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Flashcards in Tough stuff Deck (70):
1

AA class 1 (rhythm) use

Na+ channel blockers (phase 0) - slow conduction, prolong repolarisation

2

AA class 1 examples

lignocaine
flecainide

3

AA class 2 (rate) use

B-adrenoceptor blockers (phase 4)

4

AA class 2 examples

Atenolol
Propranolol

5

AA class 3 (rhythm) use

K+ channel blockers (phase 3) - prolong repolarisation

6

AA class 3 examples

amiodarone
sotalol

7

AA class 4 (rate) use

Ca2+ channel blockers (phase 2)

8

AA class 4 examples

verapamil
diltazem

9

treatment for bradycardia

IV atropine
temporary/ permanent pacing

10

treatment for acute SV tachycardias

vagal manœuvres
carotid massage
IV adenosine
IV verapamil
anticoagulate (warfarin)

11

ECG for SV tachycardia?

normal QRS - they arise form the atrium

12

treatment for SV tachycardias

1. get back to NSR - DC cardioversion and class 1 (lignocaine) or 3 AA drugs (amiodarone)

2. rate control - accept the AF but control the ventricular rate --> digoxin, B-blocker or verapamil

3. anticoagulation

4. AV node ablation

13

ECG of VT

broad QRS complex

14

treatment of VT

1. DC cardioversion if haemydynamic compromise

2. Defib if pulseless VT

3. amiodarone and lignocaine (class 3 and 1 rhythm AA drugs)

15

ECG of VF

shapeless, unorganised QRS complexes, a shambles🤦🏼‍♂️

16

treatment of VF

1. basic life support

2. defib

3. magnesium chloride

4. amiodarone

17

name 4 gram -ive bacilli

haem.influenza
enterobacter
pseudomonas auriginosa
bordtella pertussis

18

name 1 gram -ive cocci

neisseria

19

name 3 gram +ive cocci

staphylococcus
streptococcus
enterococci

20

name 1 gram +ive bacilli

clostridia

21

what is the incubation time for paratyphoid/typhoid and how do you treat it

3 weeks
azithromycin

22

how does E.Coli work

1. produced by a shiga-like toxin and acts in the same way as shiga

2. produces a verotoxin that causes RBC/kidney damage

3. can lead to haemolytic ureamic syndrome (HUS)

4. no treatment for (HUS), just supportive

23

what is the most common cause of endocarditis

strep viridians

24

what is the causative organism in prosthetic valve endocarditis?

staph. epidermidis

25

how to treat C. Diff

1st occurrence = fidaxomycin
non-severe = metronidazole
severe = vancomycin

26

treatment for peritonitis, billiary tract/ intra-abdominal infection

IV amoxicillin
metronidazole
gentamicin

27

treatment for acute gastroenteritis and pancreatitis

NONE!! 😁

28

difference in treatment between non-severe and severe HAP

treat with amoxicillin and metronidazole for both-
add gentamicin for severe

29

CAP with CURB 0-2 treatment

amoxicillin

30

CAP with CURB 3-5

IV co-amoxiclav + doxycycline oral

31

what do b-lactams target

bacterial cell wall

32

target of flucloxacillin

narrow spec
only gram +ive
staph and strep

33

target of amoxicillin

wide spec
gram +ive and -ive

34

antibiotics that inhibit nucleic acid synthesis

metronidazole
fluroquinolones

35

antibiotics that inhibit protein synthesis

tetracycline
macrolides (clarithromycin, erythromycin)
aminoglycosides

36

whit is gentamicin

an aminoglycoside
works on gram -ive aerobic like coliforms and pseudomonas aeuriginosa

37

what is vancomycin

a glycopeptide
not a B-lactam
only works on gram +ive cell wall
no activity on gram -ive

38

what can metronidazole work on

clostridium
bacteriosides
anerobes
protozoa

39

what pneumonia will likely arise in an exacerbation of COPD

haem. influenzae

40

which pneumonia causes a dry cough, atypical chest signs and haemolytic anaemia

mycoplasma pneumoniae

41

how is S1 affected by mitral stenosis an mitral regurg

mitral stenosis = soft S1
mitral regurg = loud S1

42

what happens to S2 in aortic stenosis

aortic stenosis = soft S2

43

conditions that cause life threatening acidosis

life threatening asthma
COPD
opiate overdose
obesity hypoventilation syndrome

44

conditions that cause life threatening alkalosis

hyperventilation
PE
alitiude
CNS disorders
pregnancy

45

treatment of acute exacerbation of COPD

1. ABCD
2. oxygen
3. steroids - IV hydrocortisone or oral prednisone
4. antibiotics - amoxicillin or doxycycline
5. nebuliser SABA

46

what is dressler syndrome

complication of an MI that occurs weeks after initial infarction
symptoms:
mild fever, pleuritis chest pain relived by leaning forward, friction rub

occurs due to formation of antibodies against cardiac antigens released from necrotic myocytes during infarct

47

what is a parodoxus pulse?

an abnromally large decrease in SV, systolic BP and pulse wave amplitude during inspiration

commonly due to cardiac tamponade, can also be cos of PE or hypovolemic shock

48

what areas of the heart does the RCA perfuse

the inferior part of LV

49

what area of the heart does the circumflex artery perfuse

the left free wall of LV

50

what area does the LAD perfuse

septum, apex and anterior wall

51

ECG of ANTERIOR stemi

V2- V5

52

ECG of INFERIOR stemi

aVF, II, III

53

ECG of ANTERIOSEPTAL stemi

V1 - V3

54

ECG of ANTERIOLATERAL stemi

aVL, I, V4-6

55

which murmur causes a collapsing pulse

aortic regurgitation

56

what causes a bounding pulse

septic shock

57

MABP = ??

MABP = diastolic pressure + 1/3 (systolic - diastolic)

58

mid-diastolic murmur at apex of heart

mitral stenosis

59

pan systolic murmur at apex of heart

mitral regurgitation

60

how to diagnose hypertension

BP > 140/90 mmHg = ABPM is required
BP > 180/110 mmHg = start anti-hypertensive drugs IMMEDIATELY

61

brain natriuretic peptide (BNP)

released by myocardium when its being excessively stressed
main function- decrease systemic vascular resistance of body, DECREASING AFTER LOAD
increases diereses - decreases BV, reducing PRELOAD

62

ejection systolic radiating to carotids

Aortic stenosis

63

high pitched and blowing, early diastolic

aortic regurgitation

64

pan-systolic murmur radiating to apex

mitral regurgitation

65

mid/late diastolic rumbling murmur

mitral stenosis

66

which murmur causes a narrow pulse pressure, slow rising pulse and soft S2

Aortic stenosis

67

which murmur can cause AF, has a soft S1 and a displaced apex

mitral regurgitation

68

which murmur has a wide pulse pressure and a collapsing pulse

aortic regurgitation

69

which murmur can cuase exertion dyspnoea, orthopnoea and PND

aortic regurgitation

70

which murmur has a tapping, non-displaced apex beat

mitral stenosis