—> amox +/- gent
prosthetic —> vanc + rifampicin + gent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What might suggest an:
aortic stenosis
aortic regurgitation
mitral regurgitation
mitral stenosis?

A

-Reduced or absent S2/ejection systolic murmur
-Early diastolic murmur
-pan-systolic murmur
-Mid-late diastolic murmur: LOUD S1: rheumatic fever

start end
MR AS systolic
AR MS diastolic

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

What drug is used to treat 3rd degree heart block/overdose of beta-blockers?

A

Atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you treat acute and chronic heart failure?

A

ACUTE:
1) IV furosemide
2) oxygen
3) nitrates (with caution)
4) CPAP for patients with respiratory failure
5) inotropes if have hypotension e.g. dobutamine

CHRONIC:
1) ACE-inhib
2) beta blocker
3) spironolactone
4) SGLT-2 inhibs e.g. dapagliflozin
5) ivabradine if sinus rhythm
6) valsartan
7) digoxin if in AF
8) annual influenza and one off pneumococcal

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

What is the DeBakey classification and the different treatments for them?

A

Types of aortic dissection

Type I = ascending aorta, aortic arch, descending aorta

type II = ascending aorta = IV labetalol + surgery

type III = descending aorta = IV labetalol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What drug must you stop giving if the patient has a blood clot?

A

naproxen or any NSAIDs as they can cause bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is an aortic dissection?

A

aortic aneurysm (abdominal or mediastinal) is painless until it dissects

-weak carotid, brachial and femoral pulses
-variation in arm BP
-pulsating feeling in your stomach
-persistent back pain
-persistent abdominal pain
-clammy, tachy, SOB, dizzy, TLOC
-In men, the pain can also radiate down into the scrotum

diagnose with ultrasound or if a dissection use a CT angiography
May see mediastinal widening on chest x-ray

-if tear is bigger than or 5.5cm then surgery and see specialist in 2 weeks if clinically well otherwise
-if not then regular scans to keep an eye on it-surgery if it is rapidly enlarging
-rescan in 3months if enlarging slowly
-rescan once a year if 3-4.4cm
-medications to reduce BP and cholesterol level

Acute management:
-ABCDE assessment
-Call senior
-2222- call
-2 large bore cannulas- Fluid/blood resus
-high flow oxygen
-labetalol
-analgesia
-anti-emetic
-take bloods: FBC, CRP, CK, troponin, U+Es (renal failure), glucose, Lactate- end organ damage, blood gas, group and save

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

What monitoring does heparin need?

A

APTT

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

How does warfarin work?

What kind of monitoring does warfarin need, side effects and drugs that might interfere?

A

Inhibits epoxide reductive preventing the reduction of vitamin K (blocks vitamin k from making clotting factors)

INR monitoring
warfarin—> increases prothrombin time
If INR>4.5 can’t give warfarin

Side effects:
Haemorrhage, teratogenic (CAN be used in breastfeeding), purple toes, skin necrosis

Drugs interfere:
P450 enzyme inhibitors e.g. ciprofloxacin, omeprazole, SSRIs
Cranberry juice
NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is Commotio Cordis?

A

blunt, non-penetrating trauma to the chest at the upstroke of the T wave in the cardiac cycle causing cardiac arrest and sudden death –> defibrillate

young, males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Buerger’s disease (thromboangiitis obliterans) and what is the difference between this and Peripheral arterial disease (PAD)?

A

Vessel vasculitis strongly associated with smoking
It causes Raynaud’s phenomenon (discolouration of extremities with cold exposure) and pain in legs which occurs during exercise and is relieved by rest

Peripheral arterial disease (PAD) may cause leg pain with strenuous exercise, but is not commonly associated with Raynaud’s phenomenon. PAD increases progressively with age, mostly beginning after age 40.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How do you treat a STEMI? acute and long term?

A

MONA
-oxygen if less than 94%
-don’t give GTA if hypotensive

1) always give 300mg aspirin
2) PCI (or fibrinolysis if PCI not possible in 2hrs)
3) give prasugrel with aspirin if not already taking oral anticoagulants or clopidogrel with aspirin if taking an oral anticoag
4) Give unfractionated heparin with bailout GPI for radial access

5) if did fibrinolytic give anti-thrombin at same time and then give ticagrelor and repeat ECG 60-90mins later

6) if no PCI then give ticagrelor

Long term:
Aspirin
ACE-inhibitor
Beta-blocker
Statin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When should a statin be perscribed?

A

when there is a QRisk score of >10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How do you treat stable angina?

A

episodes of angina attacks = GTN spray or isosorbide mononitrate (IM)
- use asymmetric dosing interval for IM

treating stable angina = beta blocker (CANNOT USE THIS IF PATIENT HAS ASTHMA) or a calcium channel blocker and combine the two if monotherapy doesn’t work

CC monotherapy: verapamil
CC combination: amlodipine, nifedipine

prevention of stable angina (LONG TERM)= aspirin and statin OR aspirin + statin with an ACE-inhib if also have diabetes

if drugs do not work = CABG or PCI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What drug can cause angioedema (swelling, usually around the eyes, lips, tongue)?

A

ACE inhibitors e.g. Ramipril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the usual warfarin ranges?

A

1.1 or less = normal

2-3 = on warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What does hypothermia look like on an ECG?

A

ST-elevation
J waves or Osborn waves
torsades de pointes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is superficial thrombophlebitis?

A

inflammation associated with thrombosis of one of the superficial veins, usually the long saphenous vein of the legtreat with NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How does metronidazole affect anticoagulants (e.g. warfarin) if taken together?

A

increases the anticoagulant effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What can be seen on an ECG that would suggest a pulmonary embolism?

A

‘S1Q3T3’ - large S wave in lead I, a large Q wave in lead III and an inverted T wave in lead III

right bundle branch block and right axis deviation

sinus tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

When should warfarin, heparin and DOACs be stopped before surgery and started again?

A

warfarin - 5 days before and resumed on the evening of/morning next day (if emergency then give vit K)

heparin - stopped 24hrs before and not restarted until 48hrs after

DOACs - 24hrs before for low risk procedure and 48-72hrs for high risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is used to treat torsades de pointes?

A

IV magnesium sulphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How do you treat SVT (supraventricular tachycardia), acute and chronic?

A

acute management:
-vasovagal maneouvre but if systolic BP<90 then shock first
-IV 6mg adenosine (can cause chest pain)–> 12mg –> 18 mg UNLESS have asthma then use verapamil

Prevention of episodes:
beta-blockers
radio-frequency ablation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is a normal PR interval?

A

0.12-0.2 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How do you calculate heart rate on an ECG?

A

300/ (number of large boxes between two R waves)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Can you have sex after a heart attack?

A

Yes, when you feel ready to usually around 2-4 weeks after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

When does tripe A screening happen?

A

SINGLE abdominal ultrasound for MALES aged 65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the treatment for high INR?

A

INR 5-8 no bleeding = withhold 1 or 2 doses of warfarin

INR 5-8 bleeding = stop warfarin, give IV vit K 1-3mg, restart when INR < 5

INR > 8 no bleeding = stop warfarin, give oral vit K 1-5mg, restart when INR < 5

INR > 8 minor bleeding = stop warfarin, give IV vit K 1-3mg, restart when INR < 5

Major bleed e.g. head injury, surgery = stop warfarin, give IV vit K 5mg, PCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How do you remember the classes of antiarrhythmic drugs?

A

Some Block Potassium Channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What specific protein can be looked at to try and diagnose heart failure?

A

B-type natriuretic peptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What side effect can taking statins have and what would you do?

A

Muscle aches and RHABDOMYOLYSIS –> check creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are varicose veins?

A

dilated superficial veins usually in the legs

risk factors: old age, pregnancy, females, obesity

ultrasound will show retrograde venous flow

-leg elevation, weight loss, exercise and compression stockings
-refer to secondary care if pain, eczema or ulcer
-ablation, foam sclerotherapy, surgery (ligation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the contraindications to thrombolysis e.g. atleplase, tenecteplase, streptokinase?

A

active internal bleeding
recent haemorrhage, trauma or surgery (including dental extraction)
coagulation and bleeding disorders
intracranial neoplasm
stroke < 3 months
aortic dissection
recent head injury
severe hypertension

49
Q

What is the difference between cardiac tamponade and constrictive pericarditis?

A

TAMponade = TAMpaX
absent Y descent in the JVP

pericarditis = X + Y present

50
Q

What test is used to keep an eye on ACE inhibitors?

A

U+Es

51
Q

What monitoring does digoxin need?

A

none.

52
Q

How do treat an NSTEMI and unstable angina?

A

1) aspirin 300mg and fondaparinux if no immediate PCI
2) calculate GRACE score
3) if GRACE > 3% = PCI, heparin, prasugrel or ticagrelor
4) if GRACE < 3% = ticagrelor

53
Q

What is the difference between non-ST elevation myocardial infarction (NSTEMI) and unstable angina?

A

non-ST elevation myocardial infarction = ST depression and elevation troponin

unstable angina = ST depression

54
Q

How do you manage hypertension if already on an ACE inhib and calcium channel blocker?

A

add a thiazide like diuretic

55
Q

How do you treat bradycardia?

A

1) atropine 500mcg (up to 6 times)
2) transcutaneous pacing
3) adrenaline infusion

56
Q

To prevent strokes, what drug is used for a patient with AF?

A

Warfarin and should be started 2 weeks after a stroke

57
Q

What drug can cause reflex tachycardia?

A

nifedipine

58
Q

What cardiac abnormality is seen with Marfan’s syndrome?

A

aortic regurgitation

59
Q

What drug can cause the patient to have grey skin?

A

amiodarone

60
Q

Persistent ST elevation following recent MI and no chest pain?

A

Left ventricular aneurysm

61
Q

What actually is stable angina? What investigations?

A

Chest pain that is worse on exertion and can be relieved by GTN

investigations: CT coronary angiography

62
Q

What blood test needs to be checked before starting a statins and when?

A

Baseline: LFTs, TSH, U+Es, lipid profile

Only for LFT:
3 months
12 months

63
Q

How do you treat atrial flutter?

A

radiofrequency ablation of the tricuspid valve

64
Q

What would be the most likely diagnosis if someone had breathlessness and PALPITATIONS with pain worse when lying down? and what would be seen on an ECG? How do you treat?

A

acute pericarditis

PR depression and saddle shaped ST elevation

management:
-NSAID AND colchicine

65
Q

What is the ORBIT scoring system used for?

A

estimates the risk of bleeding for patients on anti-coags for AF

66
Q

What ECG changes are seen in LAD, right coronary and left circumflex arteries?

A

LAD = V1-6
Right coronary = II, III, aVF
Left circumflex = I, aVL

67
Q

What cardiac drug can you not give to patients with hypotension?

A

Nitrates

68
Q

What is Wolff-Parkinson White syndrome?

A

short PR interval
wide QRS with a slurred upstroke (delta wave)

–> ablation of accessory pathway

69
Q

What is the treatment for a PE presenting with hypotension?

A

thrombolysis

70
Q

What are the features of cardiac tamponade and how do you manage it?

A

accumulation of pericardial fluid under pressure

-Beck’s triad = hypotension, raised JVP and muffled heart sounds
-can also be worse when lying down like pericarditis
-pulsus paradoxus = an abnormally large drop in BP during inspiration
-ECG: electrical alternans: QRS height varies

management: ugrent pericardiocentesis

71
Q

What ECG changes are normal in an athelte? And what is never normal?

A

sinus bradycardia

1st degree heart block

Mobitz type 1 (Wenckebach)

LBBB IS NEVER NORMAL!!

72
Q

How much calf swelling would suggest a DVT?

A

> 3cm compared to the other leg

73
Q

What is subclavian steal syndrome (SSS)?

A

diversion of blood flow away from the affected arm - usually left - resulting from atherosclerosis most commonly

arm pain or paraesthesia made worse with arm movement

syncope
vertigo
diplopia
dysphagia
dysarthria
visual loss

antiplatelet and statins
percutaneous angioplasty

74
Q

What is Takotsubo cardiomyopathy?

A

chest pain that looks like an MI but is usually caused by stress e.g. bereavement

ballooning of the myocardium (octopus pot)

supportive management

75
Q

What AF drug is known to cause constipation?

A

verapamil

76
Q

What are the different types of lower leg ulcers?

A

Venous = oedema, brown pigmentation, lipodermatosclerosis (champagne bottle legs), eczema, above ankle, painless–> compression banding

Marjolin’s = squamous cell carcinoma, seen around burns and chronic osteomyelitis

Arterial = toes and heels, deep punched out appearance, painful, cold with no pulses, low ABPI

Neuropathic = metatarsal head and plantar surface of hallux, diabetics, due to pressure–> cushioned shoes

Pyoderma gangrenosum = IBD/rheumatoid arthritis, stoma sites, erythematous nodules or pustules which ulcerate

77
Q

What is Dressler’s syndrome?

A

fever, pleuritic pain, pericardial effusion and a raised ESR, 2-6 weeks following a MI

–> NSAIDs

78
Q

What is peripheral arterial disease (PAD)?

A

-burning or aching in leg muscles after walking
-calf pain = femoral vessels
-bum pain = iliac vessels-can walk for a certain distance before symptoms start
-relived by stopping walking
-not present at rest

check pulses
check ABPI
venous duplex ultrasound first line then MRA (angiography)

ABPI results:
1 Normal
0.6-0.9 Claudication
0.3-0.6 Rest pain
<0.3 Impending

management:
quit smoking
atorvastatin 80mg
clopidogrel 75mg
exercise

79
Q

What drug can cause a dry cough to appear?

A

ACE- inhibitors

80
Q

What is the treatment for acute limb ischaemia?

A

pain relief
IV heparin
vascular review

81
Q

What artery is most likely if someone goes into complete heart block after an MI?

A

Right coronary artery

82
Q

What valve is most likely to be affected in infected endocarditis?

A

mitral valve

tricuspid valve in IV drug users

83
Q

Do you need to inform the DVLA after a heart attack?

A

No, but should stop driving for:

1 week if had an angioplasty
4 weeks if had an angioplasty and it wasn’t successful
4 weeks if you had a heart attack but didn’t have an angioplasty

84
Q

How can you tell the difference between the different types of murmurs:
ejection systolic
pansystolic
early diastolic
mid-diastolic
continuous

A

ejection systolic = louder on expiration, tetralogy of fallot

pansystolic = louder during inspiration

early diastolic = high-pitched and ‘blowing’ in character

mid-diastolic = ‘rumbling’ in character

continuous = patent ductus arteriosus = hum sound

systolic = swish
diastolic = whoosh

Right-sided murmur → heard best on Inspiration

Left-sided murmur → heard best on Expiration

85
Q

What are the features of a PE and how do you manage it?

A

tachypnea
tachycardia
crackles
fever
chest pain

Calculate Well’s score and follow below: can also order ECG and chest x-ray

If a PE is ‘likely’ (more than 4 points) = CTPA/VQ scan and give a DOAC if delay in imaging
if the CTPA is positive then a PE is diagnosed
if the CTPA is negative then consider a proximal leg vein ultrasound scan if DVT is suspected

If a PE is ‘unlikely’ (4 points or less) = D-dimer test
if positive follow above steps

Management:
-DOACs for 3 months if there was a cause or for 6 months if there was no known cause
-If renal impairment/anti phospholipid syndrome/pregnancy give LMW heparin
-Thrombolysis for hypotensive PE

86
Q

What are the symptoms of hypercalcaemia AND what is seen on an ECG?

A

stones
groans
bones
moans

–> short QT interval

87
Q

What would be the likely diagnosis: 1-2 weeks after an MI, a patient presents with cardiac tamponade symptoms?

A

left ventricular free wall rupture

88
Q

What is a coronary artery bypass graft surgery (CABG)?

A

used to treat coronary heart disease

might need 2, 3 or 4 grafts = double, triple or quadruple bypass

grafts can be taken from leg, arm, chest (may have scars here)

a large midline chest incision is made (big scar)

89
Q

What is De Musset’s sign?

A

head bobbing at the same time with heart beat –> aortic regurg

90
Q

What is the cut off blood pressure for elective surgeries?

A

160/100

91
Q

What are the clinical findings of aortic stenosis and management?

A

Chest pain
Dyspnoea
Syncope (exertional dizziness)
Ejection systolic murmur

Most likely caused by calcification

Cyanosis
SOB
Pallor
Malar flush
Oedema
Corneal arcus
Xanthelasma
Pectus excavatum/carinatum
Scars on chest

management:
-asymptomatic = observe
-symptomatic = aortic valve replacement (angiogram is often done prior to surgery) done by surgery or transcatheter
-balloon valvuloplasty 2nd line

92
Q

What is orthostatic hypotension and how do treat it?

A

ONYL a drop in BP within 3 minutes of standing
Presyncope
Syncope

Treat with midodrine and fludrocortisone

93
Q

What is the most common cause of secondary hypertension?

A

Primary hyperaldosteronism

94
Q

What drug and dose is used to prevent cardiovascular disease?

A

Primary = Statin, 20 mg
Secondary = statin, 80 mg

95
Q

What are the symptomatic differences between left and right sided heart failure?

A

Left: Lung symptoms
-dyspnoea
-tachypnoea
-crackles
-cough: worse at night
-fatigue
-cyanosis

Right: Rest of body
-Peripheral oedema
-ascites
-hepato/splenomegaly
-raised JVP
-weight gain from fluid overload

96
Q

How could you tell the difference clinically between ventricular fibrillation and ventricular tachycardia?

A

The patient will NOT be conscious in VF

97
Q

What could the loss of the left heart border a sign of?

A

Left lingula consolidation

98
Q

Can pregnant women have statins?

A

NO!!

99
Q

Developing acute heart failure days after a MI and a new pan-systolic murmur….diagnsis?

A

ventricular septal defect

100
Q

What drugs can cause erectile dysfunction?

A

beta-blockers
thiazide-like drugs
SSRIs

101
Q

What is the antidote for dabigatran?

A

Idarucizumab

102
Q

How are palpitations investigated?

A

Holter monitor after bloods/ECG

103
Q

What can cause torsades de pointes?

A

Macrolides e.g. erythromycin
Hypothermia

104
Q

What type of rash is seen with rheumatic fever, and how do you treat it?

A

Erythema marginatum

Oral penicillin and NSAIDs

105
Q

What drug can cause glucose tolerance (high glucose reading)?

A

Thiazides

106
Q

What is aortic regurgitation?

A

Blood flows in the reverse direction during ventricular diastole

Can present with:
Dizziness+SOB+fatigue
Rheumatic fever
Endocarditis
Aortic dissection

Early diastolic murmur
Soft S1
Collapsing pulse
De Musset’s sign

Echo

Manage heart failure
Surgery for valve replacement

107
Q

What is Hypertrophic Obstructive Cardiomyopathy (HOCM)?

A

most common cause of sudden cardiac death in the young
autosomal dominant

Symptoms:
S4 heart sound!!
often asymptomatic
exertional dyspnoea
sudden death
ejection systolic murmur: Increases with Valsalva manoeuvre and decreases on squatting

Associations:
Friedreich’s ataxia
Wolff-Parkinson White

Echo findings - mnemonic - MR SAM ASH:
mitral regurgitation (MR)
systolic anterior motion (SAM)
asymmetric hypertrophy (ASH)

ECG
left ventricular hypertrophy
atrial fibrillation may occasionally be seen

108
Q

What would be the diagnosis if after starting an ACE inhibitor the potassium and creatinine increased (renal impairment)?

A

bilateral renal artery stenosis

109
Q

If at a routine GP appointment, AF is picked up how do you treat it?

A

If the CHAD-VASc score is 0 then no treatment needed…hence why always check this score first!

110
Q

How do you treat the different types of heart block?

A

AV blocking drugs stopped: beta-blockers, calcium channel blockers, antiarrhythmics, and digoxin
Pacemaker if symptomatic

Atropine, transcutaneous pacing, adrenaline (for complete block)

111
Q

Learn ECG examples.

A
112
Q

What is the only calcium channel blocker that can be used in heart failure to treat hypertension?

A

Amlodipine

113
Q

What are the ECG differences between hypokalaemia and hyperkalaemia?

A

PER: Peaked T waves, p wave flattening

PO: T wave inversion, ST depression, U wave

114
Q

Learn how to recognise the difference between ventricular, tachycardia and ventricular fibrillation on an ECG?

A
115
Q

What drug can you not give with verapamil?

A

Beta-blockers

116
Q

What kind of murmur is heard best in the lower left sternal edge?

A

Ventricular septal defect

117
Q

If a female of childbearing age required valve replacement, what type of valve would be given?

A

Usually a tissue valve as if they were given a mechanical valve they would need to be put on warfarin and this is teratogenic

118
Q

How do you treat NON-PULSELESS ventricular tachycardia?

A

This is a broad complex tachycardia
If there are no adverse signs then give
Amiodarone 300mg IV

119
Q

If someone says they have to sleep with lots of pillow and they wake up in the night short of breath…what is the most likely diagnosis?

A

heart failure

ALSO DO NOT MISS ACUTE HEART FAILURE IN A SOB STATION!

Year 4 PT (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions