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Flashcards in Conditions Deck (67):
1

chest pain relieved on sitting forward
saddle shaped ST elevation, PR depression on ECG

pericarditis

2

first line treatment for hypertension confirmed by ABPM

lifestyle modification - diet, stop smoking, exercise

3

treatment pathway for hypertension confirmed by ABPM after lifestyle modification

1. ACEi/ARB or CCB
2. ACEi/ARB and CCB
3. ACEi/ARB and CCB and diuretic
4. ACEi/ARB and CCB and diuretic and something else

4

who get ACei/ARB first line in hypertension

who get CCB first line in hypertension

ACEi/ARB - if white <55 years old

CCB - if afrocarribean or >55 years old

5

indication for ARB

ACEi gives a cough

6

ACEi used in hypertension

Lisinopril (-pril)

7

ARB used in hypertension

losartan (-sartan)

8

CCB used in hypertension

verapamil, amlodipine

9

diuretic used in hypertension

any - furosemide, bendroflumethiazide

10

which type of angina is not relieved by GTN alone

unstable angina

11

treatment of unstable angina (5)

MONA + T (used to be C)

morphine
oxygen
nitroglycerin (GTN spray)
aspirin 300mg
ticagrelor (used to be clopidogrel) 300mg (or 600mg if giving PCI)

12

treatment of NSTEMI (5+3)

MONA + T(used to be C)

morphine
oxygen
nitroglycerin (GTN spray)
aspirin 300mg
ticagrelor (used to be clopidogrel) 300mg (or 600mg if giving PCI)

thrombolysis
PCI
CABG

(exact same as STEMI lol, though PCI and CABG less likely)

13

treatment of STEMI (5+)

MONA + T (used to be C)

morphine
oxygen
nitroglyceride (GTN spray)
aspirin 300mg
ticagrelor (used to be clopidogrel) 300mg (or 600mg if giving PCI)

PCI
thrombolysis
CABG

(exact same as NSTEMI lol)

14

LBBB

lead III = W
lead aVL = M

WiLLiaM

15

RBBB

lead III = M
lead V3 = W

MaRRoW

16

how close must you be to a hospital to do a PCI in someone with a STEMI

40 mins

needs to be done within 90 mins form onset

17

when would you thrombolyse someone with a NSTEMI/STEMI

if PCI unavailable (>40 mins from hospital)

18

post MI (4 weeks later)
pain relieved by sitting forward
saddle shaped ST elevation in all leads
no fever

dresslers (pericarditis)

19

in what rhythms can you shock someone with a defib

VF or pulseless VT

20

in what rhythms must you not shock someone with a defib

what do you do instead

asystole or pulseless electrical activity

give them amiodarone and adrenaline

21

reversible causes of cardiac arrest (8)

4Hs and 4Ts
hypovolaemia
hypoxia
hypothermia
hypo/hyperkalaemia
thrombosis
toxins
cardiac Tamponade
tension pneumothorax

22

gold standard investigation for heart failure

transthoracic ECHO

23

which sided heart failure causes pulmonary oedema

left sided

(think about it)

24

which sided heart failure causes peripheral oedema

right sided

(think about it)

25

which group of people (gender and age) are most likely to get a AAA

men >65

26

pulsatile expansible abdo mass
sudden onset epigastric pain that radiates to the back
collapse
male 65
likely to die on the way to hospital

rupture AAA

27

prevention of ruptured AAA

screening in men >65!!

28

treatment of ruptured AAA

emergency surgery to insert stent

29

which type of heart murmur sounds like a 'swoosh' (stenosis or regurg) = high pitch

regurgitation

30

which type of heart murmur (stenosis or regurg) happens in the MIDDLE or systole/diastole

stenosis

mitral stenosis = mid diastolic
aortic stenosis = mid systolic

31

which type of heart murmur sounds like a low pitched 'grunt' (stenosis or regurg)

stenosis

32

ejection systolic (midsystolic) murmur
radiates to carotids
low pitched grunt = hear with bell
slow rising pulse

aortic stenosis

33

mid diastolic murmur
low pitched grunt = hear with bell
at apex
associated with AF
best heard when patient rolled onto left side
rheumatic fever

mitral stenosis

34

swoosh sound = high pitched = hear with diaphragm
early diastolic
heard at left sternal edge (best heard when sitting up)
collapsing pulse
displaced apex

aortic regurgitation

35

swoosh sound = high pitched = hear with bell
pan systolic
displaced apex
heard in mid axillary line

mitral regurg

36

treatment of sinus tachycardia >100 bpm

beta blocker (B1 usually causes increased heart rate so want to block it)

eg atenolol (cardioselective = good)

37

treatment of sinus bradycardia <60 bpm

atropine (M2 antagonist - M2 usually causes decreased heart rate so want to block it)

38

treatment of pulseless VT (ventricular tachycardia)

shock (defib, DC cardiovert)

39

treatment of VF (ventricular fibrillation)

shock (defib)

40

irregularly irregular pulse
300 bpm heart rate
no P waves

atrial fibrillation

41

what are the 3 types of atrial fibrillation

paroxysmal - sorts itself <48 hours
persistent - fixed with drugs
permanent - not fixed with drugs

42

treatment of AF (4)

ACBD

anticoag (warfarin) and ablation
beta blockers (rate control) - GIVE FIRST
cardiovert (drugs first (AF = amiodarone or flecamide) then electrical)
digoxin (rhythm control)

43

what score do you need to figure out before you give someone anticoags eg warfarin

CHA2DS2-VASc score

44

treatment of atrial flutter

ablation

45

torsades des pointes on ECG
congenital problem

long QT syndrome

46

ventricular arrhythmias typically cause rate/rhythm problems?

hence what are they treated with (class of anti arrhythmia drug)

rate

class II or IV

47

atrial arrhythmias typically cause rate/rhythm problems?

hence what are they treated with (class of anti arrhythmia drug)

rhythm

class I or III

48

class I anti arrhythmia drug examples (2)

lignocaine, flecainide

49

class II anti arrhythmic drug example

metoprolol (beta blocker)

50

class III anti arrhythmic drug example

amiodarone

51

class IV anti arrhythmic drug example

verapamil

52

ventricular tachycardia treatment

beta blocker eg propranolol, atenolol

53

which side of the heart do you usually get endocarditis in

left (mitral/aortic valves)

54

who typically get right sided valve endocarditis

IV drug users

55

janeway lesions
osler nodes
splinter haemorrhages
roth spots in eyes

infective endocarditis

56

diagnostic investigation for infective endocarditis

transoesophageal echo (also do a transthoracic one)

57

infective endocarditis

who get strep viridans

post dental surgery

bc strep viridans is in the mouth

58

infective endocarditis

which micro bacterial is green on agar

strep viridans

59

infective endocarditis

treatment of strep viridans (be green on agar)

benzypenicillin IV and gentamicin IV

(bc Be Green on agar)

60

infective endocarditis

who get staph aureus

where does it occur

IV drug users

right sided

61

infective endocarditis

treatment of IV drug user with staph aureus infection

flucloxacillin IV

62

infective endocarditis

who get staph epidermis

prosthetic valves, IV lines

something entering the body form outside bc staph epidermis is on the skin

63

infective endocarditis

who get enterococcus

GI problems

64

treatment of enterococcus infective endocarditis

amoxicillin Iv an gentamicin IV

(bc All Germs ENTER the body)

65

native valve endocarditis treatment

amoxicillin IV and gentamicin IV

(bc Always Got your native valves)

66

prosthetic valve endocarditis treatment

vancomycin IV, gentamicin IV and rifampicin IV

(bc prosthetic valves give you Very Good Rhythm)

67

treatment of infective endocarditis if antibiotics ineffective

surgery - valve replacement