Cardio 2a flashcards Flashcards by Grace C Braithwaite

What are the signs and symptoms of heart failure?

breathlessness, fatigue, cough, ankle swelling
tachycardia, displaces apex, increased JVP
high NTproBNP

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What is cardiopathy and the classifications?

chronic disease of the primary heart muscle
hypertrophic
dilated
arrhythmogenic

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How are the symptoms pericarditis?

chest pain - severe, central, pleuritic, squeezing, relieved by sitting forward

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What are the tests for pericarditis?

ausculatation - friction rub heart sound

ECG - PR depression, saddle ST elevation

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What is WPW?

prescence of a congenital accessory pathway between the atria and ventricles

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How would you detect WPW?

tachycardic

ECG - delta waves, short PR, QRS prolongation

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ST elevation on which leads show which type of STEMI?

anterior - v3-v6
lateral - I, VL, V5-V6
inferior - II, III, aVF

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How would you treat pericarditis?

sedetary activity
NSAIDs and aspirin
cochicine

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What is the tetralogy of fallot?

congenital cardiac malformation

pulmonary stenosis
over-riding aorta
right ventricular hypertrophy
VSD

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What are the structural heart defects that cause cyanosis?

tetralogy of fallot 
stenosis of RV 
eisenmenger's syndrome 
patent ductus arteriosis 
pulmonary stenosis

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How do atheroscelorotic lesions develop?

damaged endothelial cells have higher cell adhesion for monocytes, increased permeability and thrombogenicity
this allows inflammatory cells and lipis to enter the intima

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How would you diagnose a valvular heart disease?

echo

ECG, CXR

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What are the effects of endocarditis?

localised problems e.g. HF
shedding of emboli from vegetations
immune complex formation

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How would you treat an MI?

MONA - morphine, oxygen, nitrate, aspirin

PCI/CABG

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What are foam cells?

macrophages that have phagocytosed oxidised lipoproteins

seen in atherosclerosis

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What are the guidelines for hypertension treatment?

<55/DM - Ace-i
>55/black - calcium channel blocker
both A & C
A & C & thiazide

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What are the 4 most common types of valvular heart disease?

aortic stenosis and regurgitation

mitral stenosis and regurgitation

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What are the risk factors of PVD?

smoking
hypertension
hypercholesterolaemia

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What are the symptoms of PVD?

claudication
rest pain
ulceration, gangrene
6Ps - pain, pale, perishingly cold, paralysis, paraestethia, pulseless

What are the 2 layers of pericardium and what is it’s function?

parietal and visceral

restrain the volume of the heart

How would you treat chronic heart failure?

Ace-inhibitor and beta blocker
add spironolactone
specialist could add digoxin, CRT, hydralazine with nitrate, ivabradine, sacubitril-valsartan

What are the stages of atherosclerosis?

fatty streaks
intermediate lesions
advanced lesions

What is aortic dissection and the two types?

blood bursts through aortic media
Type A - abdominal aorta
Type B - doesn’t involve abdominal aorta

How would you detect atrial flutter on ECG?

ECG - narrow complex tachycardia, sawtooth pattern (I,II)

How do you treat ischaemia in PVD?

``` risk factor modification balloon angioplasty stenting amputation carotid endartectomy ```

How would you diagnose IHD?

12 - lead ECG - ST depression echo CT angiogram stress treadmill/echo

What is the first line pharmalogical treatment of IHD?

beta blockers or calcium channel blockers

What are secondary prevention medications given in ischaemic heart disease?

aspirin, statin, nitrate

Who gets endocarditis and which pathogens are likely to cause it?

Native valves - strep viridans, enterococci IVDU - staph epidermidis/aeureus, psedomonas, candida Prosthetic - coagulase - staph, gram - bacilli, candida

What is coarctation of aorta?

narrowing at the site of insertion into ductus arteriosus

What are the classes of haemorrhagic/hypovolaemic shock?

I: HR<100, blood loss <15%, RR 14-20, urine output >30mls/hr II: HR 100-120, blood loss 15-30%, RR 20-30, urine output 20-30 mls/hr III: HR >120, blood loss >30%, RR 30-40, urine output 5-15 mls/hr

What is an aortic aneurysm and how would you treat it?

artery dilation ruptured = surgery, treat shock unruptured AAA = monitor then surgery

What do statins do?

inihibitors of HMG COA reductase which limits hepatic cholesterol synthesis reduces inflammation promotes plaque stability

What is atrial fibillation and how would you treat it?

atria fire too quickly = tachycardia BB, dilitizaem, digoxin for rate control flecainide, amiodarone or satalol for rhythm control anticoagulate them catheter ablation

What is the classification for HF?

``` New York Heart Association Class I - no limitation Class II - slight limitation Class III - marked limitation Class IV - unable to carry out any physcial activity without discomfort ```

What indicates heart block?

p waves without QRS complex | 1st - 3rd heart block shows severity

What are the 3 types of diuretics and give examples?

loop - furosemide K+ sparing - spironolactone thiazide - bendrofluromethazide

What is the classification for MI?

STEMI (Q wave or non Q wave) | NSTEMI

What is atherosclerosis and where does it occur?

disease of arteries where fatty plaques develop in intima eventually obstructing blood flow occurs in coronary arteries

What is ACS?

acute coronary syndromes = unstable angina, STEMI, NSTEMI

What is the treatment for endocarditis?

antimicrobials for 6 weeks treat complications surgery

How would you treat shock?

ABCDE treat cause fluid resus

What are the 5 main types of shock?

``` anaphylaxis hypovolaemic cardiogenic neurogenic septic ```

What do nitrates do and give an example?

vasodilators - arterial and venous - decrease pre-load and after-load so decrease BP e. g. GTN spray

What are the 3 parts of angina pain?

central, crushing, radiates to arm and jaw precipitated by exercise better with rest

What symptoms are on hands of people with infective endocarditis?

splinter haemorrhages Osler nodes - tips of fingers, painful, local immune response Janeway lesions - palms and soels of feet, not painful, microemboli petichial black spots

What does aspirin do?

irreversible COX-1 inhibitor so inhibits platelet aggreeggation