Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

3A > sun 8th > Flashcards

sun 8th Flashcards

1
Q

What classification is used to define heart failure severity?

A

NYHA classification

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

what is the first line investigation for heart failure?

A

NT-proBNP

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

what should be the action following NT-proBNP result (depends on level)

A

> 2000= high NT-proBNP -> should be reviewed for transthoracic echo within 2 weeks

400-2000 = raised NT-proBNP -> should be reviewed for echo within 6 weeks

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

what may cause a falsely raised NT-proBNP?

A

Left ventricular hypertrophy
Ischaemia
Tachycardia
Right ventricular overload
Hypoxaemia (including pulmonary embolism)
GFR < 60 ml/min
Sepsis
COPD
Diabetes
Age > 70
Liver cirrhosis

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

What may cause a falsely low NT-proBNP

A

Obesity
Diuretics
ACE inhibitors
Beta-blockers
Angiotensin 2 receptor blockers
Aldosterone antagonists§

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

what is the first line management of heart failure

A

beta blocker and ACEi

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

what is the second line management of heart failure

A

aldosterone antagonist (e.g. spironolactone)

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

what is the third line management of heart failure?

A

specialist medications (one of the following):
- ivabradine
- digoxin
- hydralazine with nitrate
- sacubilnl valsartan

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

what vaccines should someone with heart failure have?

A

one of pneumococcal and yearly influenza

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

what are causes of atrial fibrillation

A

mrs SMITH
Sepsis
mitral valve pathology
ischaemic heart disease
thyrotoxicosis
hypertension

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

what are the 4 pathological features of AF

A
  • irregularly irregular ventricular rate
  • tachycardia
  • heart failure due to poor filling of ventricles
  • increased stroke risk due to blood pooling in the ventricles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what will and ECG show in AF

A

absent p waves
narrow QRS complex tachycardia
irregularly irregular ventricular rhythmn

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

When would rhythmn control be used in AF?

A

if it is new onset within the past 24 hours
if it has a reversible cause
if it is causing heart failure

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

what two drugs might be used for cardioversion

A

amiodarone
flecainide

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

what is the first and second line rate control for AF?

A

1- beta blocker or CCB
2- Beta blocker + CCB/digoxin

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

when would immediate and when would delayed cardioversion be used?

A

immediate if onset was within 48 hours or the person is haemodynamically unstable
delayed by 3 weeks if not (take anticoagulants during 3 weeks)

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

what anticoagulatin is used in AF?

A

DOAC- apixiban

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

second line anticoagulation in AF

A

warfarin

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

what intervention might be used in AF if antiarrhythmic drugs arent effective?

A

catheter ablation

20
Q

first line management of COPD

A

SABA or SAMA

21
Q

second line management of COPD

A

depends if steroid responsive or not

if steroid responsive:
- add ICS and LABA
(if taking a SAMA already this should be changed to a SABA)

If not steroid responsive
- add LABA and LAMA
(if taking a SAMA already this should be changed to a SABA)

22
Q

how is it determined if someone is steroid responsive or not in COPD

A
  • if they have had a previous diagnosis of asthma or atopy
  • if they have raised blood eosinophils
  • if they have diurinal variation in the PEF > 20%
  • if they have had variation in their FVC over time >400ml
23
Q

3rd line management of COPD

A
  • SABA when needed plus LAMA+LABA+ICS
24
Q

what prophylactic antibiotic might be given to certain COPD patients

A

azithromycin

25
what medication may be able to reduce the amount of infective exacerbations in COPD?
phosphodiesterase inhibitors (such as roflumilast)
26
how are infective exacerbations of COPD managed?
5 day prednisolone + antibiotics if purulent sputum (either amoxicillin, clarithromycin or doxycycline)
27
what is the first line management of type 2 diabetes?
IF no CV risk/HF: metformin If CVD risk/HF: metformin + SGLT-2 inhibitor
28
give an example of an SGLT-2 inhibitor
dapagliflozin
29
second line management of diabetes?
metformin plus one of the following: - DPP-4 inhibitor - SGLT-2 inhibitor - sulfonylurea - pioglitazone
30
3rd line management of diabetes?
triple therapy or insulin therapy
31
what might be added to diabetes management if triple therapy isnt working or insulin is contraindicated?
GLP-1 mimetic
32
Give the action, an example and side effect of sulfonylurea
action: inhibits the reabsorption of glucose in the kidneys Example: gliclazide SE: UTIs and thrush
33
Give the action, an example and side effect of DDP-4 inhibitor
action: increase incretin secretion which inhibits glucagon Example: sitagliptin and alogliptin SE: headaches
34
Give the action, an example and side effect of pioglitazone
it is an thiazolidinedione action: increases the sensitivty to insulin and decreases hepatic glucose production SE: Weight gain Heart failure Increased risk of bone fractures A small increase in the risk of bladder cancer
35
Give the action, an example and side effect of GLP-1 mimetic
action: mimics incretin which inhibits glucagon example: exenatide and liraglutide SE: reduced appetite, weight loss and GI symptoms
36
what might levodopa be combined with
a peripheral decarboxylase inhibitor such as carbidopa or beserazide - forms co-carbeldopa or co-beneldopa
37
what is the main side effects of levodopa and give some specific examples
dyskinesia included: - dystonia - chorea - athetosis
38
how might dyskinesias be treated in levodopa use and what is its action
amantadine - glutamate antagonist
39
How do COMT inhibitors work?
inihbit catechol-o-methyltransferase which is an enzyme that metabolises levodopa in the body and brain
40
give an example of a COMT inhibitor
entacapone
41
give 3 examples of dopamine agonsits
cabergoline, bromocriptine, pergolide
42
how doe MAO-B inhibitors work and give some examples
they inhibit the break down of dopamine selegilline rasagilline
43
what two drugs might be used in alcohol dependence management
acamprosate and disulfram
44
how does acamprosate work?
it is a weak agonist of the NDMA receptor it reduces cravings
45
how does disulfram work?
it inhibits acetylaldehyde dehydrogenase - produces a reaction when the patient drinks alcohol making them ill
46

3A (42 decks)

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