Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CARDIO > old HF, pulmonary oedema, cardiogenic shock, HTN > Flashcards

old HF, pulmonary oedema, cardiogenic shock, HTN Flashcards

(69 cards)

Start Studying
1
Q

what is the definition of heart failure?

A

CO inadequate for body’s requirements despite adequate filling pressures

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

what is the pathophysiology of HF?

A 
1) reduced CO initially -> compensation 
starling effect dilates heart to enhance contractility 
remodelling -> hypertrophy 
RAS + ANP/BNP release
sympathetic activation

2) progressive decrease in co-> decompensation
progressive dilatation leads to impaired contractility + functional valve regard
hypertrophy leads to relative myocardial ischaemia
RAS activation leads to na+ and fluid retention leads to increase venous pressure leads to oedema
sympathetic excess leads to increase in afterload and decrease in CO

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

what is low output HF?

A

CO decreases and fails to increase with exertion

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

what are the cateogires of causes of low output HF?

A

1) pump failure
2) excessive pre-load
3) excessive afterload

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

what are the causes of pump failure in low output hf?

A 
1) systolic failure leads to impaired contraction 
ischaemia/MI
dilated cardiomyopathy
HTN
myocarditis

2) diastolic failure leads to imapired filling
pericardial effusion/tamponade/constriction
cardiomyopathy: restrictive, hypertrophic

3) arrhythmias- bradycardia, heartblock, tachycardias, anti-arrhythmics eg bb, verapamil

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

what are the causes of excessive preload in low output hf?

A

AR
MR
fluid overload

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

what are the causes of excessive afterload in low output hf?

A

AS
HTN
HOCM

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

what is high output hf?

A

there are higher needs which lead to RVF initially and then LVF

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

what are the causes of high output hf?

A

anaemia, AVM
thyrotoxicosis, thiamine deficiency (beri beri)
pregnancy, pagets

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

what are the causes of right ventricular dysfx?

A

LVF
co pulmonale
tricuspid pulmonary valve disease

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

what are the symptoms of RVF?

A

anorexia and nausea

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

what are the signs of RVF?

A

raised jvp + jugular venous distension
tender smooth hepatomegaly (may be pulsatile)
pitting oedema
ascites

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

what are the causes of LVF?

A 
IHD
idiopathic dilated cardiomyopathy
systemic HTN
mitral and aortic valve disease 
specific cardiomyopathies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the symptoms of LVF?

A 
fatigue 
exertional dyspnoea
orthopnoea + PND
nocturnal cough (+/- pink frothy sputum)
weight loss + muscle wasting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the signs of LVF?

A 
cold peripheries +/- cyanosis 
often in AF
cardiomegaly with displaced apex
S3 + tachy= gallop rythm
wheeze (cardiac asthma)
bibasal creps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is acute HF?

A

new onset or decompensation of chronic
peripheral/pulmonary oedema
+/- evidence of peripheral hypoperfusion

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

what is chronic HF?

A

develops/progresses slowly
venous congestion common
arterial prssure mainted until very late

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

how is chronic HF diagnosed?

A

framingham criteria

2 major criteria or 1 major + 2 minor

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

what investigations woudl you do for chronic hf?

A

bloods- FBC, UE, BNP, FT, glucose, lipids
CXR
ECG
ECHO

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

what would you see on CXR for chronic hf?

A 
ABCDEF
alveolar shadowing
kerley b lines
cardiomegaly 
upper love divesion
effusions 
fluid in fissures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what can you see on ECG for chronic heart failure?

A

ischaemia
hypertrophy
AF

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

what can be seen on echo for chronic heart failure?

A

focal/global hypokinesia
hypertrophy
valve lesions
intracardiac shunts

global systolic/diastolic function. EF normally about 60%

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

what classification system is used for hf?

A

NYHA classification

1- no limitation of activity
2- comfortable at rest, dypsnoea on ordinary activity
3- marked limitation of ordinary activity
4- dyspnoea at rest and all activity

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

what is the primary/secondary cardiovascular risk prevention for HF?

A 
smoking cessation
decrease salt intake
weight loss/gain- dietician
rehab programme 
aspirin 
statins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the underlying cause for chronic heart failure requiring treatment?
valve disease arrhytmias ischaemia
26
what are the exacerbating factors for chronic heart failure requiring treatment?
anaemia infection increased bp
27
what treatments lower mortality in chronic heart failure?
ace inhibitors bb spironolactone
28
what is the 1st line management of chronic hf?
ACEi/ARB- lisinopril or candesartan. hydrazlazine + ISDN if not tolerated (watch K+ on ACE-i) bb- carvedilol or bisoprolol. loop diuretic- frusemide or bumetanide
29
what is the 2nd line management of chronic hf?
specialist advice spironolactone/eplerenone- watch K+ ACEI/ARB vasodilators- hydralazine + ISDN- additional treatment in black people
30
what is the 3rd line of chronic hf?
digoxin | cardiac resynchornisation therapy +/- ICD
31
what other monitoring do you need to do in chronic hf?
BP- may be very low renal function plasma K+ daily weights use amlodipine for comrbid HTN or angina avoid verapamil, diltiazem and nifedipine - short-acting
32
what invasive therapies can be done for chronic hf?
cardiac resynchronisation +/- ICD intra-aortic balloon counterpulsation LVAD heart transplant
33
what are the causes of severe pulmonary oedema?
1) cariogenic MI arrythmia fluid overload- renal, iatrogenic 2) non-cardiogenic ARDS- sepsis, post-op, trauma upper airway obstruction neurogenic- HI
34
what are the symptoms of severe pulmonary oedema?
dyspnoea orthopnoea pink frothy sputum
35
what are the signs of severe pulmonary oedema?
``` distressed, sweaty, cyanosed tachycardic, tachypnoeic raised jvp S3/gallop rythma bibasal creps pleural effusions wheeze ```
36
what are ddx of severe pulmonary oedema?
asthma/copd pneumonia PE
37
how do you monitor the progress of severe pulmonary oedema?
``` bp hr rr jvp urine output abg ```
38
what is the definition of cardiogenic shock
inadequate tissue perfusion primarily due to cardiac dysfunction
39
what are the causes of cardiogenic shock?
MI HEART ``` MI hyperkalaemia (inc electrolytes) endocarditis- valve destruction aortic dissection rhythm disturbance tamponade obstructive- tension p neumo, massive PE ```
40
what is the presentation of cardiogenic shock?
unwell, pale, sweaty, cyanosed, distressed cold clammy peripheries tachycardia/pnoeic pulmonary oedema
41
what are the causes of tamponade
``` trauma lung/breast cancer pericarditis MI bacteria eg TB ```
42
what are the signs of tamponade
beck's triad- low bp, raised jvp, muffled heart sounds kussmaul's sign- raised jvp on inspiration pulsus paradoxus- pulse fades on inspiration
43
what investigations do you do in tamponade?
echo- diagnostic | CXR- globular heart
44
what is the management of tamponade?
ABCs | pericardiocentesis- under echo guidance
45
what is stage 1 HTN
>140/90
46
what is stage 2 HTN
>160/100
47
what is severe HTN
>180/110
48
what is malignant HTN
>180/110 + papilloedema +/or retinal haemorhage
49
what is isolated SHT
systolic >/ 140, diastolic <90
50
what is the aetiology of HTN?
PREDICTION primary- 95% renal- RAS, GN, APKD, PAN endo- high T4, cushings, phaeo, acromegaly, conn's ``` drugs- cocaine, NSAIDs, OCP, steroids ICP high CoA- coarcation of aorta toxaemia of pregnancy PET increased viscosity overload with fluid neurogenic- diffuse axonal injury, spinal section ```
51
what symptoms/signs could you see with HTN that could suggest its cause?
``` high HR- thyrotoxicosis RF delay- CoA renal bruit- RAS palpable kidneys- APKD paroxysmal headache, tachycardia, sweating, palps, labile or postural hypotension- phaeo ```
52
what end-organ damage can HTN cause? (categories)
``` CANER cardiac aortic neuro eyes- hypertensive retinopathy renal ```
53
what end-organ damage can HTN cause to the heart?
IHD LVH leading to CCF AR MR
54
what end-organ damage can HTN cause to the aorta
aortic dilation leading to AR + dissection aneurysm dissection
55
what end-organ damage can HTN cause to the brain?
CVA- ischaemic, haemorrhagic | encephalopathy (malignant HTN)
56
what end-organ damage can HTN cause to the eyes?
``` hypertensive retinopathy Keith-Wagener classifcation:: 1. tortuosity and silver wiring 2. AV nipping 3. flame haemorrhages+ cotton wool spots 4. papilloedema ``` grades 3 +4= malignant HTN
57
what end-organ damage can HTN cause to the kidneys?
proteinuria | CRF
58
what investigations would you conduct for HTN?
1) 24h ABPM- then treat unless severe HTN 2) urine- haematuria, ab:cr ratio 3) bloods- fbc, u+e eGFR glucose fasting lipids 4) 12 lead ECG- LVH, old infarct 5) calculate 10yr CV risk
59
what is the lifestyle management for HTN?
``` more exercise smoking cessation less alcohol less salt less caffeine ```
60
what are the indications for pharmacological management of HTN?
1) stage 2 HTN >160/100 2) severe/malignant HTN - specialist referral 3) consider specialist if <40yo with stage 1 HTN + no end organ damage 4) <80yo stage 1 and one of: target organ damage 10yr CV risk >/20% established CVD DM renal disease
61
what is BP target for <80yo patients?
<140/90
62
what is BP target for <80yo with DM?
<130/80
63
what is BP target for >80yo patients?
<150/90
64
what is the CV risk management in HTN?
statins for primary prevention if 10yr CVD risk >/20% | aspirin- evaluate risk of bleeding
65
how would you manage malignant HTN?
1) controlled decrease in BP over days to avoid stroke 2) atenolol or long-acting CCB PO 3) encephalopathy/CCF: frusemide + nitroprusside/laetalol IV with aim to decrease bp to 110 diastolic over 4h - nitroprusside needs intra-aterial bp monitoring
66
what medications by stage for HTN management <55yo white?
1st) ACEi or ARB 2nd) ACEi/ARB + CCB 3rd) ACEi/ARB + CCB + thiazide-like diuretic 4th) RESISTANT HTN- so ACEi/ARB + CCB + diuretic + another diuretic eg spiro OR alpha or beta blocker seek expert opinion
67
what medications by stage for HTN management >55yo or black?
1st) CCB (or thiazide-liked diuretic) 2nd) CCB + ARB (over ACEi in black people) 3rd) CCB + ARB + thiazide-like diuretic 4th) resistant HTN so CCB + ARB + thiazide diuretic + further diuretic or alpha/beta blocker seek expert opinion
68
why would you want to avoid thiazide-like diuretics and beta blockers if you can in HTN management?
increases rsk of diabetes
69
when would you consider using beta blockers to control HTN?
it is used 4th line for resistant HTN but only consider if young and ACEi/ARB not tolerated

CARDIO (10 decks)

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