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Medicine - Zero to Finals > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Atherosclerosis

A

atheromas (fatty deposits) with sclerosis (hardening, stiffening) of blood vessel walls

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2
Q

What cases atherosclerosis?

A

Chronic inflammation and activation of immune system -> deposition of lipids, building up the atheromatous plaques

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3
Q

What do atherosclerotic plaques cause?

A

Stiffening - hypertension, Stenosis - reduced blood flow, Plaque rupture - giving off a thrombus

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4
Q

Atherosclerosis modifiable risk factors

A
  • Cholesterol
  • Smoking
  • Alcohol
  • Poor diet (high fat and sugar)
  • Low exercise
  • Obesity
  • Poor sleep
  • Stress
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5
Q

Atherosclerosis non modifiable risk factors

A
  • Old age
  • Family history
  • Male
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6
Q

Medical conditions increasing risk of atherosclerosis

A
  • Diabetes
  • HTN
  • CKD
  • RA
  • atypical antipsychotic medications
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7
Q

End results of atherosclerosis

A
  • Angina
  • MI
  • TIA
  • Stroke
  • Peripheral vascular disease
  • Mesenteric ischaemia
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8
Q

QRISK 3 score

A

% risk of pt having a stroke or MI in the next 10 years

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9
Q

QRISK 3 >10%

A

> 10% risk of stroke or MI in the next 10 years

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10
Q

QRISK 3 >10% treatment

A

Statin (atorvastatin 20mg at night)

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11
Q

Exercise - per week, recommended by NICE

A

Aerobic activity 150 min moderate intensity, or 75 min vigorous intensity

Strength training activity at least 2x week

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12
Q

2* prevention of CVD 4As

A

Aspirin (+2nd antiplatelet for 12mths)
- Atorvastatin 80mg
- Atenolol (or bisoprolol)
- ACE inhibitor (ramipril)

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13
Q
A
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14
Q

Statin side effects

A
  • Myopathy (check creatinine kinase)
  • T2D
  • Haemorrhagic stroke
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15
Q

Stable angina

A

Relieved by rest or glyceryl trinitrate

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16
Q

Unstable angina

A

Symptoms start randomly while at rest -> acute coronary syndrome

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17
Q

Angina management - RAMP

A

Refer to cardio
Advice about management and when to call ambulance
Medical treatment
Procedural or surgical interventions

18
Q

GTN spray use

A

(immediate symptomatic relief of Angina)
GTN, repeat after 5min, if still pain after 5 min - call ambulance

19
Q

Long term relief of angina (2 drugs)

A

B Blocker (Bisoprolol 5mg 1x)
Calcium channel blocker (Amlodipine 5mg 1x)

20
Q

2* prevention of angina

A

Aspirin (75mg 1x)
Atorvastatin (80mg 1x)
ACE inhibitor

21
Q

Surgery for angina

A

PCI - percutaneous coronary intervention with coronary angioplasty - dilating the blood vessel with balloon or inserting a stent

22
Q

Acute Coronary Syndrome

A

When thrombus from atherosclerotic plaque blocks off a coronary artery (usually made from platelets)

23
Q

Acute Coronary Syndrome treatment

A

Anti platelet medications: aspirin, clopidogrel, ticagrelor

24
Q

3 types of acute coronary syndrome

A

unstable angina
STEMI
NSTEMI

25
Q

STEMI signs on ECG

A

ST elevation
New LBBB

26
Q

If no ST elevation on ECG:

A
  • if raised troponin + other ECG changes = NSTEMI
  • if normal troponin + no ECG changes = unstable angina or MSK pain
27
Q

NSTEMI signs on ECG

A
  • ST depression
  • T wave inversion
  • Pathological Q waves (late sign)
28
Q

Left coronary artery /heart area/ leads

A

Anterolateral / I, aVL, V3-6

29
Q

LAD /heart area/ leads

A

Anterior / V1-4

30
Q

Circumflex a / heart area/ leads

A

Lateral / I, aVL, V5-6

31
Q

Right Coronary Artery /heart area/ leads

A

Inferior / II, III, aVF

32
Q

What are the types of Troponins?

A

Troponin I, Troponin T

33
Q

Alternative causes of raised troponin

A

CKD
Sepsis
Myocarditis
Aortic dissection
PE

34
Q

Pt presenting with STEMI within 12h of symptom onset

A

Primary PCI (within 2h of presentation)
Thrombolysis (if PCI not available within 2h)

35
Q

Percutaneous Coronary Intervention

A

Done to keep artery open; gap is widened or blockage aspirated/removed

36
Q

Thrombolysis

A

Injecting fibrinolytic (to break down fibrin) to dissolve clots (eg streptokinase, alteplase, tenecteplase)

37
Q

Acute NSTEMI treatment

A

BATMAN
B Blockers
Aspirin 300mg stat
Ticagrelor 180mg stat (or 300mg clopidogrel)
Morphine
Anticoagulant (fondaparinux)
Nitrates (GTN to relieve coronary artery spasm)
+ Oxygen if sats dropping <95%

38
Q

MI complications

A

Death
Rupture
E (heart failure)
Arrythmia and Aneurysm
Dressler’s syndrome

39
Q

Dressler’s syndrome

A

Localised immune response and pericarditis 2-3 weeks after MI. Pleuritic chest pain, pericardial rub and effusion, pericardial tamponade.

40
Q

Dressler’s syndrome management

A

Pericardiocentesis - to remove fluid
NSAIDs (Aspirin, ibuprofen) or steroids (prednisolone)

41
Q

GRACE score

A

6mth death risk or repeat MI risk post NSTEMI (>10% is high risk)

42
Q
A

Medicine - Zero to Finals (1 decks)

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