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Y5 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Stable vs unstable angina (Time till GTN relief)

A

20 mins

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2
Q

Risk tool for ACS

A

GRACE 2 Score

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3
Q

What is killip score

A

Use of fluid overload signs to predict 30 day mortality for ACS

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4
Q

Type 1 MI

A

Secondayr to coronary artery disease

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5
Q

Type 2 MI

A

Supply vs demand mismatch e.g. anaemia, bleed, prolonged tachyarrythmias (no plaque disruption)

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6
Q

What is prinzmetal angina

A

Vasospastic angina, where coronary artery spasms and suddenly narrows.

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7
Q

What is type 3 MI

A

Someone dies of MI before confirmation by raised trop (can be changed to 1 if thrombosis found on autopsy)

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8
Q

1st line anti-anginal

A

Beta blocker or CCB monotherapy

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9
Q

2nd line anti-anginal

A

If mono not tolerated switch, if mono tolerated add the other

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10
Q

3rd line anti-anginal

A

If bitherapy not tolerated, ISMN, Ivabradine, nicorandil

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11
Q

Never give to treat anginal

A

Beta-blocker + verapamil/diltiazem.

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12
Q

Timing for trop levels

A

0h and 2h (if >250 no need to repeat)

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13
Q

Immediate management ACS

A

Single/dual antiplatelet (300mg aspirin)
Give ticagrelor if trop rise (180mg)
Oxygen
GTN
Morphine

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14
Q

2 main non cardiac causes of raised trop

A

Renal failure
Sepsis

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15
Q

Ischaemic ECG changes

A

T wave peak or depression
ST elevation or depression

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16
Q

V1 ECG region

A

Septal

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17
Q

V2-V4 ECG region

A

Anterior

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18
Q

What leads to assess bundle branch block

A

V1 + V6

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19
Q

Why not thrombolise pts with MI presenting after 12 hours onset of symptoms

A

Risk of CA rupture (clot has organised)

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20
Q

Everyone who has ACS gets a what

A

Echocardiogram

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21
Q

Secondary management of MI

A

ACEi or ARB
Dual anti-platelet
Beta blocker
Statin

22
Q

Becks triad

A

Raised JVP
Hypotension
Muffled heart sounds

23
Q

Cushings triad

A

High systolic pressure/wide pulse pressure
Bradycardia
Irregular breathing

24
Q

AF causes

A

MITRAL AF

M - Mitral valve disease
I - Infection/IHD
T - Thyrotoxicosis
R - Raised BP
A - Alcohol
L - Lung pathology

25
Q

Explain Mobitx type 1

A

PR progressively increases followed by dropped beat

26
Q

Mobitz type 2

A

Intermittent failure of QRS, usually ratios e.g. 3 beats drop etc.

27
Q

Third degree heart block

A

Complete dissociation between P and QRS

28
Q

Mx heart block

A

If stable, observe
If unstable (type 2 or complete) - IV atropine 500mcg.
Can repeat up to 6 doses
Transvenous cardiac pacing

29
Q

NYHA Class of HF

A

1 - No limitation
2 - Slight limitation
3 - marked limitation
4 - severe limitation (symptoms at rest)

(of physical activity)

30
Q

Healthy ejection fraction

A

> 50%

31
Q

Mid-range ejection fraction

A

40-50%

32
Q

Systolic HF (ejection fraction)

A

<40%

33
Q

Management of chronic HF

A

1st ACEi + Beta blocker (+loop diuretic if oedema)
2nd Aldosterone antagonist
3rd Digoxin

34
Q

Mx of acute pulmonary oedema

A

POND

P - Position (upright)
O - Oxygen
N - Nitrates (IV isosorbide mononitrate)
D - diuretic (IV Furosemide)

35
Q

Chronic limb ischaemia

A

Narrowing or occlusion of peripheral blood vessels
FONTAINE Classification

36
Q

Test for chronic limb ischaemia

A

Beurgers test.
Lift legs, if pink beyond 20 degrees then negative
If pallor then positive

37
Q

Normal ABPI

A

0.9 - 1.2

38
Q

6 P’s of limb ischaemia

A

Pain
Paralysis
Paraethesia
Pulselessness
Pallor
Perishingly Cold

39
Q

Immediate management of acute limb ischaemia

A

IV Heparin + treat underlying cause

40
Q

Reperfusion injury

A

Sudden return of blood from anoxia
Inflammatory response, oxidative damage and capillary leakage

41
Q

AAA definition

A

Dilation of >3cm

42
Q

If AAA <4.5cm

A

Rescan 12 months

43
Q

If AAA <5.5

A

Rescan 3 months

44
Q

If AAA >5.5cm

A

Surgical repair, 2WW referral

45
Q

What is Grey-Turners sign

A

Sign of AAA rupture
Bleeding into retroperitoneal space, bruising on hips/back

46
Q

Varicose vein pathophysiology

A

Venous valvular insufficiency, backflow of blood and hence vein distension

47
Q

Hemosiderin

A

Haemoglobin breakdown, circular red discolouration

48
Q

Venous eczema

A

Pooling causes inflammation, skin becomes itchy dry + flaky

49
Q

Lipodermatosclerosis

A

Skin and soft tissue become fibrotic and tight. Stocking distribution

50
Q

Duplex USS

A

Speed and volume of blood flow assessing venous insufficiency

51
Q

PE management

A

Thrombolysis Alteplase
Acute - DOAC e.g. Apixaban (2nd line LMWH e.g. Enoxaparin)
Chronic - Anticoag for 3mo if caused
6mo if unprovoked

Y5 (11 decks)

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