Brainscape's Knowledge GenomeTM

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


See full index

MSRA > Cardio > Flashcards

Cardio Flashcards

1
Q

CI and monitoring for ACEi

A

Contra:
preg/breastfeeding
renovascular disease - bilat renal artery stenosis
AS

Check U&Es before dose - acceptable changes = inc creatinine 30% and K to 5.5

SEs - angioedema, cough, hyperkal

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

ecg territories

A

Ant = V1-4 (LAD)
Inf = II, III, aVF (RCon)
Lat = I, V5-6 (Lcirc)

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

Tx for STEMI

A

MONA (O2 only if sats <94)

If PCI is possible within 120 mins - give prasugrel (or clopi if on DOAC)
preferable via radial access

If not - Fibrinolysis within 12 hours of onset of symptoms - given antithrombin and ticagrelor after
ecg after 90-120 mins - if persistent myocardial ischaemia still the consider PCI

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

GRACE risk assessment for NSTEMI

A

age
heart rate, blood pressure
cardiac (Killip class) and renal function (serum creatinine)
cardiac arrest on presentation
ECG findings
troponin levels

  • If GRACE >3% risk of future adverse events - PCI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tx for NSTEMI

A

Aspirin + Fondaparinux (if no immediate PCI is planned)

GRACE score
Low risk (<3^%) - conservative management - give ticagralor
High risk - PCI (immediately if unstable, otherwise within 72hrs)
Give prasugrel or ticagralor, unfractionated heparin

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

Mx for pericarditis

A

Tx - NSAID and colchicine
All patients should have transthoracic echocardiography

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

Adenosine SEs

A

Adenoside used to terminate SVTs
NB avoid in asthmatics due to risk fo bronchospasm

SEs - chest pain, bronchospasm, transient flushing

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

ACS summary

A

Shockable = VF/VT
Unshoickable = PEA, asystole

1mg adrenaline IV ASAP for non-shockable
Adrenaline after 3rd shock in VF/VT
Repeat every 3-5mins

VF/VT - amiodarone 300mg after 3 shocks
further 150mg after 5th shock

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

Antiplatelets in ACS (medicaly treated)

A

1 = Aspirin (life) + ticagrelor (12mo)

is aspirin CI - clopi (lifelong)

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

Antiplatelets in PCI

A

1 = Aspirin (life) + ticagrelor or prasurgrel (12mo)

is aspirin CI - clopi (lifelong)
Prasugrel CI if Hx pf stroke/TIA

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

Antiplatelets in TIA or ischaemic stroke

A

1 = Clopi (lifelong)

2= aspirin (lifelong) and dipyridamole (life)

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

Antiplatelets in PAD

A

1 = lifelong Clopi

2= lifelong aspirin

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

Management of aortic disection

A

Type A (Ascending aota) - surgical Mx, control BP pre-op

Type B (descending) conservative, bed rest, BP control

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

Features of aortic regurg

A

EarlyDM, collapsing pulse, wide pulse pressure, nailbed pulsation, head bobing

NB - acute presentation of AR - ?> inf endocarditis, ? aortic dissection

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

Features of AS

A

Pc - chest pain, SOB, syncope/presyncope

ESM, rad to corotids, narrow pulse pressure, slow rising pulse, soft/absent S2

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

Causes of AS

A

degen calcification - most common in >65
bicuspid aortic valve - most common in < 65

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

CHADSVASC score (SAD CHAVS)

A

S (prior stroke/TIA ) = 2
Age > 75 = 2
Diabetes
Congestive heart failure
HTN
Age 65-74
Vasc disease
Sex (female)

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

Anticoag in AF

A

Chadsvasc -
Score 1 - if men, consider
Score >2 - offer

DOAC = 1st line
If DOAC not tolerated - warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

AF - cardioversion

A

If < 48hrs since AF started - cardiovert
- DC cardioversion
- medical - amiodarone or flecainide (flecainide CI if structural Heart disease)

If unknown or > 48hrs
Give anticoag for 3w then cardiovert (electrical better)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

AF and stroke

A

If AF and TIA - start anticoag as soon as the haemorrhage excluded
If stroke - anticoag after 2w

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

ecg; PR > 0.2s

A

1st deg heart block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ecg - second deg heart block

A

Mobitz 1 (wenchebach) - progressive prolongation then drop
Mobitz 2 - PR constant but sometimes dropped beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Causes of artificially low BNP

A

ACEi, ARB, diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Side effects of BBs

A

Bronchospasm, cold peripheries, fatigue, sleep disturbances, erectile dysfunc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Raynauds disease in stong smoker
Buergers disease Ft - ischaemia - intermittent claudication, superficial thrombophlebitis, raynauds
26
Becks triad in cardiac tamponade
Hypotension, raised JVP, muffled heart sounds ecg = electrical alternans Tx = urgent pericardiocentesis
27
Classic causes of dilated cardiomyopathy
alcohol Coxsackie B virus wet beri beri doxorubicin
28
Classic causes of restrictive cardiomyopathy
amyloidosis post-radiotherapy Loeffler's endocarditis
29
Takotsubo Cardiomyopathy
Transient - stress-induced cardiomyopathy TRansient apical ballooning of myocardium Supportive Tx
30
History of asthma, Marfan's etc Sudden dyspnoea and pleuritic chest pain
Pneumothorax
31
Sudden dyspnoea and pleuritic chest pain Current combined pill user, malignancy
PE (Calf pain/swelling)
32
'Tearing' chest pain radiating through to the back Unequal upper limb blood pressure
Dissection
33
Sharp pain relieved by sitting forwards
Pericarditis
34
Severe vomiting the sudden onset severe chest pain
Boorhave syndro - spontaneous rupture of oesophagus Dx via CT contrast swallow
35
Management of chronic heart failure
1st - ACEi + BB (ARB if intollerant to ACEi) 2nd = Aldosterone agonist (spiro/eple) if HFrEF - SGLT2i if co-existent Af - digoxin Other options - add Ivabradine or Hydralazine w/ nitrate Or replace ACEi with Sacubitril valsartan One off pneumococcal, Annual influenza
36
NYHA classification CHF
NYHA Class I: No symptoms and no limitation; II = mild NYHA Class III: Moderate symptoms with marked limitation of physical activity; comfortable at rest NYHA Class IV: Severe symptoms; unable to carry out any physical activity without discomfort, with symptoms present even at rest.
37
Clopi MOA
Inhibits activation of platelets Less effective if given with PPI
38
infant heart failure, HTN, radio-femoral delay
Co-arctation of the aorta CXR - notching of inferior border of ribs Asso - turnurs, bicuspid AV, berry naeurisms, NF
39
DVLA - cardiovasc
HTN - can drive bus etc if BP consistently > 180/100 Election angio - 1w off CABG - 4w off ACS (treated) - 1w ACS (conservatively managed) 4w Pacemaker - 1w off
40
ecg - horizontal ST dep, tall & broad R waves, upright t waves, Dominant R wave in V2
Posterior MI
41
ecg - downsloping ST dep, flattened /inverted T waves, short QT
Digoxin tox (reverse tick) also arythmias (AV block or brady)
42
ecg - small/absent t wave, long PR, ST dep[, long QT, second wave after t wave
hypokal (U wave)
43
Bradycardia, long QT, small hump at end of QRS complex (J wave), 1st deg heart block
Hypothermia
44
Causes of LBBB
NB - alway pathological - W in V1, M in V 6 A2D2H2 Ant wall MI, Aortic stenosis Digoxin, dilated cardiomyopathy Hyperkal, HTN
45
ecg - inc P wave amplitude
cor pulmonale
46
ecg - notched, bifid p waves
Mitral stenosis
47
Causes of prolonged PR int
Athletes/idiopathic Ischaemic heart disease digoxin Hypokal
48
ecg - short PR int
WPW syndrome
49
ecg - ST depression
Abnormal QRS (LVH, LBBB, RBBB) Ischaemia Digoxin Hypokal
50
ecg peaked t waves
Hyperkal Myocardial ischaemia
51
ecg inverted t waves
Ischaemia, digoxin, SAH, PE
52
Causes of S3
lub-dub-ta diastolic filling of ventricle Causes; left ventricular failure (e.g. dilated cardiomyopathy), constrictive pericarditis (called a pericardial knock) and mitral regurgitation
53
Causes of S4
le-lub-dub Atrial contraction against a stiff ventricle Causes; aortic stenosis, HOCM, hypertension
54
Blood pressure targets
Age <80 Clinic = 140/90, ABPM = 135/85 Age >80 Clinic 150/90, ABPM 145/85
55
Young adult, exertional SOB, angina, syncope, jerky pulse, double apex beat, ESM
HOCM - Hx of sudden death in family (A Dom) ecg - LVH, deep q waves
56
Echo findings in HOCM
MR SAM ASH mitral regurgitation (MR) systolic anterior motion (SAM) of the anterior mitral valve leaflet asymmetric hypertrophy (ASH)
57
Tx for HOCM
Amiodarone Berta blockers/Verapamil Cardioverter defib Dual chamber pacemaker Endocarditis prophylaxis
58
Causes of inf endocarditis
Staph a. - most common, esp in acute presentation and IVDU Strep viridans - linked with poor dentician Staph epidemidis - psosthetioc valves NB - most commonly affects Mitral valve, if IVDU (tricuspid)
59
Non-pulsatile JVP
SVCO
60
paradoxical rise in JVP during inspiration
Kussmaul sign Constrictive pericarditis
61
Causes of long QT syndro (>450ms)
Drugs - amiodarone, TCAs, SSRIs (esp citalopram), erythromycin Electrolyte imbalance - hypocal, hypokaL, Hypomag acute MI Myocarditis hypothermia
62
MOA + SEs loop diuretics
Inhib Na-K-Cl co-transporter in ascending limb of loop of henle (dec NaCl re-abs) Ses - hyponat, hypok, hypomag, hypocal, ototoxic
63
SOB, haemoptysis, malar flush, murmur
Mitral stenosis mid-late diastolic murmur (louder on exp), loud S1, opening Snap, low volume pulse Asso Af Causes - Rheumatic fever, carcinoid Tx - if symptomatic percutaneous mitral balloon valvotomy, surgery
64
Ejection systolic murmus
Louder on exp - AS, HOCM Louder on isp - PS, ASD NB RILE Right-sided murmur → heard best on Inspiration Left-sided murmur → heard best on Expiration
65
Pansystolic murmus
high pitched/blowing - MR/TR harsh - VSD NB - MR radiates top apex
66
early diastolic murmur
high pitched/blowing - AR
67
mid-late diastolic murmur
rumbling - MS Austin flint = severe AR%
68
Continuous machine like mumur
PDA
69
Cause of death post MI
VF
70
Chest pain after MI, better on sitting forward
Peridarditis common in first 48hrs Dressler = at 2-6w. Tx with NSAIDs
71
Persistent St elevation post MI
LV aneurism. ST elev + LVF, need anticoag
72
Acute heart failure, raised JVP, pulsus paradoxicus, muffled heart sounds, post MI
LV free wall rupture - needs urgent pericardiocentesis and thoracotomy
73
Post MI- acute heart failure with new pan-systolic mumur
VSD
74
Post MI, early/mid systolic murmur
Acute mitral regurg due to rupture of papillary muscle
75
Drugs to be on post-MI
DAPT (aspirin + ___) ACEi BB Statin
76
Adverse SEs and CIs for nicorandil
Used to treat angina SEs- Headache, flushing, anal ulceration CIs - LVF
77
Tx for acute brady
Atropine 500mcg IV = first line Repeat up to 6x (3mg) Transcutaneous pacing
78
Anticoag in replacement heart valves
Biopsrosthetic - low dose aspirin long term, nil need for further anticoag Prosthetic - warfarin
79
ecg - deep spike in V1, Tall spike in V3, inverted T wave V3
PE - S1Q3T3
80
Pulsus paradoxicus
Severe asthma Cardiac tamponade
81
Slow rising pulse
AS
82
Collapsing pulse
AS PDA
83
Pulsus alternans
Severe LVF
84
Jerky pulse
HOCM
85
Statins MOA, SEs, Monitoring and CIs
HMG CoA Reductase inhib SE - myopathy, liver impairment Monitor LFTs at baseline, 3mo, 12mo CIs - erythromycin/clarithromycin, pregnancy
86
Tx for SVT
Narrow complex tachy Tx - vagal manouvers (valsalva, carotid sinus massage) Iv adenosine 6mg (then 12, then 18) Electrical cardioversion
87
Headache, unequal BP in upper limbs, weak peripheral pulses, upper and lower limb claudication on exertion
Takayasu's arteritis -> occlusion of the aorta, more common in young female asians Tx steroids
88
Thiazide diuretics MAO and SEs
inhib Na reabs at beginning of DCT SEs - postural hypoT, hypokal, hyponat, hypercal, gout, impaired glucose tolerance, impotence
89
Tx for TdP
= polymorphic VT Tx = Iv Mg sulph
90
Tx for VT
Amiodarone if stable Electrical cardioversion if not AVOID verapamil
91
Symptoms of LVF
Breathlessness, reduced exercise tollerance, orthopnoea, paroxysmal nocturnal dysopnoea, fatugue, nocturnal cough, ankle swelling Tachycardia, Tachypnoea, displaced apex, pulmonary crep
92
Symptoms of RVF
fatigue, dizziness, ankle swelling Jugular venous distension, periph oedema, pulsatile hepatomegaly, ascites
93

MSRA (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions