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GP > GP - cardiology > Flashcards

GP - cardiology Flashcards

1
Q

What is tachycardia in < 12 months, 12-24 months and 2-5 years?

A

< 12 months = > 160bpm
12-24 months = > 150 bpm
2-5 years = > 140 bpm

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2
Q

Name 3 causes of heart failure

A

MI, coronary heart disease, hypertension, congenital, arrhthmyias, cardiomyopathy

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3
Q

How would you classify heart failure?

A

New York Heart Association Class I to Class IV
I - no limitation
II - slight limitation
III - marked limitation
IV - unable to carry out any physical activity without discomfort

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4
Q

What is the prognosis of severe heart failure?

A

90% die within 1 year

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5
Q

What is the treatment for heart failure?

A

ACEi then beta blocker
seek specialist advice
diuretics e.g. spitinalactone

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6
Q

What is the hypertension pathway, give an example?

A

A or C then A&C then A,C,D
A = angiotensin conducting enzyme inhibitor e.g. ramapril
C = calcium channel blocker e.g. amlodipine
D = thiazide-like diuretic e.g. bendoflumethiazide

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7
Q

Give an example of an ACE-i

When would you use it?

A

ramapril
first line treatment of heart failure
First line treatment of hypertension in <55, non-Afro-Caribbean

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8
Q

What is the main side effect of ACE-is?

A

prolonged dry cough

kidney problems

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9
Q

Give an example of a BB

When would you use it?

A

bisoprolol

2nd line treatment of heart failure

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10
Q

How do ACE-i work?

A

Angiotensin converting enzyme inhibitors
ACE causes retention of salt and water and vasocontriction so inhibiting the enzyme results in decreased in blood volume and vasodilation

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11
Q

How does bisoprolol work?

A

B1 adrenergic selective beta blocker - cardiospecific

Normally adrenaline and noradrenaline activate B1 receptors increasing contractility and increase HR

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12
Q

What are some side effects of beta blockers?

A

“fuzzy head”

impotence

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13
Q

Give an example of CCB

When would you use it?

A

amlodopine

First line treatment of hypertension if >55 or Afro-Carribbean

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14
Q

How does amlodopine work/

A

Calcium channel antagonist - inhibit calcium influx in smooth muscle cells so inhibit contraction

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15
Q

What is the main SE of amlodopine?

A

ankle swelling

do not prescribe with beta blockers as they both slow HR

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16
Q

What are the 3 main types of diuretic and give an example of each

A

Thiazide like - bendrofluromethiazide
Potassium sparing - spironolactone
Loop - furosemide

17
Q

When would you prescribe diuretics?

A

Third stage treatment for hypertension or heart failure

  • loop diuretics better for heart failure
  • bendrofluromethazide better for hypertension
18
Q

What is the main SE of diuretics?

A

electrolyte imbalance

increased urinary frequency

19
Q

How does bendrofluromethazaide work?

A

Inhibit sodium resorption in distal convoluted tubule = more sodium in collecting ducts so more water lost = lower BP

20
Q

How do loop diuretics work?

A

Inhibit resorption of sodium chloride and potassium in loop of henle - release of renin - increase in GFR
Increase production of prostaglandins = vasodilation and incrased blood supply to kidney

21
Q

How does spironolactone work?

A

Antimineralcorticoid

potassium sparing so can cause hyperkalaemia

22
Q

What are the screening questions for heart failure?

A 
How many pillows do you sleep with?
do you have frothy pink sputum?
Are you urinating more than normal?
How far can you walk without getting out of breath? 
Do you have swollen ankles? 
Do you get cold extremities?
23
Q

What are two tests for DVT?

A

doppler scan of leg

D-dimer

24
Q

What are 3 anticoagulants and their contraindications?

A

heparin - liver failure
Warfarin - pregnancy
Rivaroxaban - hepatic disease

25
Q

What are some symptoms of DVT?

A

throbbing or cramping pain in leg, swelling in 1 leg, warm skin around painful area, red or darkened skin, swollen veins that are hard or sore when touched

26
Q

How do you assess cardiac risk? What are some factors involved?

A

QRisk3
age, sex, ethnicity, postcode, smoking
PMH (DM, CKD, AF, HTN, migraine, RA, SLE, mental illness)
Family history - first degree relative IHD <60
Drug history
measurements - BP, cholesterol, BMI

27
Q

What is Wolffe-Parkinson White sydrome?

A

ventricular pre-excitation = SVT

More in males

GP (11 decks)

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