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Finals > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is the difference between Mobitz type 1 and 2?

A
  • Mobitz Type 1: progressive PR prolongation

- Mobitz Type 2: the PR interval is constant but some P waves are dropped

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2
Q

Name some indications for temporary pacing

A
  • Symptomatic bradycardia

- Prophylactically for severe bradycardia (2nd/3rd degree AV block, posterior MI etc.)

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3
Q

Name some indications for permanent pacing

A
  • Alternating RBBB/LBBB
  • Unexplained syncope with bifascicular/trifascicular block
  • Symptomatic sinus node disease
  • Carotid sinus hypersensitivity/ malignant vasovagal syncope
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4
Q

What is the mechanism of digoxin

A
  • Cardiac glycoside: inhibits the sodium-potassium ATPase pump
  • Improves cardiac contraction
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5
Q

Describe the presentation of digoxin toxicity

A
  • Nausea and vomiting
  • Bradycardia or tachycardia
  • VT/VF
  • Reverse tick appearance in lateral leads
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6
Q

Describe the management of digoxin toxicity

A
  • Stop digoxin

- Digibind

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7
Q

Name the indications for amiodarone

A
  • VT

- Supraventricular tachycardia

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8
Q

What is adenosine used for?

A

Conversion of paroxysmal supraventricular tachycardia

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9
Q

Which factors does warfarin inhibit?

A

II, VII, IX and X

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10
Q

What is the mechanism of action of dabigatran and apixaban?

A

Direct thrombin inhibitors

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11
Q

What is the mechanism of action of rivaroxaban and edoxaban?

A

Factor Xa inhibitors

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12
Q

What investigations might be done to diagnose heart failure?

A
  • ECHO
  • 12 lead ECG
  • BNP
  • Radionucleotide scan
  • Left ventriculogram
  • Cardiac MRI
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13
Q

Name some of the causes of heart failure

A
  • Ischaemic heart disease
  • Valvular heart disease
  • Pericardial constriction or effusion
  • Inherited
  • Cardiomyopathies
  • Hypertension
  • Infections
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14
Q

Name the management options for heart failure

A
  • Diuretics (furosemide/bumetanide)
  • ACE Inhibitors/ARBs
  • Beta blockers
  • ARBs
  • ARNIs (Entresto)
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15
Q

Which heart failure treatments improve symptoms?

A
  • Diuretics
  • Digoxin
  • ACE inhibitors/ARBs
  • Spironolactone
  • Valsartan
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16
Q

Which heart failure treatments improve survival?

A
  • ACE inhibitors/ARBs
  • Spironolactone
  • Valsartan
  • Beta blockers
  • Ivabradine
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17
Q

Name some of the common side effects of furosemide

A
  • Dehydration
  • Hypotension
  • Hypokalaemia
  • Hyponatraemia
  • Gout
  • Impaired glucose tolerance
  • Diabetes
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18
Q

Describe the stages of hypertension

A
  • Stage 1: ABPM 135/85 mmHg
  • Stage 2: ABPM 150/95mmHg
  • Severe: Systolic >180mmHg or diastolic > 110mmHg
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19
Q

What is the first line anti-hypertensive medication for someone aged over 55 years or of Afro-Caribbean descent

A

Calcium channel blockers (if contraindicated then thiazide like diuretic)

20
Q

What is the second line treatments for hypertension?

A

Thiazide type diuretic (indapamide etc.)

21
Q

What are the third line options for hypertension?

A
  • CCB
  • ACEI
  • Diuretic
22
Q

What is the first line management of hypertension in someone <55 years?

A

ACEI or ARB

23
Q

What is the fourth line management for hypertension

A
  • Spironolactone if potassium <4.5

- Alpha blocker or beta blocker if potassium >4.5

24
Q

How can stable angina be managed?

A
  • Address risk factors
  • Statins
  • ACE Inhibitors
  • Aspirin 75mg or Clopidogrel
  • Beta blockers
  • Calciun channel blockers
  • Ivabridine
  • GTN
  • Nicorandil (K+ channel blocker)
  • PCI or CABG
25
Q

Name the drugs used for thrombolysis in an MI

A
  • Tenecteplase
  • Alteplase
  • Streptokinase
26
Q

How can an MI be managed acutely?

A

-Oxygen if sats <94%
-GTN
-Opiates
-Aspirin 300mg
-Clopidogrel 300mg or Ticagrelor 180m
-Fondaparinux/LMWH
-GIIb/IIIa receptor blockers
-Prasugrel
-

27
Q

How can MIs be prevented by secondary prevention

A
  • Aspirin 75mg
  • Clopidogrel 75mg or Ticagrelor 90mg
  • Beta blockers
  • Statins
  • ACE inhibitors
28
Q

How does dilated cardiomyopathy present?

A
  • Dyspnoea
  • Fatigue
  • Orthopnoea
  • Ankle swelling
  • Cough
  • Narrow pulse pressure
  • Elevated JVP
  • MR murmur
29
Q

Which drugs can be used to treat dilated cardiomyopathy?

A
  • ACEIs
  • Diuretics
  • Beta blockers
  • Spironolactone
  • Cardiac transplant
30
Q

How does hypertrophic cardiomyopathy present?

A
  • Fatigue
  • Dyspnoea
  • Angina
  • Pre-syncope and syncope
  • Notched pulse pattern
  • Thrills and murmurs
31
Q

How can hypertrophic cardiomyopathy be managed?

A
  • Avoid heavy exercise or dehydration
  • Genetics
  • Beta blockers or verapamil
  • Surgery or alcohol septal ablation
32
Q

How can pericarditis be managed?

A
  • NSAIDs and colchicine

- Drainage

33
Q

How does cardiac tamponade present?

A
  • SOB and dizziness and chest pain
  • Low BP
  • Pulsus paradoxus
34
Q

How can constrictive pericarditis be managed?

A
  • Limited diuretics

- Pericardectomy

35
Q

Which organism is the most common cause of infective endocarditis?

A

Strep viridans (staph aureus is 2nd)

36
Q

How does infective endocarditis present?

A
  • Fever
  • New heart murmur
  • Splenomegaly
  • Petechiae
  • Osler nodes
  • Janeway lesions
  • Splinter haemorrhages
37
Q

Which antibiotics should be used for infective endocarditis?

A
  • Amoxicillin +/- gentamicin
  • Severe: vancomycin + gentamicin
  • Prosthetic valve: vancomycin + gentamicin
38
Q

How does mitral stenosis present?

A
  • Dyspnoea
  • Haemoptisis
  • Systemic embolisation
  • IE
  • Chest pain
  • Mitral facies
  • Diastolic thrill and RV heave
  • Rumbling diastolic murmur at apex
39
Q

How does mitral regurgitation present?

A
  • Acute: SOB, pulmonary oedema and cardiogenic shock
  • Chronic: dyspnoea, exhaustion and RHF
  • High pitched blowing holosystolic murmur
40
Q

How does aortic stenosis present?

A
  • Chest pain
  • Syncope
  • Breathlessness on exertion
  • Heart failure
  • Harsh cresendo-decrescendo systolic murmur
41
Q

How does aortic regurgitation present?

A
  • Exertional breathlessness
  • Collapsing pulse
  • Wide pulse pressure
  • Soft high pitched early diastolic murmur
42
Q

How does acute limb ischaemia present?

A
  • Pale
  • Pulseless
  • Painful
  • Paralysed
  • Paraesthetic
  • Perishingly cold
43
Q

How can acute limb ischaemia be managed?

A
  • Urgent reconstruction for trauma
  • Fasciotomy for compartment syndrome
  • Embolectomy
  • Anticoagulation
  • Thrombolysis
  • Amputation
44
Q

How can chronic limb ischaemia be managed?

A
  • Antiplatelets
  • Statin
  • BP control
  • Smoking cessation
  • Exercise
  • Diabetic control
  • Angioplasty, stent, surgical bypass and endovascular reconstruction
  • Amputation`
45
Q

How can varicose veins be managed?

A
  • Prevention
  • Referral for bleeding varicose veins or venous ulcers
  • Endothermal ablation, ultrasound guided foam sclerotherapy and striping of the vein
46
Q

How can venous ulcers be managed?

A
  • Graduated compression
  • Debridement and cleaning
  • Dressing
  • Antibiotics only if infected
  • Pentoxifylline if chronic
  • Topical steroid for surrounding venous dermatitis

Finals (18 decks)

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