29/2 - LOOK BACK AT THIS FORGOT LOTS Flashcards
MI, HF, Arryhthmias
What clinical signs are associated with cardiac tamponade?
Pulsus paradoxus - absence of radial pulse on inspiration
What electrolyte imbalance is associated with tornade de pointes (occurs when QT gets too big)?
What other ECG changes are you likely to find?
How is torsades de pointes managed?
Hypomagnesaemia and hypokalaemia
U waves
small T-waves
PR prolongation
ST depression
Long QT
Magensium sulphate
What kind of murmur would be associated with a ventricular septal defect?
Pansystolic murmur - heard best at left sternal edge
What artery is affected in each of the following STEMIS
- Inferior
- Anterior/septal
- Lateral
Inferior - RCA
Anterior/septal - LAD
Lateral - LCx
What is a common contraindication of GTN?
Hypotension
Viagra
NSTEMi is initially managed the same way as a STEMI - what changes at the end?
LWMH or fondaparinux given (antithrombin treatment)
Some sent for angiogram within 72hrs
HF can occur due to problems with the systolic (IHD, dilated CM, myocarditis) or diastolic (restrictive CM, cardiac tamponade).
What EF is each associated with?
Systolic problems (blood can’t get out) - reduced EF (<50%) = HFrEF
Diastolic problems (blood can’t get in) - preserved EF (>50%) = HFpEF
How is HF managed acutely and chroniclly?
What improves mortality?
Acute - POND
Position
Oxygen
Nitrates
Diuretics
Chronic - LABA
Loop dieuritic - med that doesn’t improve mortality
ACEi
Beta-blocker
Aldosterone antagonist - spirolocatone
SGLT-2i also improve mortality
HF on CXR
ABCDE
Alveolar oedema
kerley B lines
Cardiomegaly
Dilated upper lobe vessels
Effusion
Given max dose of atropine in a pt with life-threatening bradycardia and no response. What is next step?
Transcutaneous pacing
Max dose = 500mcg x 6 = 3mg
If a patient has life threatening tachycardia with pulse (shock, syncope, MI, severe HF) what is the first management?
Synchronised DC shock - up to 3 times
What is the pathway in CPR?
2 min CPR and assess rhythm and deliver shock (if Vfib or pulseless Vtach)
Amiodarone 300mg after 3rd shock
Adrenaline 1mg after 3rd shock (unless unshockable then immediate) then every 3 mins
What are the causes of AF?
PIRATES (imagine a pirate tapping irregularly irregular beat)
PE, pulmonary disease, post-op
IHD, idiopathic
Rheumatic valvular disease (mitral stenosis or regur)
Anaemia, alcohol, age, autonomic tone
Thyroid disease (hyperthyroidism)
Elevated BP, electrocution
Sleep apnea, sepsis, surgery
Symptoms of AS
SAD
Syncope
Angina
Dysponea
What does the CHAzDSzVAS score assess?
What does it stand for again?
Stroke risk
Congestive HF
HTN
Age >75 (2 points)
Diabetes
Stroke, TIA or thromboemobolism
Vascular disease
Age 65-74
Sex (female)
