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Revision > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Angina first line management

A

Beta blocker/ccb

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2
Q

Angina management

A
  1. Aspirin, statin, s/l GTN to abort angina attacks.
  2. Beta-blocker or CCB.
    If CCB used as monotherapy, a rate-limiting one such as verapamil or diltiazem should be used.
    If used in combination with a beta-blocker then use a longer-acting dihydropyridine calcium channel blocker (e.g. amlodipine, modified-release nifedipine)
  3. Titrate medications to max tolerated doses.
  4. If still symptomatic after monotherapy with a beta-blocker add a calcium channel blocker and vice versa.
  5. If can’t do step 4 then add one of:
    a long-acting nitrate
    ivabradine
    nicorandil
    ranolazine
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3
Q

What can’t you prescribe with a beta blocker

A

Verapamil (risk of complete heart block)

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4
Q

What is used to treat torsades

A

IV magnesium

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5
Q

Becks triad

A

For tamponade
Muffled HS
Raised JVP
Low bp

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6
Q

How to screen for ADPCKD

A

USS

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7
Q

Hypokalaemia ECG changes?

A

PR prolongation and flattened T waves

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8
Q

When could you cardiovert for AF

A

If within 48h.
If not need to anticoagulate and wait 3 weeks.

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9
Q

How is familial hypercholesterolaemia treated in pregnancy?

A

colesevalm. (Bile salt thing)
Only thing thats safe in pregnancy/ breastfeeding.

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10
Q

What criteria is used to diagnose familial hypercholesterolaemia?

A

Simon Broome.

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11
Q

What would make you suspect familial hypercholesterolaemia

A

TC > 7.5 mmol/L

+/-

A personal or family history of premature coronary heart disease (event u 60).

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12
Q

How to clinically diagnose familial hypercholesterolaemia

A

Use Simon Broome criteria:
In adults total cholesterol > 7.5 and LDL > 4.5

plus:
for definite FH: tendon xanthoma in patients or 1st or 2nd degree relatives or DNA-based evidence of FH

for possible FH: family history of myocardial infarction below age 50 years in 2nd degree relative, below age 60 in 1st degree relative, or a family history of raised cholesterol levels

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13
Q

What are you looking for when assessing response to statin in familial Hypercholesterolaemia?

A

aim to achieve at least a 50% reduction in LDL

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14
Q

How would you treat familial hypercholesterolaemia?

A

Atorva 20 or rosuva 10.
Atorva 20 if renal impairment.

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15
Q

Hypercalcaemia ecg changes

A

Shortened QT
Osborn (J) waves if severe.

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16
Q

Hypocalcaemia ECG changes

A

prolonged QT

17
Q

Hypokalaemia ECG changes

A

Flattened T
ST depression
U waves

18
Q

Hypomagnaesaemia ECG changes

A

Tall T
ST depression

19
Q

Hypermagnaesaemia ECG changes

A

Prolonged PR
Widened QRS

20
Q

When can you cardiovert AF?

A

If within 48h

21
Q

What condition is a rate limiting CCB C/I

A

Heart failure

22
Q

What chadsvasc score would you anticoagulate

A

Greater than or equal to 2
Consider in men with score of 1.

23
Q

Rumbling mid diastolic murmur

A

Mitral stenosis

24
Q

What is Dresslers syndrome?
When does it happen?

A

2-6 weeks after MI

Fever, pleuritic pain, pericardial effusion and a raised ESR.

It is treated with NSAIDs.

Autoimmune.

25
Q

How is LV aneurysm treated

A

Anticoag

26
Q

After which MI is AV block more common?

A

Inferior.

27
Q

Which vessel is affected in inferior MI

A

Right coronary

28
Q

Which territory is LAD

A

V1->v4 (anterior

29
Q

Which territory is Lcx?

A

V5v6, 1 and AVL

30
Q

Which meds do you need to be careful with in first degree heart block

A

Beta blockers, rate limiting CCBs, dig.

31
Q

When would warfarin be favoured over DOAC

A

Severe liver impairment, eGFR below 30, weight over 120 kg

32
Q

Which valvular complication do you get post MI and why?

A

Mitral regurgitation due to rupture of papillary muscles.

33
Q

Which valve is most commonly affected in endocarditis

A

Mitral

34
Q

MR murmur

A

pan systolic

35
Q

ST depression with TWI v5 and v6

A

Digitalis effects (reverse tick).

36
Q
A

Revision (29 decks)

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