Cardiology Flashcards
Which nerve is responsible for pain radiating to the shoulder when have pericarditis?
phrenic nerve- this nerve supplies the pericardium
What is classically associated with a sawtooth appearance on an ECG?
Atrial Flutter
First, second line treatment to reduce stroke risk in AF?
First line: DOACs- apixaban, dabigatran, edoxaban, rivaroxaban
Second line: Warfarin
Side effects of nicotinic acid? (Niacin)
Flushing: mediated by prostaglandins
Impaired glucose tolerance
Myositis
What causes acute mitral regurgitation?
Ischaemia or rupture of papillary muscles
Timeline of MI histology findings
0-24hrs: early coagulative necrosis, neutrophils, wavy fibres, hyper contraction of myofibrils. High risk of ventricular arrhythmia, HF and cardiogenic shock
1-3 days: Extensive coagulative necrosis, neutrophils (associated with fibrinous pericarditis)
3-14 days: macrophages + granulation tissue at margins. high risk of free wall rupture, papillary muscle rupture and LV pseudo aneurysm
2weeks- several months: dressler syndrome, contracted scar complete, HF, arrhythmia, mural thrombus
How do the vertebral arteries enter the cranial cavity?
Through the foramen magnum
P.s. if someone tilts there head back, like washing hair in a salon, the vertebral artery can be dissected
What is heparin mechanism of action?
Activates antithrombin III
Thiazide diuretic side effects
Dehydration Postural hypotension Hyponatraemia, hypokalaemia, hypercalcaemia Gout Impaired glucose tolerance Impotence
Which nerve regulates the baroreceptors reflect correcting an acute decrease in arterial blood pressure- in the aortic arch!!?
Vagus nerve
Which nerve regulates the baroreceptors reflect correcting an acute decrease in arterial blood pressure- in the carotid sinus?
Glossopharyngeal nerve
What is the mechanism of action of adenosine?
A1 receptor agonist
Mechanism of action of warfarin
Inhibits epoxide reductase preventing vitamin K from being converted to it’s activated form
What do all the different troponin do in skeletal and cardiac muscle contraction:
troponin C- binds to calcium ions
troponin T- binds to tropomyosin, forming a troponin-tropomyosin complex
Troponin I- binds to actin to hold the troponin-tropomyosin complex in place
If you get painless loss of vision with a stroke, where is the lesion?
Either ophthalmic artery or central retinal artery (branch of ophthalmic artery)
And ophthalmic artery is a branch of the internal carotid artery
Complications from CABG
Atrial fibrillation (30-40%) Stroke (2%)
What is administered as first line treatment for significant hypercalcaemia?
Calcium chloride
What is varicocele and what does it suggest
When veins in your scrotum swell and get larger- “bag of worms”. Most often on the left
Can indicate left renal tumour
When do you do pre-operative U&Es?
If patient over 60 years old Cardiovascular and renal disease Diabetics and patients on steroids Diuretics ACE inhibitors
How do ACEI affect eGFR?
Some reduction in GFR is expected because of haemodynamic changes within the kidney.
What does this all mean:
A) Normal urine + normal stools
b) dark urinalysis + normal stools
C) dark urine + pale stools
A= pre-hepatic cause b= hepatic cause C= post-hepatic cause (obstructive)
What is sclera icterus?
Also known as conjunctival icterus
Yellowish pigmentation of the sclera- normally white part of the eye
What is Gilbert’s syndrome?
Isolated elevation of bilirubin, and specific elevation of unconjugated bilirubin
Lack of risk factors for hepatitis
What is the MELD score used to measure?
Severity of Cirrhosis based on: Serum bilirubin INR Sodium Creatinine Need for dialysis
