Cardiology Flashcards

1
Q

Recent Chest pain red flag Qs

A

Chest pain at rest
Chest pain now or within the last 72 hours

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2
Q

Heart Failure Ix

A

Bloods inc BNP
2WW Echo - HF + BNP >400
6ww Echo - HF + BNF >100

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3
Q

Heart Failure lifestyle advice

A

Smoking - stop
Alcohol - reduce
Salt - reduce
Cardiac rehab
Annual flu and pneumococcal vaccine

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4
Q

Heart failure HFrEF Mx

A

ACEi (or ARB)
B Blocker
Spironolactone (if NYHA III/ IV)
Aspirin - if vascular disease
DIuretics - symptom releief

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5
Q

Atrial fibrillation Ix

A

ECG
24 hr ECG monitoring
Bloods - FBC, TFT, UE
Echo - if suspected structural disease

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6
Q

Atrial fibrillation Mx

A

Rate control
- B Blocker (bisoprolol)
- CCB (diltiazem)
- Digoxin - sedentary lifestyle

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7
Q

HTN Mx (stage 1)

A

Stage 1: BP >140/90 or ABP > 135/85
- Treat if:
Adult <80 years with persistent stage 1 hypertension AND ≥1 of:
target organ damage
established cardiovascular disease
renal disease
estimated 10-year risk CVD ≥10%
Use clinical judgement if frailty or multimorbidity.

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8
Q

HTN Mx (stage 2)

A

BP >160/100 or ABP 150/95
- start treatment

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9
Q

HTN Mx (stage 3)

A

SBP >180 or DBP >110
- treat immediately.
- if papilloma/ retinal haemorrhage/ suspected phaeochromocytoma - need admission

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10
Q

HTN Mx

A

Step 1:
<55/ Diabetic/ CKD - ACEi/ ARB
>55/ Black - CCB

Step 2:
add CCB or ACEi

Step 3:
Thiazide like diuretic - eg Indapamide

Step 4:
K < 4.5 - Spironolactone
K > 4.5 - Alpha blocker/ Beta Blocker

Step 5:
Refer to Cardiology

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11
Q

Angina Ix

A

Rapid access clinic to confirm diagnosis

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12
Q

Angina Fx

A

Typical (3)
Constricting pain
Precipitated by exertion
Relieved by rest

If pain at rest = unstable angina = 999 admission

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13
Q

Angina Mx

A

Rapid access chest pain clinic

GTN spray - symptom relief
Risk factor Mx - Smoking, BP, diabetes, cholesterol, exercise
Secondary prevention - Aspirin 75mg od (unless already on Clopidogrel, then continue this). Atorvastatin 20mg OD. ACEi (if Diabetes, CKD etc)

1st - BBlock (bisoprolol/ atenolol) or CCB (diltiazem/ verapamil)

2nd - Ranolazine, Ivabradine, Nicorandil, long acting CCB

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14
Q

CHADSs VASc score (anticoag risk in AF)

A

Congestive heart failure
Hypertension
Age 65-74 (1)
Diabetes
Stroke/ TIA (2)
Vascular disease
Ages >75 (2)
Sex female

Female >2 = anticoag
Male >1 = coag

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15
Q

Orbit score (bleeding risk in AF)

A

Older age - >75 (1)
Reduced Hb - <130 Male or < 120 Female (2)
Bleeding Hx (2)
Insufficient Kidney function - eGFR <60 (1)
Treatment with antiplatelets (1)

Score:
0-2 = low
2-4 = med
>4 = high

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16
Q
A