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Gen Med and Surg - C.U > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What is a cause of an pulsus paradoxus? (abnormally large drop in BP on inspiration)

A

cardiac tamponade

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2
Q

Clinical features of an unruptured AAA

A

Can be asymptomatic
Back pain
Pulsating mass on abdo exam

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3
Q

Clinical features of a ruptured AAA

A 
Abdominal pain radiating to the back 
Sweating 
SOB
Shocked 
Dilated abdomen
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4
Q

Best imaging for a AAA

A

US

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5
Q

At what size can a AAA be monitored every 6m

A

< 5.5cm

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6
Q

What is used to monitor a AAA

A

Exam and US

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7
Q

When is surgery considered in a AAA

A

> 5.5cm or rapidly expanding

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8
Q

Two options for surgical intervention in AAA

A

Open / endoluminal approach

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9
Q

Acute approach to ruptured AAA

A

ABCDE
oxygen
contact vascular team

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10
Q

Prophylactic AB in AAA

A

Cefuroxime and Metronidazole

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11
Q

Type A dissecting aortic aneurysm

A

Includes the ascending aorta, starts proximal to the left SA branch

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12
Q

Type B dissecting AA

A

starts distal to the left SA brach

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13
Q

Aortic dissection risk factors

A
B
C

A

Age
Baby / BP
Connective tissue disorders

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14
Q

If dissection progresses proximally it can cause…

A

MI - affects the coronary arteries

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15
Q

If dissections progresses distally it can cause…

A

renal hypoperfusion

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16
Q

Typical description of pain in dissecting AA

A

tearing back pain between scapulae

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17
Q

Clinical features of a dissecting AA

A 
Back pain - tearing, scapula 
Loss of peripheral pulses 
May mimic an MI 
May be radio - radio delay 
Neuro symptoms if spinal arteries involved 
Shock if rupture
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18
Q

Bedside test for dissecting AA

A

ECG

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19
Q

Imaging (3) for dissecting AA

A

US
CT/MR
TO Echo

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20
Q

Management of a type A dissecting AA

A

Surgical

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21
Q

Management of type B dissecting AA

A

Medical - anti hypertensive and monitor

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22
Q

Potential complications in dissecting AA (4)

A

MI
Acute renal failure due to ischeamia
Neurological damage - hemiplegia
Lower limb ischaemia

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23
Q 
Primary causes of myocardial disease 
H
A
R
D
A

Hypertrophic obstructive
Arrhythmogenic RV
Restrictive
Dilated

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24
Q

Secondary causes of myocardial disease

A

systemic
ischaemic
hypertension
inflammatory

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25
Q

what may dilation cardiomyopathy mask?

A

hypertrophy

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26
Q

3 common causes of dilated CM

A

Hypertension
Alcohol
Chemotherapy

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27
Q

What is found on biopsy in dilated cardiomyopathy?

A

haphazard architecture
enlarged myocytes
t cell infiltration
fibrosis

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28
Q

Signs of myocardial disease

Peripheral

Heart

Lung

Abdo

A

Peripheral

  • cyanosis
  • oedema

Heart

  • tachycardia
  • raised JVP
  • S3

Lungs

  • tachypnoea
  • basal creps
  • pleural effusions

Abdo
- ascites and hepatomegaly

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29
Q

Blood tests in dilated cardiomyopathy

A 
UandEs 
LFTs 
TFTs 
Iron studies 
Infection screen 
Autoimmune screen 
Genetic screening
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30
Q

Possible ECG tests for DCM

A

Normal ECG
24 hr ECG
Exercise testing

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31
Q

Imaging in DCM

A

Echo
CXR
Cardiac MR

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32
Q

Complications of ventricular dilation

A

Tachyarrhythmias
LV thrombus w/ embolism causing stroke
Valve dysfunction

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33
Q

How does hypertrophic cardiomyopathy causes reduced CO?

A

Stiff ventricular walls lead to reduced diastolic filling

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34
Q

main cause of hypertrophic cardiomyopathy?

A

genetic

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35
Q

where is abnormal tissues focused in hypertrophic cardiomyopathy? and what does this lead to

A

septal

leading to left ventricular outflow obstructin

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36
Q

ECG results in hypertrophic cardiomyopathy?

A

may be normal

may be ST depression and T wave inversion

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37
Q

Imaging in hypertrophic cardiomyopathy?

A

ECHO

Cardiac MRI

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38
Q

Patient education in hypertrophic cardiomyopathy?

A

Controlled exercise to prevent sudden death

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39
Q

Medical treatment in hypertrophic cardiomyopathy?

How does each drug work

A

Beta blockers - improve diastolic filling and reduce myocardial demand

Calcium channel blockers - negatively inotropic, reduce HR during activity

Disopyramide - sodium channel blocker, antiarryhthmic

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40
Q

Other management of hypertrophic cardiomyopathy? (4)

A

ablate the septum
pacemaker
implantable defib
myomectomy

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41
Q

How does restrictive cardiomyopathy cause poor CO

A

Poor diastolic filling, unable to increase due to a FIXED stroke volume

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42
Q

Causes of restrictive cardiomyopathy

A 
idiopathic 
systemic sclerosis 
infiltration e.g. from amyloid 
familial 
fibrosis due to infection
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43
Q

restrictive cardiomyopathy is difficult to distinguish clinically from?

A

constrictive pericarditis

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44
Q

clinical features of restrictive cardiomyopathy

A

Peripheral

  • SOB
  • Fatigue
  • oedema

Heart

  • palpable apex
  • Loud S3 / S4
  • Raised JVP

Lung
- pulmonary oedema if severe

Abdo
- hepatomegaly

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45
Q

P wave changes in restrictive cardiomyopathy

A

P mitrale and P pulmonale

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46
Q

Imaging + other tests in restrictive cardiomyopathy

A

Echo

Cardiac catheterisation

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47
Q

Most common viral cause of myocarditis

A

Coxsackie virus B

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48
Q

Causes of myocarditis

A

Infective - bacterial / viral etc
Immune reactions - post viral, rheumatic fever
Transplant rejection

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49
Q

Clinical features of myocarditis

A

spans from asymptomatic to heart failure

Can be - fever, SOB, chest pain, palpitations, tachycardia

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50
Q

Main blood tests in myocarditis

A

Serology for infectious agents

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51
Q

ECG sign in hypercalcaemia

A

Shortened QT interval

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52
Q

Imaging if suspect heart valve disease

A

CXR

Echo - TTE / TOE

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53
Q

Complications of replacement valves

A

Infective endocarditis
PE / DVT
Haemolysis / anaemia

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54
Q

Arrhythmia resulting from mitral stenosis

A

AF (increase in left atrial pressure)

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55
Q

Two main causes of mitral stenosis

A

Rheumatic fever and senile calcification

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56
Q

Symptoms of right heart failure

A

Dyspnoea
Reduced exercise tolerance
Cough Haemoptysis
Palpitation

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57
Q

Signs on examination of mitral stenosis

A

Clubbing - heart failure
Raised JVP
? anaemia due to haemolysis
Early diastolic murmur

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58
Q

ECG signs of mitral stenosis

A

AF
Right heart failure - right axis deviation
P mitrale (if in sinus rhythm)

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59
Q

Signs of hf on CXR

A

ABCDE

Aveolar oedema 
Kerly B lines - interstitial oedema 
Cardiomegaly 
Dilated upper lobe vessels 
Pulmonary effusions
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60
Q

Causes of mitral regurg

A

Post MI
Infective endocarditis
Rheumatic fever

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61
Q

General symptoms of heart failure

A

SAD - syncope, angina and dyspnoea

  • SOB
  • Palpitations
  • Chest pain
  • Syncope / presyncope
  • Swelling / weight gain
  • orthopnea
  • paraoxysmal nocturanl dyspnoea
  • nocturia
  • cough with pink frothy sputum
  • abdo pain / swelling
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62
Q

Mitral regurg on clinical exam

A

pansystolic murmur

radiates into the axilla

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63
Q

Management in heart valve problems

A

Medical

  • AF control
  • anticoag in valve replacement

Surgical

  • valve repair
  • valve replacement
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64
Q

3 causes of aortic stenosis

A

Age related
Bicuspid valve e.g. turners syndrome
Rheumatic fever

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65
Q

Pulse in aortic stenosis

A

narrow pulse pressure

slow rising

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66
Q

Which type of arrhythmia is common in AS

A

AV block - calcification in this area

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67
Q

Which type of medication should be avoided in AS?

A

Drugs that reduce after load e.g. nitrates and ACE inhibt

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68
Q

Causes of AR?

A

Infective endocarditis
Rheumatic fever
Connective tissue diseases

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69
Q

Pulse in AR

A

Collapsing and wide pulse pressure

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70
Q

Medications to be use in regurgitation conditions

A

vasodilators to reduce afterload

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71
Q

HF definition in terms of ejection fraction

A

<40%

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72
Q 
New York heart association classification of HF
1
2
3
4
A

1 no symptoms
2 symptoms on moderate exertion (climbing a flight of stairs)
3 mild effort (100m on flat ground)
4 symptoms at rest

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73
Q

How does reduced renal perfusion in heart failure contribute to further decompensation

A

Activates RAAS and sympathetic system

  • fluid retention
  • vasoconstriction
  • fluid overload
  • increased muscle stretch - the cycle continues
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74
Q

Causes of left ventricular failure

1) Low output
2) Increased demand

A
  • IHD
  • valve disease
  • HTN
  • cardiomyopathy
  • pregnancy
  • anaemia
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75
Q

Signs of heart failure

A 
Clubbing 
Peripheral cyanosis 
Tachycardia
Tachypnoea 
Displaced apex 
3rd heart sound 
basal creps 
oedema - sacral and pedal
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76
Q

Bed side tests in heart failure

A 
FBC 
U&amp;Es (kidney function) 
LFTs 
BNP 
TFTs 
Bone and clotting profile 
Fasting glucose and lipids 
Urine dip

ECG
CXR

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77
Q

Imaging in heart failure

A

ECHO = gold standard

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78
Q

Acute management of heart failure

A

ABCDE

  • sit up
  • ECG
  • Full set of bloods
  • ABG - look for hypoxia
  • CXR
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79
Q

Acute medical management fo HF if BP >100

A

IV furosemide
IV GT
IV opiates

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80
Q

Acute medical management fo HF if BP <100

A

Consider CPAP - aid venodilation and reduce preload

Consider ICU

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81
Q

Important education in CHF

A 
Regular vaccinations 
fluid input and output 
Exercise important
good diet 
stop smoking
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82
Q

3 key drugs in heart failure

A

Diuretic
ACE inhib
Beta blocker

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83
Q

Device therapy for heart failure

A

Implantable defib

Cardiac biventricular pacemakers

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84
Q

Which drugs are contraindicated in HF?

A

Calcium channel blockers and NSAIDs - precipitate decompensation

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85
Q

Anteroseptal ST elevation MI

ECG changes
Coronary artery

A

V1-4

LAD

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86
Q

Inferior ST elevation MI

ECG
changes
Coronary artery

A

II, III and aVF

Right coronary

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87
Q

Anterolateral ST elevation MI

ECG changes
Coronary artery

A

I, aVL and V1-4

LAD / circumflex

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88
Q

Lateral ST elevation MI

ECG changes
Coronary artery

A

I, aVL +/- V5-6

Left circumflex

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89
Q

Posterior ST elevation MI

ECG changes
Coronary artery

A

Tall R waves V1-2

Left circumflex / right coronry

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90
Q

Which valve is most commonly affected in infective endocarditis

A

Infective endocarditis in intravenous drug users most commonly affects the tricuspid valve

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91
Q

Dose of statin

Primary prevention

Secondary “”

A

20mg

80mg

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92
Q

AF rate control therapies (2)

A

Digoxin
Beta blockers
Diltiazem

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93
Q

AF anti-arrhythmics

A

amiodarone

flecanide

94
Q

Anticoagulation in AF

A

Heparin / Warfarin / NOAC

95
Q

Main complication of AF

A

Systemic embolisation

96
Q

Atrial flutter usually accompanied by with arrhythmia?

A

AV block

97
Q

Two treatment strategies for atrial flutter

A

Rate control - antiarrythmics and anticoagulants

curative - DV cardioversion / ablation

98
Q

WPW definition

A

atrial re-entry tachy + accessory pathway linking atrium and ventricle

99
Q

ECG signs of WPW

A

Short PR, delta wave and wide QRS

100
Q

Treatment options for WPW

Invasive
Medical

A

DC cardioversion / ablation

rate control - beta blocker / calcium channel blocker

101
Q

Common causes of VT

A

Ischaemia
Drugs
metabolics problems
long QT syndrome

102
Q

VT presentation on ECG

A

broach complex tachy

103
Q

VT treatment

medical
invasive

A

Amiodarone / lidocaine

DC cardioversion

104
Q

VT recurring, treat with

A

Implantable cardiac defib

105
Q

VT main complication?

A

VF

106
Q

Presentation of VF

A

syncope or cardiac arrest

107
Q

Treatment of VF

A

Cardiac defib

108
Q

Definition of first degree block?

A

PR longer than 5 small squares

109
Q

Definition of mobitz type 1

A

PR interval lengthens then drops

110
Q

Definition of mobitz type 2

A

1:3 or 1:2 p to QRS ratios (no link to PR interval)

111
Q

Definition of third degree block?

A

no association between Ps and QRSs

112
Q

Medical treatment for AV block

A

atropine

113
Q

Gold standard for symptomatic 2nd or 3rd degree heart block

A

Cardiac pacing

114
Q

Cardiac risk factors (8)

A 
HTN 
Hyperlipidaemia 
IHD 
Diabetes 
FH 
Smoking 
Cocaine - young people?
115
Q

What is seen in aortic dissection on CXR

A

widened mediastinum

116
Q

Aortic dissection suspected - two types of imaging

A

CXR

CT

117
Q

Imaging in PE

A

CTPA

118
Q

ACS immediate management

A 
Morphine 
Oxygen (if sats below 94%) 
Nitrates 
Aspirin 
Clopidogrel 
Antiemetic
119
Q

PCI vs Fibrinolyitc therapy for ST elevation

A

Can you initiate treatment within 120 mins

120
Q

How to recognise bifasciular block

A
  • RBBB / LBBB

- And left/ right axis deviation

121
Q

How to recognise trifesicular block

A
  • RBBB / LBBB
  • And left/ right axis deviation
  • Above + AV node block
122
Q

What can trifesicular block lead to?

A

heart block

123
Q

In IVDU which side of the heart is usually affected by endocarditis?

A

RHS

124
Q

Causes of the introduction of bacteria into the blood

A

IVDU
Surgery
Lines being put in etc
Liver / renal failure

125
Q

2 commonest bacteria causing infective endocarditis

A

Strep virians

Staphylococcus

126
Q

2 non infective causes of endocarditis

A

SLE

Marantic

127
Q

In which patient presentation should you have a high index of suspicion for IE

A

New murmur and fever

128
Q

Valves affected by IE in order of how common

A

Aortic > Mitral > Tricuspid

129
Q

Clinical features of IE

A 
Fever 
Rigors 
Sweats 
High temp 
Malaise
Fatigue 
Anorexia 
Splenomegaly
130
Q

Findings on peripheral exam in IE

A 
Clubbing 
Splinter haemorrhages 
Oslers nodes 
Janeway lesions 
Roth spots
131
Q

Bloods in IE

A

CRP
FBC
LFTs
UandEs

BLOOD CULTURES - 3 SITES, 1-2hrs apart, must be +ve in two

132
Q

Bedside tests in IE

A

ECG
Urine dip and culture
Swab wounds / cavaties

133
Q

Imaging in IE

A

TOE

CXR

134
Q

Major in dukes criteria

A

2 seperate +ve blood cultures
+ve echo - vegetation / abscess
New valve regurg

135
Q

Minor in dukes criteria

A 
Risk factor for IE 
Fever <38 
Vascular phenomena e.g. embolic stroke 
Immunological phenomena e.g. +ve blood culture not meeting major criteria 
\+ve echo no meeting major criteria
136
Q

Dukes criteria diangosis

A

2 major
1 major, 3 minor
all 5 minor

137
Q

what must be confirmed before starting treatment of IE?

A

3 +ve blood cultures

138
Q

Importance of the presence in mechanical valve in IE?

A

More aggressive medical treatment and lower threshold for surgery

139
Q

Monitoring in IE

A 
Vital signs 
bloods 
blood cultures = repeat
consider PIC line 
ECG
ECHOs
140
Q

Commonest cause of death in IE

A

Septic thromboemboli and infarcts

141
Q

first line for AF in most - >

A

rate control

142
Q

drug to be given alongside cardioversion

A

amiodarone

143
Q

acute temporary causes of AF

A

include alcohol abuse, hyperadrenergic states or sympathomimetic drug intoxication, cardiac or non-cardiac surgery, electrocution, myocarditis, PE, chronic pulmonary disease, and hyperthyroidism

144
Q

AF patients with hemodynamic compromize require with new onset AF of <48hrs …

A

Immediate DC cardioversion

145
Q

AF patients with a wide complex AF suggestive of WPW syndrome require…

A

Immediate DC cardioversion

146
Q

AF patients with evidence of conducting system disease

A

Pacemakers insertion before DC cardioversion

147
Q

Pt with LV dysfunction, choice of rate control drug =

A

diltiazem and digoxin

148
Q

Malignant hypertension defined as?

A

200 / 130

149
Q

Which end organs can be damaged by high blood pressure?

A

Heart, kidney, eyes and brain

150
Q

Most common cause of secondary hypertension

A

Renal disease

151
Q

Definition of essential hypertension

A

140 / 90

152
Q

RF for HTN

A 
Metabolic syndrome 
Obesity 
High alcohol intake 
DM
Black ancestry 
Age 60+ 
FH
153
Q

Grade 1 HTN retinopathy

A

Slight arterionlar narrowing

154
Q

Grade 2 HTN retinopathy

A

Definite narrowing

155
Q

Grade 3 HTN retinopathy

A

Cotton wool spots and flame haemorrhages

156
Q

Grade 4 HTN retinopathy

A

Papilloedema

157
Q

Blood tests in HTN

A

Lipids
U&Es
Fasting glucose

158
Q

Hypertensive emergency how fast should BP be reduced?

A

25% in 4hrs

159
Q

BP aim in diabetic patients

A

< 130mmHg

160
Q

1st line for HTN in under 55s

A

ACE inhibi

161
Q

1st line for HTN in over 55s / AFC

A

Calcium channel blocker

162
Q

2nd line in essential HTN

A

A + C

163
Q

3rd line in essential HTN

A

A + C + D

164
Q

lifestyle measures to combat HTN

A

Lose weight
regular exercise
eat well
stop smoking

165
Q

Mechanism of action of aspirin

A

Thromboxabe A2 inhibitor so inhibits platelets

166
Q

Clopidogrel mechanism of action

A

inhibits platelet function by inhibiting ADP induced platelet aggregation

167
Q

Ticagrelor MOA

A

inhibit platelet aggregation

168
Q

MOA of statins

A

HMG- CoA reductase inhibitors

169
Q

SE of beta blockers

A 
Bradycardia 
Heart block 
Hypotension 
Fatigue 
Impotence
170
Q

Two classes of angina

A

Stable - relieved by rest and brought on by prolonged physical activity

Unstable - severe and persistent. not relieved by rest.

171
Q

Causes of angina

A

Atherosclerosis
Anaemia
AS
Tachyarrythmias

172
Q

Modifable risk factors for angina

A 
Obesity 
Diet - low fat 
Smoking
Diabetes 
Sedentary lifestyle 
Stress excess alcohol
173
Q

Non modifiable risk factors for angina

A 
Family hx 
Increasing age
Males
Post menopausal 
Asian race
174
Q

ECG findings in angina

A

ST depression

175
Q

Investigations for angina in a non acute setting

A 
ECG 
Exercise stress test 
Stress echo 
Myocardial perfusion scan 
Coronary angiography
176
Q

Acute treatment of stable angina

A

Nitrates - sublingual GTN

177
Q

Medical treatment of stable angina

A

Beta blockers - first line

Calcium channel blockers
Nitrate tablets

178
Q

Invasive management of stable angina

A

PCI

Bypass surgery

179
Q

Medication post stent

A

Aspirin for life

Clopi added for a length of time depending on the type of stent inserted

180
Q

WHO definition of MI (two of) ….

A

Chest pain >15min, good clinical hx
Dynamic ECG changes - ST elevation / depression, Q waves, T waves
Rise in troponin

181
Q

3 types of condition in ACS

A

STEMI
NSTEMI
Unstable angina

182
Q

STEMI defining features

A

ST elevation >2mm in two congruent leads (V1-6) OR 1mm in limb leads OR new LBBB

Troponin +ve

183
Q

NSTEMI defining features

A

Troponin +ve

Without STEMI on ECG but may be ischaemic changes

184
Q

Unstable angina defining features

A

Minimal ECG changes
Troponin -ve

High risk of MI in 30 days

185
Q

Specific pathology of MI

A

Rupture of atherosclerotic plaque, causing ischaemia to the heart

186
Q

Management of ACS

A 
A
- airway 
B
- sats - low O2 
- RR
- listen to chest 
C
- cap refil 
- HR
- BP 
- ECG
- Blood - FBC, U&amp;E, Troponin 
D
- glucose

E
- drugs - aspirin, nitrates

Aspririn 300mg
Second anti platelet

Consider

  • anti thrombotic therapy
  • PCI
187
Q

Medication post MI

A

Beta blocker - immediately and titrate up
ACEi - within 24hrs
Statin - immediate
Continue on an anti-platelet

188
Q

Complications on an MI

A

Angina
Arrhythmia
Valve disease

189
Q

MOA of amiodarone

A

blocks patassium channels

190
Q

Amiodarone SE

A
  • thyroid dysfunction
  • corneal deposits
  • pulmonary
  • fibrosis/pneumonitis
  • liver fibrosis/hepatitis
  • peripheral neuropathy, myopathy
  • photosensitivity
  • ‘slate-grey’ appearance
  • thrombophlebitis and injection site reactions
  • bradycardia
191
Q

Causes of pericarditis

A 
Infective - Virus, TB, Rheumatic fever 
Vascular - Post MI 
Metabolic - Uraemia (acute renal failure) 
Autoimmune - CTD, SLE 
Trauma - bleed post surgery
192
Q

Signs of pericarditis on ECG

A

Widespread concave ST elevation

193
Q

Treatment of pericarditis

A

NSAIDs and treat the cause

194
Q

What is pulsus paradoxus

A

drop in arterial pressure of greater then 10 when the patient is in inspiration (seen in cardiac tamponade)

195
Q

Pericardial effusion vs cardiac tamponde

A

Pericardial effusion - fluid build up in the pericardium

Cardiac tamponade - when the heart is unable to fill properly due to a pericardial effusion

196
Q

Causes of pericarial effusion

A 
Vascular - MI, aortic dissection 
Infection - TB
Trauma - post surgery 
Autoimmune 
Malignancy 
Metabolic - renal failure
197
Q

Beck’s triad for tamponade

A

Distant heart sounds
Distended jugular veins - increased JVP
Decreased arterial pressure

198
Q

Causes of acute limb ischaemia

A

Vascular - thrombosis from atheroma or embolus from the heart (e.g. AF)
Trauma
Graft occlusion post surgery

199
Q

6 clinical features of an ischaemic limb

A 
Pale 
Perishingly cold 
Pulseless 
Pain 
Paralysed 
Paraesthetic
200
Q

Imaging in acute limb ischaemia

A

Arteriogram

201
Q

Risk factors for atherosclerosis in LL

A 
Atherosclerosis elsewhere 
DM
Hyperlipideamia 
FH
Smoking
202
Q

Bedside test in chronic limb ischaemia

A

CV exam

ABPI

203
Q

How is ABPI calculated?

A

largest of the popliteal systolic / brachial systolic

> 1 - normal

Diabetic hardened veins may give a false +ve result

204
Q

Blood tests in chronic limb ischaemia

A 
FBC
U&amp;E
LFTs
blood glucose 
Clotting 
Platelets
205
Q

Conservative treatment of chronic limb ischaemia

A

lose weight
stop smoking
good diet

206
Q

medical treatment of chronic limb ischaemia

A

aspirin
statin
control diabetes

207
Q

surgical options in chronic limb ishcaemia

A

angioplasty
bypass graft
amputation

208
Q

Screening for AAA

A

Screening for an abdominal aortic aneurysm consists of a single abdominal ultrasound for males aged 65

209
Q

In venous insufficiency

Doppler US looks for?

Duplex US looks for?

A

reflux

anatomy / flow of the vein

210
Q

Where do arterial ulcers occur?

A

Heels and toes

211
Q

Arterial ulcer presentation

A 
On heel and toes 
Foot is painful 
Cold 
Difficult to feel pulses 
ABPI low
212
Q

Normal ABPI score

A

1.0 - 1.2

213
Q

ABPI score > 1.2 may indicate?

A

may indicate calcified, stiff arteries. This may be seen with advanced age or PAD

214
Q

MOA of clopidogrel

A

Blocks platelet aggregation

215
Q

Virchow’s triad

A

Abnormal blood flow e.g. stasis
Vessel wall abnormalities
Hypercoagulable state

216
Q

Causes of blood stasis

A

Dehydration
Nephrotic syndrome
Post operatively
Immobility

217
Q

Causes of vein wall abnormalities

A

trauma
varicose veins
phlebitis

218
Q

Hypercoaguable state can be due to

A 
Pregnancy 
COCP 
Obesity 
Maligancy 
Hereditary
219
Q

Anticoagulation treatment post VTE

A

3-6 m if known trigger now eliminated

If not - long term

220
Q

Hereditary causes of thrombophilia

A

Factor V leiden
Antiphosopholipid syndrome
Protein C and S deficiency
Antithrombin deficiency

221
Q

Most common heritable form of thrombosis

A

Factor V leiden - autosomal dominant

Results in overactivity of the clotting cascade

222
Q

ECG changes for thrombolysis or percutaneous intervention ->

A

ECG changes for thrombolysis or percutaneous intervention:

ST elevation of > 2mm (2 small squares) in 2 or more consecutive anterior leads (V1-V6) OR

ST elevation of greater than 1mm (1 small square) in greater than 2 consecutive inferior leads (II, III, avF, avL) OR

New Left bundle branch block

223
Q

Which group of medications are associated with long QT?

A

Antipsychotics

224
Q

Which coronary artery supplies the AV node?

A

Right coronary artery

225
Q

Acute management of PE

A

Normotensive - LMWH

Hypotensive - Thromboylsis

226
Q

Second line management of heart failure

A

second-line treatment is now either an aldosterone antagonist, angiotensin II receptor blocker or a hydralazine in combination with a nitrate

227
Q

After second line management, if symptoms persist in hf what are the next options?

A

if symptoms persist cardiac resynchronisation therapy or digoxin* should be considered.

228
Q

vaccinations in heart failure

A

yearly flu

one of pneumococcal

229
Q

NIV used in pulmonary oedema

A

CPAP

230
Q

Types of cardiac implantable devices

A

Pacemaker
Bi ventricular
ICD
Implantable cardiac loop recorder

231
Q

Classic cause of digoxin toxicity

A

hypoK

Gen Med and Surg - C.U (16 decks)

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