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The Holy Grail (Treatments) > Cardio > Flashcards

Cardio Flashcards

1
Q

Hypertension <55 year-olds

A
  1. ACE Inhibitors (Ramipril, Lisinopril, Perindopril)
  2. CCBs (Amlodipine, Nifedipine, Verapamil, Diltiazem)
  3. Thiazide Diuretics (Bendroflumethiazide)
  4. Beta-Blockers (Atenolol, Bisoprolol)
    or Alpha-Blockers (Prazosin, Doxazosin)
    or Spironolactone

Exchange ACE Inhibitors for Angiotensin Receptor Blockers (Losartan, Valsartan, Candesartan)

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2
Q

Hypertension > 55 year-olds or Black patients

A
  1. CCBs (Amlodipine, Nifedipine, Verapamil, Diltiazem)
  2. ACE Inhibitors (Ramipril, Lisinopril, Perindopril)
  3. Thiazide Diuretics (Bendroflumethiazide)
  4. Beta-Blockers (Atenolol, Bisoprolol)
    or Alpha-Blockers (Prazosin, Doxazosin)
    or Spironolactone

Exchange ACE Inhibitors for Angiotensin Receptor Blockers (Losartan, Valsartan, Candesartan)

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3
Q

Targeted additional therapies for Hypertension

A 
Angina: BBs and CCBs (never together) 
Heart Failure: BBs and ACE Is 
Diabetic Nephropathy: ACE Is and ARBs
Prostatism: Alpha-Blockers 
Elderly: Thiazide Diuretics
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4
Q

Angina

A

ABC BAGS P

Aspirin
B1-Blockers (Atenolol, bisoprolol, metropolol) C
CCBs (Amlodipine, Nifedipine, Felodipine) B
Bypass
Angioplasty
GTN
Statins (if choleosterol >5mm/L)
Potassium Channel Openers (nicorandil, minoxidil)

Unstable: Old ladies are unstable, HAG

  • IV Heparin
  • Aspirin
  • IV GTN

Coronary Artery Spasm:

  • CCBs
  • Isosorbide mononitrate
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5
Q

Heart Failure

A

Acute: Remember to be SOFD

  • Sit up
  • Oxygen
  • IV Furosemide
  • IV Diamorphine (not in COPD)

Standard therapy (or previous MI): ABDDS

  • ACEi
  • B-Blockers
  • Diuretics
  • Digoxin
  • Spironolactone

Cor Pulmonale:

  • Diuretics
  • Oxygen

Valvular Disease:
- Surgery

AF:

  • Digoxin
  • DC Cardioversion
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6
Q

Acute Pulmonary Oedema

A

Furosemide

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7
Q

DVT

A

DVTS happen Lower than the Waist

Anticoagulation:

  • LMWH
  • Warfarin (not in pregnancy)

TED compression stockings

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8
Q

Phlegmasia Dolens

DVT caused obstruction of arterial flow due to back pressure created

A

IVC filter through femoral artery which prevents thrombus entering lungs (PE prophylaxis)

  • if long term give anticoagulation (as IVC increases DVT risk)
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9
Q

Limb Ischaemia

A sudden lack of blood flow to a limb- causing intermittent claudication, ulcers or gangrene

A

You can’t go skiing in the ALPS if you have limb ischaemia

Anti-platelets
Lifestyle change (stop smoking, exercise more)
PCI or vascular bypass
Statins

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10
Q

Abdominal Aortic Aneurysm

Defect in collagen-elastin regulation, causing excessive dilation + increase in abdominal aortic wall stress

A

Endovascular Aneurysm Repair

(Stent inserted via groin and passed up until the weakened part of the artery aneurysm is reached, where it seals off the aneurysm from inside the artery)

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11
Q

Varicose Veins

Back pressure due to incompetent valves causes blood to pool in superficial veins

A 
Foam sclerotherapy (chemical thrombophlebitis)
Endovenous ablation
Compression stockings
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12
Q

Stroke

(Disrupted blood supply to the brain, causing ischaemia and focal neuropathy)

2 Types:

  • Ischaemic: Thrombus (blood clot)
  • Haemorrhagic: Hypoperfusion from bleed (aneurysm)
A

Strokes happen in the brain, must be smart, probably got decent SATS

Ischaemic: SATS

  • Statins
  • Aspirin
  • Thrombolysis (tPA)
  • Supportive

Haemorrhagic:
- supportive

Admit to Stroke Unit obvs
Anti-hypertensives

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13
Q

Acute STEMI

A

Patient is probably moaning bc they are having an MI

MONA C 
Morphine (give with anti-emetic) 
Oxygen obviously 
Nitrate
Aspirin 
Clopidogrel

PCI within 90 mins, or else thrombolysis

Can use:
B1-Blockers (Metroprolol)

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14
Q

Post-MI

A 
SABA + C 
Statin 
ACEi
Beta Blocker
Aspirin 
\+ Clopidogrel for 4 weeks

CCBs (Verapamil, Diltiazem) in place of B-Blockers
Warfarin in place of Aspirin & Clopidogrel

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15
Q

Supraventricular Arrhythmias

3 Types:

  • AF
  • Atrial Flutter
  • Ectopic Atrial Tachycardia
A 
VAV
Vagal manoeuvres (Hold breath, bear down, equalise) 
Carotid massage (usually in children with low stroke risk)
IV adenosine (Anti-arrhythmic) 
IV verapamil (CCB)

Unstable: DC Cardiovert

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16
Q

Chronic Arrhythmias

A

Radiofrequency Ablation

Selective cauterisation of cardiac tissue to prevent tachycardia- all anti-arrhythmic drugs must be stopped prior

17
Q

Ventricular Tachycardia

A

Acute (unstable): DC Cardioversion
Paroxysmal (stable): Amiodarone

If unsure if its VT /SVT give Adenosine (Anti-arrhythmic)

18
Q

Atrial Fibrillation

A

ABCDD

  • Amiodarone (Anti-arrhythmic) - rhythm control
  • B1- Blockers (Atenolol, Bisoprolol, Metropolol) - rate
  • CCB (Verapamil, Diltiazem) - rate control
  • Digoxin (Anti-arrhythmic) - rate control
  • DC Cardioversion - rhythm control

Anti-coagulation
Maze procedure

19
Q

Pulseless VT

A

Shock that mofo tf (defibrillation)

20
Q

Ventricular Fibrillation

A

Did someone say clear? SHOCK EM’ (defibrillation)

Consider adenosine if unsure

21
Q

Asystole

A

Patient is fucked

Adrenaline 1mg IV every 3-5 mins following CPR
Atropine
Intubation and IV access

22
Q

Pulseless electrical activity

A

Patient est fuckéd

CPR
IV access for: Atropine, Vasopressin, Adrenaline
Oxygen and intubation
Pray

23
Q

Aortic Stenosis

A

Valve replacement
Balloon valvotomy
TAVI (valve implantation)

24
Q

Mitral Regurgitation

A 
Valve replacement
Percutaneous mitral valve repair
Loop Diuretics (Furosemide)
ACE Is (Ramipril, Lisinopril, Perindopril)
Digoxin
Warfarin
25
Q

Mitral Stenosis

A 
Valve replacement
Mitral balloon valvuloplasty
Loop Diuretics (Furosemide)
B-Blockers
Digoxin
Warfarin
26
Q

Aortic Regurgitation

A

Valve replacement
ACE Is
ARBs
Diuretics

27
Q

Cardiac Tamponade

A

Pericardialcentesis

28
Q

Cardiomyopathy

A

Treat underlying disease

ACE Is
ARBs
B-Blockers
CCBs
Diuretics
Anti-Arrhythmics (Amiodarone and Digoxin)
29
Q

Coarctation of the Aorta

A

Balloon dilation + stenting

Surgery

30
Q

Pericarditis

A

Supportive (as its viral usually)

Antibiotics for specific bacteria

31
Q

Tetralogy of Fallot

A

Oxygen
Beta-Blocker
Endocarditis prophylaxis
Surgery

32
Q

Myocarditis

(Inflammation of the cardiac muscle) caused by:
Virus

A

Supportive treatment

33
Q

Sinus Bradycardia

(<60bpm)

Caused by:

  • athlete
  • beta-blockers
  • ischaemia (common in inferior STEMIs)
A

Atropine (>600mg)

34
Q

Sinus sick syndrome

SA node dysfunction

A

Pace

35
Q

Torsades de pointes

Looks like Forth-Rail Bridge on an ECG

A

Magnesium Sulphate

36
Q

SVT

A

AdenoSin bc “S”VT

  1. Adenosine
  2. BBs

Unstable: D.C. Cardiovert

37
Q

Aortic Incompetence (if evidence of LV dilation)

A

ACE Is

The Holy Grail (Treatments) (13 decks)

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