Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CPTP 4.24-26 > CPTP 4.24-26 > Flashcards

CPTP 4.24-26 Flashcards

(60 cards)

Start Studying
1
Q

usual cause of AF in young

A

structural problem - valvular, heart muscle abnormality, cardiomyopathy, pericarditis

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

non cardiac causes of AF

A

acute infections (pneumonia), electrolyte depletion, lung cancer, intrathoracic pathology (e.g. pleural effusion), PE, thyrotoxicosis

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

Valvular abnormality that predisposes to AF

A

mitral stenosis - get left atrial dilation which predisposes to AF

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

4 types of AF

A

acute, paroxysmal, persistent, permanent

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

what is paroxysmal AF

A

2 or more episodes less than 48h duration.

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

what is persistent AF

A

longer than 7 days - but can be terminated with tx

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

mx of patient in AF who’s CV status is unstable

A

electrical cardioversion - synchronised DC shock.

remember heparin for thromboprophylaxis

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

is an alcoholic with cardiomyopathy and AF likely to be successfully treated with cardioversion?

A

no

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

is patient with mitral stenosis and dilated LA likely to be successfully treated with cardioversion?

A

no

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

if electrocardioversion is planned what must happen prior to this

A

anticoagulated 6w before cardioversion

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

who is suitable for rhythm control

A

AF with reversible cause
heart failure caused by AF
new onset AF
atrial flutter (suitable for ablation strategy)

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

initial monotherapy to AF patients who need rate control

A

beta blocker or rate limiting CCB

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

when is digoxin monotherapy considered

A

non paroxysmal AF patients that are sedentary

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

what should not be offered for LT rate control

A

amiodarone

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

if rate control monotherapy does not control sx?

A

consider rhythm control if eligible. if not but sx not controlled combination therapy with 2 of: a beta blocker, diltiazem, digoxin

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

what is diltiazem

A

rate limiting CCB

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

beta blockers is first line for rate control, but who is prescribed CCBs instead

A

asthmatics, COPD, PVD, tachy-brady syndrome

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

which beta blockers used

A

any except sotolol. cardioselective preferable

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

why not sotolol

A

increased risk of sudden death in IHD patients (QT prolongation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

chronic adverse effect of beta blockers

A

fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

are amlodipine and nifedipine good drugs in AF

A

no. CCBs must be non-dihydropyridine. diltiazem or verapamil (l type calcium channel inhibition)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

verapamil side effect

A

constipation

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

what can precipitate digoxin toxicity

A

AKI

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

for which other patients would you also consider rhythm control

A

symptomatic patients (sob, lethargic, palpitations) or if have idea of LT anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Tx of persistent AF >48h and already on anticoagulants
electrical cardioversion (consider amiodarone pre and post)
26
tx of persistent AF >48h and not on anticoagulants
consider TOE guided cardioversion or anticoag for 3w before cardioversion
27
common tx for paroxysmal AF
pill in the pocket
28
in addition to beta blocker what drugs considered in paroxysmal AF patients with heart failure or left ventricular impairment
amiodarone
29
what should you not offer patients with known ischaemic or structural heart disease (paroxysmal AF)
1c antiarrthythmic drugs such as flecanide or propafenone
30
amiodarone administration
long line or central line as toxic to veins
31
do you attempt to correct rhythm in new AF patient
yes
32
name a class III agent
amiodarone
33
name class Ic agent
flecanide, propafenone
34
efficacy of class III vs class Ic agents
Ic more effective than amiodarone if given early (within 12h onset). by 24h no difference
35
acute adverse effects of class III and Ic agents
heart failure and hypotension
36
adverse effects of Ics in structural HD
increase risk of fatal (ventricular) arrhythmias
37
when is amiodarone given in patient who has been electo-cardioverted
6w before and up to a year after
38
chronic adverse effects of amiodarone
photosensitivity (solar urticarial rash), thyroid dysfunction, pulmonary fibrosis
39
AF complications
rate related cardiomyopathy, pulmonary oedema, shock, stroke
40
who are low risk CHADVASC patients
men with score of 0 women with score of 1
41
recommended antithrombotic therapy if chadvasc 0
either aspirin or none. none preferred
42
recommended antithrombotic therapy if chadvasc 1
OAC or aspirin. OAC preferred
43
recommended antithrombotic therapy if chadvasc 2 or more
OAC
44
which antithrombin therapies have lower risk IC haemorrhage
NOACs
45
what induces warfarin metabolism
st johns wort, sulphonylureas, carbamazepine, rifampicin, chronic alcohol, phenytoin
46
catastrophic scenario of warfarin patient who comes into hospital with pneumonia
given erythromycin, catastrophic bleed as inhibits metabolism
47
what inhibits warfarin metabolism
sodium valproate/SSRIs, isoniazid, cimetidine, ketoconazole, fluconazole, amiodarone/acute alcohol, chloramphenicol, erythromycin, ciprofloxacin, omeprazole, metronidazole
48
what drugs used in AF thrombosis prophylaxis
warfarin or NOACs
49
what used in patients who cant take anticoag med
considered for left atrial appendage occlusion
50
what anticoag drugs cant be taken in renal failure
NOACs
51
what are NOACs
factor X inhibitors (apixaban etc), or DTIs (dabigatran)
52
problem with apixaban
no reversing agent
53
why is pharmacology of NOACs more reliable than warfarin
act further down clotting cascade
54
AF mx <48h
rate or rhythm control
55
AF mx >48h
rate control
56
LT side effects of amiodarone (EXAM Q)
Photosensitivity, hepatotoxicity, pulmonary fibrosis, thyroid dysfunction
57
acute side effects of amiodarone worried about
hypotension
58
are patients with structural heart defects suitable for electrical cardioversion
no
59
INR target in AF
between 2-3
60
tx for INR >6, stable, minor bleeding
vitamin k

CPTP 4.24-26 (1 decks)

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