Cardiology Flashcards
MoA of clopidogel/ticagrelor
Inhibits ADP from binding to platelet receptor (P2Y12)
Dabigatran reversal
Idaracuzimab
Apixaban and rivaroxaban reversal
Andexanet alfa. It binds and sequesters direct factor Xa inhibitors.
Heparin reversal
Protamine is used to reverse heparin. It is a peptide that binds and sequesters heparin molecules.
JVP waveform
A= Atrial contraction
C= Closure of triCuspid
x descent= relaXation of the Atrium (ventricular contraction)
V= passiVe filling of the atrium (ANS here as you can localise tricuspid regurg from stem)
Y descent= Tricuspid opening
MUGA Scan
MUGA (multigated acquisition) scan, also known as radionuclide ventriculography or nuclear angiography, is a non-invasive nuclear medicine test that uses a small amount of radioactive tracer to evaluate the pumping function of the heart. It provides precise quantification of left ventricular ejection fraction (LVEF), which is an important parameter for assessing cardiac function. In patients receiving cardiotoxic chemotherapy agents like doxorubicin, monitoring LVEF with MUGA scans can help detect early signs of cardiotoxicity and guide timely interventions.
Early diastolic murmur
Aortic regurgitation
e(AR)ly diastolic -> Aortic Regurgiation (AR)
(M)id Diastolic -> (M)itral stenosis
Mid diastolic murmur
Mitral stenosis
e(AR)ly diastolic -> Aortic Regurgiation (AR)
(M)id Diastolic -> (M)itral stenosis
Ivabradine SE
visual effects, particular luminous phenomena, are common
headache
bradycardia, heart block
Metabolised by CYP P450 therefore inhibitors of CYP 450 with increase SEs
ECG changes with hypothermia
J waves (small bumps at the end of the QRS complex)
bradycardia
‘J’ wave (Osborne waves) - small hump at the end of the QRS complex
first degree heart block
long QT interval
atrial and ventricular arrhythmias
ACEi first dose phenomenon?
First dose hypotension with ACEi
Where is the site of action of bendroflumethiazide
Proximal part of the distal convoluted tubule
Thiazides/thiazide-like drugs (e.g. indapamide) - inhibits sodium reabsorption by blocking the Na+-Clˆ’ symporter at the beginning of the distal convoluted tubule
Abx treatment for infective endocarditis with strep vs staph
Staph -> fluclox (+gent + rifampacin)
if penn allergic Vanc + gent
Strep -> Benpen (if penn allergic vanc)
Also addition of rifamacip depends on native or non native valve
Tx for PAH without response to vasoactive substances on testing
If there is a negative response to acute vasodilator testing (the vast majority of patients)
prostacyclin analogues: treprostinil, iloprost
endothelin receptor antagonists
non-selective: bosentan
selective antagonist of endothelin receptor A: ambrisentan
phosphodiesterase inhibitors: sildenafil
Note: PDE inhibitors and proscyclin anallogues CI in patients with recent stroke (? risk of heamorrrhaagic transformation)
Spndylarthropathies/ ank spond aassociated with what valve disease?
Aortic reguritaiton
Best & worst pathogens in infective endocarditis for prognosis
best - strep worst - staph
The correct answer is Streptococcus viridans infection. This is because Streptococcus viridans is a common cause of subacute infective endocarditis, which typically has a more indolent course and better prognosis compared to other causes. It is often sensitive to penicillin, and the mortality rate associated with it is relatively low.
Staphylococcus aureus infection, on the other hand, often leads to acute infective endocarditis, which has a much higher mortality rate due to its rapidly progressive nature. Furthermore, methicillin-resistant Staphylococcus aureus (MRSA) may be resistant to many antibiotics, making treatment more difficult.
Common SE of ticagrelorr
Dysponeoa
hypothesised that the sensation of dyspnoea in ticagrelor-treated patients is triggered by adenosine, because ticagrelor inhibits its clearance (by inhibiting the enzyme adenosine deaminase), thereby increasing its concentration in the circulation.
Rare advrse effects of thiazides
Rare adverse effects
thrombocytopaenia
agranulocytosis
photosensitivity rash
pancreatitis
bisferiens pulse
mixed aortic valve disease
Name two endothelin receptor antagonists and when would they be used
PAH that is not rresponsive to vasaodialators)
Bosentan aand ambrisentan
B-type natriuretic peptide is mainly secreted by?
the ventricular myocardium
AV node supplied by which coronary artery?
The atrioventricular node is supplied by the posterior interventricular artery, which in the majority of patients is a branch of the right coronary artery.
Keshan disease
Dialatd cardiomyopathy caused by selenium deficiency
Wet beri beri disease caused by?
Thiamine deficiency
Medications to avoid/use in Wolff parkinsons white
Avoid ABCD
Adenosine, Beta blockers, Calcium channel blockers, Digoxin
SAFe medications
Sotalol unless A.fib, Amiodarone, Flecainide
