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Year 4 Finals > Cardiology > Flashcards

Cardiology Flashcards

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?

A

Lateral
- via circumflex artery

24
Q

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

A

Anterior
- via left anterior descending artery

25
Q

In regards to ECG interpretation:
Changes in leads II, III and aVF indicate pathology in which heart location?

A

Inferior
- via right coronary artery

26
Q

What is a normal PR interval?

A

120-200ms (3-5 small squares)

27
Q

Consistently prolonged PR internal with no QRS dropping is indicative of which type of heart block?

A

First degree

28
Q

Which types of non-pathological heart block may be seen in athletes via increased vagal tone?

A

First degree and second degree Mobitz type 1 (Wenckebach)

29
Q

Name 3 drugs that can lead to heart block

A

Beta blockers, CCBs, digoxin

30
Q

Increasing PR interval with QRS drop is indicative of which type of heart block?

A

Second degree Mobitz type 1 (Wenckebach)

31
Q

Consistent PR interval with QRS drop is indicative of which type of heart block?

A

Second degree Mobitz 2

32
Q

Statins should not be co prescribed with what class of medication?

A

Macrolides
Examples - azithromycin, clarithromycin, erythromycin

33
Q

Bisoprolol should not be co-prescribed with what?

34
Q

Fill in the blank:
___ can increase the risk of developing pulmonary oedema in a patient with chronic heart failure.

35
Q

What ECG change occurs first in hyperkalaemia?

A

Tall tented T waves

36
Q

Which arm should a cannula be inserted into for a patient suspected of having an MI and why?

A

Left, right radial artery used for PCI

37
Q

Irregularly irregular pulse is associated with what?

A

Atrial fibrillation

38
Q

Rhythm control is suggested first line in patients with AF plus coexistent what?

A

Heart failure

39
Q

What are the 2 first line medications used in rate control for AF?

A

Beta blockers or rate limiting calcium channel blockers (diltiazem, verapamil)

40
Q

Which medication should not be used concurrently with beta blockers?

41
Q

What type of calcium channel blockers are contraindicated in heart failure?

A

Rate limiting - verapamil, diltiazem

42
Q

Which medications should be used for rhythm control in AF in patients with:
1. No structural heart problems
2. Presence of structural heart problems

A
  1. Flecainide
  2. Amiodarone
43
Q

What is first line anticoagulation therapy in AF patients?

A

DOAC - apixaban, dabigatran, rivaroxaban, edoxaban

44
Q

If CHADVASC score indicates no need for anticoagulation in AF patients, what investigation should be carried out?

A

Transthoracic echocardiogram

45
Q

How long after a stroke should a patient with AF be started on anticoagulation?

46
Q

How long after a TIA should patients with AF be started on anticoagulation?

A

No wait, start immediately

47
Q

For how long before attempting electrical cardioversion in AF should patients be anticoagulated for?

48
Q

Which organism is most commonly implicated in infective endocarditis in IV drug users?

A

Staph aureus

49
Q

Which heart valve is most commonly implicated in infective endocarditis in:
1. Non IV drug users
2. IV drug users

A
  1. Mitral
  2. Tricuspid
50
Q

Tall R waves in leads V1-V2 on ECG are suggestive of what?

A

Posterior MI

51
Q

Which 2 medications are used in first line management of acute pericarditis?

A

NSAIDs and colchicine

52
Q

Electrical cardioversion can be considered for new atrial fibrillation if patients present within what time frame?

A

Under 48 hours

53
Q

Kussmaul’s sign is demonstrated by what? What condition does it indicate?

A

Rise in JVP on inspiration
Constrictive pericarditis

54
Q

Electrical cardioversion is synchronised to which part of an ECG?

55
Q

What is the most common cause of mitral stenosis?

A

Rheumatic fever

Year 4 Finals (15 decks)

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