Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PT 2019 > cardio - pass med > Flashcards

cardio - pass med Flashcards

1
Q

hypercalcaemia and hyperkalaemia on ECG

A
  • shortened QT interval (hi cal is qute)

- Peaked T waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Coronary arteries and regions on ECG with STEMI

A

Anterior - V1-V4 - Left anterior descending

Inferior - II, III, AVF - Right coronary artery

Lateral - V5-V6, I
-Left circumflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Warfarin stopped before surgery

A

Stop warfarin 5 days prior to surgery

  • wait for INR to be less than 1.5
  • warfarin started evening of surgery or next day

-KEPT - extrinsic, vit L - PT ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Anaphylaxis - Adrenaline doses

A

Adult - 500mg (0.5ml 1 in 1000)

6-12 years - 300mg (0.3ml 1 in 1000)

6 months - 6 years - 150mg (0.15ml in 1000)

<6 months - 150mg (0.15ml 1 in 1000)

  • repeat ever 5 minutes if necessary
  • observe for 6-12 hours

Adult self injecting - contain 0.3mg adrenaline and paediatric contain 0.15mg IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Cardiac arrest

A

30: 2 chest compressions to breaths
- adrenaline 1mg is given once chest compressions have restarted after thrid shock, and then every 3-5 minutes afterwards.

asystole/ pulseless electrical activity should be treated with 2 mins cpr prior to reasses rythm.

-ox sats of 94-98%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cardiac tamponade

A

-SOB, raised JVP, tachycardia, hypotension, muffled heart sounds, oulses paradoxus, kussamauls sign (rare), , abset y waves in JVP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Provoked pulmomary embolism - how long to give anticoagulatin for (e.g post srugery)

A

Helath pathwyas - 6-12 months

-unprovoed - long term anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PE

A
  • LMWH given straight away (unfractioned heparin) then move to vitamin K agonist (warfarin) 24 hours after
  • give LMWH + wafarin until the INR is 2
  • if big - can do thrombolysis
  • IVC filter - if repeated despite anticoagulant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

AF - new onset

A

-heparin and cardiovert if less than 48hrs

New onset AF

  • bisoprolol and oral anticoagulant for 3 weeks then electrical cardioversion
  • new onset AF - can cardiovert
  • if haemonatically stable, do not mneed to do it straight away.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cardioversion protocol - for AF

A
  • Patients must be anticoagulated or have had symptoms for less than 48 hours to reduce the risk of stroke
  • anticoagulation for 3 weeks and rate control offered.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

AF rate control

A

-first use beta blocker if that deosnt work can try combo of two below

  • beta blocker
  • diltiazem
  • digoxin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

chadsvas

A

2 or more - give anticoagulation or males with 1.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thiazide diueritc side effects

best use

A

hypokalaemia, hyponatraemia
best use is mild heart failure, and loop for reducing overload
-begining of DCT blocks Na/CL transporter (stops resorption of sodium)

other - dehydration, postural hypotension, hyponatraemia, hypokalaemia, hypercalcaemia, gout, impared glucose tollerace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Spirinolactone - how it works, side effect

SpanK - think hyperK

A
  • blocks aldosterone receptor - stops transcription of receptors being made
  • Na+ channels in the lumen - no resorption
  • decrease Na/K+ atpase pumps in membrane - so get less K plus pumped into the urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does aspirin and clopidogrel work?

A

Aspirin - inhibits production of thromboxane A2

Antiplalte - adp binds to platelet receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

narrow complex SVT tachycardia medication

A

adenosine

17
Q

S3 and S4 causes

A

S3 - volume overload (disatole)

  • normal <30
  • heard in left ventricular failure (dilated cardiomyopathy, constricte pericarditis, MR)

S4 - aortic stenosis, HOCM, HTN

  • atrial contraction against a stiff ventricle
  • HOCM a double aplical impulse may be felt as a resukt
18
Q

What is assoicated with hypothermia on ECG

A

J waves - small bumps at the end of the QRS complex

  • bradycardia
  • first degree heart block
  • long QT
  • atrial and ventricular arrythmias
19
Q

HOCM

A
  • autosomal dominant disorder
  • sudden cardiac death in young patients
  • SOB, angina, syncope, sudden death (arrhythmias)

Echo findings - mnemonic - MR SAM ASH
mitral regurgitation (MR)
systolic anterior motion (SAM) of the anterior mitral valve leaflet
asymmetric hypertrophy (ASH)

20
Q

LV hypertrophy

A
  • Pressure overload due to AS or HTN
  • Thickened LV wall leads to prolonged depolarisation (increased R wave peak) and delayed repolarisation (ST and T wave abnormalities) in lateral leads

-increased S wave depth in right sided leads

21
Q

Hypokalaemia

A

In hypokalaemia U have no Pot and no T but a long PR and a long QT

22
Q

INR levels and recommendation

A

Major bleed - stop warfarin, give IV vit K 5mg, Prothrombin complex concentrate or FFP

INR >8 + minor bleed - stop warfarin, give IV vit K 1-3mg, repeat vit K if INR still too high after 24 hours, restart warfarin with inr <5

INR>8 - stop warfarin , give vit K 1-5mg by mouht, repeat vit K, restart when INR <5

INR 5-8 w bleed- stop warfarin, give IV vit K 1-3mg, restart when inr <5

Inr 5-8 no bleed - withhold 1-2 doses of warfarin, reduce maintenance dose

23
Q

why should verapamil and beta blocker not be given together?

A

-can get heart block

24
Q

Takotsubo cardiomyopathy

A 
Features
chest pain
features of heart failure
ST elevation
normal coronary angiogram
25
Q

SVT

A

1st - valsalva (blocks av nodes and stop tachycardia caused by a reentrant pathway)

  • Electrical cardioversion - only if there is syncope and shock
  • adenosine - only if valsalva manoeurere does not succeed in stopping the tachycardia

-beta blockers - not initially indicated as they do not block AV node so would not slow tachycardia

26
Q

CPR how to shock VT/VF

A

1 shock then 2 min CPR

-if in coronary care unit can give 3 shocks

27
Q

MI stages on ECG

A

Acute myocardial infarction (MI)
hyperacute T waves are often the first sign of MI but often only persists for a few minutes
ST elevation may then develop
the T waves typically become inverted within the first 24 hours. The inversion of the T waves can last for days to months
pathological Q waves develop after several hours to days. This change usually persists indefinitely

28
Q

If INR is <2 on warfarin - what to do?

A

-need to give a low molecular weight heparin until INR is 2 and increase dose of warfarin

29
Q

warfarin

A

Factors that may potentiate warfarin
liver disease
P450 enzyme inhibitors, e.g.: amiodarone, ciprofloxacin
cranberry juice
drugs which displace warfarin from plasma albumin, e.g. NSAIDs
inhibit platelet function: NSAIDs

Side-effects
haemorrhage
teratogenic, although can be used in breastfeeding mothers
skin necrosis: when warfarin is first started biosynthesis of protein C is reduced. This results in a temporary procoagulant state after initially starting warfarin, normally avoided by concurrent heparin administration. Thrombosis may occur in venules leading to skin necrosis
purple toes

30
Q

Asystole - how to do CPR

A
  • give adrenaline
  • CPR + 2 min check activity
  • no atropine
31
Q

Medication for AF

A
  1. Beta blocker
  2. Calcium channel blocker
  3. digoxin
    - NEVER give calcium channel blcoker and beta blocker togehte r- heart block

PT 2019 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions