Flashcards in Cardiology Deck (58):
What are the general mechanisms of action of vaughan williams classes 1-4?
Class 1 block sodium channels to reduce threshold
Class 2 block beta adrenoceptors to reduce sympathic input to the heart
Class 3 block potassium channels to prolong repolarisation and reduce re-entry
Class 4 block calcium channels to slow repolarisation and reduce re-entry
Give an example of a vaughan williams class 1a drug
Give an example of a vaughan williams class 1b drug
Give an example of a vaughan williams class 1c drug
Give an example of a vaughan williams class 2 drug
Give an example of a vaughan williams class 3 drug
Give an example of a vaughan williams class 4 drug
What are the three main causes of a microcytic anaemia?
What iron study results will be found in iron deficiency anaemia?
Low ferritin (unless infection)
High Total Iron Binding Capacity
High transferrin receptors
What will be seen on a blood film in iron deficiency anaemia?
How will thalassaemia appear on an FBC?
Low Mean cell volume
High red cell count
How is thalassaemia managed?
What is sideroblastic anaemia?
Inability to properly form haem. Iron accumulates in the mitochondria
What are three causes of sideroblastic anaemia?
How will sideroblastic anaemia appear on a blood film?
How is sideroblastic anaemia treated?
Remove cause, if possible
Give 4 causes of normocytic anaemia
Sickle cell anaemia
Anaemia of chronic disease
Acute blood loss
Chronic kidney disease
Give three conditions which are associated with anaemia of chronic disease
How does anaemia of chronic disease appear on iron studies?
Normal or raised ferritin
What investigations show the presence of haemolytic anaemia?
FBC with normal or riased MCV and raised reticulocytes
LFTs show raised bilirubin
Raised serum LDH
Raised urinary urobilinogen
What investigations can be done to establish the cause of haemolytic anaemia?
Osmotic fragility test
Give three inherited causes of haemolytic anaemia
Sickle cell anaemia
Give three acquired causes of haemolytic anaemia
Microangiopathic haemolytic anaemia (MAHA)
Drugs eg penicillin or quinine
What are the megaloblastic causes of macrocytic anaemia?
What are the non-megaloblastic causes of macrocytic anaemia?
What pathologies can cause B12 deficiency?
Which sites of the GI tract are important in B12 metabolism?
Stomach is site of intrinsic factor production and so binding of B12
Terminal ileum is site of B12 absorption
How can pernicious anaemia be tested for?
Parietal cell antibodies
Intrinsic factor antibodies
Give three causes of folate deficiency
Drugs eg AEDs
What drugs should be used as rate control in AF?
Either a beta blocker (not sotalol) or verapamil (not both)
Or digoxin if sedentary and non-paroxysmal AF
What are the features of acute sarcoidosis?
Bilateral hilar lymphadenopathy
What are the CXR features of sarcoidosis?
Bilateral hilar lymphadenopathy
Peripheral pulmonary infiltrates
How is stage 1 hypertension defined?
Clinic BP of >140.90
ABPM of >135/85
How is stage 2 hypertension defined?
Clinic BP of >160/100
ABPM of >150/95
How is severe hypertension defined?
What is the target blood pressure in diabetes?
If end organ damage then <130/80
If no end organ damage then <140/90
When should hypertension be medically managed?
If stage 2 at any age
If stage 1 and <80 years old and one of:
End organ damage
Established cardiovascular disease
10 year cardiovascular risk >/=20%
How is chronic heart failure managed?
ACE inhibitor and Beta blocker but dont's start at same time
Add aldosterone antagonist or ARB or hydralazine with nitrate
Cardiac resynchronisation or digoxin or ivabradine
Diuretic if fluid overload
What is NYHA classification grade 1?
No symptoms and no limitation of normal exercise
What is NYHA classification grade 2?
Mild symptoms and slight limitation. Ordinary activity causes fatigue, dyspnoea or palpitations
What is NYHA classification grade 3?
Moderate symptoms and marked limitation. Less than ordinary activity leads to symptoms
What is NYHA classification grade 4?
Severe symptoms. Discomfort at rest and worsened by any activity
Give 5 causes of hyperlipidaemia
When should statins be given?
As primary prevention in people with 10 year CVD risk of at least 10% or T1DM or CKD stage 2 and above
As secondary prevention in all patients with cardiovascular disease and no contraindications
Other than statins, what drugs can be used to treat dyslipidaemia?
What is the mechanism of action of ezetimibe?
Reduces the absorption of cholesterol in the small intestine
What is the mechanism of action of nicotinic acid in dyslipidaemia?
Reduces hepatic secretion of vLDLs
What is the mechanism of action of fibrates in dyslipidaemia?
Increases the expression of lipoprotein lipase
What is the mechanism of action of cholestyramine in dyslipidaemia?
Reduces the reabsorption of bile acids in the small intestine so increases the conversion of cholesterol into bile acids
When should a person with ?ACS be admitted to hospital?
If current chest pain
Signs of complications
Pain within 12 hours and an abnormal ECG
When should a person with ?ACS be referred to hospital?
Same day if pain free but pain was within 12 hours and they have a normal ECG and no complications or if pain was 12-72 hours ago with no complications
2WW if pain over 72 hours ago and no complications
Name three ways in which cardiomyopathy may present?
What are the two main inherited cardiomyopathies?
Hypertrophic obstructive cardiomyopathy
Arrythmogenic right ventricular dysplasia
What are the features of a dilated cardiomyopathy?
Normal ventricular wall thickness but ventricular enlargement and abnormal contractility
Causes congestive heart failure and embolic disease
What are the features of a restrictive cardiomyopathy?
Ventricular chamber is a normal size and has normal systolic function but it has increased myocardial stiffness leading to incompliance and reduced diastolic filling
What is the main cause of dilated cardiomyopathy?
What is the main cause of restrictive cardiomyopathy?