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Year 2 > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Definition of typical angina

A
  • Constricting discomfort in the front of the chest, in the neck, shoulder, jaw or arms
  • Precipitated by physical exertion
  • Relieved by GTN
    (Atypical only 2 symptoms)
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2
Q

Treatment of uncomplicated, stable angina?

A

GTN (symptom relief)

beta-Blocker (or CCB)

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3
Q

Treatment for atrial fibrillation?

A

beta-Blocker (or CCB)

If CHA2DS2VASc score =>2…anticoagulate

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4
Q

Signs & symptoms of AF?

A 
Irregular pulse obvs!
And
Breathlessness
Palpitations
Chest discomfort
Syncope or dizziness
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5
Q

Diagnosis of ACS?

A

Chest/arm or other myocardial ischaemia type pain
ECG changes
Troponin rise

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6
Q

General terms what does STEMI vs NSTEMI mean?

A

STEMI - complete coronary artery occlusion

NSTEMI - incomplete occlusion

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7
Q

Immediate treatment for ACS?

A

GTN + Aspirin (+ opoid) in primary care

+ anticoagulants in secondary

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8
Q

Long term treatment after ACS?

A 
ACE inhibitor
Beta-blocker
Statin
Anti-platelet therapy
(Aldosterone antagonist if LV dysfunction)
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9
Q

Example of discharge medicines post-ACS?

A 
Clopidogrel (anti-platelet)
Ramipril (ACEi)
Simvastatin 
Bisoprolol (beta-blocker)
(Eplerenone/Spironolactone)
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10
Q

Example of angiotensin II receptor blocker and when it is used?

A

Candesartan
Eprosartan
Losartan
Used when ACEi contraindicated or not tolerated

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11
Q

Changes on ECG initially with ACS?

A

Tenting T waves…followed by ST elevation (and possible T wave inversion)

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12
Q

Other ECG changes of ACS?

A

New LBBB

Pathological Q waves (hours-days) - MI

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13
Q

Mechanism of action of heparin?

A

Binds to antithrombin III, which inactivates thrombin and factor Xa

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14
Q

Mechanism of action of eptifibatide/tirofiban

A

Glycoprotein IIb/IIIa inhibitors, inhibit platelet aggregation (as the drugs bind to glycoprotein receptors)

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15
Q

What is vWF?

A

von-Willebrand Factor, found in subepithelial matrix of blood vessel, binds to glycoprotein Ib on platelets, activating platelets (upon endothelial injury, which exposes vWF)

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16
Q

Henoch-Schonlein pupura symptoms (and signs)?

A

Classic triad: Purpura; arthralgia (arthritis); abdo pain

Signs include proteinuria and haematuria

17
Q

Henoch Schonlein purpura pathophysiology?

A

Immune complexes of IgA and complement C3 are deposited on veins, arteries, capillaries, therefore a vasculitis essentially

18
Q

Diagnosis of hypertension?

A

BP >140/90, and confirmed with ABPM (>135/90)

Or BP>180/110

19
Q

1st line Treatment for HTN age <55

A

ACEi (or ARB)

20
Q

1st line Treatment for HTN age > 55, or black any age?

A

Ca channel blocker

21
Q

2nd step treatment for HTN? any age

A

Add either ACEi or Ca channel blocker (whichever wasn’t added at step 1)

22
Q

3rd step treatment for HTN? any age

A

ACEi + Ca blocker

Add thiazide diuretic e.g. indapamide or chlortalidone

23
Q

4th step treatment for HTN?

A

ACEi + CCB + thiazide diuretic

Add low dose spironolactone

24
Q

Collapsing pulse sign of…?

A

Aortic Regurgitation

25
Q

When to give apixaban instead of warfarin?

A 
Confirmed eGFR 30-50 and AF and one of:
Age > 75
Hypertension
Diabetes
Previous stroke/TIA
26
Q

Treat simple HTN in pregnancy?

A

Labetalol
or
Methyldopa

27
Q

Wolff-Parkinson-White syndrome pathophysiology?

A

Accessory pathway from atria to ventricles - Bundle of Kent, not AV node, so conduction isn’t slowed, hence delta waves on ECG, and tachycardia

28
Q

Antiplatelet therapy post ACS?

A

NSTEMI-ACS: dual platelet therapy for 12 months post then keep on single therapy long term (aspirin).
STEMI-ACS: dual platelet therapy for >1 months (asp + clop) post then keep on single therapy long term (aspirin). Or ticag and aspirin for upto 12 months.
Aspirin
clopidogrel
Ticagrelor

29
Q

Drug for bradycardia?

A

Atropine 500mcg

further use of 500mcg up to max 3mg

30
Q

Regular narrow complex tachycardia algorithm?

A
  1. Vagal maneuvers
  2. Adenosine 6mg rapid IV bolus
  3. 12mg adenosine twice more max
31
Q

Regular broad complex tachycardia algorithm?

A

if regular:
- VT = amiodarone 300mg IV over 20-60 mins
then 900mg over 24hrs
- SVT = give adenosine as for regular narrow complex tachycardia

32
Q

Secondary prevention drugs for angina

A

Statin
Aspirin 75mg OD - if low bleeding risk
Antihypertensive

33
Q

Warfarin indications

A

Atrial Fibrillation
Venous thromboembolism
Mechanical heart valves

34
Q

Target INR on warfarin

A

AF - 2.5
VTE - 2.5
if recurrent VTE - 3.5
Heart valves depending - mitral valves higher INR than aortic

Year 2 (21 decks)

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