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Pre Reg Exam > Atrial Fibrillation > Flashcards

Atrial Fibrillation Flashcards

1
Q

What is atrial fibrillation

A

Irregular or disorganized electrical activity in the atria

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2
Q

How can you describe AF

A

Palpitations
Fluttering feeling
Rapid/irregular heartbeat

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3
Q

List the 3 types of AF

A

Paroxysmal
Persistent
Permanent

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4
Q

What is a normal heart rate

A

60-100 beats per mins

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5
Q

What is AF heart rate

A

160-180 beats per mins

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6
Q

What are the risk factors of AF

A

Hypertension
Diabetes
Hyperthyroidism
Heart surgery
Asthma
Lung cancer
Pulmonary embolism

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7
Q

What is lone AF

A

When there is no pre existing conditions or risk factors

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8
Q

What are the symptoms of AF

A

Chest pain
Dyspnoea (shortness of breath)
Palpitations
Syncope (fainting)

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9
Q

How long does lone or acute Af present for?

A

<48 hrs

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10
Q

How long does chronic AF present for?

A

> 48hrs

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11
Q

List things about paroxysmal AF

A

Last less than 7 days
Terminates spontaneously

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12
Q

List things about persistent AF

A

Last longer than 7 days
Does not terminate spontaneously

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13
Q

List things about permanent AF

A

Long standing AF
Does not terminate spontaneously

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14
Q

What is the aim of treatment ?

A

Prevent stroke and thromboembolism
Restore and maintain sinus rhythm

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15
Q

What is the assessment for stroke risk

A

CHADS2 - VASC score

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16
Q

What’s CHADS2-VASc and the score point?

A

C- congestive heart failure - 1
H - hypertension (140/90mmhg) - 1
A - age >75 - 2
D - Diabetes - 1
S2 - prior stroke or TIA - 2
V - vascular disease - 1
A - age (64-75) - 1
Sc - sex (females 1pt) 1

17
Q

What is the assessment for bleeding risk

A

ORBIT or HASBLED

18
Q

What is ORBIT and the scores

A

O - older than 75 yrs - 1
R - reduced hemoglobin - 2
B - bleeding history - 2
I - insufficient kidney function - 1
T - treatment with antiplatelet - 1

Low (0-2)
Medium (3)
High (4-7)

19
Q

What is HASBLED?

A

H - hypertension
A - abnormal liver/renal
S - stroke
B- bleeding
L - INR
E- elderly >65
D - drugs

20
Q

If someone has AF or CHA2Ds2 VASC score of 2 or above, what do you offer as first line treatment?

A

DOAC - Direct acting oral anticoagulant

21
Q

A man with AF and CHA2DS2 VASc of 1, asses bleeding too. What do you give as first line

A

DOAC

22
Q

List examples of DOAC

A

Apixaban
Edoxaban
Rivaroxaban
Dabigatran

23
Q

If DOAC is contraindicated, not toenrated or not suitable, what do you give?

A

Vitamin K antagonist eg (warfarin)

24
Q

Do not offer DOAC to or<65 with only age as risk factor. True or false

A

True!

25
Q

After DOAC, what should you consider starting?

A

Drug treatment for rate control

26
Q

When do you not offer rate control treatment?

A

Af within 48hrs
Heart failure caused by AF
Reversible cause

27
Q

What are the rate control drug treatments?

A

Beta blockers - bisoprolol, metoprolol (except sotalol)

Rate limiting CCB - Verapamil or diltiazem

28
Q

What do you give in non paroxysmal AF or if all treatment are not tolerated?

A

Cardiac glycoside - Digoxin

29
Q

Rate control treatment is recommended for people with non acute AF. True or false

A

True

30
Q

If mono therapy of RCT is not working, move to dual therapy?true or false

A

True

31
Q

What do you avoid in dual therapy and why?

A

Anything with verapamil.

Verapamil + beta blockers are condraindicated due to a risk of reduced cardiac output and heart failure.

32
Q

If RCT do not work at work, what do you use?

A

Amiodarone
Beta blocker except sotalol
Dronedarone

33
Q

What is cardioversion

A

It’s a procedure used to return an abnormal heartbeat to a normal rhythm

34
Q

What do you do before cardioversion

A

Rule out left atrial thrombus with toe and treat with heparin immediately

35
Q

What do you give to treat cardioversion?

A

IV antiarrhythmic
Eg amiodarone or flecainide

36
Q

What do you use when there is structural heart disease in cardioversion?

A

IV amiodarone

37
Q

What do you use when there is no structural heart disease in cardioversion?

A

Flecainide

38
Q

What do people with infrequent paroxysmal Af episode do?

A

Pill in pocket drugs
eg - Flecainide
Single dose- 200mg <70kg, 300>70kg

Pre Reg Exam (11 decks)

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