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Final year actually useful flashcrads > Cardio management > Flashcards

Cardio management Flashcards

1
Q

Management of periarrets: bradycardia?

A
  1. identify presence of (hemodynamic compromise shock, syncope,MI, HF)
  2. idenifty risk of asystole - may need transvenous pacing
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2
Q

First line treatment for bradycardia?

A

-Atropine 500mcg IV
-Can be up to maximum of 3mg
-Isoprenaline/adrenaline infusion
-Transvenous pacing

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3
Q

What is transvenous pacing?

A

Catheter connected to pacemaker

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4
Q

What is management of torsades de pointes?

A

-Correct underlying cause (electrolyte imbalance, stop medication)
-IV magnesium sulfate
-Defibrillation if VT occurs

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5
Q

Medication in torsades de pointes?

A

MAgnesium sulfate infusion

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6
Q

Pericarditis medication?

A

NSAIDs and colchiecine

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7
Q

WHat is a major contraindication in statin therapy?

A

-Pregnancy
-Macrolide therpay

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8
Q

Hypertension >180/120 management?

A
  1. Admit for specialist assessment if signs of haemorrhage or papilledema (suggesting accelerated hypertension) or signs of pheochromocytoma
  2. If no signs of end organ damage bloods, ACR, ECG
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9
Q

Signs end organ damage with reading 180/120?

A

Consider starting antihypertensive drug immediately

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10
Q

No signs of end organ damage with reading 180/120?

A

-Repeat clinic blood pressure measurement within 7 days

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11
Q

irregular broad complex tachycardia?

A

atrial fibrillation with BBB

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12
Q

Black african or african caribbean second agent after calcium channel blocker?

A

ARB in perferance to ACEi

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13
Q

Regular broad complex tachycardia no adverse features?

A

IV amiodarone

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14
Q

immediate symptom management for angina?

A

GTN spray
-When pain start every 5 minutes 3 times, if symptoms remain call an ambulance

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15
Q

Long term symptomatic management for angina?

A

Either or combination
-Beta blocker (bisoprolol)
-CCB (diltiazem or verapamil)
-Can also consider Long acting nitrates (isorbide momonitrate)
-Ivabradine
-Nicrandil
-Ranolazine

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16
Q

Beta blocker contraindicated already on CBB?

A

Isosorbide mononitrate

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17
Q

Secondary prevention of angina?

A

-Asprin 75mg
-Atorvastatin 80mg
-ACEi (if CKD, Hypertension, HF)
-BB - symptomatic relief

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18
Q

What is the only calcium channel blocker licensed for use in heart failure?

A

Amlodipine

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18
Q

Most common cause endocarditis?

A

-Staph aurues
-Staph epidermidis if <2 month post valve surgery

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19
Q

Loop diuretics can cause what eletrolyte imablance?

A

Hypokalaemia - furosemide

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20
Q

Medications causing accumulation of warfarin and raised INR?

A

drugs that inhibit P450 system
-Antibitocs clarithromycin, ciprofloxacin, erythromycin
-Amiodaraone
-SSRI

21
Q

What investigation is used to exclude other pathology in PE?

A

Chest X ray

22
Q

PE and hypotension?

A

Thrombolyse patient

23
Q

Longer acting dihydropyridine calcium channel blockers examples

A

Amlodipine
-Modified release nifedipine

24
Gout preferred 2nd step treatment for HTN?
Calcium channel blocker over thiazide
25
Ischaemic stroke antiplatelet ?
-Aspirin 300mg 2 weeks -Clopiogrel 75mg life long
26
Warfarin bleeding patient (haemorrhage)?
-Stop warfarin -5mg IV Vit K -Prothrombin complex concentrate (if not available FFP)
27
Acute heart failure with respiratory failure?
CPAP
28
INR 5-6 no bleeding?
-Withhold 1-2 doses -Reduce maintenance dose
29
Reverse bleeding patient on dabigitran?
Idarucizumab
30
When are SGLT-2 inhibtors useful in heart failure? - end in "flozin"
Patient on ACEi, beta blocker, aldoesterone antagonist and have reduced EF
31
CPTA negative for PE but signs DVT what invetsigation?
Proximal leg vein US
32
Definitive diagnostic tool for echocardiogram?
Echocardiogram
33
CHADVASC 0?
No anticoagulation indicated - arrange transthoracic echocardiography (exclude valvular patholgoy -Asprirn
34
type B aortic dissection?
-IV labetalol -Bedrest and conservative management
35
What antihypertensives are contraindicated in pregnancy?
ACE inhibtors - fetal abnormalities and renal failure
36
macrolides and statins?
Statin concentration can become high - increase risk of adverse effects including hepatotoxicity and rhabdomyolysis
37
Name of alpha or beta blocker used if treatment resistant hypertenison?
38
choices of prosthetic heart valve in younger patient?
Mechanical heart valve
39
What is an autograft?
-Replacing aortic valve with pulmonary valve -Pulmonary valve is replaced with valve conduit or homograft
40
What are the drawbacks of mechanical heart valve?
Lifelong anticoagulation with warfarin due to risk of thromboembolic event
41
When is an autograft used?
young patients who want to avoid anticoagulation and are willing to undergo replacement of pulmonary valve
42
What is a homograft?
Valve from deceased donor -Infective endocarditis with aortic root abscesses
43
Bioprosthetic bovine pericardial valve or biproprosethtic porcine vlave?
-Bovine (cow tissue) and porcine (pig tissue) -For older patients or cannot be on long term anticoagulation
44
INR range for patient with mechanical valve?
-2.5-3.5
45
INR range for patient with aortic mechanical valve?
3
46
INR range for patient with mitral valve?
3.5
47
Mechanism of action statins?
Inhibit HMG-CoA reductase (inhibiting hepatic cholestrol synthesis)
48
When is sacubitril-valsartan considered in HF ?
Left ventricular fraction <35% and symptomstaic with ACE/ARBs
49
What is important to remember when prescribing sacubitril-valsartan?
ACEi or ARB wash out period
50
Patient allergic to atropine?
Adrenaline
51

Final year actually useful flashcrads (6 decks)

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