Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CCC - LM > AF & Hypertension > Flashcards

AF & Hypertension Flashcards

1
Q

What type of AF is more common in younger patients?

A

Paroxysmal

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

How would you describe AF to a patient?

A

AF is an abnormally fast and irregular heart rhythm meaning that you heart cannot fill with blood as effectively and can’t pump blood as effectively around your body
Symptoms include palpitations, dizziness, shortness of breath & tiredness

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

What is the average atrial rhythm in AF and average ventricular rhythm?

A

Atrial: 300-600 bpm
Ventricular: 160-180

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

What are the most common causes of AF?

A 
Ischaemic heart disease/ heart failure 
MI
Htn 
Valvular heart disease
Hyperthyroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some less common causes of AF?

A 
Caffeine/ alcohol 
PE
pneumonia 
post-op 
Hypokalaemia/ hypomagnaesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is paroxysmal AF?

A

Episodes lasting >30 seconds but less than 7 days
Self limiting & recurrent
More common in younger

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

What is persistent AF?

A

2 or more episodes
Require medical/DC cardioversion to resolve
Return

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

What is permanent AF?

A

AF not resolved with cardioversion
AF that relapses within 24 hours
Controlled by rate limiting drugs

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

What are the complications of AF?

A

Stroke/TIA - thromboembolic risks or anticoagulant risk due to warfarin
Heart failure

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

How would AF be described on an ECG?

A

Irregularly irregular narrow complex tachycardia

Absent P waves

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

What investigations are carried out if suspected AF?

A

24 hour ambulatory ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What would be seen on an ECHO in AF?

A

(Left) atrial enlargement

mitral valve disease

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

What is CHADS2VASC score used to determine?

What are the components?

A 
Assess stroke risk
C - congestive HF = 1
H - hypertension - 1
A - age ≥75 = 2
D - diabetes = 1
S2 - stroke/TIA/ thromboembolism = 2
V - vascular disease = 1
A - age 65-74 = 1
S - sex female = 1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the recommendation of a Female with a chads2vasc score of 1?

A

No action - she is scoring for sex

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

What is the recommendation of a male with a chads2vasc score of 1?

A

Consider starting anticoagulation

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

What is the recommendation of a Female with a chads2vasc score of 2?

A

Offer anticoagulation

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

What anticoagulation is recommended for AF?

A

Warfarin

NOAC

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

What is the risk of a person with AF developing a stroke compared to someone in normal sinus rhythm?

A

5x higher

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

What tool is used to assess someone’s bleeding risk with anticoagulant?

A

HAS BLED

H - hypertension = 1
A - abnormal renal/liver function = 1 or 2
S - stroke = 1

B - bleeding = 1
L - labile INRs = 1
E - elderly >65 = 1
D - drugs/alcohol = 1 or 2

20
Q

What is the normal starting dose of warfarin?

A

5-10mg

21
Q

What is the target INR for those with AF?

A

2-3

22
Q

Who should warfarin be avoided in?

A

Pregnancy - teratogen
Peptic ulcer
Bleeding disorders
p450 metabolising drugs

23
Q

What is the mechanism of action of warfarin?

A

Vitamin K antagonist

24
Q

What is the mechanism of action of NOACs?

A

Inhibit free factor Xa

25
Q

What is the dose of NOACs?

A

20mg OD with food

26
Q

What is first line for rate control in AF?

When is this contraindicated?

A

B-blocker - metaprolol
Use rate limiting CCB if asthmatic - verapamil/diltiazem
If not controlled then combine b blocker & diltiazem or digoxin

DO NOT COMBINE B-BLOCKER AND VERAPAMIL = COMPLETE HEART BLOCK

27
Q

When is digoxin used in rate control of AF?

A

Not as effective as CCB or B-blocker

Used in HF

28
Q

What is used to maintain sinus rhythm in those with known AF?

A

Sotalol
Amiodarone
Flecainide

29
Q

If a haemodynamically stable patient presents with AF 12 hours after onset what is the treatment?

A

Pharmacological cardioversion - flecainide or amiodarone

30
Q

What is the treatment for all new onset AF?

A

LMWH - tinzaparin until assessment is made

31
Q

What is classified as hypertension?

A

BP > 140/90

32
Q

What is classified as malignant hypertension?

A

> 200/120

33
Q

What should BP aim be for those age ≥80?

A

150/90

34
Q

Further testing should not be conducted and treatment started right away if the BP is what?

A

> 180/90

35
Q

Ambulatory BPM takes the average of at least how many BP readings throughout the day?

A

14

36
Q

ABPM of what indicates need for treatment?

A 
<80 = 135/85
>80 = 145/85
37
Q

What is used to assess cardiovascular risk?
What does it calculate?
How often should this be repeated?

A

QRISK2
% risk of MI or stroke in next 10 years
Repeat every 5 years

38
Q

What other investigations should be done when suspecting htn?

A

U&Es - inc. createnine
Glucose - DM or obese
eGFR

39
Q

For someone with stage 1 htn, medication is started when the QRISK2 score is?

A

> 20%

40
Q

What is 2nd line management of htn if 1st line is not adequate?

A

ACE-i + CCB OR ARB

41
Q

What is 3rd line management of htn?

A

ACE-i + CCB + Thiazide (ACD)

42
Q

What is 4th line management of htn?

A 
Add alpha-blocker
OR
Add another diuretic - low dose k+ sparing or high dose thiazide 
OR
Beta-blocker
43
Q

ARB should be preferred over ACE-i in which group of people?

A

Afro-carribean

44
Q

Why should you try not to combine ACE-i with ARB or B-blocker with diuretic?

A

can aggravate diabetes

45
Q

What is 2nd line treatment of htn in afro-carribeans?

A

CCB + ARB

ARB preferred over ACE-i

CCC - LM (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions