Cardiovascular Flashcards
(56 cards)
Enzyme that statins inhibit?
HMG Co A reductase
Changes to the ECG in an exercise street test when the patient has angina?
ST segment depression
What do you do if a GP diagnoses a patient with unstable angina
Send to A&E it is a medical emergency (acute coronary syndrome)
Main difference in STEMI and NSTEMI?
STEMI - lumen is completely blocked
NSTEMI - the lumen is partially blocked
Treatments for STEMI and NSTEMI?
STEMI - Thrombolysis or PCI
NSTEMI - no thrombolysis but PCI could be useful
Features of cardiac pain?
Triggered by exercise and relieved at rest
Heavy, pressing or tight
Breathless, nausea
Radiates to arms
In a normal ECG are leads I, II and III positive or negative?
Leads I, II and III should be positive
What interval on an ECG do you use to assess heart rate?
RR interval
Possible causes of chest pain?
MI Angina GORD Aortic Dissection PE Pericarditis Musculoskeletal costochondritis
Types of heart block?
1st degree - enlarged PR interval
2nd degree:
Mobitz type I - PR interval gradually enlarges then skips a beat
Mobitz type II - Intermittent non-conducting p waves, some do some don’t
3rd degree - bundle branch block, no communication between SAN and AVN at all, random p waves
Signs of ventricular tachycardia?
Widened QRS
What is the ECG sign in ischaemia and in a previous infarction?
Ischaemia - ST elevation
Infarction - ST depression
What is a vulnerable plaque?
A plaque with a large risk of rupture
Initial pharmacological treatment for a STEMI?
Aspirin, Clopidogrel, B-blocker, atorvastatin, LMW heparin, ACE inhibitor
Other treatment for STEMI?
PCI
What is classified as an acute coronary syndrome?
STEMI, NSTEMI, unstable angina
Three physiological buffers, which has the biggest buffering capabilities?
Bicarbonate (is regulated to produce acid-base changes)
Proteins (mostly haemoglobin) carry a negative charge and will accept H+, has the most capacity but is not regulated
Phosphate buffer
What enzyme catalyses the reaction forming carbonic acid and bicarbonate?
Carbonic anhydrase
Where is bicarbonate formed, how?
In the red blood cell, the reaction is catalysed by carbonic acid, CO2 reacts with O2 to form H2CO3, which bissociates to form bicarbonate (HCO3) and H+ (which is buffered by haemoglobin).
How is acid secreted?
CO2 is blown off in the lungs and metabolic acids are excreted in the kidney
What primarily drives the impulse to breathe?
Acid/base balance driven by CO2 in the medulla
What substances are detected in the peripheral and in the central chemoreceptors?
Central - CO2
Peripheral - H+
What’s the Haldane effect?
The fact that during the passage of blood through the lungs O2 is taken up by red blood cells (makes them a stronger acid) This promotes the excretion of CO2
What two measurements of blood gas data show metabolic acidosis/alkalosis and what two show respiratory acidosis/alkalosis
Respiratory - High CO2 suggests respiratory acidosis
Metabolic - negative BXS suggests metabolic acidosis
