Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3a > Cardiovascular > Flashcards

Cardiovascular Flashcards

(118 cards)

Start Studying
1
Q

What is the threshold for hypertension?

A

140/90 mmHg

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

What is the target BP for someone with hypertension and diabetes?

A

130/80 mmHg

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

What is hypertension a risk for?

A

Stroke, MI, HF, CKD, AF, hypertensive retinopathy, vascular dementia

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

How does hypertension cause atherosclerosis?

A

Thickens media of muscular arteries

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

What is the threshold for malignant hypertension?

A

200/130 mmHg

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

Which renal diseases cause hypertension?

A

Glomerulonephritis, polycystic kidneys, systemci sclerosis

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

Which endocrine diseases cause hypertension?

A

Cushing’s, acromegaly, Conn’s

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

Which drugs cause hypertension?

A

Steroids, amphetamines, cocaine

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

Coarctation of the aorta can cause hypertension. What is a sign of this?

A

Weak femoral pulse

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

What Ix’s would you do to diagnose hypertension?

A
  • 24 hour ambulatory BP monitoring
  • blood glucose to rule out diabetes
  • U&E and urinalysis to exclude renal disease
  • Ophthalmoscopy : retinal haemorrhage
  • ECG :LV hypertrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What lifestyle changes can reduce hypertension?

A
  • Exercise
  • Stop smoking
  • Low fat diet
  • Reduce salt
  • Reduce alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If a patient is under 55 years old, which drug do you give them for hypertension?

A

ACEi or ARB

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

If a patient is >55 or of Afro-Caribbean origin of any age, which drug would you give them for hypertension?

A

CCB

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

After initial treatment of hypertension, you can combine ACE/ARB with CCB. If the BP is still not controlled, what drug would you prescribe?

A

Thiazide diuretic

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

What drugs would you prescribe for resistant hypertension?

A
  • Spironolactone if K+ <4/5 mmol/L

- alpha blocker or beta blocker if K+>4.5 mmol/L

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

How many stages of hypertension are there?

A

3.
stage 1: 140/90 mmHg
stage 2: 160/100 mmHg
stage 3: 180/120 mmHg

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

Which test would you do to assess CV disease risk?

A

Qrisk3.

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

What does Qrisk3 predict?

A

Risk of having a heart attack or stroke in next 10 years

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

Which extra conditions/medications does Qrisk3 ask for compared to Qrisk2?

A
  • Erectile dysfunction
  • Migraine
  • Severe mental illness
  • Anti-psychotic medication
  • Steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which non-modifiable factors does Qrisk 3 ask for?

A
  • Age
  • Sex
  • Ethnicity
  • UK postcode
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which conditions do both Qrisk2 and Qrisk 3 ask about?

A
  • Smoking status
  • Diabetes
  • Angina or heart attack in 1st degree relative <60
  • CKD
  • AF
  • Hypertension
  • RA
  • BMI
  • Cholesterol/HDL ratio
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the target BP for someone with hypertension <80 years old?

A

<135/85 mmHg

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

What is the target BP for someone with hypertension >80 years old?

A

<145/85 mmHg

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

Name an ACE inhibitor

A

Ramipril

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Name an ARB
Losartan
26
Name a CCB
Amlodipine
27
Name a thiazide diuretic
Indapamide
28
Name an alpha blocker
Doxazosin
29
Name a beta blocker
Atenolol
30
Name symptoms and signs of malignant hypertension
- Retinal haemorrhage - Papilloedema - New onset confusion, chest pain - Signs of AKI
31
What are the risk factors for atherosclerosis?
- Age - Smoking - High serum cholesterol - Obesity - Diabetes - Hypertension - FH
32
Which coronary arteries are most likely to develop atherosclerosis?
- Circumflex - Left anterior descending - Right coronary
33
Which cells in the artery are damaged due to plaques?
Endothelial cells
34
What can atherosclerosis lead to?
- Coronary artery disease 1. Angina 2. MI 3. HF
35
Which drugs can be used to treat atherosclerosis?
- Statins - inhibits enzymes which make cholesterol - Clopidogrel - inhibits P2Y12 ADP receptor on platelets - Aspirin - irreversible inhibitor of platelet cyclo-oxygenase - Canakinumab injections - inhibit IL-1
36
Which surgery can be done to treat atherosclerosis?
Stent made out of steel and cobalt chromium
37
Which conditions does acute coronary syndrome consist of?
- STEMI - NSTEMI - Unstable angina
38
Which chemical is released when myocardial cells die?
Troponin
39
What are the features of a STEMI on an ECG?
- ST elevation - New LBBB - Pathological Q wave
40
What does a Q wave represent?
Septal depolarisation . This shows on the ECG due to it not being masked by ventricular wall depolarisation, due to the ventricular wall being dead - i.e. from an MI
41
Which conditions cause a raised troponin?
- MI - Aortic dissection - Hypertrophic cardiomyopathy - Severe anaemia - Heart failure - Sepsis - Stroke - Renal failure - Subarachnoid haemorrhage
42
Name the 2 main types of MI
1. Spontaneous - due to plaque rupturing/occlusion of artery 2. Secondary to ischaemia Other types include those instigated by stents and bypass
43
Name the clinical features of ACS
- Chest pain, radiating to arms, back or jaw - Pain >15 minutes - Nausea + vomiting - Sweating - Breathlessness
44
What is the initial management of an MI?
- 12 lead ECG - Morphine - Oxygen - Glyceryl trinitrate - Aspirin 300mg - Rapid acting antiplatelet e.g. Ticagrelor
45
What is ST elevation a sign of in the artery?
Complete occlusion of epicardial coronary artery
46
What is the gold standard treatment for a STEMI?
PCI: primary percutaneous intervention UP TO 12 hours after onset of pain (thrombolysis is no longer first line due to significant bleeding risks)
47
What is a NSTEMI a sign of in the artery?
Partial coronary occlusion
48
What are the features of a NSTEMI on an ECG?
- ST depression - T wave inversion - No Q wave
49
Which test can be done to distinguish between a NSTEMI and unstable angina?
Troponin - a rise indicates NSTEMI
50
Which troponins are most specific to the heart?
I and T
51
Which drugs are given in the management of a NSTEMI?
- Beta blocker - ACE inhibitor - Atorvastatin 80mg OD The same treatment is given for unstable angina.
52
Which score is used to predict mortality after a NSTEMI?
GRACE score
53
Which surgical treatment is used for high risk or young NSTEMI patients?
Coronary angiography, with subsequent PCI if required
54
Which drugs are given in the management of an MI?
- Dual antiplatelet therapy for 1 year, usually aspirin + clopidogrel - Anticoagulate to inhibit fibrin formation e.g, fondaparinux - Beta blocker - ACE inhibitor - Atorvastatin 80mg OD
55
Which lifestyle changes would you suggest after an MI?
- Stop smoking - Treat diabetes, hypertension, hyperlipidaemia - Healthy, low fat diet - Daily exercise
56
Unstable angina is ACS without a rise in troponin. What are its features?
- Angina >20 mins at rest - New onset of severe angina - Angina that occurs after recent MI
57
What are the differentials of an MI?
- Myocarditis - Pericarditis - PE - Aortic dissection - Arrhythmias - Sepsis - Cardiotoxic agents - Pneumothorax - Pneumonia - Reflux
58
When does troponin rise after an NSTEMI?
2-3 hours after onset of chest pain
59
What are the complications of a MI?
- Heart failure - Arrhythmias - BBB, sinus brady/tachy, heart block, AF, VF - Pericarditis - Depression - Cardiac tamponade - Mitral regurgitation
60
What is the definition of angina?
Symptomatic reversible myocardial ischaemia
61
What causes angina?
Atherosclerosis leading to restricted coronary blood flow
62
What are the clinical features of angina?
-Heavy/constricting pain in chest, jaw, shoulders or arms -Symptoms brought on by exertion and relieved by rest or GTN Typical angina = all 3 features Atypical angina = 2 features
63
Name the 5 types of angina.
1. Stable 2. Unstable - occurs on minimal exertion, increasing severity 3. Decubitus - happens when lying flat 4. Prinzmetal - caused by coronary artery spasm 5. Microvascular - syndrome X
64
Name the supply related precipitant factors of angina.
1. Anaemia 2. Hypoxaemia 3. Polycythaemia 4. Hypothermia 5. Hypovolaemia
65
Name the demand related precipitant factors of angina.
1. Emotional stress 2. Hypertension 3. Hyperthyroidism 4. Tachyarrhythmia 5. Hypertrophic cardiomyopathy 6. Cold weather 7. Heavy meals
66
Which Ix's would you do to diagnose angina?
- Exercise stress treadmill test - look for ST depression - Stress echo - 12 lead ECG, ST depression, inverted T wave - SPECT
67
Which drugs are given to treat angina?
- Aspirin 75mg OD - Statin - Beta blocker - contraindicated in Prinzmetal angina - GTN spray - CCB
68
What are the side effects of beta blockers?
- bradycardia - erectile dysfunction - cold hands and feet - fatigue
69
Beta blockers are -ve chronotropes and -ve inotropes. What does ths mean?
- ve chronotrope = reduces HR | - ve inotrope = reduces contractility
70
How does GTN work?
Dilates systemic veins to reduce preload on heart.
71
How do CCBs work?
Dilates systemic arteries to lower BP and afterload on heart.
72
What is the surgical management of angina (high risk or when medication fails)?
1. PCI | 2. CABG
73
What are the pros and cons of PCI?
Pros: - Less invasive - Repeatable Cons: - Risk of stent thrombosis - Risk of re-stenosis - Requires dual antiplatelet therapy
74
What are the pros and cons of CABG?
Pros: -Deals with complex disease Cons: - Invasive - Risk of stroke and bleeding - Cannot be done on frail patients - Long procedure - Need time for recovery
75
What is the infarct site when there is ST elevation V1-V3?
Anterior
76
What is the sign on an ECG of an inferior infarct?
ST elevation II, III, AVF
77
What is the infarct site when there is ST depression V1-V3, Dominant R wave and ST elevation V5-6?
Posterior
78
What is the sign on an ECG of a lateral infarct?
I, AVL, V5-V6
79
What is chronic heart failure?
Reduced cardiac output due to impaired cardiac contraction
80
How do you calculate cardiac output?
Heart rate x Stroke volume
81
Name factors which reduce cardiac output
- lower HR - lower preload - lower contractility - higher afterload
82
Name the cardiac causes of heart failure
- MI - AF - Valve disease - Hypertension - Cardiomyopathy
83
Name the non cardiac causes of heart failure
- Hypo and hyperthyroidism - Diabetes - Cushing's - Sepsis - RA - SLE - Renal failure - Nephrotic syndrome - Hepatic failure
84
Which medications can cause heart failure?
- Beta blockers - Anti-arrhythmics - Calcium antagonist
85
What are the clinical features of heart failure?
- Dyspnoea on exertion - Fatigue - Orthopnoea - sleeps with several pillows - Paroxysmal nocturnal dyspnoea - Nocturnal cough - Pre-syncope
86
Which social risk factors are associated with heart failure?
- Smoking - Excess alcohol - Recreational drug use
87
What the signs of heart failure you might find on examination?
- Tachycardia at rest - Hypotension - Narrow pulse pressure - Raised JVP - Displaced apex beat - Right ventricular heave - Gallop rhythm - Murmurs - Pedal and ankle oedema - Tachypnoea - Stony dullness on percussion (pleural effusion) - Bibasal end-inspiratory crackles and wheeze - Hepatomegaly - Ascites
88
What are the ECG findings of heart failure?
- Tachycardia - AF - Left axis deviation due to hypertrophy - P wave abnormalities - Prolonged PR interval (AV block) - Wide QRS complex
89
What blood tests are included in a cardiomyopathy screen?
- Serum iron and copper to rule out haemochromatosis and Wilson's - Rheumatoid factor - ANCA/ANA - Serum ACE to rule out sarcoidosis - Serum free light chains to rule out amyloidosis
90
Which blood test is gold standard for heart failure?
Serum NT-proBNP
91
What is the threshold value of NT-proBNP which suggests heart failure?
>400 ng/L
92
Which other conditions present with raised NT-proBNP?
- Left ventricular hypertrophy - Tachycardia - Liver cirrhosis - Diabetes - Renal disease
93
Which echo is needed to diagnose heart failure?
Transthoracic
94
What are the CXR signs of congestive heart failure?
``` A -alveolar oedema (bat wings) B - kerley B lines (interstitial oedema) C - cardiomegaly D - dilated upper lobe vessels E - effusion (blunted costophrenic angle) ```
95
Name the classification system for heart failure
New York Heart Association classification system Class I: no symptoms during ordinary physical activity Class II: slight limitation of physical activity by symptoms Class III: less than ordinary activity leads to symptoms Class IV: inability to carry out any activity without symptoms
96
What is the ejection fraction in systolic HF?
EF < 40%
97
What is the ejection fraction in diastolic HF?
EF >40%
98
Name conditions which cause high output heart failure
- Anaemia - Pregnancy - Hyperthyroidism
99
What are the complications of heart failure?
- Renal dysfunction - Rhythm disturbance - Systemic thromboembolism - DVT - LBBB - Hepatic dysfunction - Depression
100
What is ejection fraction?
% of blood ejected out of LV with each beat (should be 70%)
101
What lifestyle management is advised for heart failure?
- Fluid and salt restriction - Regular exercise - Smoking cessation - Reduced alcohol intake
102
Which medications can worsen heart failure?
- CCB - Tricyclic antidepressants - Lithium - NSAIDs - Corticosteroids
103
Which medications are prescribed to treat heart failure?
- Diuretics - relieve symptoms of fluid overload - ACE inhibitors (measure U&E to check hyperkalaemia) - Beta blockers - ARB if cannot tolerate ACEi
104
Which medications are prescribed for resistant heart failure?
- Spironalactone | - Ivabradine
105
Which surgical treatments can be used for heart failiure?
- CABG - Valve surgery - ICD - Heart transplant
106
What is AF?
Chaotic irregular rhythm 300-600 bpm
107
What are the causes of AF?
- Post surgery - Heart failure - Hypertension - Mitral valve disease - Pneumonia - Hyperthyroidism - Caffeine and alcohol - Hypokalaemia
108
What are the triggers of AF?
- PE - Ischaemia - Thyroid disease - Alcohol - Sepsis - Sleep apnoea
109
What are the symptoms of AF?
- Asymptomatic - Chest pain - Palpitations - Dyspnoea - Dizziness - Collapse
110
What are the signs of AF?
- Irregularly irregular pulse | - Tachycardia
111
How will an ECG present in AF?
- Absent P wave | - Irregular, narrow QRS complex
112
Which other Ixs (other than ECG) can you do for AF?
- CXR - Echo - Bloods: U&E, thyroid function, FBC
113
How would you manage acute AF?
- ABCDE - Cardioversion - Amiodarone to control rhythm - Beta blocker to control HR - Heparin - Correct electrolyte imbalance - Treat precipitating factors - Fluids
114
How would you manage chronic AF?
- Beta blocker or CCB - Flecainide to control rhythm - Warfarin (anticoagulation to prevent stroke from emboli)
115
Which score calculates risk of stroke?
CHA2DS2-VASc
116
Which score calculates risk of bleeding?
HAS-BLED
117
What term is given to AF when the episodes are intermittent and stop within 48 hours?
Paroxysmal AF
118
What are the risk factors of developing chronic AF from paroxysmal AF?
- Age - Hypertension - Obesity

3a (13 decks)

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