Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 2A conditions > Cardiology Conditions > Flashcards

Cardiology Conditions Flashcards

1
Q

In which leads would you see an inferior MI?

A

II , III and aVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In which leads would you see a septal MI?

A

V1 and V2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In which leads would you see a lateral MI?

A

V5, V6 and I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In which leads would you see a anterior MI?

A

V3 and V4, aVR and aVL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the tree stages of atherosclerosis?

A

Fatty streaks, Intermediate lesions, Fibrous plaque and rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are RF for atherosclerosis?

A

age, smoking, high cholesterol, obesity, diabetes, HTN, family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What happens in fatty streaks?

A

appear very early, aggregations of lipid laden macrophages and T-lymphocytes in intimal layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens in intermediate lesions?

A

layers of foam cells, t lymphocytes and smooth muscle cells, platelets start to adhere to vessel wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens in fibrous plaques?

A

Lesion is covered by dense fibrous cap that impedes flow and is prone to rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the Qrisk2?

A

Risk of developing CVD in the next 10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is prinzmetal’s angina?

A

angina due to a coronary artery spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is decubitus angina?

A

angina occurring when laying down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is angina pectoralis?

A

chest pain or discomfort arising from the heart as a result of ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is stable angina?

A

chest pain exacerbated when exercising

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are three criteria for typical angina?

A

central radiating chest pain, precipitated precipitated by exertion and relieved by rest of GTN spray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does angina present with?

A

chest pain induced by effort and relieved by rest, dyspnoea, palpitations and syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what tests do you order for stable angina?

A

12 lead ECG (usually normal), CT angiography (shows narrowing), FBC and Cxr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you treat stable angina?

A

lifestyle changes, gtn spray and PCI or CABG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is unstable angina?

A

crushing chest pain at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do you test for unstable angina?

A

FBC, cardiac enzymes, ECG (ST depression) and CT angiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you treat unstable angina initially?

A

aspirin and fondaparinux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the mechanism of fondaparinux?

A

indirect inhibitor of factor Xa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

If you established low risk for a MI what do you do?

A

no angiography, ticagrelor and aspirin or clopidogrel and aspirin (high bleeding risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

if you established high risk what do you do?

A

angiography within 72 hours, prasugrel (if PCI) or ticagrelor or clopidogrel with aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are complications of unstable angina?

A

DARTH VADER: death, arrhythmia, renal failure, tamponade, HF, valve disease, aneurism, dressler’s syndrome, embolism and reoccurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is dressler’s syndrome?

A

pericarditis following an MI (1-6 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the pathology of acute coronary syndromes?

A

rupture or plaque erosion with subsequent clot formation and vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the types of MI?

A

1: spontaneous due to primary coronary event
2: secondary due to increased demand or decreased supply of oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is a STEMI?

A

necrosis of cardiac tissue due to complete occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are RF for a STEMI?

A

age, male, CHD, HTN, hyperlipidaemia, family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How does a STEMI present?

A

crushing central chest pain, sweating, SoB, fatigue, nausea, vomiting
occurs at rest, not relieved by GTN, longer than 20 min, 4th heart sound, pansystolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What tests do you order for a STEMI?

A

ECG (ST elevlation, tall T waves, LBBB, Q waves follow (evidence of previous infarction)), cardiac markers, CT angiography, FBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do you treat a STEMI initially?

A

MONA: morphine, oxygen (if under 94), nitrates, fondaparinux and aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Within what time frame can you do reperfusion therapy?

A

12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What do you give if you are performing a PCI?

A

pasugrel with aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What do you do if you cannot deliver PCI within 120 minutes?

A

Fibrinolysis (IV alteplase) and aspirin with ticagrelor/clopidogrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is ticagrelor and clopidogrel?

A

Antiplatelet: P2Y12 receptor antagonist (ADP cannot bind and glycoprotein 2b/3a is not activated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is secondary prevention for STEMI?

A

ACEi: ramipril
BB: atenolol or bisoprolol
statin: atorvastatin
dual anti platelet therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is a NSTEMI?

A

complete occlusion of a minor artery or partial of a major

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How do you test for a NSTEMI?

A

ECG (St depression and T wave inversion), cardiac enzymes (troponin rise (3-12 hours) or fall)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

How do you treat a NSTEMI?

A

initial aspirin and fondaparinux (antithrombin)

  • Establish high or low risk with GRACE score (6 month mortality), troponin and ECG
  • low risk: no angiography, ticagrelor and aspirin or clopidogrel and aspirin (high bleeding risk), assess LV function
  • high risk: angiography within 72 hours, prasugrel (if PCI) or ticagrelor or clopidogrel with aspirin, assess LV function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the tetralogy of fallot?

A

ventricular septal defect, enlarged aorta, Left ventricle hypertrophy and pulmonary stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is a true aneurism?

A

dilations involve all layers of arterial wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is a false aneurism?

A

outer layer (adventitia) only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

when do you speak of a AAA?

A

aortic diameter over 3 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are some RF or aetiology of AAA?

A

Fhx, smoking, male, increasing age, HTN, COPD, trauma and atherosclerotic damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How does an unruptured AAA present?

A

asymptomatic, pain in abdomen, vague pulsatile abdominal swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How does a ruptured AA present?

A

intermittent or continuous abdominal pain, pulsatile swelling, collapse, hypotension, tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How do you test for a AAA?

A

ultrasound, CT and MRI angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

How do you treat a AAA?

A

below 5.5 cm: monitor

above: surgical repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is a thoracic abdominal aneurism?

A

if aorta reaches crucial diameter (6 or 7 cm) is looses distensibility and raise in BP can trigger dissection or rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is aortic dissection?

A

medical emergency that begins with a tear in the intima. Blood then penetrates and flows between layers which forces lasers apart (false lumen) and results in dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How does aortic dissection present?

A

sudden onset of severe and central chest pain (mimics MI), pain is described as tearing, HTN, may develop neurological symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How do you confirm a diagnosis of dissection?

A

transoesophageal echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How do you treat aortic dissection?

A

IV metoprolol (BB) if hypertensive, analgesia, surgery to replace arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is a shock?

A

acute circulatory failure with inadequate perfusion resulting in hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How do you recognise shock?

A

pale, cold and sweaty skin
weak and rapid pulse
confusion, weakness, collapse and coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are different types of shock?

A

hypovolaemic, cariogenic (heart is not pumping), anaemic, cytotoxic, septic, anaphylactic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is peripheral vascular disease?

A

Partial blockage of leg or peripheral vessels by an atherosclerotic plaque and/or thrombus resulting in insuffucient perfusion and ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are RF for PVD?

A

smoking, diabetes, HTN, obesity, inactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

How does PVD present?

A

claudication (pain) when exercising, ulcers that aren’t healing, colour changes (elevation pallor and dependent rubor)

can progress to rest pain when legs are elevated and relieved then leg is lowered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

How to you test for PVD and what do you expect?

A

Bruit sound when asculation, doppler ultrasound, ankle brachial index below 0.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

How do you treat PVD?

A

Treat with lifestyle changes, revascularistaion for critical ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is mitral stenosis?

A

Narrowing of mitral valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What causes mitral stenosis?

A

rheumatic fever, annular calcification, congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How does mitral stenosis present?

A

Symptoms when area is less than 2cm: exertion dyspnoea, haemoptysis, palpitations, chest pains, malar flush, a fib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What heart sounds do you expect in mitral stenosis?

A

mid diastolic murmur with opening snap (expiration and lying on left side) and loud S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What tests do you order for mitral stenosis?

A

CXR, ECG and echo (gs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

How do you treat mitral stenosis?

A

percutaneous mitral ballon valvotomy, replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is mitral regurgitation?

A

Mitral valve doesn’t shut completely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What causes mitral regurgitation?

A

papillary muscle rupture or dysfunction, mitral valve prolapse, rheumatic heart disease, infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What are RF for mitral regurgitation?

A

low BMI, females, age, previous MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

How does mitral regurgitation present?

A

palpitations, fatigue, weakness, a fib, displaced apex

74
Q

What type of murmur do you hear in mitral regurgitation?

A

pan systolic, sort or absent S1

75
Q

What tests do you order for mitral regurgitation?

A

ECG, cxr and echo

76
Q

How do you treat mitral regurgitation?

A

ACEi, control a fib with BB+CCB+digoxin, diuretics for fluid overload, serial echo
- symptoms at least or asymptomatic with ejection fracture below 60% means surgery

77
Q

What is aortic stenosis?

A

Narrowing of aortic valve?

78
Q

What causes aortic stenosis?

A

calcification, congenital bicuspid valve and rheumatic heart disease

79
Q

How does aortic stenosis present?

A

triad of syncope, angina and dyspnoea

sustained heaving apex, slow rising pulse, narrow pulse pressure

80
Q

What murmur do you hear in aortic stenosis?

A

ejection systolic murmur

81
Q

How do you treat aortic stenosis?

A

regular dental care and valve replacement

vasodilators are contraindicated

82
Q

What is aortic regurgitation?

A

aortic valve doesn’t fully shut

83
Q

What causes aortic regurgitation?

A

aortic dissection and infective endocarditis in acute disease, rheumatic HD and connective tissue disorders

84
Q

How does aortic regurgitation present?

A

Can be asymptomatic for years and then palpitations, angina and dyspnoea, wide pulse pressure and displaced apex

Corrigan’s sign (carotid pupation)
De musset’s sign (head nodding with heart beat), Quincke’s sign (capillary pulsation in nail bed

85
Q

What murmur do you hear in aortic regurgitation?

A

early diastolic murmur (expiration and sat forward)

86
Q

What do you see on an ECG in aortic regurgitation?

A

tall R waves, inverted t waves in left leads

87
Q

How do you treat aortic regurgitation?

A

Treat with vasodilator if symptomatic and surgery if heart is enlarged or deterioration

88
Q

What is infective endocarditis?

A

Infection of inner lining of the heart and valves

89
Q

What causes infective endocarditis?

A

staph. aureus, strep. viridans (mouth or oral surgery) and staph. epidermis (prosthetic valve)

90
Q

How does infective endocarditis present?

A

signs of infection, splinter haemorrhages, osler nodes (fingers), Janeway lesions (nodules on palms), roth spots (haemorrhage with clear centre on fundoscopy)

91
Q

How do you investigate infective endocarditis?

A

Echo

92
Q

What are modified duke’s criteria?

A

blood cultures positive (2 separate ones), evidence of endocardial involvement (regurgitation or echo positive)

93
Q

How do you treat infective endocarditis?

A

treat with antibiotics for 4-6 weeks
1st line: FAG fluoxacillin, ampicillin, gentamicin
staph aureus: flucloxacillin, rifampicin, gentamicin
MRSA: vancomycin, rifampicin, gentamicin
not staph: benzylpenicillin and gentamicin

94
Q

What is pericarditis?

A

Inflammation of pericardium

95
Q

What causes pericarditis?

A

ideopathic, infection (HIV, echovirus, coxsackie B), trauma

96
Q

How does pericarditis present?

A

chest pain (relieved when leaning forward and worsened by inspiration), fever, pericardial friction rub

97
Q

What tests do you order for pericarditis and what do you expect?

A

ECG (saddle shaped ST elevation, PR depression) and echo

98
Q

How do you treat pericarditis?

A

NSAIDS and colchicine

99
Q

What is cardiac tamponade?

A

accumulation of fluid in pericardial space, compression of chambers

100
Q

How does a cardiac tamponade present?

A

Beck’s triad: falling BP, rising JVP and muffled heart sounds

101
Q

How do you treat a cardiac tamponade?

A

pericardiocentesis

102
Q

What is sinus arrhythmia and how does it present?

A

fluctuations in autonomic tone lead to changes in sinus discharge rate

inspiration: parasympathetic tone falls and HR quickens
expiration: parasympathetic tone increases and HR slows

103
Q

What is atrial fibrillation?

A

chaotic irregular atrial rhythm at 300-600 bpm with the AV node responding intermittently causing an irregular ventricular rate

104
Q

What are the different types of A.fib?

A
  • acute: within 48 hours
  • paroxysmal: stops spontaneously within 7 days
  • recurrent: 2 or more episodes
  • persistent: continuous for more than 7 days and not self terminating
  • permanent
105
Q

What causes A.fib?

A

includes idiopathic, HTN, HF, CAD, valvular heart disease (mitral stenosis)

anything resulting in raised atrial pressure, atrial muscle mass, atrial fibrosis or inflammation

106
Q

What are RF for A.fib?

A

older than 60, diabetes, HTN, CAD, prior MI, structural heart disease

107
Q

How does A.fib present?

A

variable symptoms (sometimes asymptomatic): palpations, dyspnoea, fatigue

108
Q

What will you see in A.fib on the ECG?

A

absent P waves and irregular and rapid QRS

109
Q

How do you treat acute A.fib?

A

treat provoking cause, cardioversion with defibrillator (give enoxaparin with it)

if that fails give amiodarone

ventricular rate control by blocking AV node: CCB, BB, digoxin and amiodarone

110
Q

what are the two strategies for LT a.fib control?

A

Rate control: BB, CCB and if that fails digoxin then amiodarone

Rhythm control: BB, warfarin and flecainide (or amiodarone if structural heart defect)

111
Q

What do you use to calculate stroke risk after a.fib and how do you act upon result?

A

CHA2DS2VASc:
congestive HF, HTN, 75 or over, diabetes, stroke, vascular disease, 65-74 years, female

  • 1: consider anticoagulation
  • 2 and above: anticoagulation needed
112
Q

What is atrial flutter?

A

organised atrial rhythm with atrial rate between 250 and 350 bpm

113
Q

What causes atrial flutter?

A

idiopathic, CHD, obesity, HTN, HF, COPD, pericarditis and excess alcohol

114
Q

How does atrial flutter present?

A

palpitations, breathlessness, chest pain, dizziness, syncope and fatigue

115
Q

What do you see on an ECG in atrial flutter?

A

regular f waves (saw tooth flutter) between QRS complexes

If F waves not visible, they can be unmasked by slowing AV conduction through IV adenosine

116
Q

How do you treat atrial flutter?

A

electrical cardioversion (enoxaparin before if acute), catheter ablation or IV amiodarone with BB

117
Q

Where is an atrioventricular heart block located?

A

block in AV node or bundle of his

118
Q

What are the types of AV block?

A

First degree, Mobitz I, Mobitz II and 3rd degree

119
Q

What causes first degree HB?

A

hyperkalaemia, myocarditis, inferior MI and AV node blocking drugs (BB, CCB and digoxin)

120
Q

Describe the ECG of a first degree HB

A

prolongation of PR interval to more than 0.22 but every atrial polarisation is followed by QRS complex

121
Q

How do you treat 1st degree block?

A

Asymptomatic so no treatment

122
Q

What causes Mobitz I block?

A

AV node blocking drugs and inferior MI

123
Q

How does a Mobitz I block present?

A

dizziness, light headed and syncope

124
Q

Describe the ECG of Mobitz I block

A

progressive PR prolongation until P wave fails to conduct. then starts again with PR prolonging until dropping QRS

125
Q

How do you treat Mobitz I block?

A

only needs a pacemaker if poorly tolerated

126
Q

What causes a Mobitz II block?

A

anterior MI, SLE, rheumatic fever or mitral valve surgery

127
Q

How does Mobitz II present?

A

shortness of breath, postural hypotension and chest pain

128
Q

Describe the PCR of Mobitz II

A

PR interval constant and QRS is dropped occasionally

129
Q

How do you treat Mobitz II?

A

Pacemaker

130
Q

What is a third degree heart block?

A

Complete block and P waves are fully independent from QRS complex

131
Q

What causes 3rd degree block?

A

structural HD, CHD, HTN and endocarditis

132
Q

What is a narrow complex escape rhythm in 3rd degree block and how do you treat it?

A

QRS is less than 0.12 seconds: originates in bundle and can respond to atropine if acute or requires pacemaker if chronic

133
Q

What is a broad complex escape rhythm in 3rd degree block and how do you treat it?

A

more then 0.12 sec: block is below bundle and permanent pacemaker is needed

134
Q

What is a bundle branch block?

A

block lower in conduction system

135
Q

How does BBB present?

A

usually asymptomatic

136
Q

How can you tell between a complete and incomplete BBB?

A
  • incomplete block: slight widening of QRS

- complete block: wider QRS

137
Q

What is a RBBB?

A

late activation of right ventricle

138
Q

What is a LBBB?

A

late activation of left ventricle

139
Q

What causes a RBBB?

A

PE, CHD, atrial or ventricular septal defect

140
Q

What causes a LBBB?

A

CHD and aortic valve disease

141
Q

Describe the ECG of a RBBB

A

(maRRow) deep S wave in I and V6, tall late R wave in V1, QRS looks like an M in V1 and W in V5 and 6

142
Q

Describe the ECG of a LBBB

A

abnormal QRS waves, (William) W in leads V1,2 and M in leads V4-6

143
Q

What do you hear in RBBB?

A

wide splitting of S2

144
Q

What do you hear in LBBB?

A

reverse splitting of S2: splitting heard in expiration and not inspiration

145
Q

What are the two types of Supraventricular tachycardia?

A

Atrioventricular nodal re-entrant tachycardia (AVNRT) and Atrioventricular re-entrant tachycardia (AVRT)

146
Q

Where does a supraventricular arise?

A

arises from atria or atrioventricular junction

147
Q

How do you treat SVT?

A
  1. emergency cardioversion if haemodynamically unstable
  2. once stable then vagal manoeuvres: hold breath, carotid massage and valsalva manoeuvre (abrupt increase in pressure by straining)
  3. if unsuccessful then IV adenosine
148
Q

What is AVNRT?

A

accessory pathways is used to stimulate AV node rather than the usual slow pathway resulting in not having to wait for depolarisation

149
Q

What are RF for AVNRT?

A

exertion, emotional stress, coffee, tea and alcohol

150
Q

How does AVNRT present?

A

brupt onset palpitations with sudden termination, chest pain, breathlessness, neck pulsations (JV), polyuria

151
Q

What does an ECG with AVRNT look like?

A

no visible P waves or normal

152
Q

What is AVRT?

A

atrial activation after ventricular activation

153
Q

Give an example of AVRT

A

Wolff-parkinson-White syndrome

154
Q

How does AVRT present?

A

palpitations, severe dizziness and syncope

155
Q

What does a ECG with AVRT look like?

A

short PR, wide QRS with slurred start

156
Q

What is ventricular ectopy?

A

Type of ventricular tachycardia: premature ventricular contraction

157
Q

How does ventricular ectopy present?

A

Commonly post MI: usually asymptomatic but can present with irregular pulse, faint and dizziness

158
Q

Describe an ECG with ventricular ectopy

A

widened QRS complex (0.12)

159
Q

How do you treat ectopy?

A

beta blocker

160
Q

What is prolonged QT syndrome?

A

Type of ventricular tachycardia: OT interval greatly prolonged

161
Q

What is HTN?

A

140/90 on at least two readings on separate occasions

162
Q

What are two types of HTN?

A
  • primary/essential: 95%

- secondary: CKD, drugs, acromegaly

163
Q

What are RF for HTN?

A

family history, age, male, obesity, lack of exercise

164
Q

How does HTN present?

A

Asymptomatic presentation except in malignant, occasional headache

165
Q

What is malignant HTN?

A

rapid rise leading to vascular damage (180/110 and bilateral renal haemorrhage)

166
Q

How do you treat malignant HTN?

A

sodium nitroprusside

167
Q

How do you decide whether to treat HTN?

A

If BP classifies as high then confirm using ABPM (or multiple measurements)

- below 135/85: no treatment
- 135/85 (stage 1): lifestyle advice, consider drug treatment in over 80, under 80 with organ damage/CVD/renal disease/diabetes, high QRISK
- 150/95 (stage 2): lifestyle advice and drug treatment
168
Q

How do you treat HTN?

A
  1. diabetes or white under 55: ACE or ARB (ramipril), 2nd CCB (amlodipine), 3rd thiazide diuretic (bendroflumethiazide)
  2. over 55 or black: CCB, 2nd ACE or ARB, 3rd thiazide diuretic
169
Q

What is HF?

A

clinical syndrome where breathlessness, fluid retention and fatigue are associated with cardiac abnormality that reduces CO

170
Q

What are the two types of HF and what causes them?

A
  • systolic: failure to contract (MI, CHD, HTN)

- diastolic: inability to relax (pericarditis, HTN, tamponade)

171
Q

What are two compensation mechanisms leading to HF and how do they work?

A
  1. adrenergic activation: vasoconstriction causes increased afterload and increased HR. HR increases cardiac work and both lead to damage and decreased CO
  2. renin angiotensin activation: salt and water retention leading to increased preload therefore increased work therefore damage and decreased CO
172
Q

What causes HF?

A

CHD, HTN, dilated and hypertrophic cardiomyopathy, aortic stenosis, congenital heart disease, factors increasing work

173
Q

What are RF for HF?

A

previous MI, male, obesity, age

174
Q

What causes left HF?

A

HTN and cardiomyopathy

175
Q

What causes right HF?

A

caused by LV failure, pulmonary stenosis, cor pulmonale, shunts

176
Q

How does left HF present?

A

3 and 4 sounds, cardiomegaly, pulmonary oedema, cool peripheries, weight loss

177
Q

How does right HF present?

A

raised JVP, hepatomegaly, pitting oedema, ascites, weight gain

178
Q

What tests do you order for HF and what will have increased?

A

CXR, ECG and FBC

brain natriuretic peptide increased

179
Q

What do you see on an xray with HF?

A

ABCDE: alveolar oedema, kerley B lines, cardiomegaly, dilated upper vessels, effusions

180
Q

How do you treat acute HF?

A

OMFG: oxygen, GTN spray, IV opiates, IV furosemide

181
Q

How do you treat chronic HF?

A

lifestyle improvement and AABCDD:

  • 1st: ACE and BB
  • 2nd ARB and nitrate
  • 3rd: cardiac resynchronisation or digoxin
  • diuretics: furosemide

Phase 2A conditions (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions