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high yield- year 2 > 1st year cardio > Flashcards

1st year cardio Flashcards

1
Q

what is classed as hypertension?

A

-clinic BP 140/90
AND
-ABPM or HBPM 135/85

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2
Q

treatment for hypertension <55 or diabetic?

A
  1. ACEI/ARB
  2. ACEI/ARB + CCB OR ACEI/ARB + Diuretic
  3. ACEI/ARB + CCB + Diuretic
  4. A + C + D + further diuretic or alpha or beta blocker
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3
Q

treatment for hypertension > 55 or African or Carribean origin?

A
  1. CCB
  2. CCB + ARB/ ACEI OR CCB + Diuretic
  3. ACEI/ARB + CCB + Diuretic
  4. A + C + D + consider further diuretic or alpha or beta blocker
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4
Q

SE ACEI

A

dry cough

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5
Q

SE CCB

A

swollen ankles

CCB= cankles

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6
Q

what is Virchow’s triad?

A

-how thrombosis occurs

  • stasis of blood flow
  • endothelial injury
  • hyper coagulability
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7
Q

management of VTE?

A

Direct oral anticoagulants

e.g. rivaroxaban

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8
Q

treatment stable angina?

A

acute= GTN spray

  1. BB
  2. +/- rate limiting CCB (diltriazem/veramapil)
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9
Q

inferior limb leads?

A

II, III and AVF

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10
Q

anterior limb leads?

A

V1-V6

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11
Q

anteroseptal limb leads?

A

V1-V4

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12
Q

anterolateral limb leads?

A

I, avL, V1-6

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13
Q

treatment for STEMI?

A
  • PCI (if <120mins)
  • Fibrinolysis (if PCI cannot be delivered in <120 mins)
MONAT
Morphine IV
Oxygen- if hypoxic
Nitrate (GTN)
Aspirin 300mg
Tricagrelor 180mg
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14
Q

treatment NSTEMI?

A

-Aspirin and Fondaparinux (fibronylitic therapy to break up clot)

High risk= refer for angiography within 96 hours (+/- PCI)

Low risk= Aspirin and Ticagrelor

(use GRACE score to decide if high risk of low risk)

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15
Q

what occurs to cardiac output in heart failure?

A

-it decreases

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16
Q

presentation right sided HF?

A
  • peripheral oedema
  • raised JVP
  • hepatosplenomegaly
  • ascites
17
Q

presentation left sided HF?

A
  • exertional dyspnoea
  • PND (wakes up at night breathless)
  • orthopnea (how many pillows do they sleep with)
  • fatigue
  • cyanosis
  • pulmonary congestion (pink, frothy sputum and crackles and wheezes)
18
Q

how does HF present on CXR?

A

ABCDE

  • Alveolar oedema
  • Kerley B lines
  • Cardiomegaly
  • Dilated upper Lobe vessels
  • Pleural Effusion
19
Q

investigations for HF?

A

1st line= NT- pro- BNP (released when the heart is under strain)

echo- best way to assess cardiac function and structure

ECG + CXR may be useful

CXR: ABCDE

  • alveolar bat wings
  • Kerley B lines
  • Cardiomegaly
  • Dilated upper lobe vessels
  • Pleural effusion
20
Q

management of heart failure?

A

1st= ACEI + BB dual therapy (e.g. ramipril + bisoprolol)

2nd= spironolactone

Fluid overload= furesomide (loop diuretic)

21
Q

what does S3 suggest?

A
  • heart failure

- can be normal in younger adults and adolescents

22
Q

what does S4 suggest?

A

(heard just before S1)

  • always abnormal
  • hypertrophic ventricle
23
Q

what valve is heard at 2nd ICS, right of the sternum?

A

-aortic valve

24
Q

what valve is heart 2nd intercostal space left of the sternum?

A

-pulmonary valve

25
Q

what is heard at 5th intercostalspace left of the sternum?

A

Tricuspid valve

26
Q

what is heard at the 5th intercostal space, mid clavicular line?

A

mitral valve/ apex beat

27
Q

what murmurs are heard during systole?

A

MRS ASS

  • mitral regurgitation
  • atrial stenosis
28
Q

infective endocarditis- IV drug user

  • what bacteria?
  • what valve is most commonly affected?
A

Staph aureus

Tricuspid valve most commonly affected

29
Q

Infective endocarditis- prosthetic valve surgery

-What bacteria?

A

Staph epidermic

30
Q

describe aortic stenosis

A

Aortic stenosis is hardening of aortic valve

  • heard over the 2nd intercostal space, right of the sternum
  • low volume, slow rising pulse
  • ejection systolic murmur
  • radiates to carotid
31
Q

describe mitral regurgitation

A

Backflow of blood through the mitral valve due to floppy valves

  • heard at the 5th intercostal space, mid clavicular line
  • displaced apex
  • pansystolic murmur
  • maximal at the apex and radiates to the axilla
32
Q

describe mitral stenosis

A

Hardening of mitral valves

  • heard loudest at 5th intercostal space, mid clavicular line
  • malar flush
  • tapping apex beat
  • mid diastolic murmur localised at the apex

high yield- year 2 (20 decks)

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