Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular: Heart Failure > CCF > Flashcards

CCF Flashcards

1
Q

what are the major criteria for CCF? 9

A
  • paroxysmal nocturnal dyspnoea
  • crepitations
  • S3 gallop
  • cardiomegaly
  • increased central venous pressure
  • weight loss in response to treatment
  • neck vein distention
  • acute pulmonary oedema
  • hepatojugular reflux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the minor criteria for CCF? 7

A
  • bilateral ankle oedema
  • dyspnoea or ordinary exertion
  • tachycardia
  • decrease in vital capacity by 1/3 from maximum recorded
  • nocturnal cough
  • hepatomegaly
  • pleural effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

which investigations should be carried out for CCF? 6

A
  • ECG
  • B-ype natriuretic peptide
  • FBC; U &E; BNP
  • CXR
  • echo
  • endomyocardial biopsy is rarely needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If ECG and B-type natriuretic peptide are normal, heart failure is _____ and an alternative diagnosis should be considered; if either is _____, then echocardiography is required

A

If ECG and B-type natriuretic peptide are normal, heart failure is unlikely and an alternative diagnosis should be considered; if either is abnormal, then echocardiography is required

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

what signs are possible of CXR? 8

A
  • cardiomegaly
  • prominent upper lobe veins
  • peribronchial cuffing
  • diffuse interstitial or alveolar shadowing
  • bats wing
  • fluid in the fissures
  • pleural effusions
  • septal line (kerley B lines)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what causes the septal lines (kerley B lines)

A

variously attributed to interstitial oedema and engorged peripheral lymphatics

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

the ecg may indicate cause, what causes may be shown on ecg?

A

look for evidence of ischaemia, MI, ventricular hypertrophy

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

Echocardiography is the key investigation. It may indicate the cause (___, _____-) and can confirm the presence or absence of ___ dysfunction.

A

Echocardiography is the key investigation. It may indicate the cause (MI, valvular heart disease) and can confirm the presence or absence of LV dysfunction.

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

specific causes of heart failure and their treatments:

what is the treatment for cor pulmonale?

A

Rx diuretics and oxygen only

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

specific causes of heart failure and their treatments:

what is the treatment for valvular disease?

A

surgery ideally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

specific causes of heart failure and their treatments:

what is the treatment for fast AF?

A

digoxin or DC shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If you have a bad ____ then drugs are not going to be helpful for you

A

If you have a bad valve then drugs are not going to be helpful for you

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

what are the drugs used in CCF? 4/2/3

A
  • diuretics- to excrete retained fluid
  • ACE inhibis
  • B blockers
  • Spironolactone - severe cases only
  • digoxin
  • other vasodilators (nitrates, hydralazine)
  • ICD
  • cardiac resynchronisation therapy
  • transplantation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the first step in management?

A

lifestyle: stop smoking, eat less salt, optimise weight and nutrition

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

before drugs, what is done?

A

Treat the cause
Treat exacerbating factors
Avoid exacerbating factors

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

what are some exacerbating factors of CCF that should be treated before drug therapy?

A

anaemia, thyroid disease, infection, increased BP

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

what are some exacerbating factors of CCF that should be avoided before drug therapy?

A

NSAIDS (fluid retention) and verapamil (negative inotrope

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

Thiazide diuretics are used for ___ CCF only

A

mild

19
Q

Loop diuretics are used to ____ symptoms

A

relieve

20
Q

give an example of a very effective loop diuretic

A

furosemide

21
Q

what is a side effect of furosemide?

A
  • you may lose potassium
22
Q

although furosemide makes you lose K, conincidental drugs like ACE inhibitors, spironolactone help to _____

A

conincidental drugs like ACE inhibitors, spironolactone help to retain and normalise K

23
Q

_ levels must be checked regularly. Too high or too low ___ can both cause arrhythmias

A

K levels must be checked regularly. Too high or too low a K can both cause arrhythmias

24
Q

In refractory oedema - consider adding a _____

A

thiazide

25
Q

ACE should be considered in all people with ____ _____ _____ ______.

A

ACE should be considered in all people with left ventricular systolic dysfunction.

26
Q

give some examples of ACE

A

catopril, enaparil, lisinopril

27
Q

what are some side effects of ACE

A
  • angioneurotic oedema
  • first dose hypertension especially if serum Na are low
  • renal impairment
  • cough
28
Q

______ must be monitored after ACEi begun

A

u and E

29
Q

Beta blockers : these decrease _____ in heart failure.

These benefits appear to be additional to those of ____ in patients with heart failure due to ____ _______.

A

Beta blockers
these decrease mortality in heart failure.
These benefits appear to be additional to those of ACEi in patients with heart failure due to LV dysfunction.

30
Q

when should b blockers be initiated?

A

after diuretic and ACEi

31
Q

It is good in the long term but can ____ CCF in short term

A

It is good in the long term but can worsen CCF in short term

32
Q

what are the initial risks of b blockers?

A

hypotension, worsening dyspnoea

33
Q

give an example of a beta 1 selective beta blocker

A

bisoprolol

34
Q

give an example of a non selective beta blocker with alpha blockade

A

carvedilol

35
Q

what does spironolactone do?

A

it is an aldosterone receptor antagonist

36
Q

spironolactone is used in _____ CCF

A

severe

37
Q

spironolactone is ___ sparing but there is a little risk of significant _______, even when given with ACE inhibitors

A

spironolactone is K sparing but there is a little risk of significant hyperkalaemia, even when given with ACE inhibitors

38
Q

what are the side effects of spironolactone?

A

renal dysfunction, gynaecomastia

39
Q

what does ivabradine do?

A

slows HR however only does this in sinus rhythm

For example, if in AF (want to reduce HR) - ivabradine will not work.

40
Q

Only use ivabradine if the HR is fast despite _________

A

Only use ivabradine if the HR is fast despite B blockers

41
Q

sacubitral varsartan is a combination of ___ and _______ inhibitor. ______ inhibitor blocks _____ _______ breakdown and boosts ______ ______ (BNP) levels.

A

is a combination of ARB and Neprilysin inhibitor. Neprilysin inhibitor blocks natriuretic peptide breakdown and boosts natriuretic peptide (BNP) levels.

42
Q

why are ICDs useful in HF?

A

some patients may appear to be very well dealing with the HF and then have a sudden death. This is due to arrhythmias.

It is useful to have ICDs - detects heart rhythm and will give an electrical shock to get the rhythm back to normal

43
Q

for patients with severe HF and a bundle branch block ( meaning that the RV and LV contract milliseconds apart), what is the treatment ?

A

cardiac resynchronisation therapy.

Cardiovascular: Heart Failure (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions