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Holy Grail Docs > Cardio treatments > Flashcards

Cardio treatments Flashcards

1
Q

what are the 3 steps in treatment of unstable angina + NSTEMI?

A

1) MONA C
2) could add fondaparinux (similar to LMWH)
3) Revascularisation
- PCI
- Thrombolysis if too late
- CABG (if >3 vessels affected)

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2
Q

what are the steps in treatment of STEMI?

A

1) diaMorphine + anti-emetic (metoclopramide)
2) oxygen
3) GTN
4) Aspirin (300mg chewed)
5) Clopidogrel/tricagrelor 300mg
6) PCI (angioplasty) within 90 mins
- Thrombolysis if PCI unavailable (streptokinase + aspirin)
7) emergency angioplasty if this fails

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3
Q

what are the contradindications for emergency angioplasty?

A 
trauma
haemorrhage
ulcers
recent surgery
severe hypertension
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4
Q

what is PCI?

A

percutaneous coronary intervention

AKA angioplasty with stent

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5
Q

what are the 5 stages of treatment for stable angina?

A

1) GTN
2) secondary prevention: aspirin, ACE, statins
3) beta blockers/CCBs(amlodipine)
4) isosorbide mononitrate/ivabradine
5) CABG/PCI

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6
Q

how is heart failure investigated?

A

1) transthoracic ECHO
- systolic = low ejection fraction
- diastolic = LVH
2) ECG
3) CXR
4) FBC

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7
Q

what is the treatment for acute heart failure?

A

1) sit up
2) oxygen
3) IV furosemide
4) IV diamorphine

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8
Q

what is the treatment for chronic heart failure?

A

1) lifestyle advice
2) furosemide + bendroflumethiazide at start
3) ACE + Beta blockers
4) Spironolactone
5) Digoxin, ivabradine
6) other vasodilators - nitrates, hydralazine
7) ICD/CRT (if LBBB)
8) CABG (check eligibility via catheterisation)
9) cardiac transplant

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9
Q

what are the stages of treatment in SVT?

A

1) vagal manoeuvres: Valsalva movement/carotid massage (massage only in young and fit)
2) IV adenosine
3) IV verapamil

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10
Q

what are the steps in treatment of atrial fibrillation?

A

1) digoxin + CCB/Beta blocker
2) AAD class I (disopyramide) and III (amiodarone)
3) DC cardioversion if able to cardiovert (paroxysmal/persistent)
4) If permanent then AV node ablation or pacing in older patients
5) anticoagulate for stroke risk (esp in prosthetic valves)

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11
Q

what are the steps in treatment of atrial flutter?

A

1) amiodarone
2) DC cardioversion
3) RF ablation
4) anticoagulation

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12
Q

what are the steps in treatment of ventricular tachycardia?

A

1) Unstable = DC cardioversion
2) pulseless = defibrillation
3) stable = class 1 (disopyramide) + class III (amiodarone)
4) calcium chloride if hyperkalaemia
5) ICD (if life threatening)

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13
Q

what is the treatment for ventricular fibrillation?

A

1) defibrillation
2) IV magnesium chloride
3) ICD (first line long term)

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14
Q

what is ICD?

A

implantable cardiac defibrillator

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15
Q

what is torsades de pointes?

A

polymorphic ventricular tachycardia

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16
Q

what is the treatment fot torsades de pointes?

A

1) IV magnesium chloride
2) isoprenaline
3) pacemaker

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17
Q

what is the treatment for sinus bradycardia?

A

1) IV atropine

2) pacing (permanent if sick sinus syndrome)

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18
Q

how is 1st degree heart block treated?

A

stop block medications

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19
Q

how is2nd degree heart block treated?

A

mobitz type 1 = stop block medications

Mobitz type 2 = pacemaker + atropine

20
Q

how is 3rd degree heart block treated?

A

pacemaker + atropine

21
Q

what is the treatment for bundle branch block?

A

1) IV atropine

2) Pacemaker

22
Q

what is the treatment for mitral regurgitation?

A

1) diuretics and ACE
2) surgical
- repair = prolapse
- replacement = degenerative
3) percutaneous
- clips in infancy

23
Q

what is the treatment for mitral stenosis?

A

1) diuretics, beta blockers, digoxin (treat AF)
2) mitral valve replacement
3) balloon valvotomy

24
Q

what is the treatment for aortic regurgitation?

A

1) diuretics and ACE

2) aortic valve replacement

25
Q

what is the treatment for aortic stenosis?

A

1) aortic valve replacement
2) balloon valvotomy
3) TAVI

26
Q

what is the treatment for empirical native valve infective endocarditis?

A

amoxicillin + gentamicin

27
Q

what is the treatment for empirical prosthetic valve infective endocarditis?

A

vancomycin + gentamicin

28
Q

what is the treatment for staph aureus infective endocarditis?

A

flucoxacillin

29
Q

what is the treatment for MRSA endocarditis?

A

vancomycin + gentamicin + rifampicin PO

30
Q

what is the treatment for strep viridans endocarditis?

A

penicillin + gentamicin

31
Q

what is the treatment for strep epidermidis endocarditis?

A

vancomycin + gentamicin + rifampicin PO

32
Q

what is the treatment for enterococcus/HACEK endocarditis?

A

amoxicillin/vancomycin + gentamicin

33
Q

what is the treatment for intermittent claudication?

A

1) lifestyle advice
2) antiplatelets to increase walking distance
3) surgery in severe cases
- angioplasty +/- stent via femoral artery
- bypass grafts
- amputation

34
Q

what are the steps in treatment of acute lower limb ischaemia (PE/DVT)?

A

1) heparin, warfarin if severe (MI/AF assoc)
2) angioplasty
3) graft thrombolysis
4) bypass grafting
5) surgery - embolectomy

35
Q

when does an AAA require intervention?

A

> 5.5 cm
grown more than 1cm in past year
symptomatic

36
Q

what is the treatment for AAA?

A

1) lifestyle advice
2) fitness testing
3) EVAR
4) open surgery

37
Q

how is DVT treated?

A

1) anticoagulation
2) phlegmasia dolens - caval filters
3) compression (TED) stockings

38
Q

how are varicose veins treated?

A

stockings
foam sclerotherapy
endovenous ablation

39
Q

what is thrombophlebitis?

A

infection that causes a blood clot to form and occlude a vessel (usually in the legs)

40
Q

what is the treatment for thrombophlebitis?

A

analgesics
elevation of limb
fondaparinux

41
Q

what is the treatment for a stroke?

A

1) ABCDE, Oxygen
2) thrombolysis
3) hemicraniectomy
4) long term = address risk factors

42
Q

what is the treatment for hypertrophic cardiomyopathy?

A

1) treat symptoms, prevent sudden death
2) low risk = amiodarone
3) medium risk = Beta blockers + verapamil
4) high risk = ICD

43
Q

what is the treatment for dilated cardiomyopathy?

A

1) heart failure management
2) cardiac resynchronisation therapy
3) high risk = ICD

44
Q

what is the treatment for arrythmogenic right ventricular cardiomyopathy?

A

non-life threatening = beta blockers

symptomatic = amiodarone, soltalol

45
Q

what is the treatment for myocarditis?

A

1) treat underlying cause (eg remove drugs, treat infection)
2) bed rest, avoid athletics
3) ACE, beta blockers, spironolactone, digoxin

46
Q

what is the treatment for pericarditis?

A

NSAIDs - ibuprofen

Holy Grail Docs (39 decks)

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