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6. Cardiovascular System > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

How would you describe an arterial thrombosis?

A

Platelet rich - a ‘white thrombosis’.

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2
Q

What are the potential consequences of arterial thrombosis?

A
  1. MI.
  2. Stroke.
  3. Peripheral vascular disease e.g. gangrene
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3
Q

What is the treatment for arterial thrombosis?

A
  1. Aspirin.
  2. LMWH.
  3. Thrombolytic therapy.
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4
Q

What might you give to someone with hypertension if they are ACE inhibitor intolerant?

A

ARB.

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5
Q

What classification is used to group anti-arrhythmic drugs?

A

Vaughan Williams classification.

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6
Q

Vaughan Williams classification: name 3 class 1 drugs.

A

Class 1 are Na+ channel blockers. There are 3 sub-divisions in this group.
1a: disopyramide.
1b: lidocaine.
1c: flecainide.

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7
Q

Vaughan Williams classification: name 3 class 2 drugs.

A

Class 2 are beta blockers:
1. Propranolol.
2. Atenolol.
3. Bisoprolol.

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8
Q

Vaughan Williams classification: name a class 3 drug.

A

Class 3 drugs prolong the action potential. E.g. amiodarone. Side effects are very likely with these drugs.

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9
Q

Vaughan Williams classification: name 2 class 4 drugs.

A

Class 4 drugs are calcium channel blockers but NOT dihydropyridines as these don’t effect the heart.
1. Verapamil.
2. Diltiazem.

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10
Q

How does digoxin work?

A

It inhibits the Na+/K+ pump therefore making the action potential more positive and ACh is released from parasympathetic nerves.

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11
Q

What are the main effects of digoxin?

A
  1. Bradycardia.
  2. Reduced atrioventricular conduction.
  3. Increased force of contraction (positive inotrope).
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12
Q

Give 4 potential side effects of digoxin.

A
  1. Nausea.
  2. Vomiting.
  3. Diarrhoea.
  4. Confusion.
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13
Q

In what diseases is digoxin clinically indicated?

A

Atrial fibrillation and severe heart failure.

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14
Q

What additional property makes propranolol the most useful beta blocker to help control the arrhythmias which occur immediately following a heart attack ?

A

It can also block sodium channels.

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15
Q

What does furosemide block?

A

The Na+/K+/2Cl- transporter.

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16
Q

Doxazosin can be used in the treatment of hypertension. How does this drug work?

A

It is an alpha 1 receptor antagonist.

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17
Q

How do beta blockers provide symptom relief in angina?

A
  1. They reduce O2 demand by slowing heart rate (negative chronotrope).
  2. They reduce O2 demand by reducing myocardial contractility (negative inotrope).
  3. They increase O2 distribution by slowing heart rate.
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18
Q

What drug might you give to someone with angina caused by coronary artery vasospasm?

A

Amlodipine.

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19
Q

What are channelopathies?

A

Mutations in genes coding for ion channels.

20
Q

Name 4 channelopathies.

A
  1. Long QT syndrome.
  2. Short QT syndrome.
  3. Brugada.
  4. CPVT.
21
Q

What ion channel is affected in Brugada?

A

Sodium channel.

22
Q

What is the commonest symptom of channelopathies?

A

Recurrent syncope.

23
Q

What might the ECG look like from someone with Brugada?

A

Characteristic ST elevation in chest leads.

24
Q

What is Brugada?

A

A channelopathy caused by a mutation in sodium channels.

25
Q

What is giant cell arteritis?

A

A common type of vasculitis: localised, chronic and granulomatous inflammation of temporal arteries.

26
Q

What are the signs of giant cell arteritis?

A
  1. Thickened often palpable blood vessels.
  2. Evidence of granulomatous inflammation.
27
Q

Give a possible consequence of giant cell arteritis.

A

Blindness if the occular artery is affected.

28
Q

Name a disease might cause flattening of the P wave.

A
  1. Hyperkalaemia.
  2. Obesity.
29
Q

Give 3 effects of hyperkalaemia on an ECG.

A
  1. Tall ‘tented’ T waves.
  2. Flat P waves.
  3. Broad QRS.
30
Q

Give 2 effects of hypokalaemia on an ECG.

A
  1. Flat T waves.
  2. QT prolongation.
  3. ST depression.
  4. Prominent U waves.
31
Q

Give an effect of hypocalcaemia on an ECG.

A
  1. QT prolongation.
  2. T wave flattening.
  3. Narrowed QRS.
  4. Prominent U waves.
32
Q

Give an effect of hypercalcaemia on an ECG.

A
  1. QT shortening.
  2. Tall T waves.
  3. No P waves.
33
Q

Cardiac arrhythmias: what is the treatment of choice in a patient who is hemodynamically unstable due to the underlying rhythm?

A

DC cardioversion.

34
Q

Describe 4 steps in the initial management of a STEMI.

A
  1. ABCDE.
  2. Morphine.
  3. Oxygen (if hypoxic).
  4. Nitrates.
  5. Aspirin.
35
Q

PCI is the treatment of choice for a STEMI. What might you do instead if you were unable to do PCI?

A

Thrombolysis using streptokinase.

36
Q

Name a drug that can be used for thrombolysis in the treatment of a STEMI.

A

Streptokinase.

37
Q

What organism can cause rheumatic fever?

A

Group A strep e.g. s.pyogenes.

38
Q

What type of drug is digoxin?

A

Digoxin is a cardiac glycoside.

39
Q

What is a typical lesion of atherosclerosis?

A

Fatty streaks.

40
Q

Write an equation for mAP.

A

mAP = DP + 1/3 PP.

41
Q

What is the cause of reactive hyperaemia?

A

When blood flow increases following occlusion to arterial flow.

42
Q

Give the equation for BP.

A

BP = CO x TPR.

43
Q

Give the equation for stroke volume.

A

SV = EDV - ESV.

44
Q

Give the equation for cardiac output.

A

CO = SV x HR.

45
Q

Give 2 ECG signs of PE.

A
  1. Sinus tachycardia.
  2. Atrial fibrillation.
46
Q

Give 3 symptoms of Dressler’s syndrome.

A
  1. Fever.
  2. Chest pain.
  3. Pericardial rub.

Occurs 2-10 week after MI.

47
Q

Describe the treatment for an MI.

A
  1. MONA.
  2. PCI or streptokinase.
  3. Aspirin and clopidogrel.
  4. LMWH.
  5. Anti-anginals e.g. beta blockers, CCB, nitrates.
  6. Preventing a secondary CV event: ACEi, aspirin, statins, RF modification.

6. Cardiovascular System (24 decks)

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