Ischaemic Disease Flashcards Preview

Cardiovascular > Ischaemic Disease > Flashcards

Flashcards in Ischaemic Disease Deck (27):
1

What are the features of Tetralogy of Fallot?

Right ventricular hypertrophy

Ventricular septal defect

Pulmonary Stenosis

Over-riding aorta

2

What is the first line treatment for hypertension?

< 55 years

ACE-I or ARB

 

>55 or African/caribbean

Calcium-channel blocker

3

What is the second line treatment for hypertension?

Add in whichever of ACE-I/ARB or Calcium channel blocker patient is not current taking

4

What is the third line treatment for hypertension?

Thaizide diuretic

5

Which vessels are commonly used for coronary artery bypass?

Long saphenous vein

Internal mammary artery

6

What is intermittent claudication?

Angina like pain of the lower leg on exercise

7

How is intermittent claudication investigated?

Ankle brachial pressure index

Duplex ultrasound scanning

----

Magnetic resonance angiography

CT angiography

Catheter angiography

8

What is critical limb ischaemia?

Pain in toe/foot on rest

Lying

Sleeping

9

What is the definition of an arterial aneurysm?

50% increase in normal diameter

10

What are the main structural complications that can arise from MI?

Cardiac rupture

Ventricular septal defect

Mitral valve regurgitation

11

What are the four stages of the killip classification?

I - no sign of heart failure

II - crepitations <50% of lung fields

III - crepitations >50% of lung fields

IV - cardiogenic shock

12

At what blood pressure should ambulatory monitoring be offered?

140/90mmHg

13

How many measurements should be taken for ambulatory BP monitoring?

2 per hour during normal waking hours

14

What are the two types of stroke?

Haemorrhagic (20%)

Ischaemic (80%)

15

What is the definition of stroke?

Acute onset of focal neurological symptoms and signs due to disruption of blood supply

16

What is the pathology of haemorrhagic stroke?

Raised blood pressure

Weakened blood vessel wall due to:

aneurysm

arteriovenous malformation (AVM)

vasculitis (inflammation of vessel wall)

17

What are the three types of ischaemic stroke?

Thrombotic

Embolic

Hypoperfusion

18

After which types of stroke should a patient be given statin therapy?

Ischaemic stroke.

Not for haemorrhagic stroke.

19

Which modifiable risk factors carry the highest risk for stroke?

Hypertension

Smoking

Hyperlipidaemia

20

Give some examples of conditions that can mimic stroke.

Hypoglycaemia

Seizure - postictal states

Migraine

Hyperglycaemia, hyponatraemia

Lesions, tumours

Functional hemiparesis

21

How can haemorrhagic and ischaemic stokes be differentiated?

Brain imaging

CT +/- angiography

MRI with DWI +/- angiography

MRI with GRE (look for old bleeds - haemosiderin)

22

What investigations should be carried out in ischaemic stroke?

Glucose, lipids, thrombophilia - young patients

Atheroembolisms - carotid scanning, CT/MR of aortic arch

Cardioembolism - ECG, Echo

23

What is the difference between atheroembolism and cardioembolism?

Atheroembolism infarcts in the same side as the carotid artery

Cardioembolism infarcts in more than one arterial territory - bilateral

24

What is the definition of a TIA?

Focal neurological symptoms that resolve within 24 hours

25

What is the medical management for ischaemic stroke?

Aspirin 75mg OD

Dipyridamole 200mg BD/Clopidogrel 75mg OD

Statins

Antihypertensives

Anticoagulation if AF

26

What surgical management is appropriate in stroke?

Haematoma evacuation

Relief of raised intercranial pressure

Carotid endarterectomy

27

What is the emergency treatment for ischaemic stroke?

Thrombolysis