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JG Year 2 > 238 HF > Flashcards

238 HF Flashcards

1
Q

Which 2 drugs should be prescribed asap following Dx of HF?

A

ACEI

Beta blocker

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2
Q

Which drug should be added into ACEI and beta blockers treatment for HF?

A

Spirinolactone

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3
Q

What should be considered before starting Spirinolactone?

A

Blood pressure - causes drop

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4
Q

At which level of LVEF should ACEI be started in HF?

A

Moderate LV dysfunction ie LVEF less than 45%

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5
Q

What is the main adverse effect of ACEI?

A

Cough caused by build up of bradykinin

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6
Q

Which other enzyme in the RAAs is active even when ACEI are in situ?

A

Chymase

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7
Q

Which ACEI is used in paeds?

A

Captopril

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8
Q

Which ACEI is a non-peptide antagonist?

A

Captopril

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9
Q

Name 2 C/I of ACEI

5 listed

A 
Pregnancy 
Bilateral renal artery stenosis
Severe AS, MS, LVOT
Hx of idiopathic/hereditary agioedema
Creat >220
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10
Q

Which 2 drugs are used in HF to relieve symptoms?

A

Diuretics

Digoxin

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11
Q

What type of drug is Candesartan?

A

Angiotensin 2 receptor blocker

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12
Q

Which 2 cardiac drugs can cause gyneacomastia?

A

Spironolactone

Digoxin

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13
Q

What is the alternative to spironolactone and causes less gyneacomastia?

A

Emplerenone

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14
Q

Name 2 C/I of beta blockers

6 listed

A 
Asthma
Cardiac condition defects
Severe HF
Severe peripheral vascular disease
Raynauds
Unopposed pheochromocytoma
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15
Q

Which beta blocker is used in pregnancy?

A

Labetolol

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16
Q

Which drug inhibits the I (f) channel to decrease HR in sinus rhythm?

A

Ivabradine

17
Q

Phosphenes (flashing lights) are a side effect of which drug?

A

Ivabradine

18
Q

What is the only drugs which have evidence to support treatment in diastolic HF?

A

Diuretics

19
Q

What does pulmonary venous congestion lead to?

A

Left ventricular failure

20
Q

What is does systemic venous congestion cause?

A

Right ventricular failure

21
Q

Name 3 S+S of LHF

A

Dyspnoea
Orthopnoea
PND

22
Q

Name 3 S+S of RHF

4 listed

A

Peripheral oedema
Elevated JVP
Hepatomegaly
Ascites

23
Q

Name 4 of the commonest causes of HF

6 listed

A 
IHD
HTN
Valvular heart disease
Cardiomyopathy
Toxic
DM
24
Q

What type of heart failure is caused by:

  • COPD
  • Pulmonary HTN (PE)
  • ASD/VSD
  • Chronic valvular heart disease
A

Right heart failure

25
Q

What is cardiac cachexia?

A

W/L and anorexia commonly seen in HF

26
Q

What do these signs indicate?

  • Displaced apex beat
  • Tachycardia
  • PSM
  • Basal inspiratory crackles
A

Left ventricular failure

27
Q

What is diastolic HF?

A
  • HF with preserved ejection fraction

- Increased LV wall thickness with diastolic dysfunction

28
Q

What type of HF (high output/low output) do the following cause?

  • Anaemia
  • Thyrotoxicosis
  • Liver failure
  • Septicaemia
A

High output

29
Q

What is HF-PEF (HF with preserved ejection fraction) associated with?

  1. CAD, HTN, DM
  2. HTN and AF
A

2

30
Q

What percentage of people who are hospitalised due to HF are readmitted/dead within 1 year?

A

40%

31
Q

Name 4 features you would see on a CXR of a pt with HF

A
  • Cardiomegaly
  • Pulmonary oedema
  • Pleural effusions
  • Kerley B lines
  • Pulmonary venous congestion
32
Q

Which investigation would be useful for a sensitive and specific prediction of CAD than a ETT?

A

Perfusion scintigraphy

33
Q

Why should alcohol be avoided in HF?

A

Negatively inotropic

Raises BP and arrythmogenic

34
Q

What is CRT-P

A

Cardiac resynchronisation therapy - pacemaker. Resynchronises inter and intraventricular contraction

35
Q

What is a CRT-D?

A

Cardiac resynchronisation therapy - defibrillator

36
Q

Why are opiates useful in the treatment of acute HF?

A

Useful in pulmonary oedema to relieve anxiety and distress due to dyspnoea

37
Q

Which anti-emetic should be used in conjunction with diamorphine during acute HF?

A

Metoclopromide - don’t use cyclizine as causes vasoconstriction

38
Q

What is nesiritide?

A

Human BNP - vasodilator to reduce dyspnoea

JG Year 2 (28 decks)

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