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Y6 Senior Med > Cardio 2 > Flashcards

Cardio 2 Flashcards

1
Q

What is the difference between fast and slow AF

A

Fast AF = >100bpm

Slow AF = <60bpm

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2
Q

first line mx angina

A

aspirin + atorvastatin

beta blocker /non DHP CCB + GTN

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3
Q

what are non-DHP CCB

A

THE WEIRD NAMED ONES

e.g. diltaziem, verapamil

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4
Q

what is second line mx angina

A

beta blocker + DHP CCB + GTN

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5
Q

what are DHP CCB

A

the usual named ones

e.g. nifedipine

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6
Q

what typeof CCB must you never give with BB and why

A

never give NON DHP CCB with BETA BLOCK

because they can cause complete heart block

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7
Q

causes of secondary HTN

A

Renal - RAS, PKD, CKD, chronic glomerulonephritis
Endocrine - hyperthyroid, cushings, conn’s, phaeo, CAH
CV - aortic coarctation

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8
Q

when do you treat HTN

A

if >140/90 and UNDER 80yo and with end organ damage, CVD, renal disease, diabetes, Qrisk >10%

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9
Q

what is the target BP for <80yo with HTN

A

Target for <80yo: <140/90n

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10
Q

what is the target BP for >80yo with HTN

A

Target for over 80yo: <150/90

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11
Q

how do you manage resistant HTN (after ACEi/ARB + CCB+ TLD)

A

if K+<4.5: spironolactone

if K+>4.5: alpha/betablocker

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12
Q

what patients must you give ATORVASTATIN 80mg in

A

FOR SECONDARY PREVENTION

so if known IHD, CVD, PAD (not if just high Qrisk)

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13
Q

how is a pericardial rub audible

A

on left lower sternal edge, with patient leaning forward on inspiration

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14
Q

what do you need to monitor with unfractionated hepain

A

APTT

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15
Q

what does QRISK measure

A

your 10 year risk of developing cardiovasc disease

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16
Q

what should you be given if Qrisk <10%

A

lifestyle modification

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17
Q

what should you be given if Qrisk >10%

A

high dose statin (20mg atorvastatin)

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18
Q

causes of cardiac tampoinade

A

vascular: MI, rupture, aortic dissection
infection: pericarditis
trauma: includes iatrogenic
cancer…
cause a pericardial effusion

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19
Q

when is it appropriate to do a PCI after the reccomended time priod of 12h from sx onset?

A

when patients have persistent ischaemia following fibrinolysis (e.g. at a nonPCI centre)

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20
Q

which angina med do patients commonly develop resistance to

A

standard-release isosorbide mononitrate (not modified release)

21
Q

investigations for suspected rheumatic fever

A 
Throat swab)
Bloods (FBC, ESR, ASOT anti streptolysin O titre )
Blood cultures 
ECG
CXR 
Echo
22
Q

what will Echo show in rheymatic fever

A

valve leaflet and chordal thickerning

mitral valve dilatation and collapse

23
Q

what is the time pattern of rheumatic feber

A

rheumatic fever is RECURRENT > causes progressive cardiac damage

24
Q

how long should patients with rheum fever keep taking antibioitics for as secondary prevention?

A

10 years or until age 40

lifetime prophylaxis may be needed if severe heart damage

25
Q

what occurs in ECG in acute rhem fever

A

prolonged PR

Heart block

26
Q

what is the timescale of the two disease patterns in Rheumatic fever

A

ACUTE&raquo_space; immune response to strep pyogenes, 2-6 weeks from initial pharyngeal infection

CHRONIC&raquo_space; recurrent through life

27
Q

ix for pericarditis

A

ECG: widespreast PR depression and saddle shgaped ST elevation

Echo (TTE): to exclude pericardial effusion

Troponin: to check for PRIOR MISSED MI

viral serology (later, non-urgent) if suspecting viral cause

28
Q

why is it important to do a troponin for pericarditis

A

because a prior silent MI may have caused it

29
Q

what is the most common complication of pericardityis you must be weary of ?

A

PERICARDIAL EFFUSION > TAMPONADE

so get a CXR > it will show cardiomeg with normla pulm vassc

30
Q

what causes WPW

A

presence of an accessory pathway conducting between atria and ventricles abnormally > premature ventricular contractions

31
Q

ecg features of WPW

A

short PR interval
wide QRS complexes with a slurred upstroke - ‘delta wave’
left axis deviation if right-sided accessory pathway*
right axis deviation if left-sided accessory pathway*

32
Q

what sets off WPW arrythmia?

A 
HOCM
mitral valve prolapse
Ebstein's anomaly
thyrotoxicosis
secundum ASD
33
Q

mx of WPW

A

ablation of accessory pathway

OR

amiodarone / fleicanide

34
Q

findings on ECG for pericarditis

A

Saddle shaped ST elevation

PR dePRession

35
Q

absolute contraindications to thrombolysis

A 
active internal bleeding
recent haemorrhage, trauma or surgery (including dental extraction)
coagulation and bleeding disorders
intracranial neoplasm
stroke < 3 months
aortic dissection
recent head injury
severe hypertension
36
Q

what is first line is CHADS VASC high?

A

DOAC e.g. apixaban, rivaroxaban, dabigatran

37
Q

what must you give if witnessed cardiac arrest while on monitor

A

3 SHOCKS (instead of just 1)

38
Q

what kind of erythema do you get with rheumatic fever

A

erythema MARGINATUM

39
Q

what must you synchronise DC cardioversion to?

A

synchronise to R wave

40
Q

when do you NOT need to synchronise DC cardioversion

A

in defibrillation (VF, VT)

41
Q

what drug reverses dabigatran effect

A

Idarucizumab

42
Q

posterior MI on ECG

A

tall R waves in V1, V2

43
Q

ECG change with HYPERCALCAEMIA

A

short QT

44
Q

what must you not forget to give in AF if you can cardiovert <48 hours

A

GIVE RAPID ANTICOAG e.g.

45
Q

causes of orthostatic hypotension (drop of BP >20/10 on standing)

A
  • hypovolaemia
  • autonomic dysfunction: diabetes, Parkinson’s
  • drugs: diuretics, antihypertensives, L-dopa, phenothiazines, antidepressants, sedatives
  • alcohol
46
Q

which cardiac drug must be avoided in VT

A

VERAPAMIL – because it will inhibit heart contraction furter

47
Q

electrolyte changes causing long QT

A

hypocalcaemia, hypokalaemia, hypomagnesaemia\

48
Q

what is the second investigation type you must do in someone found to have a RAISED BP in clinic?

A

AMBULATORY BP MONITORING (this will confirm whether they actually have HTN - no need to call them back into clinic!)

Y6 Senior Med (29 decks)

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