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Year 4 Finals > Cardiology > Flashcards

Cardiology Flashcards

(55 cards)

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1
Q

What is the first line IV drug to be given in hypertensive crisis?

A

Labetolol

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2
Q

Amlodipine most often disrupts which organ system?

A

Gastrointestinal
- can be diarrhoea or constipation

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3
Q

What is the max percentage of drop in eGFR recommended before changing medication when administering ramipril?

A

25%

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4
Q

What is the most appropriate treatment to give to relieve acute angina symptoms?

A

GTN spray

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5
Q

What is the first line medication prescribed for anti-angina?

A

Beta blocker (bisoprolol)
- if C/I use calcium channel blocker such as verapamil or diltiazem
- do NOT combine bisoprolol with verapamil/diltiazem due to risk of heart block

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6
Q

What is the second line medication prescribed as an anti-anginal in combination with bisoprolol?

A

Long acting CCB (amlodipine, nifedipine)
- do NOT combine bisoprolol with short acting CCB (verapamil, diltiazem)

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7
Q

After how long should a patient repeat a GTN spray dose if they still have chest pain?

A

5 minutes

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8
Q

What GTN spray side effects are important to council patients on?

A

Headache, dizziness

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9
Q

Cor pulmonale describes heart failure of which side of the heart?

A

Right

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10
Q

What is the first line diagnostic investigation in angina patients?

A

CT coronary angiogram

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11
Q

How long might troponin stay elevated in cases of MI?

A

2 weeks

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12
Q

Which 2 CCB’s are C/I in heart failure?

A

Diltiazem and verapamil

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13
Q

Torsades de Pointes is managed via what?

A

IV magnesium sulfate

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14
Q

How is ventricular tachycardia managed in:
- stable patients
- unstable patients (shock/syncope)

A
  • stable - IV amiodarone
  • unstable - DC cardioversion; follow by repeat DC cardioversion and IV amiodarone if first not successful
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15
Q

Torsades de Pointes is associated with which metabolic disturbance?

A

Hypocalcaemia

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16
Q

Which drug should be utilised in AF in those with pre-existing heart failure?

A

Digoxin

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17
Q

Delta waves on ECG are indicative of what syndrome?

A

Wolff-Parkinson White syndrome

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18
Q

With regards to ECG interpretation:
Deflection in lead I to become negative plus deflection in lead III to become positive indicates what?

A

Right axis deviation

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19
Q

What is the most common cause of right axis deviation in the ECG?

A

Right ventricular hypertrophy

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20
Q

In regards to ECG interpretation:
Deflection in lead I to become more positive plus deflection in lead III to become more negative indicates what?

A

Left axis deviation

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21
Q

What is the most common cause of left axis deviation in the ECG?

A

Conduction defects
- can also be caused by left ventricular hypertrophy

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22
Q

In regards to ECG interpretation:
Changes in leads V1 and V2 indicate pathology in which heart location?

A

Anterior
- via left anterior descending artery

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23
Q

In regards to ECG interpretation:
Changes in leads V5, V6 and I indicate pathology in which heart location?

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A

Lateral
- via circumflex artery

24
Q

In regards to ECG interpretation:
Changes in leads V3 and V4 indicate pathology in which heart location?

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A

Anterior
- via left anterior descending artery

25
In regards to ECG interpretation: Changes in leads II, III and aVF indicate pathology in which heart location?
Inferior - via right coronary artery
26
What is a normal PR interval?
120-200ms (3-5 small squares)
27
Consistently prolonged PR internal with no QRS dropping is indicative of which type of heart block?
First degree
28
Which types of non-pathological heart block may be seen in athletes via increased vagal tone?
First degree and second degree Mobitz type 1 (Wenckebach)
29
Name 3 drugs that can lead to heart block
Beta blockers, CCBs, digoxin
30
Increasing PR interval with QRS drop is indicative of which type of heart block?
Second degree Mobitz type 1 (Wenckebach)
31
Consistent PR interval with QRS drop is indicative of which type of heart block?
Second degree Mobitz 2
32
Statins should not be co prescribed with what class of medication?
Macrolides Examples - azithromycin, clarithromycin, erythromycin
33
Bisoprolol should not be co-prescribed with what?
Verapamil
34
Fill in the blank: ___ can increase the risk of developing pulmonary oedema in a patient with chronic heart failure.
Verapamil
35
What ECG change occurs first in hyperkalaemia?
Tall tented T waves
36
Which arm should a cannula be inserted into for a patient suspected of having an MI and why?
Left, right radial artery used for PCI
37
Irregularly irregular pulse is associated with what?
Atrial fibrillation
38
Rhythm control is suggested first line in patients with AF plus coexistent what?
Heart failure
39
What are the 2 first line medications used in rate control for AF?
Beta blockers or rate limiting calcium channel blockers (diltiazem, verapamil)
40
Which medication should not be used concurrently with beta blockers?
Verapamil
41
What type of calcium channel blockers are contraindicated in heart failure?
Rate limiting - verapamil, diltiazem
42
Which medications should be used for rhythm control in AF in patients with: 1. No structural heart problems 2. Presence of structural heart problems
1. Flecainide 2. Amiodarone
43
What is first line anticoagulation therapy in AF patients?
DOAC - apixaban, dabigatran, rivaroxaban, edoxaban
44
If CHADVASC score indicates no need for anticoagulation in AF patients, what investigation should be carried out?
Transthoracic echocardiogram
45
How long after a stroke should a patient with AF be started on anticoagulation?
2 weeks
46
How long after a TIA should patients with AF be started on anticoagulation?
No wait, start immediately
47
For how long before attempting electrical cardioversion in AF should patients be anticoagulated for?
3 weeks
48
Which organism is most commonly implicated in infective endocarditis in IV drug users?
Staph aureus
49
Which heart valve is most commonly implicated in infective endocarditis in: 1. Non IV drug users 2. IV drug users
1. Mitral 2. Tricuspid
50
Tall R waves in leads V1-V2 on ECG are suggestive of what?
Posterior MI
51
Which 2 medications are used in first line management of acute pericarditis?
NSAIDs and colchicine
52
Electrical cardioversion can be considered for new atrial fibrillation if patients present within what time frame?
Under 48 hours
53
Kussmaul’s sign is demonstrated by what? What condition does it indicate?
Rise in JVP on inspiration Constrictive pericarditis
54
Electrical cardioversion is synchronised to which part of an ECG?
R wave
55
What is the most common cause of mitral stenosis?
Rheumatic fever

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