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Revision Powerpoint Cardio Flashcards

1
Q

general rules for endocarditis antibiotics?

A

needs high dose (IV)
long course (4-6 weeks)
bactericidal
synergistic effect of combination

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2
Q

what organisms cause native valve endocarditis?

A

staph aureus (most common)
strep viridans
enterococcus
staph epidermidis

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3
Q

what organisms cause endocarditis in IV drug users?

A

staph aureus

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4
Q

what organisms cause prosthetic valve endocarditis?

A

staph epidermidis

staph aureus

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5
Q

endocarditis after dentist?

A

strep viridans

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6
Q

endocarditis after line insertion?

A

staph epidermidis

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7
Q

treatment for prosthetic valve endocarditis?

A

vancomycin
rifampicin
gentamicin
valve replacement usually needed

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8
Q

normal P wave?

A

0.0-0.1 secs

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9
Q

normal QRS?

A

<0.1

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10
Q

PR interval?

A

AV node delay

0.12-0.2 secs

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11
Q

QT interval?

A

diastole

0.36-0.44 secs)

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12
Q

where is angiotensinogen produced?

A

liver

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13
Q

where is renin produced?

A

kidney

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14
Q

where is ACE produced?

A

lung surface

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15
Q

how do thiazide diuretics work?

A

reduce blood volume by increasing Na, Cl and H2O excretion

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16
Q

side effects of thiazide diuretics?

A

hypokalaemia

electrolyte disturbance

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17
Q

how do beta blockers work?

A

reduce sympathetic activity, reducing CO, reducing renin release from kidney

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18
Q

beta blocker side effects?

A

cold peripheries
asthma
fatigue

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19
Q

how do CCBs work?

A

block L type calcium channels, reducing Ca2+ entry into vascular smooth muscle, reducing contraction

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20
Q

side effects of CCBs?

A

ankle oedema

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21
Q

how do alpha blockers work?

A

block alpha 1 adrenoceptors causing vasodilation

reduces sympathetic transmission

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22
Q

side effects of alpha blockers?

A

dizziness

confusion

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23
Q

what is stage 1 hypertension?

A

BP > 14/90 in clinic
OR
ABPM average of 135/85

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24
Q

what is stage 2 hypertension?

A

clinic BP > 160/100
OR
ABPM average >150/95

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25
causes of left sided heart failure?
ischaemid heart disease cardiomyopathy valvular disease
26
symptoms of left sided heart failure
dyspnoea on exertion/rest orthopnoea paroxysmal nocturnal dyspnoea pink frothy sputum
27
signs of left heart failure?
tachycardia fine crepatations pleural effusion S3 (gallop rhythm - S3 + tachycardia)
28
heart failure on CXR?
cardiomegaly bat wing shadows (esp. lower zones) interstitial fluid
29
right heart failure is usually 2ndary to left, true or false?
true
30
what can cause primary right heart failure?
cor pulmonale | congenital heart disease
31
symptoms of right heart failure?
body oedema
32
signs of right heart failure?
``` oedema elevated JVP hepatomegaly ascites CXR ```
33
when are thiazide diuretics used for heart failure?
mild CCF only | loop diuretics more commonly used (furosemide)
34
what is the main side effect of furosemide and how is this counteracted?
``` hypokalaemia coincidental drugs (ACE and spironolactone) help retain and normalise K ```
35
what drugs are used in heart failure?
``` diuretics spironolactone ACE inhibitors Beta blockers Ivabradine Digoxin ```
36
what are the initial risks of Beta blockers in HF?
hypotension | worsening dyspnoea
37
what kind of drug is spironolactone?
aldosterone receptor antagonist
38
side effects of spironolactone?
hyperkalaemia renal dysfunction gynaecomastia
39
what does ivabradine do and when is it used for HF?
slows HR | only used if HR fast despite B blockers
40
what is the sign of digoxin poisoning?
yellow vision
41
signs of patent foramen ovale?
machine like murmur
42
how is a patent foramen ovale diagnosed and treated?
ECHO, Doppler US | treated with surgery
43
signs of patent ductus arteriosus?
laboured breathing
44
how is a PDA treated?
NSAIDs
45
signs of persistant pulmonary hypertension of the newborn?
``` sick at birth or in hrs following cyanosis tachycardia low blood sats on high flow O2 pre and post ductal saturations ```
46
how is persistent pulmonary hypertension of the newborn treated?
nitric oxide
47
what are the signs of duct dependant circulation (DDC-also known as patent ductus arteriosus)?
present at 3-5 days | suddenly pale, tachypnoeic and distressed
48
how is DDC treated?
IVPGE2 | prostaglandin E2 - keeps duct open until surgery as baby is dependant on open duct
49
what is the main use for antiplatelets?
arterial thrombosis
50
how does aspirin work?
irreversibly blocks COX in platelets preventing TXA2 synthesis also blocks COX in endothelial cells inhibiting production of antithrombotic prostaglandin I2
51
side effect of aspirin?
GI bleeding | ulceration
52
how does clopidogrel work?
links to P2Y12 receptor via disulphide bridge producing irreversible inhibition (usually used when aspirin allergic or alongside aspirin)
53
how does tirofiban work?
binds to factor IIb/IIIa | prevents MI in high risk unstable angina
54
what are anticoagulants mainly used for?
venous thrombosis
55
how does warfarin work?
inhibits Vit K reductase preventing conversion of epoxide to active hydroquinone inactivates factors II, Vii, IX and X
56
how does rivaroxiban work?
direct thrombin inhibitor | factor Xa inhibitor
57
how does LMWH work?
inhibits Xa | not thrombin IIa
58
4 Hs and 4 Ts of reversible causes of cardiac arrest?
``` Hypothermia Hyperkalaemia/hypokalaemia Hypovolaemia Hypoxia Tamponade Tension pneumothorax Thromboembolism Toxin ```
59
saddle shaped ST elevation?
pericarditis
60
continuous machine like murmur?
PDA
61
diminished or absent lower limb pulses?
coarctation of aorta
62
radio-femoral delay?
coarctation of aorta
63
slow rising pulse?
aortic stenosis
64
collapsing pulse?
aortic regurgitation
65
JVP rising on inspiration?
cardiac tamponade or constrictive pericarditis
66
tapping apex beat, loud S1?
mitral stenosis
67
drug causing gout?
thiazide diuretics

Holy Grail Docs (39 decks)

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