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Final Year - Passmed > Cardio 4 > Flashcards

Cardio 4 Flashcards

1
Q

pulmonary stenosis
heard loudest?

A

second intercostal space on the left sternal border
> right sided heart failure

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2
Q

Triad of symptoms for right sided heart failure?

A

JVP
hepatomegaly
ankle oedema

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3
Q

amiodarone IV has one common injection side effect?

A

thrombophlebitis
> ensure given into ventral veins

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4
Q

amiodarone is a class?

A

class III anti arrhythmic agent

blocks potassium channels

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5
Q

amiodarone interaction with which commonly used anticoagulant ?

A

decreases metabolism of warfarin

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6
Q

what are u waves?

A

u waves appear as small + deflections after t wave

lead V2 and V3

caused by hypokalaemia

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7
Q

short QT interval?

A

QT interval prolongation

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8
Q

J waves are what?

A

osborn waves

hypotrhermia

hypercalcaemia

junction between QRS and ST segment

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9
Q

Raynauds with extremity ischaemia?

A

buerger’s disease

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10
Q

other name for buergers disease?

A

thromboangitis obliterans

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11
Q

how to differentiate between myocarditis and pericarditis

A

Myocarditis is more likely to show a focal ECG changes
> also more likely to show acute congestive HF signs / Left ventricular failure signs

pericarditis is widespread

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12
Q

why does myocarditis present with left ventricular dysfunction signs?

A

inflammation reducing contractile strength of the heart

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13
Q

causes of myocarditis?

A

viral : coxsackie
bacterial : diphtheria, clostridia
fungal : toxoplasmosis

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14
Q

mx of angina?

A

First line : beta blocker

or if not tolerated / contraindicated
first line : CCB NDHP - verapamil / diltiazem

2nd line: Beta blocker and Dihydropyridine CCB - amlodipine / nifedipine

3rd line - add 3rd drug but awaiting PCI / CABG

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15
Q

other angina medications?

A

a long-acting nitrate
ivabradine
nicorandil
ranolazine

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16
Q

Stage III HF

A

pain on less vigorous studd

like daily activities impacted
but no pain at rest

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17
Q

stage 1 HF?

A

Stage I - No limitation on ordinary physical activity (incorrect)

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18
Q

PKD is associated with what valve abnormality?

A

mitral valve prolapse

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19
Q

management of cardiac tamponade?

A

pericardiocentesis

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20
Q

when should you take statins?

A

at night- increases efficacy

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21
Q

beta blockers licensed for HF?

A

bisoprolol, carvedilol, and nebivolol.

22
Q

2nd line HF?

with reduced ejection fraction

A

beta blocker, ACEi, + mineralocorticioid receptor antagonist

> be wary of hyperkalaemia

role of SGLT-2 drugs inhibitors

23
Q

SGLT-2 inhibitors

A

reduce glucose reabsorption and increase urinary glucose excretion

dapagliflozin

24
Q

sacubitril-valsartan

criteria?

A

3rd line
left ventricular fraction < 35%

reduced ejection fraction who are symptomatic on ACE inhibitors or ARBs

initiated after a washout period

25
Q

role of digoxin

A

very helpful w symptoms
t is strongly indicated if there is coexistent atrial fibrillation

26
Q

major bleed and on warfarin mx?

A

stop warfarin

IV vitamin K 5mg and prothrombin concentrate complex

27
Q

Ivabradine is used in?

MOA?

S/E?

A

inhibition of IF channels

I current
F = funny

mixed na+/K+ in heart like Sinoatrial node

angina management

transient luminous phenomenon

28
Q

what is the MOA of ivabradine?

A

inhibits channels
= delay in depolarisation
= slows down heart rate

29
Q

HTN management?
when should you start antihypertensives?

A

if more than 150/95

stage 2

30
Q

> 135/85 on
ABPM / HBPM

when to start anti hypertensives?

A

<80

+ target organ damage
CVD disease
renal disease
DM
QRISK >105

31
Q

black african or african-caribbean ethnicity first line anti hypertensives?

second line?

A

CCB

> CCB + ACEi / ARB
CCB +thiazide like diuretic (indapamide)

32
Q

<55 or T2DM

first line antihypertensive?

A

ACEi / ARB

33
Q

acute HF management
with hypotension?

A

high dependency unit

inotropes considered for reversible cardiogenic shock

34
Q

HF acute management?

A

IV loop diuretic - furosemide

O2 - if needed

Vasodilate
> contraindicated if hypotensive

Respiratory support
CPAP

Inotropic agent
vasopressor agent
mechanical circulatory assistance

35
Q

Acute mx of HF summarised

if hypotensive?

A

IV furosemide
O2
Vasodilation
CPAP

Iv furosemide
O2
HDU with inotropic support
vasopressor
> norepinephrine
Mechanical circulatory support

36
Q

breathing problems with a clear chest ?

A

pulmonary embolism

37
Q

differentials for acute breathlessness?

A

COPD exarcebations : wheeze and crackles
Pneumothorax : absent breath sounds
astham attack - wheeze

38
Q

which murmur gets louder during inspiration

lower left sternal edge

A

tricuspid regurgitation

venous blood flow into right atrium and ventricle are increased
> stroke volume of right ventricle during systole

39
Q

murmurs at lower left sternal edge?

A

Tricuspid regurgitation / mitral regurgitation

HOCM

VSD

40
Q

HOCM murmur?

A

harsh
ejection systolic
loudest on expiration

41
Q

side effect of indapamide

A

hypokalaemia
erectile dysfunction
dehydration
hyponatraemia

hypercalcaemia
impaired flucose tolerance
gout

42
Q

antihypertensives which cause hyperkalaemia

A

spironolactone
ACEi

43
Q

angina pectoris triad

A

chest discomfort
triggered by exertion
alleviated with rest

44
Q

angina pectoris first line mx?

A

beta blocker
CCB - rate limiting one
> diltiazem / verapamil

45
Q

s/e of beta blockers?

A

bronchospasm
cold peripheries
fatigue
sleep disturbances
erectile dysfunction

46
Q

tachyarrhythmia management
if not stable
narrow complex

A

signs of shock

DC cardioversion

1) Midazolam large bore IV - sedate
2) pads places ; synchronised

take blood at same time
potassium
magnesium
calcium

47
Q

irregular broad complex tachycardia management?

A

seek expert help
atrial fibrillation with bundle branch block

> ventricular pre excitation
torsades de pointes

48
Q

loop diuretic
mechanism of action?

A

inhibition of Na-K-Cl transporter in the thick ascending limb of the loop of henle

49
Q

mx post ischaemic stroke?

A

300mg aspirin for 2 weeks
75mg clopidogrel for life

50
Q
A

Final Year - Passmed (22 decks)

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