Cardio Bible Flashcards
what are the side effects of ACE inhibitors?
dry cough
hyperkalaemi
when are ACE inhibitors contraindicated?
pregnancy
renal artery stenosis
what are tall tented T waves and wide QRS complexes indicative of?
hyperkalaemia
what does rib notching on CXR indicate?
coarctation of the aorta
what does radial-radial delay indicate?
aortic dissection/coarctation of aorta
collapsing pulse?
aortic regurgitation
slow rising pulse?
aortic stenosis
crescendo-decrescendo murmur?
aortic stenosis
who gets staph aureus endocarditis?
prosthetic valves
IV drug users
who gets strep viridans endocarditis?
post dental surgery
how is AF treated?
treat underlying cause Control ventricular rate with: - Beta blocker/Ca blocker - Add digoxin or amiodarone Anticoagulate - heparin
how does clopidogrel work?
binds to P2Y12 receptor via disulphide bond so ADP cant bind, GP not expressed, reduced platelet aggregation
how does heparin work?
binds to AT3 and increases affinity for clotting factors to inactivate
what is the ductus arteriosus?
connection between pulmonary artery and descending aorta during foetal development to bypass the lungs
should close
what is a patent ductus arteriosus and what is the main sign of it?
connection between the pulmonary artery and descending aorta due to failure of the closure of ductus arteriousus
continuous machine like murmur
what does strawberry milkshake coloured blood indicate?
hyperlipidaemia
which dermatome does the herpes zoster virus (shingles) affect?
rash at level T4/T5
what is the rate limiting enzyme in the production of cholesterol?
HMG - CoA - Reductase
what do cholesterol lowering drugs target?
Give an example?
HMG - CoA - Reductase enzyme
Statins = competitive inhibitor of HMG - CoA - Reductase
what are 2 side effects of statins?
rhabdomyolysis (death of muscle fibres and contents released into blood affecting the kidneys)
myositis (inflammation of muscles of movement)
what are the symptoms of an AAA?
expansile pulsatile mass
central abdominal pain
how is an AAA treated, depending on size?
only intervene if >5cm or grown more than 0.5cm in past 6 months/1cm in past year
what is an aneurysm?
vessel dilated more than 50% of normal diameter
true vs false aneurysm?
true = vessel wall intact just swollen false = breach in vessel wall, surrounding structures act as vessel wall
3 types of aneurysm?
saccular (berry)
fusiform (in line with artery)
mycotic (2ndary to infectious process, all 3 layers)
how is AAA diagnosed?
Doppler US
CT ( better as shows whether ruptured)
how is an AAA managed?
open repair
EVAR (better - excludes from inside artery)
salvageable acute limb ischaemia?
- 0-4 hrs
- white foot
- painful
- sensorimotor deficit
partly salvageable acute limb ischaemia?
4-12 hrs
mottled appearance
blanches on pressure
non-salvageable acute limb ischaemia?
>12 hrs fixed mottling non-blanching paralysis compartments tender/red
what is the triad of diabetic foot problems and what can it cause?
diabetic neuropathy
peripheral vascular disease
infection
can cause necrosis, ulceration and gangrene
what is kussmaul’s breathing?
sign of severe metabolic acidosis
indicated diabetic problem (eg. DKA)
how is diabetic foot sepsis managed?
vascular surgical emergency - remove infected tissue
appropriate antibiotics
how is diabetic foot sepsis managed?
vascular surgical emergency - remove infected tissue
appropriate antibiotics
what is the main innervation of the heart at rest?
parasympathetic via vagus nerve (to keep the HR low)
what effect does parasympathetic stimulation have on the heart?
negative chronotropic effect
slows heart rate
how does the sympathetic nervous system innervate the heart and what effect does it have?
via adenosine B1 receptors
positive chronotropic effect (increases HR)
what is the longest vein in the body?
great saphenous
which artery supplys the SA node?
right coronary artery
which artery supplies the AV node?
AV nodal branch of right coronary artery
name a potassssium sparring diuretic
spironolactone
what are the components of tetralogy of fallot?
RV hypertrophy
ventricular septal defect
Overriding aorta
Pulmonary stenosis
which side of the heart is generally affected in IV drug users?
right side
what are the anterior branches of the thoracic aorta?
bronchial oesophageal mediastinal pericardial phrenic arteries
what is the counter regulatory mechanism to the RAAS system?
Atrial natriuretic peptide
ANP
what does ANP do?
released in response to atrial distension/hypervolaemia
acts as vasodilator and decreases renin release
what is the carotid sinus?
dilated area at base of internal carotid just above bifurcation
detects stretching of walls for BP changes
monitors blood gas and pH
what nerve innervates the carotid sinus?
glossopharyngeal (CN IX)
a 4th heart sound is always pathological, true or false?
true
active filling of stiff ventricle by atrial contraction
what does a 4th heart sound often indicate?
LVH
what causes a splitting of the 2nd heart sound?
due to inspiration
pulmonary being behind aortic compartment
usually normal
name 3 orally given anticoagulants
warfarin
digoxin
rivaroxaban
which murmur is associated with AF?
mitral regurgitation
what is the treatment for ventricular tachycardia?
adenosine/Ca blocker/Beta blocker
amiodarone
cardioversion
what is atropine?
competitive antagonist of muscarinic ACh receptors
blocks parasympathetic reversing bradycardia after MI
where does the azygous vein lie?
right side of thoracic vertebrae
loops around lung root
which drug causes a slate grey rash as a side effect?
amiodarone
what is metoclopramide?
antiemetic given for gastroparesis or post MI
characteristics of aortic regurgitation?
SOB/chest pain high volume collapsing pulse early diastolic wide pulse pressure left lower sternal edge leaning forward on expiration
which murmur is associated with IV drug users?
tricuspid regurgitation
