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Zero to finals > Cardio > Flashcards

Cardio Flashcards

1
Q

when is atorvastatin given as primary prevention regardless of q risk

A

T1DM
CKD

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2
Q

QRISK for starting a statin

A

> 10%

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3
Q

what is ideal response to statin therapy

A

check lipids 3 months after starting

aim for 40% reduction in non HDL cholesterol

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4
Q

monitoring after starting a statin

A

check lipids and LFTs after 3 months

check LFTs after 12 months

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5
Q

how do statins affect LFTs

A

cause transient rise in AST/ALT in first few weeks of use

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6
Q

cholesterol lowering drugs besides statin

A

ezetimbe
PCSK9 inhibitors eg evolocumab

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7
Q

pneumonic for secondary prevention of cardiovasc disease

A

ABCD

ACEi
Beta blocker
Cholesterol
Dual antiplatelet

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8
Q

when is clopidogrel used for anticoagulation

A

PAD
after ischaemic stroke

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9
Q

aspirin daily dose

A

75mg

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10
Q

where are patients with angina referred to

A

rapid access chest pain clinic

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11
Q

when to avoid use of diltiazem and verapamil

A

HF with reduced ejection fraction

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12
Q

pharmacological mx of angina

A
  1. short term relief= GTN spray
  2. long term relief= beta blocker +- CCB (diltiazem or verapamil)
  3. secondary prevention (ABCD)
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13
Q

long acting nitrate example

A

isosorbide mononitrate

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14
Q

3 forms of ACS

A

unstable angina
NSTEMI
STEMI

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15
Q

RCA supplies

A

right atrium
right ventricle
inferior left ventricle
posterior septum

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16
Q

LCx supplies

A

left atrium
posterior aspect of left ventricle

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17
Q

LAD supplies

A

anterior left ventricle
anterior septum

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18
Q

how to use GTN

A

take when sx start
second dose after 5 mins if sx remain
third dose after 5 mins if sx remain
call an ambulance after 5 mins if sx remain

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19
Q

ECG changes in NSTEMI

A

ST depression
T wave inversion

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20
Q

LCA STEMI has changes in leads

A

I, avL, v3-6

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21
Q

LAD STEMI has changes in leads

A

V1-V4

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22
Q

LCx STEMI has changes in leads

A

I, avL, V5-V6

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23
Q

RCA STEMI has changes in leads

A

II, III, avF

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24
Q

anterolateral stemi artery involved

A

LCA

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25
Q

anterior stemi artery involved

A

LAD

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26
Q

inferior stemi artery involved

A

RCA

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27
Q

lateral stemi artery involved

A

LCx

28
Q

anticoagulation for STEMI

A

300mg aspirin

PLUS
1. clopidogrel if high bleeding risk (on other anticoag)
2. prasugrel if normal bleeding risk

PLUS
fondaparinux (not needed if immediate PCI)

29
Q

in NSTEMI how is decision made for PCI

A

GRACE score

> 3% angiography w PCI within 72 hrs

30
Q

how do ACEi and aldosterone agonists affect potassium levels

A

cause hyperkalemia

DONT USE THEM TOGETHER

31
Q

how long after MI does dresslers syndrome occur

A

2-3 weeks

32
Q

ECG changes in pericarditis

A

PR depression
saddle shaped ST elevation

33
Q

pericarditis mx

A

NSAIDs
Colchicine

maybe
steroids
percardiocentesis

34
Q

cardiac output equation

A

stroke volume x heart rate

35
Q

what system is affected in LV failure

A

pulmonary

36
Q

what is the main outcome of LV failure

A

pulmonary oedema

37
Q

in whom is LV failure common

A

older patients who are given fluid resus quickly

38
Q

what type of resp failure does acute LV failure cause

A

type 1

39
Q

what ejection fraction is normal

A

> 50%

40
Q

what cardiothoracic ratio on CXR is cardiomegaly

A

> 0.5

41
Q

COPD target o2 sats

A

88-92%

42
Q

LVF mx

A

sit up
oxygen
diuretics
stop IV fluids
monitor fluids
assess underlying causes

43
Q

inotrope example

A

dobutamine

44
Q

HFpEF arises due to a dysfunction in

A

diastole

45
Q

when asking about SOB in HF what should you remember to ask about

A

paroxysmal nocturnal dyspnoea

do you wake up at night out of breath

46
Q

what classification system is used to grade severity of HF

A

NYHA

47
Q

NYHA class 1

A

no limitation on activity

48
Q

NYHA class 2

A

comfortable at rest
symptomatic with ordinary activity

49
Q

NYHA class 3

A

comfortable at rest
symptomatic with any activity

50
Q

NYHA class 4

A

symptomatic at rest

51
Q

what BNP level warrants echo within 2 weeks

besides this within what time frame should echo be done for HF

A

> 2000- echo within 2 weeks

otherwise within 6 weeks

52
Q

medical mx of HF

A

ABK

ACEi
Beta blocker
Kidneys- aldosterone agonist and loop diuretic

53
Q

what is cardiac resynchronisation therapy

A

biventricular (triple chamber) pacemakers

objective is to synchronise contractions to optimise heart function

54
Q

what structural heart change occurs in hypertension

A

left ventricular hypertrophy

LV has to contract against an increased systemic resistance

55
Q

how is hypertension diagnosed

A

if BP in clinic is between 140/90-180/120 offer ABPM or home readings then diagnose

56
Q

stage 1 hypertension clinic and ABPM/home reading

A

clinic: >140/90
ABPM/home: >135/85

57
Q

stage 2 hypertension clinic and ABPM/home reading

A

clinic: >160/100
ABPM/home: >150/95

58
Q

stage 3 hypertension BP

A

> 180/120

59
Q

how to screen for end organ damage in hypertension

A

kidney= albumin:creatinine ratio, renal function
heart= echo for LVH, lipids
eyes= opthalmoscopy

60
Q

is CCB is not tolerated in hypertension whats given

A

thiazide like diuretic

61
Q

what is a common side effect of CCB

A

ankle oedema

62
Q

4th step hypertension mx

A

if K+ >4.5= alpha blocker (doxazosin) or beta blocker

if K+ <4.5= spironolactone

63
Q

how does spironolactone affect potassium levels

A

hyperkalemia

64
Q

hypertension BP targets

A

<80= <140/90
>80= <150/90

65
Q

alpha blocker example

A

doxazosin

66
Q
A

Zero to finals (11 decks)

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