cardiovascular 3

Question 1

What can cardiac arrhythmia be divided into

Answer 1

tachycardia
bradycardia

Question 2

Give examples of tachycardia

Answer 2

Sinus tachycardia
Supraventricular tachycardia
Ventricular tachycardia
Atrial fibrillation
Ventricular fibrillation

Question 3

What is sinus tachycardia

Answer 3

Heart rate of above 100 beats per min with ECG showing a normal P wave before each QRS complex

Question 4

When does sinus tachycardia occur

Answer 4

Normal response to exercise

Question 5

What can sinus node disease lead to

Answer 5

Both bradycardia and tachycardia due to malfunction of the Sino atrial node

Question 6

What is supra ventricular tachycardia

Answer 6

abnormal tachycardias originating in or above the AV node

Question 7

Where can supraventricualr tachycardia result from

Answer 7

May arise from the atria where a P wave will still be seen or from the AV node itself

Question 8

When does a ventricular tachycardia arise

Answer 8

Arises within the ventricle because the electrical impulse spreads from the abnormal focus directly through the heart muscle

Question 9

What is atrial fibrillation

Answer 9

atrial activity becomes completely disorded with constant electrical activity throughout the atria and loss of co ordinated atrial contraction

Question 10

what can be the risk during atrial fib

Answer 10

increase risk of clot formation and therefore stroke

Question 11

Describe the ECG of a patietn with atrial fibrillation

Answer 11

no P wave

Question 12

what medication do we use for atrial fib

Answer 12

previously warfarin but recently DOACS

Question 13

Give examples of some bradycardias
A
Sinus bradycarida
Atrio ventricular block
Sinus node

Answer 13

Sinus bradycarida
Atrio ventricular block
Sinus node disease
Cardiovascular reflex disorders

Question 14

WHAT medications can we use for anti dysrhythmic medicines

Answer 14

class 1: procainamide, quinidine, lidocaine
class 2: beta blockers
class 3: amiodarone
class 4: calcium channel blockers
glycosides

Question 15

what LA should be avoided if on anti dysthymics

Answer 15

bupivicaine

Question 16

What can sinus bradycardia be caused by

Answer 16

Drugs or hypothyroidism

Question 17

What can cadiovasuiclar reflex disorders result in

Answer 17

Syncope due to transient bradycardias

Question 18

What clinical assessments do you need to make at the time of suspected arrhythmia

Answer 18

Basic life support
Pulse
Blood pressure
ECG

Question 19

Why is digoxin given to tachycardias patients

Answer 19

To control the ventricular rate in atrial fibrillation

Question 20

Why is Amiodarone given to tachycardias patients

Answer 20

Can sometimes revert atria fibrillation to sinus rhythm

Question 21

How are drugs used to treat arrhythmia classified

Answer 21

Can be classified by what they act on
Classified using the Vaughan Williams classification

Question 22

Talk through the mechanisms of action of cardiac glycosides

Answer 22

They inhibit the membrane bound sodium potassium ATPase which result sin an increase in intracellular sodium
intracellular calcium rises producing an increase in contractility

Question 23

What impact can digoxin have on oral structures

Answer 23

pain similar to trigeminal neuralgia in the lower part of the face

Question 24

What is digoxin toxicity perciprated by

Answer 24

hypokalaemia

Question 25

Give examples of drugs in dentistry that can produce hypokalaemia

Answer 25

LA with adrenaline

Question 26

Give examples of drugs that can increase the plasma concentration of digoxin

Answer 26

NSAIDS Erythromycin Itraconazole

Question 27

What can class I antiarrhythmics be further divided into?

Answer 27

class I A class I B class I c depending on how much they bind to sodium channel and the effect on cardiac action potential

Question 28

What do class I a drugs do

Answer 28

prolong the action portenail

Question 29

What do class I b drugs do

Answer 29

shorten the action potential

Question 30

What do class I c drugs do

Answer 30

have little/no effect upon action potential

Question 31

the mechanism of action of class I membrane stabilising drugs

Answer 31

act on sodium channel blockers the binding site for these drugs is only available when the sodium channel is in the open or refractory state Accessibility to the target is governed by the rate of openign of the channel

Question 32

what effect can class I membrane stabilising drugs have on oral structures and dental management

Answer 32

They may produce angioedema that can effect the lips tongue and floor of the mouth

Question 33

what are some lifestyle adjustments patients can make

Answer 33

diet limit alchohol exercise smoking cessation flu vaccine

Question 34

what causes polyuria

Answer 34

diuretics

Question 35

what causes dry mouth

Answer 35

diuretics ace inhibitors beta blockers

Question 36

what causes glossitis

Answer 36

ace inhibitors

Question 37

what causes erythema multiform

Answer 37

ace inhibitors

Question 38

what causes lichenoid reactions

Answer 38

thiazide diuretics ace inhibitors beta blockers

Question 39

what causes peri oral numbers

Answer 39

beta blockers

Question 40

what causes bone marrow supression

Answer 40

captopril

Question 41

what causes low platelets

Answer 41

prazocin hydralazine amiofarone

Question 42

what medications can interact with NSAIDS

Answer 42

ace inhibitors antitension receptor blockers beta blockers digoxin

Question 43

what can interact with LA

Answer 43

diuretics calcium channel blockers beta blockers class 1 antiarrhymics digoxin

Question 44

what interacts with erythromycin

Answer 44

anti arrhythmic

Question 45

what interacts with some anti fungals

Answer 45

anti arrhythmic

Question 46

what causes taste disturbance

Answer 46

ace inhibitor angiotensin receptor blockers calcium channel blockers