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4 MBCHB > CARDIO 1 > Flashcards

CARDIO 1 Flashcards

1
Q

diagnosis of hypertension in clinic stage 1
2
malignanant

A

over 140/90
over or equal to 160/100
SBP>=180 DBP >=110

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2
Q

causes of primary hypertension

causes of secondary hypertension

A

usually occurs with age

glomerulonephritis, polycyctic kidney, RAS, hyperaldosterornism, cushings, phaeo, acromegaly, hyperparathyroid/hyperthyroid, steroids, pregnancy, OCP, NF, kidney tumours (JGCT), withdrawal of anti hypertensives

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3
Q

symptoms of hypertension

A

asymptomatic in primary
features of secondary cause
malignant: neuro, cardio, renal, hypertensive retinopathy, aneurysms, seizures, proteinuria etc

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4
Q

ABPM how does it work

how does HBPM work

A

ABPM takes two measurements every hour per day. average of 14 readings

seated two consecutive readings taken 1 minute apart twice daily. need 4-7 days. disregard D1 readings and use average

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5
Q

if ABPM/HBPM is <135/85
>=135/85
>=150/95

A

monitor
if over 80 and target organ damage, cardiovascular disease, renal disease, DM or 10 year cardiovascular risk if 20% or over
drugs

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6
Q

other investigations is suspected secondary cause (young) or malignant presentation
when should patients be referred

A 
USS for RAS/PKD
24 hour urinary metanephrines
dexa suppression test 
thyroid function tests 
IgF1/MRI

40 or under to exclude secondary cause

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7
Q

general measures for hypertension

A

decrease salt 3-6mg/day, decrease caffeine, lifestyle

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8
Q

if resistant a potassium of what

can’t give thiazide

A

<4.5 add spironolactone
>4.5 thiazide like diuretic

alpha blockers or beta blockers

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9
Q

targets for blood pressure

emergency treatment of high blood pressure

A

under 60 target is 140/90
over 80 150/90
diabetic <140/80 end organ damage present <130/80

IV Labetalol 20mg
IV Nicardipine 5mg/hour

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10
Q

causes of heart failure

symptoms includng

A

coronary artery disease. valvular disease. myocarditis. sarcoidosis. amyloidosis. congenital. endocrine. familial. pregnancy

SOB. orthopnoea. paroxymasl nocturnal dyspnoea. decreased exercise tolerance. fatigue. ankle swelling. increased JVP. hepatojugular reflexes. third HS. murmurs

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11
Q

ix for heart failure

what is the gold standard

A

urinalysis and urea and creatinine for renal failure
CXR:heart failure signs/rule out lung disease
ECG: Q waves, LBBB, atrial fibrillation
BNP <100 unlikely but if ECG abnormal - ECHO
>=100 do echo

CMR

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12
Q

treatment for heart failure first line - what should be given if the heart rate is fast
2
3
4
other
vaccines
what drugs improve mortality in heart failure patients

A 
ACEI and BB. Ivabridine 
Spironolactone 
Stop ACE and switch to ARB valsartan
Ivabridine 
Loop dueretics, digoxin, nitrates, hydrazine, ICD, transplant

annual flu vaccine, one off pneumococcal vaccine

ACEI, spiro, BB, hydralazine and nitrates

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13
Q 
early complications of MI:
pericarditis 
Mural thrombosis 
LV wall rupture 
3 more
A

peri: sudden onset of pain and fever 2-3d post

stasis of blood in the akinetic region -> thrombi formation which may embolism

5-10 d post

heart failure. Mitral regurgitation. arrhythmias

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14
Q

late complications of MI:

2

A

dressles 2-6 w post

ventricular aneurysm 4-6w post. rupture is rare

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15
Q

ix for angina

gold standard

A

resting ECG, ETT
for patients who can’t do ETT/abnormal ECG MPS and spect
CT angio is gold standard

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16
Q

treatment of angina
if coronary artery spasm
indications for CABG over PCI

A

BB/RLCB. nitrates statin aspirin consider ACEI
dihydropyridine
2. BB and RLCB
if can’t tolerate one then long acting nitrate/ivabridine/nicorandil
revascularisation PCI/CABG

multi vessel disease and DM, over 65

17
Q

treatment for unstable angina

A

aspirin and statin
BB
ACEI
revasculirisation

18
Q

treatment for NSTEMI acute

long term

A

aspirin 300mg. nitrates/morphone for pain
fundaparinux if not having angio within 24 h
if are having angio within 24h or Cr >265 then unfractionated heparin
coronary angio
PCI and heparin
GP2b/3a inhibitor - epctifibatide or tirofiban

Ticaglaror for 12months

19
Q

STEMI acute management

Post MI management

A

morphine and metaclopirimide
sublingual nitrates. oxygen if sats are under 94%
aspirin. ticaglaror. heparin. PCI within 120 mins. thrombolysis NOT IN STROKE/TRAUMA/HEAM/SURGERY

aspirin and ticaglarori for 12 months
ACEI BB statin

20
Q

different types of AFib
rate control
rhythm control

A

paroxysmal. persistant >24 hours but can be cardioverted and is self limiting
persistent can’t be cardioverted and is not self terminating

rate: BB not sotalol or RLCB like diltazem.
second line 2 of BB/digox/RLCCB

rhythym: DCC or disopyramide/amiodarone

21
Q

treatment of atrial flutter

A

same as AFib. more sensitive to cardioversion

radiofrequency ablation of tricuspid valve isthmus is curative for most px

22
Q

acute SVT

A 
vasovagal manouvres
carotid massage 
IV Adenosine (small half life)
IV verapamil in asthmatics 
CDV
23
Q

sinus brady causes
treatment

treatment for sinus tachy

A

athletes. drugs like BB
acute IV atropine. pacing, anticoag

BBs, CCBs

24
Q

ventricular tachycardia treatment

A

ABCDE. cardiovert if haemodynamically unstable
arrhthmiatics: amiodarone, lidocaine, procainimide
electrophysioligal study/ICD
pulseless - defibrillation

25
Q

ventricular fibrillation cause

treatment

A

IHD. post MI. hypoxia. torsades pointes

DC cardiovert. IV MgCh. life support. ICD. defibrillation

26
Q

WPW is what
ECG shows what
treatment
cx

A

congenital accessory conducting pathway - arteroventricular re entry tachy

short PR, delta waves, wide QRS, LAD if left sided accessory pathway (commonly left)

radiofrequnecy ablation. Sotalol not if also AFIb. Flecanide

cx - VFib

27
Q

rx of tornadoes pointes

rx of heart block

A

IV Mg Sulphate

isoprenaline. atropine. pacing

28
Q

causes of LBBB

causes of RBBB

A

IHD, htn, aortic stenosis, CM, IPF, digoxin. always pathological

normal with growth. RVH, cor pulmonate, PE, MI, CM

29
Q

brugada syndrome genetics
ECG
treatment

A

ADom. asiants. mutation in SCNSA gene

STI in V1-V3 and negative T wave. partial RBBB. changes more apparent post flecaeinide

ICD

4 MBCHB (80 decks)

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