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PRE-REG 2021 > Cardio > Flashcards

Cardio Flashcards

1
Q

Examples of Intrinsic Sympathomimetic Activity (ISA) beta blockers?

A

PACO

Pindolol
Acebutolol
Celiprilol
Oxprenolol

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2
Q

What do ISA beta-blockers do and what are their properties?

A
  • STIMULATE & BLOCK beta receptors
  • LESS BRADYCARDIA
  • LESS coldness of extremities
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3
Q

Water-soluble beta blockers?

A

CANS

Celiprolol
Atenolol
Nadolol
Sotalol

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4
Q

Which beta blockers are cardio selective?

A

MAN-B

Metoprolol
Atenolol
Nebivolol
Bisoprolol

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5
Q

Common side effects of beta blockers?

A
  • Fatigue
  • Coldness of extremities
  • Sleep disturbances / nightmares
  • Mask symptoms of HYPOglycaemia
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6
Q

Contraindications and cautions of beta blockers?

A
  • 2nd or 3rd degree heart block
  • worsening UNSTABLE heart failure (caution with STABLE)
  • avoid in patients with history of asthma or bronchospasm
  • avoid in patients with frequent episodes of hypoglycaemia
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7
Q

VTE Treatment?

A

LMWH (1st line)
UFH (2nd line)
Continue for >/5 days + INR >2 for 24 hours

Start oral anticoagulant (e.g. warfarin) at SAME TIME

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8
Q

Can heparins be used in pregnancy?

A
  • YES as do not cross placenta
  • LMWH preferred
    (reduced risk of osteoporosis and heparin - induced thrombocytopenia)
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9
Q

TIA Treatment?

A

1) ASPIRIN 300mg STAT until diagnosis established
2) CLOPIDOGREL (2nd line)

Start secondary prevention once diagnosis confirmed

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10
Q

Ischaemic Stroke - Treatment?

A

1) ALTEPLASE within 4.5 HOURS

2) ASPIRIN 24hrs after thrombolysis / ASAP within 48hrs if no thrombolysis

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11
Q

Are anticoagulants recommended for stroke?

A

No - except in patient with AF

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12
Q

TIA/ Ischaemic Stroke - long term management?

A

1) CLOPIDOGREL 75mg OD

OR

MR DIPYRIDAMOLE + ASPIRIN

OR

MR DIPYRIDAMOLE / ASPIRIN ALONE

2) WARFARIN / ANTICOAGULANTS for patients with AF
3) Initiate STATIN after 48 hours
4) MONITOR BP - target <130/80mmHg
* Dont use B-Blockers for hypertension following stroke unless indicated for co-existing condition*
5) Lifestyle Advice

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13
Q

Haemorrhagic stroke - treatment?

A
  • usually requires SURGERY to remove haematoma
  • DONT GIVE ANTICOAGULANTS (even in AF)
  • AVOID STATINS (unless benefit > risk)
  • STOP/REVERSE anticoagulants ( Vit K / Protamine ) - EXCEPT pts with DVT/PE
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14
Q

When would you have a target INR of 3.5?

A

1) RECURRENT DVT/PE with patients already receiving anticoagulation + their INR >2)
2) mechanical prosthetic heart valve

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15
Q

Which combination has highest risk of bleeding?

1) Aspirin + Warfarin
2) Clopidogrel + Warfarin

A

2) Clopidogrel + Warfarin

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16
Q

High risk of hyperlipidaemia?

A
  • Diabetes
  • CKD
  • Family history
  • > / 85yrs (esp smokers / hypertension)
  • 10 year risk of CVD >10%
17
Q

Is aspirin recommended for primary or secondary prevention of CVD?

A

Secondary (already established CVD)

18
Q

Signs of DIGOXIN TOXICITY

A

G - GI disturbance (diarrheoa/n&v)
A - Arrhythmias / heart block
S - Skin reactions
V - Vision (yellow/blurred)

If life-threatening: DIGOXIN-SPECIFIC ANTIBODY

19
Q

RATE CONTROL

A

B-Blocker
Verapamil
Diltiazem

If monotherapy fails: can combine

❌ B-Blocker + Verapamil ❌

Can use digoxin

20
Q

RHYTHM CONTROL

A

FAB RHYTHM (after cardioversion)

1) B-Blocker
2) Amiodarone / Flecainide

21
Q

HIGH RISK VTE

A
  • reduced mobility
  • obesity
  • malignant disease
  • history of VTE
  • > 60yrs
  • pregnancy / post-partum
  • thrombophilic disorder
22
Q

HEART FAILURE

A
  1. ACE/ARB + B-Blocker
  2. Add spironolactone / eplerenone

Loop diuretics - for fluid overload
Thiazides in mild HF

23
Q

What to look out for in blood tests when diagnosing HF?

A
  • B-type Natriuretic Peptide (BNP)
  • pro-B-type Natriuretic Peptide (NT-proBNP)

⬆️ in HF!

24
Q

How long before elective (planned) surgery do you need to stop warfarin?

A

5 days

25
Q

How long before elective (planned) surgery do you need to stop LMWH?

A

24 hours

26
Q

Patients on warfarin where surgery CAN’T be delayed?

A

IV Vit K + Dried prothrombin complex

27
Q

Patients on warfarin requiring emergency surgery that can be delayed 6-12 hours?

A

IV Vit K

28
Q

Secondary prevention post-MI

A

B - Beta-blocker
A - ACEI/ARB
D - Dual antiplatelet therapy
S - Statin

PRE-REG 2021 (8 decks)

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