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Final Year > cardiology passmed > Flashcards

cardiology passmed Flashcards

(59 cards)

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1
Q

VTE management

A

anticoagulate
> warfarin
>DOACs

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2
Q

when is it better to use LMWH?

A

antiphospholipid syndrome - triple positive

severe renal impairment <15/min

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3
Q

what score is useful for bleeding?

A

Orbit

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4
Q

Angina not controlled by beta block

A

dihydropyridine CCB - longer acting

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5
Q

ivabradine

A

reduces heart rate by inhibiting IF current

reducing oxygen demand

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6
Q

example of longer-acting dihydropyridine calcium channel blocker

A

Amlodipine
Nifedipine

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7
Q

Cardiac tamponade

Beck’s triad
hypotension
distended neck veins
muffled heart sounds

A

elevated JVP
persistent hypotension
tachycardia

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8
Q

pulsus paradoxus?

A

an abnormally large drop in BP during inspiration

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9
Q

Mx of cardiac tamponade?

A

urgent pericardiocentesis

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10
Q

Electrical cardioversion - Afib

A

synchronised to R wave to prevent delivery of shock in cardiac repolarisation > V fib can be induced

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11
Q

Cardioversion can happen in 2 eways in A fib

A

electrical DC cardiovert

Amiodarone
flecainade

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12
Q

Broad Complex Tachycardia

A

ventricular fibrillation
ventricular tachycardia

originate from the ventricles
> AMIODARONE acts on refractory period on the below

cardiac myocytes, AV node and SA node

good for ventricular arrhythmia

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13
Q

Narrow complex tachy’s

A

supraventricular - above ventricle

respond to adenosine

blocks transmission through AV node so abberrant SVT signals don’t reach ventricles

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14
Q

Unsynchronised cardioversion used in?

A

high energy shock
as soon as shock button pushed on a defibrillator

used in pulseless VT/VF

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15
Q

Synchronised DC cardioversion?

A

unstable atrial fib
atrial flutter
atrial tachy
vtach w a pulse
svt

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16
Q

Peri-arrest tachycardia

A

ABC assessment
Stable or unstable
QRS assessment > narrow or broad

Rhythm
> Regular
> Irregular

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17
Q

Peri-arrest
Stable assessment shows signs that it is unstable ?

A

shock - hypotensive <90
pallor, sweating, cold, clammy, confused

syncope
MI
HF

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18
Q

peri arrest, unstable
what next?

A

synchronised DC shock given upto 3

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19
Q

Tachycardia
Stable

QRS <0.12s
Regular QRS

A

vagal manouvres

> adenosine
6mg rapid IV blous
12mg
18mg

try CCB - verapamil
beta-block

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20
Q

Tachycardia
Stable

QRS Broad
Regular QRS

A

Amiodarone 300mg IV over 10-60 min

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21
Q

Stable tachycardia
narrow QRS
irregular

A

probable a fib
rate control : Beta blocker

consider : Digoxin / amiodarone

anticoagulate >48hours

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22
Q

broad QRS
stable tachycardia

A

Afib
bundle branch block

polymorphic VT torsades de pointes
magnesium 2g / 10 min

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23
Q

In suspected pulmonary embolism when would you use a ventilation-perfusion scan > CTPA?

A

eGFR significantly impaired V/Q scan preferred as contrast in CTPA is nephrotoxic

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24
Q

wolf-parkinson white?

Study These Flashcards
A

accessory pathwya in electrical conduction of heart

25
most common causative agent for endocarditis
Staphylococcus aureus Staphylococcus epidermidis if < 2 months post valve surgery
26
HTN stage 2
BP >160/100 HBPM >150/95
27
stage 3 HTN?
clinic >180 clinic diastolic >120
28
<55 or T2DM step 1 HTN management
ACEi ARB
29
>55 / no T2DM / black african / african- caribbean ethnicity
Caclium channel blocker nifedipine / amlodipine
30
bradycardia and signs of shock mx?
500 micrograms of atropine repeat upto max 3mg
31
Adenosine used in?
stable, narrow complex tachycardias
32
Amiodarone
Mx of ventricular fibrillation / vtachy broad complex QRS
33
Bradycardia mx 2 step approach?
1) identify the presence of signs indicating haemodynamic compromise 2) identify potential risk of asystole
34
'haemodynamic compromise'
shock: Hypotension (systolic blood pressure < 90 mmHg), pallor, sweating, cold, clammy extremities, confusion or impaired consciousness syncope Myocardial Ischaemia heart failure
35
after atropine?
atropine 500mcg IV transcutaneous pacing isoprenaline / adrenaline
36
risk of asystole from bradycardia?
mobitz II AV block complete heart block with broad QRS ventricular pause >3s
37
using ABPM to confirm a diagnosis of hypertension
2 measurements every hour for every waking hour average of at least 14 measurements used
38
Diagnosing HTN
measure both arms record one from higher reading arm
39
if BP >180/120
admit for specialist retinal haemorrhage or new onset confusion, chest pain, signs of heart failure, AKI
40
HBPM
2 consecutive measurements need to be taken at least 1 minute apart twice daily in morning and evening BP 4 days ideally for 7 days
41
when to treat stage 1 HTN?
<135/85 <80yrs and target organ damage, cardiovascular disease, renal disease DMT2
42
collapsing pulse, SOB, Cardiac murmurs
aortic regurgitation
43
Ivabradine role in angina?
lowers HR kinda when beta block cannot be used targets sinus node to reduce HR w/o affecting BP
44
how does isosorbide mononitrate work?
decreases preload by vasodilation decreases preload lowering the heart's oxygen requirement for muscle contraction effective in angina
45
contraindications to statin
macrolide > erythromycin, clarithromycin pregnancy
46
how much adrenaline in ALS?
1mg adrenaline 10mls of 1:10,000 20mls of NACL- 0.9% flush to aid entry into circulation
47
Left ventricular free wall rupture
within 48 hours chest pain
48
Mitral valve prolapse
sudden shortness of breath pulmoanry oedema
49
left ventricular aneurysm
ST elevation in V1-6 fibrosis and dead tissue not able to move properly pulmonary oedema signs > bibasal crackles, S3 sound > left ventricle is larger S4 left ventricle is stiffer than normal
50
Hypocalcemia is a side effect of which antihypertensives?
loop diuretics
51
torsades de pointes mx?
IV magnesium sulfate stabilises cardiac myocytes reduces influx of calcium
52
hypercalcaemia ECG abnormality?
short QT interval
53
aortic dissection stanford B?
site of dissection is descending aorta mx of uncomplicated? medical : IV beta blockade and analgesia
54
aortic dissection stanford A
endovascular / open interventions
55
aortic dissection DeBakey classification
type I - ascending aorta type II - originates in and is confined to the ascending aorta type III - originates in descending aorta, rarely extends proximally but will extend distally
56
candesartan
ARB better for HTN addition step 2 in black patients
57
sacubitril-valsartan
a neprilysin inhibitor) needs a 36 hour washout period to prevent accumulation of bradykinin
58
Digoxin
cardiac glycoside slows down heart rate
59

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