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Zero to Finals Medicine > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Risk factors to assess for cardiac disease?

A

Smoking, alcohol, obesity, diabetes, low exercise, kidney disease, atypical antipsychotics

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2
Q

What scoring system do you use to assess stroke and myocardial infarction risk?

A

QRISK 3 score

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3
Q

What medication should you consider for primary prevention of cardiovascular disease and in what instances?

A

If QRISK 3 >10% of stroke/MI in 10 years then start atorvastatin 20mg OD at night.
OR
in CKD or Type I diabetes

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4
Q

What should you check if you are starting a statin and why?

A

You should check lipids, after 3 months you should see a 40% reduction in non HDL cholestrol.

Check LFTs at 0, 3 and 12 months. Transient increase in ALT and AST is nomral but not more than 3x normal

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5
Q

What is the treatment regime for secondary prevention of cardiac events?

A

AABS

Asprin and clopidogrel
ACE inhibitor
Beta blocker
Statin

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6
Q

What is the difference between stable and unstable angina

A

Stable angina only happens with exercise
Ustable angina happens even at rest

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7
Q

What investigations should you do for Angina

A

Physical examination
ECG
Bloods - U&Es, LFTs, FBC, lipids, thyroid, Hba1c
CT coronary angiogram

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8
Q

What is the correct GTN usage ?

A

Spray under tounge , again at 5 minutes, at 10 minutes if there is still pain call 999

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9
Q

Secondary prevention of cardiac disease

A

Aspirin and clopidogrel
ACE inhibitor
Beta blocker
Statin

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10
Q

What is an NSTEMI

A

Raise Troponin levels alongside ST depression, T wave inversion or pathological Q waves

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11
Q

When should you take troponin levels?

A

At onsent, 6 hours and 12 hours

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12
Q

What is the acute NSTEMI treatment (medical)

A

BATMAN
Betablockers
Aspirin - 300mg
Ticagrelor 180mg or clopidogrel
Moprhine
Anticoagulant - enoxaparin
Nitrates

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13
Q

What is dresslers syndrome?

A

Pericarditis 3 weeks after an MI

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14
Q

How does dresslers syndrome present

A

Pleuritic chest pain

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15
Q

What are the signs of dresslets syndrome

A

Pericardial rub,
ECG global ST elevation and T wave inversion
Raised CRP and ESR

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16
Q

What is the treatment for dresslers syndrome?

A

NSAIDs and Steroids

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17
Q

What is the secondary prevention medication for MIs

A

6As,
Aspirin
Another antiplatelet
Atorvastatin
ACE inhibitors
Atenolol
Aldosterone anatagonist

18
Q

What are the best investigations for congestive heart failure?

A

B-type natriuretic peptide
Echocardiogram looking for ejection fraction

19
Q

What is the managment of acute left ventricular failure

A

POUR SOD
Pour away the fluids
Sit up
Oxygen
Diuretics

20
Q

What might you see on Xray in pulmonary oedema ?

A

Fluid in the fissures
Bi lateral pleaural effusions
Kerley lines

21
Q

What blood test can you check in chronic heart failure and what action should it prompt

A

N-terminal pro-B-type natriuretic peptide
If over 2000 ng/L then urgent referral to cardiology

22
Q

First line treatment for chronic heart failure?

A

ABAL

ACE inhibitor
Beta blocker
Aldosterone antagonist spironolactone or eplerenone
Loop diuretics

23
Q

What is Cor Pulmonale?

A

Right sided heart failure caused by lung disease

24
Q

What is the treatment algorithm for hypertension

A

step 1
Young = ACE inhibitor
Old Black = Calcium channel blocker

Step 2
Not black = ACE inhibitor and Calcium channel blocker
Black = Candesartan + Calcium channel blocker

Step 3
ACE inhibitor + Calcium channel blocker + Thiazide like diuretic (indapamide)

25
Q

What is candesartan and what is the usual dosage?

A

Angiotensin II recpetor blocker
8mg - 32mg OD

26
Q

What should you use if thiazide like diuretics are causing too much hypokalaemia ?

A

Use spironolactone

27
Q

What is indapamide and what is the usual dosage?

A

thiazide like diuretic 2.5mg OD

28
Q

What makes the S1 and what makes S2 heart sounds?

A

S1 Tricuspid and Mitral valves
S2 Pulmonary and Aortic valves

29
Q

What murmur is an ejection systolic high pitched murmer

A

Aortic Stenosis

30
Q

What causes a pan systolic whisteling murmor?

A

Mitral regugitation

31
Q

What causes a rumbling diastolic murmur?

A

Mitral Stenosis

32
Q

What is the target INR for a bioprosthetic valve?

A

2-3 INR

33
Q

When is rythm control the preffered 1st option rather than rate control in AF?

A

Reversible cause of AF
New onset less than 48 hours
It is causing Heart failure
Symptomatic after rate control

34
Q

What are the rate control options for AF

A

Beta Blocker Atenolol 50 mg
Calcium Channel Blocker diltiazem
Digoxin

35
Q

What is the calcium channel blocker of choice for Rate control in AF

A

Diltiazem

36
Q

You have indetified your AF patient should have cardioversion. What are the two types?

A

if new AF then immediate cardioversion

if longstanding AF then delayed cardioversion ( Anticoagulation for 3 weeks prior to cardioversion

37
Q

What is the first line drug for pharmacological cardioversion of AF

A

Flecanide
or
Amiodarone

38
Q

What are your options for long term rythmn control in AF

A

Beta blockers
Dronedarone
Amidodarone

39
Q

What is the halflife of warfarin

A

1-3 days

40
Q

What is the halflife of DOACs

A

12 hours

41
Q

What is in HASBLED

A

hypertension
abnormal renal fucntion
stroke
bleeding
liabile INR
Elderly
Drugs

42
Q
A

Zero to Finals Medicine (10 decks)

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