Brainscape's Knowledge GenomeTM

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


See full index

Final Year > Cardio > Flashcards

Cardio Flashcards

1
Q

What is the QRISK score used for?

A

The QRISK score estimates the percentage risk that a patient will have a stroke or myocardial infarction in the next 10 years.

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

QRISK > 10% what should patients be offered and what does?

A

Atorvastatin 20mg at night

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

Atorvastatin 20mg is offered as primary prevention to all patients with:

A

Chronic kidney disease (eGFR less than 60 ml/min/1.73 m2)

Type 1 diabetes for more than 10 years or are over 40 years

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

How do statins lower cholesterol?

A

reduce cholesterol production in the liver by inhibiting HMG space CoA reductase

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

Which blood test do you need to check after starting statins?

A

LFTs because they can cause a transient and mild rise in ALT and AST in the first week weeks of use

They usually do not need to be stopped if the rise is less than 3 times the upper limit of normal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some side effects of statin use?

A

Myopathy
Rhabdomyolysis
Type two diabetes
Haemorrhagic strokes

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

At how many months do you need to check LFT levels after starting statins?

A

3 months and 12 months

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

What are some alternatives to statins to lower cholesterol?

A

Ezetimibe
PCSK9 inhibitors – evolocumab - this is a monoclonal antibody and given as a subcutaneous injection every 2 to 4 weeks

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

what are the four A’s of secondary prevention in cardiovascular disease?

A

Antiplatelet medication – aspirin, clopidogrel, and ticagrelor
Atorvastatin – 80mg
Atenolol – or bisoprolol
ACE inhibitor – ramipril

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

what is the preferred antiplatelet for patients with peripheral arterial disease and ischaemic stroke?

A

Clopidogrel

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

what is the inheritance pattern for familial hypercholesterolaemia?

A

Autosomal dominant

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

Which criteria can be used to make a clinical diagnosis for familial hypercholesterolaemia?

A

Simon Broom criteria
Dutch Lipid clinic network criteria

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

what are the three features of familial hypercholesterolaemia?

A

Family history of premature cardiovascular disease
Very high cholesterol – greater than 7.5 mmol/L
Tendon xanthomata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

where are patients referred if they have stable angina?

A

Rapid access chest pain clinic

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

What medication can be used in cardiac stress testing?

A

Dobutamine

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

How long does GTN spray last?

A

5 mins

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

How many times can a patient administer GTN spray before they should call the ambulance?

A

Three times, with five minute breaks in between each dose

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

what are the key side effects of GTN spray?

A

Headaches and dizziness caused by vasodilation

19
Q

If symptoms are not relieved by GTN spray, what are the first line long-term medical options?

A

Beta blocker – bisoprolol
Calcium channel blocker – diltiazem or verapamil

20
Q

Which patients are you not allowed to give calcium Channel blockers to??

A

Patient with heart failure with reduced ejection fraction

21
Q

what other options may be considered for long-term symptomatic relief of stable angina?

A

Long-acting nitrates - isosorbide mononitrate
Nicorandil
Ivabradine
Ranolazine

22
Q

which three vessels can be used in a coronary artery bypass graph as the graft vessels?

A

Saphenous vein
Internal thoracic artery
Radial artery

23
Q

what is cardiac syndrome X?

A

It occurs in perimenopausal or postmenopausal. In women and may involve microvascular dysfunction, causing increased sensitivity of the myocardium, thereby lowering the pain threshold. This is a diagnosis of exclusion and treatment options are similar to medical management of angina.

24
Q

What does the right coronary artery supply?

A

Right atrium
Right ventricle
Inferior aspect of the left ventricle
Posterior septal area

25
Q

what does the left circumflex artery supply?

A

Left atrium
Posterior aspect of the left ventricle

26
Q

what does the left anterior descending artery supply?

A

Anterior aspect of the left ventricle
Anterior aspect of the septum

27
Q

What new finding is always pathological in an ECG

A

New left bundle branch block

28
Q

what do pathological key waves suggest?

A

Deep infection involving the full thickness of the heart muscle

29
Q

How long after an MI, will Q-waves appear on an ECG

A

After six or more hours, following onset of symptoms

30
Q

when should troponins be measured?

A

At baseline and three hours after the onset of symptoms

31
Q

what are some alternative causes of raised troponins?

A

Chronic kidney disease
Sepsis
Myocarditis
Aortic dissection
Pulmonary embolism

32
Q

what ECG changes might you find in unstable angina or NSTEMI?

A

ST depression
Tea wave inversion

33
Q

what should be prescribed with morphine during the initial management of a myocardial infarction?

A

An anti-emetic such as metoclopramide

34
Q

What are the typical antiplatelet medications given prior to PCI?

A

Aspirin and Prasugrel

35
Q

what are the typical fibrinolytic agents given in thrombolysis for myocardial infarction?

A

Streptokinase
Alteplase
Tenecteplase

36
Q

what dose of ticagrelor and aspirin should be given in the management of an NSTEMI or STEMI?

A

Ticagrelor 180mg
Aspirin 300mg

37
Q

when should an alternative to ticagrelor be considered in the management of myocardial infarction?

A

Clopidogrel if high bleeding risk
Prasugrel if having angiography

38
Q

when should fondaparinux not be prescribed?

A

If high, bleeding risk or immediate angiography

39
Q

What does the GRACE score predict?

A

It gives a six month probability of death after having an NSTEMI

3% or less is considered low risk
Above 3% is considered medium to high risk —> angiography within 72 hrs

40
Q

What medications are used for secondary prevention after a myocardial infarction?

A

Aspirin 75mg once daily indefinitely
Another Antiplatelet (e.g., ticagrelor or clopidogrel) for 12 months
Atorvastatin 80mg once daily
ACE inhibitors (e.g. ramipril)
Atenolol (or usually bisoprolol)
Aldosterone antagonist for those with clinical heart failure (i.e. eplerenone titrated to 50mg once daily)

41
Q

Which two medications carry a high risk of hyperkalaemia when used together?

A

ACE, inhibitors or angiotensin receptor blocker
And
Aldosterone antagonists

E.g. spironolactone or eplerenone plus ACE/ARB

42
Q

What are the possible complications of myocardial infarction – using the pneumonic Darth Vader?

A

Death
Arrhythmia
Rupture (free ventricular wall/ ventricular septum/ papillary muscles)
Tamponade
Heart failure (acute or chronic)
Valve disease
Aneurysm of ventricle
Dressler’s syndrome
thromboEmbolism (mural thrombus)
Recurrence/ mitral Regurgitation

43
Q

What are some signs of Dressler’s syndrome?

A

Pericardial rub
Low-grade fever
Pleuritic chest pain
Pericardial effusion
Pericardial tamponade

Widespread ST elevation
T wave inversion
Raised CRP and ESR

Final Year (7 decks)

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