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Cardiology Flashcards

1
Q

Aortic stenosis findings

A
  • narrow pulse pressure
  • slow rising pulse
  • thrill at apex
  • fourth heart sound in hypertrophy
  • soft or absent S2
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2
Q

Atorvastatin

A

If QRISK greater that 10% consider giving atorvastatin

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3
Q

Amlodipine

A

IF older than 55 or Afro-Caribbean give calcium channel blocker

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4
Q

Heart failure- longer life

A

ACE inhibitors, beta blockers and spironolactone

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5
Q

Nifedipine

A

If angina is not controlled with a beta-blocker then add calcium channel blocker

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6
Q

PE

A
  • pleuritic chest pain
  • dyspnoea
  • haemoptysis
  • tachycardia
  • S1Q3T3
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7
Q

Losartan

A

Angiotensin receptor blocker that can be added second line in hypertension treatment

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8
Q

Fibrinolysis

A

Needs to be given within 12 hrs if primary PCI cannot be given in under 120 mins

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9
Q

Heart block in heart failure

A

If left bundle branch block seen after ACE inhibitor, beta blocker and aldosterone therapy consider cardiac resynchronisation therapy

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10
Q

Thiazide-like diuretics

A

Include indapamide and can cause erectile dysfunction

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11
Q

Thiazide diuretics

A

Can worsen glucose tolerance

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12
Q

Furosemide

A

Loop diuretics can cause ototoxicity

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13
Q

PCI

A

If MI persists post fibrinolysis then consider PCI

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14
Q

Thiazide diuretics

A

Can cause hyponatraemia

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15
Q

HOCM

A
  • asymmetric septal hypertrophy and systolic anterior movement (SAM)
  • autosomal dominant inheritance
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16
Q

INR

A

In cases of recurrent VTE or PE then aim for INR of 3.5

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17
Q

S3

A
  • normal in those under 30

- suggestive of dilated cardiomyopathy

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18
Q

Hypertension and diabetes

A

ACE inhibitor is first line

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19
Q

Rhythm control

A

Treatment of AF that is coexistent with heart failure, first onset or an obvious reversible cause is found

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20
Q

Stable suspected CAD

A

CT angiography

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21
Q

Beta blockers

A

Reduce hypoglycaemic awareness

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22
Q

Ivabradine

A

Long acting vasodilator used in treatment of angina if verapamil not tolerated

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23
Q

Thiazides

A

Can cause hypokalaemia

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24
Q

Aortic dissection

A

If patient is clinically unstable transoesophageal echo can be used

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25
Spironolactone
Mineralocorticoid receptor agonist given in heart failure with reduced ejection fraction
26
ACE inhibitor and renal function
Increase in creatinine of up 30% from baseline is accepted
27
1 shock defib
Used to manage VF and pulseless VT as soon as identified
28
INR 5-8 (no bleeding)
Withhold 1 or 2 doses and reduce subsequent maintenance dose
29
Thiazide diuretics
Can cause hypercalcaemia and hypocalciuria
30
Hypokalaemia
- tiredness - constipation - cramping - u waves on ECG and prolonged QT interval
31
Posterior MI
ECG with tall R waves in V1-2
32
Symptomatic bradycardia
First with 3mg IV atropine then with external pacing
33
Ventricular septal defect
Classically associated with a pansystolic murmur
34
Acute pulmonary oedema
Complication of MI - SOB - productive cough - sweaty - raised JVP - end-inspiratory crackles - manage with IV diuretics
35
PE investigation
If Wells score less than 4 and D-dimer negative then stop anticoagulation and consider alternative diagnosis
36
Acute pericarditis
- suspect in cases of retrosternal chest pain, worse on lying down with signs of raised WBCs - investigate with transthoracic echo
37
PE
CTPA is first line investigation
38
Diabetes in cardiac ward care
If high dependency stop medications and start IV insulin infusion
39
Acute pericarditis ECG
Widespread ST elevation and PR depression
40
Bumetanide
A loop diuretic that acts on the Na-K-Cl cotransporter in the ascending limb of the loop of Henle
41
Atorvastatin
-primary prevention of MI 20mg -secondary prevention of MI 40mg
42
LBBB
New LBBB is significant in the presence of chest pain and indicates the need for thrombolysis or PCI
43
Thiazides
Can cause hypokalaemia and heart block
44
Bradycardia
500 micrograms of IV atropine
45
Tachyarrhythmia
Systolic BP less than 90 needs DC cardioversion
46
Massive PE and hypotension
Thrombolyse
47
Posterior STEMI
- ST depression in leads V1-V3 | - tall R waves in V1-2
48
Hypercalcaemia
- bone pain - rental stones - abdominal groans - psychic moans
49
Nifedipine
A Ca channel blocker that can be used in angina uncontrolled by a beta blocker
50
Electrical alternans
Suggestive of cardiac tamponade
51
Constrictive pericarditis
- Kussmauls sign negative so JVP does not fall with inspiration - pericardial knock
52
AF
Begin with Ca channel blocker or beta blocker then add digoxin
53
Adenosine
Used to treat SVT when Valsalva manoeuvres fail | -can cause warmth and flushing
54
Hypertension
BP greater than 140
55
Atrial fibrillation
Offer direct oral anticoagulant
56
BP>180/120
In the presence of confusion, chest pain, signs of heart failure or AKI then admit for specialist assessment
57
Heart failure vaccination
Offered yearly influenza and one off pneumococcal vaccination
58
Spironolactone
A mineralocorticoid receptor antagonist offered in heart failure alongside ACEi and beta blocker
59
Hypothermia
Presents with bradycardia and J waves on ECG
60
Hypertension (black or afro-caribbean)
First line with Ca channel blocker then add angiotensin receptor blocker
61
Hyperacute T waves
Big T waves that come before a myocardial infarction
62
Rheumatic fever
Develops following reaction to streptococcus pyogenes infection - recent strep infection - erythema marginatum - twitching or chorea - polyarthritis - carditis and valvulitis - subcutaneous nodules
63
Decompensated AF
Manage with DC cardioversion
64
Aortic stenosis
Late presentation with exertional syncope
65
Hypokalaemia
Can lead to long QT syndrome
66
Acute pericarditis
One risk factor is SLE
67
Constrictive pericarditis
Positive Kussmaul's sign with JVP rising on inspiration | -chest pain worse on inspiration
68
Bendroflumethiazide
Can cause hypercalcaemia
69
Aortic dissection
- tearing pain into back - sinus tachycardia - weak brachial pulse - variation in arm bp
70
Bradycardia
If patients show signs of shock give 500 micrograms of IV atropine repeated up to 3mg
71
Lateral MI
- ST elevation in I and aVL with slight V5+V6 | - left circumflex
72
HOCM
Give an implantable cardioverter defibrillator
73
Broad complex tachycardia
If no adverse features give IV amiodarone
74
Acute pericarditis ECG
Often show saddle-shaped ST elevation
75
Quincke's sign
Nailbed pulsation seen in aortic regurg

Revision (18 decks)

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