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Cardiovascular REVISION > All of cardio > Flashcards

All of cardio Flashcards

1
Q

Treatment of cardiac tamponade as a complication of an MI

A

Pericardial aspiration

Surgery

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2
Q

What does the valsalva manoeuvre active

A

aortic baroreceptors

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3
Q

What is the funny current?

A

The decreased K+ efflux superimposed upon a Na+ influx

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4
Q

If is mediated by

A

hyperpolarisation

HCN channels

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5
Q

What does a block of HCN channels cause?

A

a decrease in the slope of the pacemaker potential, therefore a reduction of heart rate

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6
Q

What is Atropine

A

a competitive inhibitor of acetylcholine, used in extreme Bradycardia to speed up the heart rate

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7
Q

Invabradine

A

selective blocker of HCN channels, used to slow down the heart rate in angina

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8
Q

Sacroplasmic recticulum

A

calcium store

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9
Q

CICR

A

calcium induced calcium release

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10
Q

Refractory period

A

a period immediately following stimulation, nerve muscle is unresponsive

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11
Q

What does a long refractory period prevent

A

tectonic contraction

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12
Q

What are the segments of heart muscle

A

Actin and myosin

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13
Q

What is the role of calcium in cardiac muscle contraction

A

Ca2+ is required to bind with troponium, pulling troponium-tropomyosin complex aside

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14
Q

What is bound to actin to prevent muscle contraction

A

tropomyosin

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15
Q

Define Preload

A

Pressure exerted on the muscle fibres in the ventricles of the heart at the end of diastole

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16
Q

Frank Starling’s Law of the Heart

A

SV vs EDV

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17
Q

Afterload

A

the resistance into which the heart is pumping

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18
Q

Length of diastole

A

0.5 s

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19
Q

Length of systole

A

0.3 s

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20
Q

How to calculate the HR from an ECG

A

300/no. of large square between each R wave
OR
if irregular

Count the number of QRS complexes in 30 large squares, and multiply by 10

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21
Q

How much is a small box and a large box worth on an ECG

A
  1. 04 seconds - small box

0. 2 seconds - large box

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22
Q

Anteroseptal MI (STEMI)

A

ST elevation in chest leads V1-V4

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23
Q

Inferior MI (STEMI)

A

ST elevation in limb leads II, III, aVF

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24
Q

Anterolateral MI (STEMI)

A

ST elevation in V4-V6, I, aVL (affects LAD or circumflex)

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25
Q

Lateral MI (STEMI)

A

ST elevation in I, aVL +/- V5-V6

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26
Q

Posterior MI (STEMI)

A

Tall R waves, V1-V2

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27
Q

What is the short term regulation of blood volume and MABP?

A

baroreceptors

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28
Q

What is the long term regulation of blood volume and MABP?

A

hormones and BV

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29
Q

MABP equation

A

CO x TPR

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30
Q

What is released in response to significant atrial distension

A

ANP

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31
Q

ANP

A

decreasing renin release

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32
Q

What is the parasympathetic relationship with cAMP

A

decreased cAMP

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33
Q

What is the effect of parasympathetic stimulation opening GIRK channels

A

opening GIRK channels causes hyperpolarisation

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34
Q

Adrenaline is used for

A

Cardiac arrest and ALS IV

Anaphylactic shock IM

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35
Q

Dobutamine is used for

A

Acute, but reversible, heart failure

e.g. following cardiac surgery, cardiogenic/septic shock

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36
Q

What type of drug is propanolol

A

non selective B-ADR

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37
Q

Examples of B1-selective ADR

A

atenolol, bisoprolol, metoprolol

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38
Q

Example of a non-selective and partial agonist B-ADR

A

Alprenolol

39
Q

What is carvedilol

A

B-ADR antagonist used to treat mild to moderate heart failure
start low, increase slow

40
Q

Adverse affects of B-ADR Antagonist

A 
Bronchospasm in asthmatics
Aggravation of cardiac patients
Bradycardia
Hypoglycaemia - diabetics
Fatigue
Cold extremities
41
Q

What is the drug used for bradycardia following an MI in incremental doses and what is this dose and what is the alternative medication?

A

Atropine
300-600 mg
Glycopyronium

42
Q

Why don’t you ever use B blockers and calcium antagonist

A

B blockers are decreasing rate
Calcium channel blockers are decreasing force
therefore together they could cause serious heart bradycardia

43
Q

What is the B-ADR antagonist used primarily for thyrotoxicosis

A

Propanolol

44
Q

What is digoxin

A

a cardiac glycoside that increasing cardiac contractibility

use in Heart failure

45
Q

Digoxin and dobuatmine are examples of

A

positive inotropic drugs

46
Q

Affect of inotropic drugs on ventricular function curve

A

upward and leftward shift

47
Q

How does digoxin work

A

digoxin binds to the alpha subunit of the potassium sodium ATPase, prevent the efflux of calcium

48
Q

How can affects of digoxin be dangerously enhanced

A

low plasma potassium

low therapeutic concentration

49
Q

Indirect effects of digoxin include

A

increases vagal activity
slows SA node discharge
slows AV node conduction

50
Q

Digoxin S.E

A

Heart block
Arrhythmias
Toxicity

51
Q

Digoxin toxicity

A 
yellow-green blurry vision
N/V
bradycardia
heart block
ventricular arrhythmias
52
Q

What is Levosemendan

A

calcium sensitiser

53
Q

What drug binds to tropnium C sensitising it to action of calcium

A

Levosemendan

54
Q

When do we use Levosemendan

A

Acute DECOMPENSATED HF

causes vasodilation - reduces after load - reduces cardiac output

55
Q

A cardiac drug that inhibits PDE in cardiac and smooth muscle cells

A

Amrinone

56
Q

Use and unwanted effects of Amrinone

A

IV in acute HF

worsens survival in arrhythmias

57
Q

What is the most important vasodilator that comes from the endothelium

A

Nitric Oxide

58
Q

Use of nitric oxides in angina

A

benefit due to increasing the myocardial oxygen requirement by i) decreasing the preload ii) decreasing the after load and iii) improving perfusion to the ischaemic zone

59
Q

When do we use Organic nitrates

A

Angina

Acute Coronary Syndrome (ACS)

60
Q

Short acting tablet or spray used for rapid effect before exception in ANGINA

A

Glyceryl trinitrate

61
Q

Glyceryl trinitrate in ACS

A

IV infusion (+aspirin)

62
Q

Longer acting NO used in prophylaxis of angins

A

Isosorbide mononitrate

63
Q

S.E. of Nitritic Oxides

A

Diminished effects
Postural hypotension
Initial headaches

64
Q

Examples of endothelin antagonists used in pulmonary hypertension

A

bostentan

ambrisentan

65
Q

Don’t use ACEI or ARBs in

A

PREGNANCY

66
Q

S.E. include dry cough and initial hypotension

A

ACEI - lisinopril

67
Q

Calcium antagonists that act on cardiac L-type channels

A

verapamil

68
Q

Dihydropyradmines used in patients with heart failure

A

amlodipine

69
Q

S.E. of L-type calcium antagonists

A 
excessive vasodilation ..
hypotension
dizziness
ankle oedema
flushing
70
Q

Examples of potassium channel openers

A

Minoxidil

Nicorandil

71
Q

Last resort of sever hypertension

A

minoxidil

72
Q

Used in untreatable angina

A

nicorandil

73
Q

alpha-1 receptor antagonists

A

pazosin

doxazosin

74
Q

Thiazide diuretics

A

mild
acts on distal tubule
BENZOFLUMETHIAZIDE
treats - mild HF, hypertension, resistant oedema

75
Q

Loop diuretics

A

stronger
acts on the loop of Henle
FUROSEMIDE
treats - Acute Pulmonary Oedema and Chronic HF

76
Q

Resistance to blood flow is inversely proportional to the radius of the blood vessel to the power of

A

4

77
Q

Bradykinin

A

vasodilatory adgent

78
Q

Sympathetic nerve stimulation shift the Frank-Stringling curve to the

A

left

79
Q

Where is the needle inserted in pericardial centesis

A

infrasternal angle, directed superoposteriorly

80
Q

Anti-hypertensive drugs

A 
Diuretics
B-blockers
ACEI
ARBs
Calcium channel antagonists
Alpha blockers
81
Q

Anti-anginal

A 
B-blockers
Nitrates
Calcium channel antagonists
Potassium channel blockers - Nicorandil
Ivabradine
Ranolazine
82
Q

Anti-thrombotic

A

Aspirin
Clopidogrel
Prasugrel
Ticgrelor

83
Q

Anti-coagulatants

A

Warfare, heparin, rivaroxaban, dabigatran

84
Q

Fibrinolitics

A

Streptokinase, PA

85
Q

S.E. of diuretics

A 
hypokalaemia
arrhythmia
hyperglycaemia
increased uric acid
impotence
86
Q

ACE S.E.

A

Cough
renal dysfunction
angioedema

87
Q

Anti platelet S.E.

A

Haemorrhage
Peptic ulcer –> haemorrhage
aspirin sensitivity - asthma

88
Q

Blocks clotting factors 2, 7, 9, 10 and can be reversed by the use of vitamin K

A

Warfarin

89
Q

Factor X inhibtor

A

Rivaroxaban

90
Q

Factor IIa inhibitor

A

Dabigatram

91
Q

Avoid streptokinase in

A 
recent haemorrhage
traum
bleeding tendencies
severe diabetic retinopathy
peptic ulcer
92
Q

Block HMG-CoA reductase

A

Statins

93
Q

Statin S.E.

A

myopathy

renal failure

94
Q

What group of drugs is bezafibrate from

A

fibrates

Cardiovascular REVISION (5 decks)

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