Brainscape's Knowledge GenomeTM

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


See full index

3a > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is the threshold for hypertension?

A

140/90 mmHg

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

What is the target BP for someone with hypertension and diabetes?

A

130/80 mmHg

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

What is hypertension a risk for?

A

Stroke, MI, HF, CKD, AF, hypertensive retinopathy, vascular dementia

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

How does hypertension cause atherosclerosis?

A

Thickens media of muscular arteries

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

What is the threshold for malignant hypertension?

A

200/130 mmHg

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

Which renal diseases cause hypertension?

A

Glomerulonephritis, polycystic kidneys, systemci sclerosis

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

Which endocrine diseases cause hypertension?

A

Cushing’s, acromegaly, Conn’s

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

Which drugs cause hypertension?

A

Steroids, amphetamines, cocaine

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

Coarctation of the aorta can cause hypertension. What is a sign of this?

A

Weak femoral pulse

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

What Ix’s would you do to diagnose hypertension?

A
  • 24 hour ambulatory BP monitoring
  • blood glucose to rule out diabetes
  • U&E and urinalysis to exclude renal disease
  • Ophthalmoscopy : retinal haemorrhage
  • ECG :LV hypertrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What lifestyle changes can reduce hypertension?

A
  • Exercise
  • Stop smoking
  • Low fat diet
  • Reduce salt
  • Reduce alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If a patient is under 55 years old, which drug do you give them for hypertension?

A

ACEi or ARB

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

If a patient is >55 or of Afro-Caribbean origin of any age, which drug would you give them for hypertension?

A

CCB

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

After initial treatment of hypertension, you can combine ACE/ARB with CCB. If the BP is still not controlled, what drug would you prescribe?

A

Thiazide diuretic

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

What drugs would you prescribe for resistant hypertension?

A
  • Spironolactone if K+ <4/5 mmol/L

- alpha blocker or beta blocker if K+>4.5 mmol/L

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

How many stages of hypertension are there?

A

3.
stage 1: 140/90 mmHg
stage 2: 160/100 mmHg
stage 3: 180/120 mmHg

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

Which test would you do to assess CV disease risk?

A

Qrisk3.

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

What does Qrisk3 predict?

A

Risk of having a heart attack or stroke in next 10 years

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

Which extra conditions/medications does Qrisk3 ask for compared to Qrisk2?

A
  • Erectile dysfunction
  • Migraine
  • Severe mental illness
  • Anti-psychotic medication
  • Steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which non-modifiable factors does Qrisk 3 ask for?

A
  • Age
  • Sex
  • Ethnicity
  • UK postcode
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which conditions do both Qrisk2 and Qrisk 3 ask about?

A
  • Smoking status
  • Diabetes
  • Angina or heart attack in 1st degree relative <60
  • CKD
  • AF
  • Hypertension
  • RA
  • BMI
  • Cholesterol/HDL ratio
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the target BP for someone with hypertension <80 years old?

A

<135/85 mmHg

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

What is the target BP for someone with hypertension >80 years old?

A

<145/85 mmHg

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

Name an ACE inhibitor

A

Ramipril

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

Name an ARB

A

Losartan

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

Name a CCB

A

Amlodipine

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

Name a thiazide diuretic

A

Indapamide

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

Name an alpha blocker

A

Doxazosin

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

Name a beta blocker

A

Atenolol

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

Name symptoms and signs of malignant hypertension

A
  • Retinal haemorrhage
  • Papilloedema
  • New onset confusion, chest pain
  • Signs of AKI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the risk factors for atherosclerosis?

A
  • Age
  • Smoking
  • High serum cholesterol
  • Obesity
  • Diabetes
  • Hypertension
  • FH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which coronary arteries are most likely to develop atherosclerosis?

A
  • Circumflex
  • Left anterior descending
  • Right coronary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which cells in the artery are damaged due to plaques?

A

Endothelial cells

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

What can atherosclerosis lead to?

A
  • Coronary artery disease
    1. Angina
    2. MI
    3. HF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Which drugs can be used to treat atherosclerosis?

A
  • Statins - inhibits enzymes which make cholesterol
  • Clopidogrel - inhibits P2Y12 ADP receptor on platelets
  • Aspirin - irreversible inhibitor of platelet cyclo-oxygenase
  • Canakinumab injections - inhibit IL-1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which surgery can be done to treat atherosclerosis?

A

Stent made out of steel and cobalt chromium

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

Which conditions does acute coronary syndrome consist of?

A
  • STEMI
  • NSTEMI
  • Unstable angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which chemical is released when myocardial cells die?

A

Troponin

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

What are the features of a STEMI on an ECG?

A
  • ST elevation
  • New LBBB
  • Pathological Q wave
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What does a Q wave represent?

A

Septal depolarisation . This shows on the ECG due to it not being masked by ventricular wall depolarisation, due to the ventricular wall being dead - i.e. from an MI

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

Which conditions cause a raised troponin?

A
  • MI
  • Aortic dissection
  • Hypertrophic cardiomyopathy
  • Severe anaemia
  • Heart failure
  • Sepsis
  • Stroke
  • Renal failure
  • Subarachnoid haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Name the 2 main types of MI

A
  1. Spontaneous - due to plaque rupturing/occlusion of artery
  2. Secondary to ischaemia

Other types include those instigated by stents and bypass

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

Name the clinical features of ACS

A
  • Chest pain, radiating to arms, back or jaw
  • Pain >15 minutes
  • Nausea + vomiting
  • Sweating
  • Breathlessness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the initial management of an MI?

A
  • 12 lead ECG
  • Morphine
  • Oxygen
  • Glyceryl trinitrate
  • Aspirin 300mg
  • Rapid acting antiplatelet e.g. Ticagrelor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is ST elevation a sign of in the artery?

A

Complete occlusion of epicardial coronary artery

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

What is the gold standard treatment for a STEMI?

A

PCI: primary percutaneous intervention UP TO 12 hours after onset of pain

(thrombolysis is no longer first line due to significant bleeding risks)

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

What is a NSTEMI a sign of in the artery?

A

Partial coronary occlusion

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

What are the features of a NSTEMI on an ECG?

A
  • ST depression
  • T wave inversion
  • No Q wave
49
Q

Which test can be done to distinguish between a NSTEMI and unstable angina?

A

Troponin - a rise indicates NSTEMI

50
Q

Which troponins are most specific to the heart?

A

I and T

51
Q

Which drugs are given in the management of a NSTEMI?

A
  • Beta blocker
  • ACE inhibitor
  • Atorvastatin 80mg OD

The same treatment is given for unstable angina.

52
Q

Which score is used to predict mortality after a NSTEMI?

A

GRACE score

53
Q

Which surgical treatment is used for high risk or young NSTEMI patients?

A

Coronary angiography, with subsequent PCI if required

54
Q

Which drugs are given in the management of an MI?

A
  • Dual antiplatelet therapy for 1 year, usually aspirin + clopidogrel
  • Anticoagulate to inhibit fibrin formation e.g, fondaparinux
  • Beta blocker
  • ACE inhibitor
  • Atorvastatin 80mg OD
55
Q

Which lifestyle changes would you suggest after an MI?

A
  • Stop smoking
  • Treat diabetes, hypertension, hyperlipidaemia
  • Healthy, low fat diet
  • Daily exercise
56
Q

Unstable angina is ACS without a rise in troponin. What are its features?

A
  • Angina >20 mins at rest
  • New onset of severe angina
  • Angina that occurs after recent MI
57
Q

What are the differentials of an MI?

A
  • Myocarditis
  • Pericarditis
  • PE
  • Aortic dissection
  • Arrhythmias
  • Sepsis
  • Cardiotoxic agents
  • Pneumothorax
  • Pneumonia
  • Reflux
58
Q

When does troponin rise after an NSTEMI?

A

2-3 hours after onset of chest pain

59
Q

What are the complications of a MI?

A
  • Heart failure
  • Arrhythmias - BBB, sinus brady/tachy, heart block, AF, VF
  • Pericarditis
  • Depression
  • Cardiac tamponade
  • Mitral regurgitation
60
Q

What is the definition of angina?

A

Symptomatic reversible myocardial ischaemia

61
Q

What causes angina?

A

Atherosclerosis leading to restricted coronary blood flow

62
Q

What are the clinical features of angina?

A

-Heavy/constricting pain in chest, jaw, shoulders or arms
-Symptoms brought on by exertion and relieved by rest or GTN
Typical angina = all 3 features
Atypical angina = 2 features

63
Q

Name the 5 types of angina.

A
  1. Stable
  2. Unstable - occurs on minimal exertion, increasing severity
  3. Decubitus - happens when lying flat
  4. Prinzmetal - caused by coronary artery spasm
  5. Microvascular - syndrome X
64
Q

Name the supply related precipitant factors of angina.

A
  1. Anaemia
  2. Hypoxaemia
  3. Polycythaemia
  4. Hypothermia
  5. Hypovolaemia
65
Q

Name the demand related precipitant factors of angina.

A
  1. Emotional stress
  2. Hypertension
  3. Hyperthyroidism
  4. Tachyarrhythmia
  5. Hypertrophic cardiomyopathy
  6. Cold weather
  7. Heavy meals
66
Q

Which Ix’s would you do to diagnose angina?

A
  • Exercise stress treadmill test - look for ST depression
  • Stress echo
  • 12 lead ECG, ST depression, inverted T wave
  • SPECT
67
Q

Which drugs are given to treat angina?

A
  • Aspirin 75mg OD
  • Statin
  • Beta blocker - contraindicated in Prinzmetal angina
  • GTN spray
  • CCB
68
Q

What are the side effects of beta blockers?

A
  • bradycardia
  • erectile dysfunction
  • cold hands and feet
  • fatigue
69
Q

Beta blockers are -ve chronotropes and -ve inotropes. What does ths mean?

A
  • ve chronotrope = reduces HR

- ve inotrope = reduces contractility

70
Q

How does GTN work?

A

Dilates systemic veins to reduce preload on heart.

71
Q

How do CCBs work?

A

Dilates systemic arteries to lower BP and afterload on heart.

72
Q

What is the surgical management of angina (high risk or when medication fails)?

A
  1. PCI

2. CABG

73
Q

What are the pros and cons of PCI?

A

Pros:

  • Less invasive
  • Repeatable

Cons:

  • Risk of stent thrombosis
  • Risk of re-stenosis
  • Requires dual antiplatelet therapy
74
Q

What are the pros and cons of CABG?

A

Pros:
-Deals with complex disease

Cons:

  • Invasive
  • Risk of stroke and bleeding
  • Cannot be done on frail patients
  • Long procedure
  • Need time for recovery
75
Q

What is the infarct site when there is ST elevation V1-V3?

A

Anterior

76
Q

What is the sign on an ECG of an inferior infarct?

A

ST elevation II, III, AVF

77
Q

What is the infarct site when there is ST depression V1-V3, Dominant R wave and ST elevation V5-6?

A

Posterior

78
Q

What is the sign on an ECG of a lateral infarct?

A

I, AVL, V5-V6

79
Q

What is chronic heart failure?

A

Reduced cardiac output due to impaired cardiac contraction

80
Q

How do you calculate cardiac output?

A

Heart rate x Stroke volume

81
Q

Name factors which reduce cardiac output

A
  • lower HR
  • lower preload
  • lower contractility
  • higher afterload
82
Q

Name the cardiac causes of heart failure

A
  • MI
  • AF
  • Valve disease
  • Hypertension
  • Cardiomyopathy
83
Q

Name the non cardiac causes of heart failure

A
  • Hypo and hyperthyroidism
  • Diabetes
  • Cushing’s
  • Sepsis
  • RA
  • SLE
  • Renal failure
  • Nephrotic syndrome
  • Hepatic failure
84
Q

Which medications can cause heart failure?

A
  • Beta blockers
  • Anti-arrhythmics
  • Calcium antagonist
85
Q

What are the clinical features of heart failure?

A
  • Dyspnoea on exertion
  • Fatigue
  • Orthopnoea - sleeps with several pillows
  • Paroxysmal nocturnal dyspnoea
  • Nocturnal cough
  • Pre-syncope
86
Q

Which social risk factors are associated with heart failure?

A
  • Smoking
  • Excess alcohol
  • Recreational drug use
87
Q

What the signs of heart failure you might find on examination?

A
  • Tachycardia at rest
  • Hypotension
  • Narrow pulse pressure
  • Raised JVP
  • Displaced apex beat
  • Right ventricular heave
  • Gallop rhythm
  • Murmurs
  • Pedal and ankle oedema
  • Tachypnoea
  • Stony dullness on percussion (pleural effusion)
  • Bibasal end-inspiratory crackles and wheeze
  • Hepatomegaly
  • Ascites
88
Q

What are the ECG findings of heart failure?

A
  • Tachycardia
  • AF
  • Left axis deviation due to hypertrophy
  • P wave abnormalities
  • Prolonged PR interval (AV block)
  • Wide QRS complex
89
Q

What blood tests are included in a cardiomyopathy screen?

A
  • Serum iron and copper to rule out haemochromatosis and Wilson’s
  • Rheumatoid factor
  • ANCA/ANA
  • Serum ACE to rule out sarcoidosis
  • Serum free light chains to rule out amyloidosis
90
Q

Which blood test is gold standard for heart failure?

A

Serum NT-proBNP

91
Q

What is the threshold value of NT-proBNP which suggests heart failure?

A

> 400 ng/L

92
Q

Which other conditions present with raised NT-proBNP?

A
  • Left ventricular hypertrophy
  • Tachycardia
  • Liver cirrhosis
  • Diabetes
  • Renal disease
93
Q

Which echo is needed to diagnose heart failure?

A

Transthoracic

94
Q

What are the CXR signs of congestive heart failure?

A 
A -alveolar oedema (bat wings)
B - kerley B lines (interstitial oedema)
C - cardiomegaly
D - dilated upper lobe vessels
E - effusion (blunted costophrenic angle)
95
Q

Name the classification system for heart failure

A

New York Heart Association classification system

Class I: no symptoms during ordinary physical activity
Class II: slight limitation of physical activity by symptoms
Class III: less than ordinary activity leads to symptoms
Class IV: inability to carry out any activity without symptoms

96
Q

What is the ejection fraction in systolic HF?

A

EF < 40%

97
Q

What is the ejection fraction in diastolic HF?

A

EF >40%

98
Q

Name conditions which cause high output heart failure

A
  • Anaemia
  • Pregnancy
  • Hyperthyroidism
99
Q

What are the complications of heart failure?

A
  • Renal dysfunction
  • Rhythm disturbance
  • Systemic thromboembolism
  • DVT
  • LBBB
  • Hepatic dysfunction
  • Depression
100
Q

What is ejection fraction?

A

% of blood ejected out of LV with each beat (should be 70%)

101
Q

What lifestyle management is advised for heart failure?

A
  • Fluid and salt restriction
  • Regular exercise
  • Smoking cessation
  • Reduced alcohol intake
102
Q

Which medications can worsen heart failure?

A
  • CCB
  • Tricyclic antidepressants
  • Lithium
  • NSAIDs
  • Corticosteroids
103
Q

Which medications are prescribed to treat heart failure?

A
  • Diuretics - relieve symptoms of fluid overload
  • ACE inhibitors (measure U&E to check hyperkalaemia)
  • Beta blockers
  • ARB if cannot tolerate ACEi
104
Q

Which medications are prescribed for resistant heart failure?

A
  • Spironalactone

- Ivabradine

105
Q

Which surgical treatments can be used for heart failiure?

A
  • CABG
  • Valve surgery
  • ICD
  • Heart transplant
106
Q

What is AF?

A

Chaotic irregular rhythm 300-600 bpm

107
Q

What are the causes of AF?

A
  • Post surgery
  • Heart failure
  • Hypertension
  • Mitral valve disease
  • Pneumonia
  • Hyperthyroidism
  • Caffeine and alcohol
  • Hypokalaemia
108
Q

What are the triggers of AF?

A
  • PE
  • Ischaemia
  • Thyroid disease
  • Alcohol
  • Sepsis
  • Sleep apnoea
109
Q

What are the symptoms of AF?

A
  • Asymptomatic
  • Chest pain
  • Palpitations
  • Dyspnoea
  • Dizziness
  • Collapse
110
Q

What are the signs of AF?

A
  • Irregularly irregular pulse

- Tachycardia

111
Q

How will an ECG present in AF?

A
  • Absent P wave

- Irregular, narrow QRS complex

112
Q

Which other Ixs (other than ECG) can you do for AF?

A
  • CXR
  • Echo
  • Bloods: U&E, thyroid function, FBC
113
Q

How would you manage acute AF?

A
  • ABCDE
  • Cardioversion
  • Amiodarone to control rhythm
  • Beta blocker to control HR
  • Heparin
  • Correct electrolyte imbalance
  • Treat precipitating factors
  • Fluids
114
Q

How would you manage chronic AF?

A
  • Beta blocker or CCB
  • Flecainide to control rhythm
  • Warfarin (anticoagulation to prevent stroke from emboli)
115
Q

Which score calculates risk of stroke?

A

CHA2DS2-VASc

116
Q

Which score calculates risk of bleeding?

A

HAS-BLED

117
Q

What term is given to AF when the episodes are intermittent and stop within 48 hours?

A

Paroxysmal AF

118
Q

What are the risk factors of developing chronic AF from paroxysmal AF?

A
  • Age
  • Hypertension
  • Obesity

3a (13 decks)

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