Brainscape's Knowledge GenomeTM

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


See full index

Phase 2a Medicine > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What might the ECG of someone with unstable angina show?

A

May be normal or might show T wave inversion and ST depression

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

What might ECG of someone with NSTEMI show?

A

May be normal or show T wave inversion and ST depression. May also be R wave regression, ST elevation and biphasic T wave in lead V3

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

What might ECG of someone with STEMI show?

A

ST elevation in anterolateral leads. After a few hours, T waves invert and deep, broad pathological Q waves develop

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

ECG: What is J point?

A

Where QRS complex becomes ST segment

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

ECG: What is normal axis of QRS complex?

A

-30 –> +90

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

ECG: What does P wave represent?

A

Atrial depolarisation

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

ECG: How long should PR interval be?

A

120-200ms

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

ECG: What might a long PR interval indicate?

A

Heart block

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

ECG: How long should QT interval be?

A

0.35-0.45s

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

ECG: What does QRS complex represent?

A

Ventricular depolarisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ECG: What does T wave represent?

A

Ventricular repolarisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ECG: Where would you place lead 1?

A

From right arm to left arm with positive electrode being at left arm. At 0

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

ECG: Where would you place lead 2?

A

From right arm to left leg with positive electrode being at left leg. At 60

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

ECG: Where would you place lead 3?

A

From left arm to left leg with positive electrode being at left leg. At 120

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

ECG: Where would you place lead avF?

A

From halfway between left arm and right arm to left leg with positive electrode being at left leg. At 90

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

ECG: Where would you place lead avL?

A

From halfway between right arm and left leg to left arm with positive electrode being at left arm. At -30

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

ECG: Where would you place lead avR?

A

From halfway between left arm and left leg to right arm with positive electrode being at right arm. At -150

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

What is dominant pacemaker of the heart?

A

SA node. 60-100bpm

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

How many seconds do following represent on ECG paper?

a) small squares
b) large squares

A

a) 0.04s

b) 0.2s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How long should QRS complex be?

A

Less than 110ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In which leads would you expect QRS complex to be upright in?

A

Leads 1 and 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In which lead are all waves negative?

A

avR

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

In which leads must R wave grow?

A

From chest leads V1 to V4

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

In which leads must S wave grow?

A

From chest leads V1 to V3. It must also disappear in V6

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

In which leads should T waves and P waves be upright?

A

Leads 1, 2, V2 –> V6

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

What might tall pointed P waves on an ECG suggest?

A

Right atrial enlargement

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

What might notched, ‘m shaped; P waves on an ECG suggest?

A

Left atrial enlargement

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

Give 3 signs of abnormal T waves

A
  1. Symmetrical
  2. Tall and peaked
  3. Biphasic or inverted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What happens to QT interval when HR increases?

A

QT interval decreases

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

What part of ECG does plateau phase of cardiac action potential coincide with?

A

QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Name 3 conditions caused by atherosclerosis

A
  1. Heart attack
  2. Stroke
  3. Gangrene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the main problem caused by atherosclerosis?

A

Plaque ruptures leading to thrombus formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Give 5 risk factors for atherosclerosis

A
  1. Age
  2. Smoking
  3. High cholesterol
  4. Obesity
  5. Diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Where are atherosclerotic plaques found?

A

Peripheral and coronary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What factor affects the distribution of atherosclerotic plaques?

A

Changes in flow/turbulence e.g. bifurcations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is a neointima?

A

A new or thickened layer of arterial intima formed by migration and proliferation of cells from the media

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

What does an atherosclerotic plaque consist of?

A
  1. Lipid
  2. Necrotic core
  3. Connective tissue
  4. Fibrous cap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What can an atherosclerotic plaque result in?

A
  1. Occlusion of lumen (angina)

2. Rupture

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

What is the response to injury hypothesis?

A
  1. Injury to endothelial cells leads to endothelial dysfunction
  2. Signals sent to leukocytes which accumulate in vessel wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What causes inflammation in the arterial wall?

A
  1. LDLs

2. Leukocytes

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

What are chemoattractants?

A

Chemicals that attract leukocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the stages of leukocyte recruitment to vessel walls?

A
  1. Capture
  2. Rolling
  3. Slow rolling
  4. Firm adhesion
  5. Transmigration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the stages of atherosclerosis?

A
  1. Fatty streaks
  2. Intermediate lesions
  3. Fibrous plaques
  4. Plaque rupture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What do fatty steaks consist of?

A

Aggregations of foam cells and T lymphocytes in the intimal layer of vessel wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the intermediate layer composed of?

A
  1. Foam cells
  2. Vascular smooth muscle cells
  3. T lymphocytes
  4. Platelets
  5. Extracellular lipids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the fibrous cap?

A

Layer of collagen and elastin that covers the lipid core and necrotic debris in fibrous plaques

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

What are fibrous plaques composed of?

A
  1. SMC
  2. Macrophages
  3. Foam cells
  4. T lymphocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What must happen to the fibrous cap to maintain it?

A

Resorption and redeposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is used to treat coronary artery disease?

A

Percutaneous coronary intervention (PCI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is a major limitation of PCI?

A

Restenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What drugs can be used to reduce restenosis?

A
  1. Taxol

2. Sirolimus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is cardiac failure?

A

Failure to transport blood out of heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What happens in severe cardiac failure?

A

Cardiogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is a ventricular septal defect?

A

Hole in septum between 2 ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What causes ischaemia?

A

Sudden reduction to lumen size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is Dressier syndrome?

A

Inflammatory reaction of pericardium following MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What happens when the stretch capacity of sarcomeres is exceeded?

A

Cardiac contraction forces decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What happens in left sided cardiac failure?

A

Pulmonary congestion and overload of the right side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What happens in right sided cardiac heart failure?

A

Venous hypertension and congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What happens in diastolic cardiac failure?

A

Stiff heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What causes congenital heart disease?

A

Misplaced structures or arrest of the progression of normal structure development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Give 3 conditions associated with congenital heart disease

A
  1. Downs syndrome
  2. Rubella
  3. Thalidomide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Give 3 congenital heart disease conditions where there are right shunt problems

A
  1. Ventricular septal defect
  2. Patent ductus arteriosus
  3. Hypoplastic left heart syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Give 2 congenital heart disease conditions where there are left shunt problems

A
  1. Tetralogy of Fallot

2. Tricuspid atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is left side shunting associated with?

A

Right side cardiac failure and right side cardiac hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is ostium secundum?

A

Central defect in central septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the 4 main features of tetralogy of Fallot?

A
  1. Pulmonary stenosis
  2. Ventricular septal defect
  3. Over-riding ventricular septal defect
  4. Right ventricle hypertrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is the result of correction of the aorta?

A

A narrowing of the aorta just after the arch, with excessive blood flow being diverted through the carotid and subclavian vessels into systemic vascular shunts to supply the rest of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is a common complication of congenital aortic stenosis and coarctation?

A

Secondary endocardial fibroelastosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is dextrocardia?

A

Rightward orientation of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are 5 risk factors for ischaemic heart disease?

A
  1. Hypertension
  2. Smoking
  3. DM
  4. Male
  5. Sedentary lifestyle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Give 4 conditions that limit coronary flow

A
  1. Atherosclerosis
  2. Anaemia
  3. Dissecting aneurysm of aorta
  4. Fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What can be the result of reperfusion of completely infarcted tissue?

A

Haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What are the patterns of infarction?

A
  1. Subendocardial/patchy

2. Transmural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Give 3 complications of ischaemia damage

A
  1. Arrhythmia
  2. Left ventricular
    failure
  3. Rupture of myocardium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is an aneurysm?

A

A dilation of part of the myocardial wall, usually associated with fibrosis and atrophy of myocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is pericarditis?

A

A delayed pericarditic reaction following infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is cor pulmonale?

A

Right ventricular hypertrophy and dilatation due to pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What causes acute rheumatic fever?

A

Group A β-haemolytic streptococcus infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What are 5 clinical features of rheumatic fever?

A
  1. Carditis
  2. Polyarthritis
  3. Chorea
  4. Erythema marginatum
  5. Subcutaneous nodules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Give 3 diagnostic criteria for rheumatic fever

A
  1. Hx of rheumatic fever
  2. Arthralgia
  3. Raised CRP, ESR, WCC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is the commonest cause for infective endocarditis?

A

Congenital heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What organisms are commonly associated with infective endocarditis?

A

Streptococci, staphylococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Give 5 symptoms of infective endocarditis

A
  1. Fever
  2. Anorexia
  3. Clubbing
  4. Sudden cardiac failure
  5. Renal impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What is the usual age of onset in calcific aortic stenosis?

A

65-80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What is the pathophysiology of calcific aortic stenosis?

A

Nodular calcific deposits in cusps with progressive distortion of valves opening/closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What does mitral valve prolapse describe?

A

Degeneration of the mitral valves such that the inner fibrosa layer becomes more loose and fragmentary with accumulation of mucopolysaccharide material

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What is myocarditis?

A

Inflammation of the myocardium usually associated with muscle cell necrosis and degeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What is the commonest form of myocarditis?

A

Viral myocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Give 6 causes of myocarditis

A
  1. Influenza
  2. Typhus
  3. Staphylococcus
  4. Drug reaction
  5. SLE
  6. Radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Give 3 symptoms of myocarditis

A
  1. Palpitations
  2. Latitude
  3. Upper respiratory tract infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What is cardiomyopathy?

A

Primary cardiac disease with contractile dysfunction and atypical morphology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Name 3 types of cardiomyopathy

A
  1. Dilated
  2. Hypertrophic (HCM)
  3. Arrythmogenic right ventricular (ARVC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What is the pathophysiology of primary dilated cardiomyopathy?

A

Poorly generated contractile force leads to progressive dilation of heart with some diffuse interstitial fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What is the heart pathology in primary dilated cardiomyopathy?

A

Enlarged, heavy and dilated heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What does the clinical progression of primary dilated cardiomyopathy involve?

A
  1. Cardiac failure
  2. Dysrhythmias
  3. Death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What are 3 causes of secondary dilated cardiomyopathy?

A
  1. Alcohol
  2. Pregnancy
  3. Male
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is the mechanism for HCM?

A

Defects in force degeneration allow progressive sarcomeric dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What are the investigations for HCM?

A
  1. High ejection fraction
  2. Echo
  3. FHx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is ARVC?

A

A degenerative condition with progressive dilatation of the right ventricle with fibrosis, lymphoid infiltrate and fatty tissue replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What are the symptoms of endomyocardial disease?

A
  1. High grade eosinophilia
  2. Rash
  3. Progressive endocarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What is a cardiac tamponade?

A

Compression of the heart leading to acute cardiac failure following bleeding in to the pericardial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What conditions is hypertensive vascular disease a risk for?

A
  1. Aortic aneurysm
  2. Stroke
  3. MI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What is the effect of hypertension?

A

Alters blood vessel walls by decreasing lumen size as wall thickness increases. This causes a progressive increase in vascular resistance in hypertensives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Name 5 conditions that cause hypertension

A
  1. Diabetes
  2. High aldosterone
  3. Cushing’s syndrome
  4. Hyperthyroidism
  5. Renin secreting tumours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What is Raynaud’s phenomenon?

A

Intermittent bilateral ischaemia of digits/extremities precipitated by motional cold temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What is vasculitis?

A

An inflammatory and variably necrotic process centred on the blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What is the commonest vasculitis?

A

Giant cell arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What is the pathology of giant cell arteritis?

A

Focal, chronic and granulomatous inflammation of temporal arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What can giant cell arteritis cause when affecting large vessels?

A

Aortic aneurysm/ dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What age does giant cell arteritis usually affect?

A

> 70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Give 4 clinical features of giant cell arteritis

A
  1. Palpable blood vessel
  2. Granulomatous inflammation
  3. Necrosis
  4. Focal scarring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What is the vasculitis of the respiratory tract and kidney called?

A

Wegener’s granulomatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Give 5 symptoms of Wegener’s granulomatosis

A
  1. Rash
  2. Joint pain
  3. Neurological changes
  4. Haematuria
  5. Sinusitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

What is Buerger disease?

A

An inflammatory disease of medium and small arteries affecting the distal limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What may lead to remission of Buerger disease?

A

Smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

What are aneurysms?

A

Dilated areas of vasculature suggesting either congenital or required weakness of the wall of the vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

What dilatation occurs in AAA?

A

> 50% of aortic diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Where do most AAA occur?

A

Below renal arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

What is the Tx for AAA?

A

Prophylactic replacement with Dacron graft or endolumenal prosthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

What is a dissecting aneurysm?

A

This is a haematoma within the arterial wall with blood entering under pressure from the lumenal surface and dissecting along the length of the media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Where do most dissecting aneurysms occur?

A

Just above aortic ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

What are 4 risk factors for varicose veins?

A
  1. Age
  2. Female
  3. FHx
  4. Posture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Give 5 risk factors for DVT

A
  1. Bed rest
  2. Trauma
  3. OCP
  4. Age
  5. Sickle cell disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

What sign is associated with DVT?

A

Homan sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

What is Homan sign?

A

Painful/tender calves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

What is the Tx for DVT?

A

Anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

What is embolism?

A

Passage of material through the venous or arterial circulations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

What is angina?

A

Mismatch of oxygen demand and supply – mostly a lack of supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

What is the commonest cause of angina?

A

Ischaemic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Give 5 predisposing factors for IHD

A
  1. Age
  2. Smoking
  3. DM
  4. FHx
  5. Hyperlipidaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Give 3 supply exacerbating factors for angina

A
  1. Anaemia
  2. Hypoxaemia
  3. Hypothermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Give 3 demand exacerbating factors for angina

A
  1. Hypertension
  2. Hyperthyroidism
  3. Valvular heart disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Give 3 environmental exacerbating factors for angina

A
  1. Cold weather
  2. Heavy meals
  3. Emotional stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Name 3 cell types that contribute to coronary disease

A
  1. SMC
  2. Fibrocytes
  3. Cholesterol crystals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

When does myocardial ischaemia occur?

A

When there is an imbalance between the heart’s oxygen demand and supply, usually from an increase in demand accompanied by limitation of supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

What can limit blood supply?

A
  1. Impaired blood flow by proximal arterial stenosis
  2. Increased distal resistance
  3. Reduced oxygen-carrying capacity of blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

When is there a rapid decline in coronary flow?

A

When diameter stenosis reaches 70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

Name 4 anginas other than stable

A
  1. Prinzmetal’s
  2. Microvascular
  3. Crescendo
  4. Unstable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

What is the prevalence of angina?

A

4-5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

When do most angina causes occur?

A

65-74

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

What are the cardiac symptoms of angina?

A
  1. Chest pain
  2. Breathlessness
  3. Fluid retention
  4. Palpitation
  5. Syncope or pre-syncope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

What is the Hx for pain in angina?

A 
OPQRST
Onset
Position
Quality
Relationship
Radiation
Relieving or aggravating factors
Severity
Timing 
Treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

What factors point to ischaemic cardiac pain?

A
  1. Heavy
  2. Central
  3. Cold weather provokes
  4. GTN relieves
  5. Breathlessness
  6. Smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

Name 4 things in a chest pain DDx

A
  1. Myocardial ischaemia
  2. Pericarditis
  3. PE
  4. Chest infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

What is the investigation for chest pain?

A
  1. Routine bloods
  2. Lipids
  3. ECG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

What diagnostic tests can be done for chronic chest pain?

A
  1. Exercise testing
  2. Myoview scan
  3. CT coronary angiography
  4. Stress echo
  5. Perfusion MRI
  6. Coronary angiography
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

What drug types can be used to treat angina?

A
  1. BB
  2. Nitrates
  3. Aspirin
  4. CCB
  5. Statin
  6. ACEI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

How do BB effect the heart?

A
  1. Reduce HR
  2. Reduce LV contractility
  3. Reduce CO
  4. Reduce O2 demand
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

Name 3 side effects of beta blockers

A
  1. Tiredness
  2. Bradycardia
  3. Erectile dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

Why are BB contraindicated in asthma?

A

Can cause severe bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

What is the effect of nitrates

A
  1. Venodilation
  2. Arteriodilation
  3. Reduce preload on heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

What is a side effect of nitrates?

A

Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

What is the effect of CCB?

A

Arterial vasodilation so reduce afterload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

What are 3 side effects of CCB?

A
  1. Flushing
  2. Hypotension
  3. Oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

What is the effect of aspirin?

A
  1. COX inhibitor
  2. Reduce prostaglandin synthesis
  3. Reduce platelet aggregation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

What is a side effect of aspirin?

A

Gastric ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

What is the mechanism of statins?

A

HMG CoA reductase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

What are the pros of PCI?

A
  1. Less invasive
  2. Convenient
  3. Repeatable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

What are the pros of CABG?

A
  1. Prognosis

2. Deals with complex disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

What are the cons of PCI?

A
  1. Risk stent thrombosis
  2. Risk restenosis
  3. No complex disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

What are the cons of CABG?

A
  1. Invasive
  2. Risk of stroke/bleedings
  3. One time treatmetn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

What are the symptoms of unstable angina?

A
  1. Cardiac chest pain at rest
  2. Cardiac chest pain with crescendo pattern
  3. New onset angina
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

How is unstable angina diagnosed?

A
  1. Hx
  2. ECG
  3. Troponin (no rise)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

How is STEMI diagnosed?

A

ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

How is NSTEMI diagnosed?

A

After troponin results and other investigations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

What is an MI?

A

Non-Q wave or Q-wave MI on the basis of whether new pathological Q waves develop on the ECG as a result of it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

Which MI types are associated with larger infarcts?

A
  1. STEMI

2. MI associated with LBBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

Describe the cardiac chest pain in MI

A
  1. Unremitting
  2. Usually severe but may be mild/absent
  3. Occurs at rest
  4. Associated with sweating, SOB, nausea
  5. 1/3 occur in bed at night
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

Give 3 conditions associated with higher risk MI

A
  1. DM
  2. Higher age
  3. Renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

What is the initial management for MI?

A

300mg aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

What is the hospital management for MI?

A
  1. Bed rest
  2. Pain relief
  3. Aspirin +- P2Y12 inhibitor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

What causes the majority of ACS?

A

Rupture of an atherosclerotic plaque and consequent arterial thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

Give 3 uncommon causes of ACS

A
  1. Plaque rupture
  2. Drug abuse
  3. Aortic dissection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

What is troponin?

A

Protein complex that regulates actin: myosin contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

Name 3 P2Y12 antagonists

A
  1. Clopidogrel
  2. Prasugrel
  3. Ticagrelor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

What is the risk of P2Y12 antagonists?

A

Bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

Name 2 GPIIb/IIIa antagonists

A
  1. Abeiximab

2. Tirofiban

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

When are GPIIb/IIIa antagonists used?

A

When pt. are undergoing PCI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

How do anticoagulants work?

A

Inhibit both fibrin formation and platelet activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

What anticoagulant is often used in ACS?

A

Fondaparinux or heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

What is the treatment of choice for STEMI?

A

Primary PCI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

When is coronary angiography performed?

A

For pt. wit troponin elevation or unstable angina refractory to medical therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

Where is clopidogrel converted to its active form?

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

Name 4 factors that affect response to clopidogrel

A
  1. Dose
  2. Age
  3. DM
  4. Drug-drug interactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

What are the mechanisms of action off ticagrelor?

A
  1. Reversibly-binding P2Y12 antagonist

2. Inhibition of adenosine uptake via ENT-1 pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

Give 5 adverse affects of ticagrelor

A
  1. Bleeding
  2. Rash
  3. GI disturbance
  4. Dyspnoea
  5. Ventricular pauses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

What are the signs and symptoms of DVT?

A
  1. Pain
  2. Swelling
  3. Tenderness
  4. Warmth
  5. Discolouration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

What are the investigations for DVT?

A
  1. D-dimer (raised)
  2. US compression test proximal veins
  3. Venogram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

What is the Tx for DVT?

A
  1. LMW Heparin
  2. Oral warfarin
  3. DOAC
  4. Compression stockings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

What are the risk factors for DVT?

A
  1. Surgery
  2. OCP
  3. Immobility
  4. Inherited thrombophilia
  5. Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

What are the preventions for DVT?

A
  1. Hydration
  2. Early hydration
  3. Compression stockings
  4. LMW Heparin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

What is the DDx for PE?

A
  1. MSK pain
  2. Infection
  3. Malignancy
  4. Pneumothorax
  5. Cardiac causes
  6. Gastro causes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

What are the symptoms of PE?

A
  1. SOB
  2. Pleuritic chest pain
  3. Signs of DVT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

What are the signs of PE?

A
  1. Tachycardia
  2. Tachypnoea
  3. Pleural rub
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

What are the investigations for PE?

A
  1. CXR
  2. ECG sinus tachy
  3. Blood gases: type 1 respiratory failure, decreased O2/CO2
  4. D-dimer - raised
  5. Ventilation/perfusion scan: mismatch
  6. CTPA spiral CT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

What patients need ventilation/perfusion scans?

A

Pregnant as cannot have CTPA spiral CT

198
Q

What is the Tx for PE?

A
  1. LMW heparin
  2. DOAC
  3. IVC filter
199
Q

What is the mechanism of warfarin?

A

Prevents synthesis of active factors II, VII, IX and X

200
Q

What is the prevention of PE?

A
  1. Early mobilisation
  2. Hydration
  3. LMW heparin
201
Q

What is thrombosis?

A

Blood coagulation inside a vessel

202
Q

Describe the arterial circulation

A

High pressure, platelet rich

203
Q

Describe the venous circulation

A

Low pressure, fibrin rich

204
Q

What happens when there is thrombosis in coronary circulation?

205
Q

What happens when there is thrombosis in cerebral circulation?

A

CVA/stroke

206
Q

What happens when there is thrombosis in peripheral circulation?

A

Peripheral vascular disease: claudication, rest pain, gangrene

207
Q

What are 5 risk factors for arterial thrombosis?

A
  1. Smoking
  2. Hypertension
  3. DM
  4. Hyperlipidaemia
  5. Obesity
208
Q

What is the diagnosis for MI?

A
  1. Hx
  2. ECG
  3. Cardiac enzymes
209
Q

What is the diagnosis for CVA?

A
  1. Hx
  2. Examination
  3. CT scan
  4. MRI scan
210
Q

What is the diagnosis for peripheral vascular disease?

A
  1. Hx
  2. Examination
  3. USS
  4. Angiogram
211
Q

What is the Tx for MI?

A
  1. Aspirin
  2. LMW heparin or fondaparinux
  3. Thrombolytic therapy: streptokinase tissue plasminogen activator
212
Q

What is the mechanism of aspirin?

A

Inhibits cyclo-oxygenase irreversible to inhibit thromboxane formation and platelet aggregation

213
Q

What is the Tx for stroke?

A
  1. Aspirin or clopidogrel, prasugrel, ticagrelor
  2. TPA
  3. Treat risk factors
214
Q

What is the mechanism for TPA?

A

TPA generates plasmin, degrades fibrin

215
Q

What are the genetic causes for venous thrombosis?

A
  1. Factor V Leiden
  2. PT20210A
  3. Antithrombin deficiency
  4. Protein C deficiency
  5. Protein S deficiency
216
Q

What are the acquired causes for venous thrombosis?

A
  1. Anti-phospholipid syndrome
  2. Lupus anticoagulant
  3. Hyperhomocysteinaemia
217
Q

What is the mechanism for heparin?

A

Binds to antithrombin and increases its activity

218
Q

How is heparin monitored?

219
Q

What is the mechanism for clopidogrel?

A

Inhibits ADP induced platelet aggregation

220
Q

What is the mechanism of warfarin?

A

Prevents synthesis of active factors II, VII, IX and X

221
Q

What is the mechanism for DOAC?

A

Directly act on factor II or X

222
Q

How many ml of serous fluid are in the pericardial sac?

223
Q

What is the function of the pericardium?

A

Restrains filling volume of heart

224
Q

Why do chronic effusions rarely cause tamponade?

A

Allows adaptation of parietal pericardium which reduces effect on diastolic filling of chambers

225
Q

What is acute pericarditis?

A

An inflammatory pericardial syndrome with or without pericardial effusion

226
Q

2 of which 4 clinical features would diagnose acute pericarditis?

A
  1. Chest pain
  2. Friction rub
  3. ECG changes
  4. Pericardial effusion
227
Q

What causes most cases of acute pericarditis in the UK?

A

Viral infections

228
Q

Name 4 viruses that can cause acute pericarditis

A
  1. Enteroviruses
  2. Herpes viruses
  3. Adenoviruses
  4. Parvovirus B19
229
Q

What are the neoplastic causes of acute pericarditis?

A

Secondary metastatic tumours (lungs, breast, lymphoma)

230
Q

What can cause delayed onset acute pericarditis?

A
  1. Pericardial injury syndromes

2. Iatrogenic trauma e.g. pacemaker insertion

231
Q

How many pericarditis cases are idiopathic?

232
Q

Give 5 symptoms of pericarditis

A
  1. Chest pain
  2. Dyspnoea
  3. Cough
  4. Hiccoughs
  5. Rash
233
Q

Describe the chest pain in pericarditis

A
  1. Severe
  2. Sharp and pleuritic
  3. Rapid onset
  4. Left anterior chest or epigastrium
  5. Radiates to arm
234
Q

What is important to differentiate against in pericarditis?

A

Myocardial ischaemia/infarction

235
Q

What are the examinations for pericarditis?

A
  1. Pericardial rub
  2. Sinus tachycardia
  3. Fever
  4. Signs of effusion
236
Q

What are the investigations for pericarditis?

A
  1. ECG
  2. Bloods
  3. CXR
  4. Echocardiogram
237
Q

Describe pericarditis ECG

A
  1. Diffuse ST elevation
  2. Concave ST segment
  3. Saddle shaped
  4. PR depression
238
Q

What are the investigations for pericarditis?

A
  1. FBC (high WCC)
  2. ESR & CRP (high)
  3. Troponin (high)
  4. CXR
239
Q

What is the management for pericarditis?

A
  1. Sedentary activity
  2. NSAID or aspirin
  3. Colchicine
240
Q

What is the recurrence rate for acute pericarditis?

241
Q

What is the commonest cause of pericarditis in the developed world?

A

Viral pericarditis

242
Q

What bacteria are most commonly involved in pericarditis?

A

Staph, strep and pneumococci

243
Q

What non-infective conditions can cause pericarditis?

A
  1. Tuberculosis

2. Dressler’s syndrome

244
Q

What is the sign of tamponade?

A

Pulsus paradoxus (fall in systolic BP >10mmHg on inspiration)

245
Q

What heart condition causes sudden death in apparently healthy young people?

A

Sudden arrhythmia death syndrome

246
Q

What are the 3 groups of cardiomyopathy?

A
  1. Hypertrophic
  2. Dilated
  3. Arrythmogenic
247
Q

What causes hypertrophic cardiomyopathy?

A

Sarcomeric protein gene mutations

248
Q

Name 4 symptoms of hypertrophic cardiomyopathy

A
  1. Angina
  2. Dyspnoea
  3. Palpitations
  4. Syncope
249
Q

What causes dilated cardiomyopathy (DCM)?

A

Cytoskeletal gene mutations

250
Q

What is the heart presentation in DCM?

A
  1. Ejects 50-60% of blood

2. Struggle to see parts of heart contracting

251
Q

What causes arrythmogenic cardiomyopathy?

A

Desmosome gene mutations

252
Q

Describe the the cardiac muscle in arrythmogenic cardiomyopathy

A

Muscle disappears in ventricles and is replaced by fat and fibrosis

253
Q

What wave is seen on ECG in cardiomyopathy?

A

Epsilon wave

254
Q

What is the presentation of Naxos disease?

A
  1. Woolly hair
  2. Palmar and plantar skin thickening
  3. Fibro-fatty infiltration of heart
  4. Arrhythmia
  5. Abnormal ECG
255
Q

What is the primary problem in Naxos disease?

A

Cell separation

256
Q

Describe Brugada ECG (look up) after ajmaline test

A
  1. Incomplete RBBB

2. ST-segment elevation

257
Q

Name 3 aortovascular conditions

A
  1. Ehler Danlos Syndrome
  2. Loeys-Dietz
  3. Marfan
258
Q

Give 4 clinical features of aortovascular conditions

A
  1. Lanky
  2. Arm span > height
  3. Protruding sternum
  4. Changes in palate and face
259
Q

Name 4 conditions hypertension is a major risk factor for

A
  1. Stroke
  2. MI
  3. HF
  4. Chronic renal disease
260
Q

What is the BP for stage 1 hypertension?

A

140/90mmHg

261
Q

What is used to confirm HT diagnosis?

A

Ambulatory blood pressure monitoring

262
Q

What is the BP for stage 2 HT?

263
Q

What are the treatments for primary HT?

A
  1. Lifestyle modification

2. Antihypertensive drug therapy

264
Q

When would secondary hypertension be considered?

A
  1. Young patient
  2. Resistant BP
  3. Signs of underlying cause
265
Q

Which stage 1 HT patients is drug Tx offered to?

A

Aged under 80 with 1 or more of

  1. Target organ damage
  2. Established CVD
  3. Renal disease
  4. Diabetes
  5. 10 year CV risk of 20%+
266
Q

What are the targets for HT Tx?

A
  1. CO and peripheral resistance
  2. RAAS and SNS
  3. Local vascular vasoconstrictor and vasodilator mediators
267
Q

Build in BP is an interplay between what 2 mechanisms?

A
  1. Hypertrophy

2. Salt retention

268
Q

Name 3 ACEI

A
  1. Ramipril
  2. Perindopril
  3. Enalapril
269
Q

What is the mechanism for ACEI

A
  1. Increase kinin production by inhibiting bradykinin breakdown
  2. Reduced angiotensin II formation
270
Q

What are 4 adverse effects to ACEI?

A
  1. Hypotension
  2. Acute renal failure
  3. Cough
  4. Hyperkalaemia
271
Q

Name 3 ARBs

A
  1. Candesartan
  2. Valsartan
  3. Losartan
272
Q

Name 4 adverse effects to ARBs

A
  1. Symptomatic hypotension
  2. Hyperkalaemia
  3. Renal dysfunction
  4. Rash
273
Q

What group of people are ARBs and ACEIs contra-indicated in?

A

Pregnant people

274
Q

When are CCB indicated?

A
  1. Hypertension
  2. Angina
  3. Tachycardia
275
Q

Name 3 CCBs

A
  1. Amlodipine
  2. Felodipine
  3. Diltiazem
276
Q

What is the mechanism of action of CCB?

A

L-type calcium channel blockers

277
Q

What is the mechanism of action of amlodipine?

A
  1. Preferentially affect vascular smooth muscle

2. Peripheral arterial vasodilators

278
Q

Give 4 adverse effects of amlodipine

A
  1. Flushing
  2. Headache
  3. Oedema
  4. Palpitations
279
Q

Give 4 adverse effects of other CCBs

A
  1. Bradycardia
  2. Atrioventricular block
  3. Worsening of HF
  4. Constipation
280
Q

Name 3 beta blockers

A
  1. Bisoprolol
  2. Propranolol
  3. Atenolol
281
Q

What does a cardioselective BB indicate?

A

Beta 1 selective

282
Q

Name 4 adverse effects of BB

A
  1. Fatigue
  2. Headache
  3. Bradycardia
  4. Erectile dysfunction
283
Q

What are the classes of diuretic?

A
  1. Thiazides
  2. Loop diuretics
  3. Potassium sparing diuretics
  4. Aldosterone antagonists
284
Q

Name 4 diuretics

A
  1. Bendoflumethiazide
  2. Furosemide
  3. Bumetanide
  4. Eplerenone
285
Q

Name 4 side effects of diuretics

A
  1. Hypovolaemia
  2. Hypokalaemia
  3. Hypotension
  4. Gout
286
Q

Which anti-hypertensive is used in pregnancy?

A

Methyldopa

287
Q

What is the main benefit of HF drugs from?

A

Vasodilator therapy via neurohumoral blockade

288
Q

What drugs are used in HF treatment?

A
  1. Diuretics
  2. ACEI and BB
  3. Aldosterone antagonists
  4. ARBs
  5. Hydralazine/nitrate
  6. Digoxin
289
Q

What is the mechanism of nitrates?

A
  1. Arterial and venous dilators
  2. Reduction of preload and afterload
  3. Lower BP
290
Q

Name 3 nitrates

A
  1. Isosorbide mononitrate
  2. GTN spray
  3. GTN infusion
291
Q

What are 2 common side effects of GTN?

A
  1. Headache

2. Syncope

292
Q

Describe chronic stable angina

A
  1. Anginal chest pain
  2. Predictable
  3. Exertional
  4. Infrequent
  5. Stable
293
Q

Describe unstable angina

A
  1. Unpredictable
  2. May be at rest
  3. Frequent
  4. Unstable
294
Q

Describe STEMI

A
  1. Unpredictable
  2. Rest pain
  3. Persistent
  4. Unstable
295
Q

What is the Tx for stable angina?

A
  1. Aspirin/clopidogrel
  2. Statins
  3. GTN spray
296
Q

What is the Tx for NSTEMI or STEMI?

A
  1. GTN spray, opiates
  2. Aspirin plus ticagrelor, prasugrel or clopidogrel
  3. Antithrombin therapy
  4. Angioplasty or CABG
297
Q

What are the classes of antiarrhythmic drugs?

A
  1. Sodium channel blockers
  2. Beta adrenoceptor antagonists
  3. Prolong AP
  4. CCBs
298
Q

Name a drug which prolongs AP

A

Amiodarone

299
Q

What is the mechanism of digoxin?

A

Inhibits Na/K pump

300
Q

Name 3 side effects of digoxin

A
  1. Nausea
  2. Vomiting
  3. Diarrhoea
301
Q

Name 4 side effects of amiodarone

A
  1. Nausea
  2. Vomiting
  3. Fatigue
  4. Tremor
302
Q

What is heart failure?

A

An inability of heart to deliver blood (and O2) at a rate commensurate with requirements of metabolising tissues, despite normal or increased cardiac filling pressures

303
Q

What is the incidence of HF?

304
Q

Give 3 causes of HF

A
  1. Myocardial dysfunciton
  2. Hypertension
  3. Alcohol excess
305
Q

What are the symptoms of HF?

A
  1. Breathlessness
  2. Tiredness
  3. Cold peripheries
  4. Leg swelling
  5. Increased weight
306
Q

What are 4 signs of HF?

A
  1. Tachycardia
  2. Displaced apex beat
  3. Raised JVP
  4. Added heart sounds
307
Q

Describe patients with acute decompensated HF

A
  1. <70yo
  2. Male dominance
  3. LVEF <40%
308
Q

Describe patients with acute HF

A
  1. 71-76yo
  2. 50% female
  3. 50% LVEF >40%
309
Q

What is the diagnosis for HF?

A
  1. CXR
  2. Blood tests incl. proBNP
  3. ECG
  4. Echocardiography
  5. Myocardial perfusion imaging
310
Q

What NT-proBNP gets referred to a cardiologist?

311
Q

Name 4 things which can raise NT-proBNP

A
  1. HF
  2. ACS
  3. Advanced age
  4. PE
312
Q

Which systems are involved in HF?

A
  1. Sympathetic NS
  2. RAAS
  3. Inflammation
313
Q

What are the cardinal symptoms of HF?

A
  1. SOB
  2. Fatigue
  3. Ankle swelling
314
Q

What is Class I HF?

A

No limitation

315
Q

What is Class II HF?

A

Slight limitation

316
Q

What is Class III HF?

A

Marked limitation

317
Q

What is Class IV HF?

A

Inability to carry out any physical activity without discomfort

318
Q

What are the stages of HF?

A
  1. High risk for developing HF
  2. Asymptomatic HF
  3. Symptomatic HF
  4. End-stage HF
319
Q

Give 3 complications of HF

A
  1. Renal dysfunction
  2. Rhythm disturbance
  3. Systemic thromboembolism
320
Q

Why are ACEI used to treat HF?

A
  1. Controls BP

2. Inhibits aldosterone which usually retains NA and water

321
Q

What is the effect of diuretics?

A

Symptomatic relief of oedema and dyspnea

322
Q

What is the Tx for HF with preserved left ventricular ejection fraction?

323
Q

What surgeries can be done in HF?

A
  1. Mitral valve repair
  2. Aortic valve replacement
  3. Mitral valve replacement
  4. Left ventricular re-modelling
324
Q

What are the symptoms of malignant HT in the eye?

A
  1. Haemorrhage

2. Papilloedema

325
Q

What is the prevalence of HT in younger people?

326
Q

What is the risk of CV events per 100mmHg increase in BP?

327
Q

What are 3 lifestyle changes for lowering BP?

A
  1. Reduce salt intake
  2. Weight loss
  3. Reduce alcohol intake
328
Q

When should BP lowering medications be withheld?

A
  1. Pregnancy
  2. BP drops for another reason e.g. weight loss
  3. Surgery (ACEI)
329
Q

What are the basic principles of ECG?

A
  1. Amplitude of deflection is related to mass of myocardium
  2. Width of deflection reflects speed of conduction
  3. Positive deflection is towards lead/vector
330
Q

What is the normal QRS axis?

A

-30 to +90 degrees

331
Q

What conditions are associated with left axis deviation (-30 to -90)?

A
  1. Left anterior fascicular block
  2. Left bundle branch block
  3. Left ventricular hypertrophy
332
Q

What conditions are associated with right axis deviation (90 to 180)?

A
  1. Left posterior fascicular block

2. Right heart hypertrophy/strain

333
Q

What conditions is PR interval prolonged in?

A
  1. Disorders of AVN

2. Disorders of specialised conducting tissue

334
Q

When is PR interval shorter?

A
  1. Younger patients

2. Wolf-Parkinson-White

335
Q

What is the pathophysiology of Wolf-Parkinson-White syndrome?

A

Extra electrical pathway between atria and ventricles causes a rapid heartbeat

336
Q

What are the symptoms of WPW?

A
  1. Heart palpitations
  2. Dizziness
  3. SOB
  4. Chest pain
  5. Sweating
337
Q

What is the treatment for WPW?

A
  1. Lifestyle changes
  2. Catheter ablation
  3. Amiodarone
338
Q

What can cause long or short QT syndromes?

A
  1. Congenital
  2. Drugs
  3. Electrolyte disturbances
339
Q

When might ST segment be elevated?

A
  1. Early repolarisation
  2. MI
  3. Pericarditis/myocarditis
340
Q

When is T wave direction opposite to QRS direction?

A

Bundle branch block

341
Q

What can T wave inversion indicate?

A
  1. Ischaemia/infarction
  2. Myocardial hypertrophy
  3. Cardiomyopathy
342
Q

What are 6 common tachycardias?

A
  1. AF
  2. Atrial flutter
  3. Supraventricular tachycardia
  4. Focal atrial tachycardia
  5. Ventricular tachycardia
  6. Ventricular fibrillation
343
Q

What are supraventricular arrhythmias?

A

Arrhythmias arising from the top part of the heart

344
Q

What is the ECG pattern of AF?

A

QRS is irregularly irregular

345
Q

What is the ECG pattern in atrial flutter?

A

Organised but rapid fluttering in atria (saw tooth pattern in baseline)

346
Q

What is the ECG in sinus tachycardia?

A

Relatively fast but regular rhythm

347
Q

Describe a patient with ventricular tachycardia

A

Fast HR, pt. may be conscious, still some BP

348
Q

Describe a patient with ventricular fibrillation

A

Pt. is unconscious and in cardiac arrest

349
Q

What are the causes of bradycardia?

A
  1. Conduction tissue fibrosis
  2. Ischaemia
  3. Inflammation/infiltrative disease
  4. Drugs
350
Q

What happens in first degree heart block?

A

1:1 conduction, PR interval is one

351
Q

What happens in second degree heart block?

A

No longer 1:1, some relationship between atria and ventricles

352
Q

What happens in third degree heart block?

A

No interaction between atria and ventricles, slower QRS

353
Q

What happens in Mobitz type I heart block?

A

PR interval increases until AVN fails and no QRS is seen

354
Q

What happens in Mobitz type II heart block?

A

Sudden unpredictable loss of AV conduction and QRS

355
Q

Describe the LBBB ECG

A

Looks like W (WiLLiam), broad QRS

356
Q

Describe the RBBB ECG

A

Looks like M (MaRRow)

357
Q

What does a deep Q wave indicate?

A

Previous infarction

358
Q

What are ectopic beats?

A

Non sustained beats arising from ectopic regions of atria or ventricles

359
Q

High burden ventricular ectopic beats can cause what?

A

Heart failure

360
Q

High burden atrial ectopic beats can cause what?

A

Atrial fibrillation

361
Q

What is the Tx for ectopic beats?

A

Reassurance/BB

362
Q

What is the mechanism for ectopic beats?

A

If area of heart has higher automaticity than SAN

363
Q

Why is AF a risk for stroke?

A

When atria don’t contract regularly can get stasis

364
Q

What are the 2 types of AF?

A

Proxysmal and persistent

365
Q

What is the Tx for AF?

A
  1. Treat underlying cause
  2. BB/CCB
  3. Electrical/pharma cardioversion
  4. BP control e.g. Sotatol, amiodarone
366
Q

What are the symptoms in diabetic MI?

A

Sweating and SOB

367
Q

What is the ECG trace for LAD occlusion?

A
  1. ST elevation

2. Tombstones

368
Q

What is the ECG trace for pericarditis?

A
  1. ST elevation - saddle shaped
369
Q

What is the ECG trace in AVNRT?

A

No P waves as these are hidden in QRS

370
Q

What is the Tx for supraventricular tachycardia?

A
  1. CCB/BB

2. Adenosine injection

371
Q

What is the Tx for AVNRT?

A

Catheter ablation

372
Q

What is the pathophysiology for AVNRT?

A

Ventricles simultaneously contract

373
Q

What is an electrical storm?

A

3+ sustained episodes of VT or VF, or appropriate ICD shocks during a 24hr period

374
Q

What is the Tx for electrical storm?

A
  1. Correct underlying cause
  2. BB, sedation
  3. Amiodarone
  4. GA/neuraxial blockade
  5. Catheter ablation
375
Q

What are the uses of catheter ablation?

A
  1. Reduce episodes of VT or frequency of ICD shocks

2. Can be curative for normal heart VT

376
Q

When do symptoms arise in aortic stenosis?

A

When valve is 1/4 of normal size (3-4cm)

377
Q

What are the types of aortic stenosis?

A
  1. Supravalvular
  2. Subvalvular
  3. Valvular
378
Q

What are 4 causes of aortic stenosis?

A
  1. Congenital aortic stenosis
  2. Congenital bicuspid valve
  3. Degenerative calcification
  4. Rheumatic heart disease
379
Q

What is the pathophysiology of bicuspid aortic valve?

A
  1. Fusion of 2 valves

2. Dilation of aortic wall

380
Q

What is the pathophysiology of aortic stenosis?

A
  1. Pressure gradient develops between left ventricle and aorta as exit of blood is restricted by narrow valve
  2. LV function initially maintained by compensatory pressure hypertrophy
  3. When compensatory mechanisms exhausted, LV function declines
381
Q

What are the symptoms of aortic stenosis?

A
  1. Syncope
  2. Angina
  3. Dyspnoea
  4. Sudden death
382
Q

What are the signs of aortic stenosis?

A
  1. Pulsus tardus and pulsus parvus
  2. Heart sounds
  3. Ejection systolic murmur
383
Q

What is the investigation for aortic stenosis?

A

Echocardiography

  1. Left ventricular size and function
  2. Doppler derived gradient and valve area
384
Q

What is the grading for aortic stenosis?

A

Mild: >1.5cm, 2.6-3.0m/s
Moderate: 1-1.5cm, 3-4m/s
Severe: <1cm, >4m/s

385
Q

What is the management for aortic stenosis?

A
  1. Dental hygiene
  2. Surgical replacement
  3. Transcatheter aortic valve implantation
386
Q

What are the indications for intervention in aortic stenosis?

A
  1. Any symptomatic pt. with severe AS
  2. Any pt. with decreasing EF
  3. Any pt. undergoing CABG with moderate or severe AS
387
Q

What is mitral regurgitation?

A

Backflow of blood from the LV to the LA during systole

388
Q

What are the causes of chronic mitral regurgitation (MR)?

A
  1. Myxomatous degeneration
  2. Ischaemic MR
  3. Rheumatic heart disease
  4. Infective endocarditis
389
Q

What is the pathophysiology of MR?

A
  1. Volume overload

2. Compensatory: Left atrial enlargement, LVH and increased contractility

390
Q

What is the presentation of MR?

A
  1. Pansystolic murmur at apex
  2. Exertion dyspnoea
  3. Heart failure
391
Q

How long is the compensatory phase in MR?

392
Q

What are the investigations in MR?

A
  1. ECG
  2. CXR
  3. Echo
393
Q

What is the management for MR?

A
  1. Medication
  2. Serial echocardiography
  3. IE prophylaxis
  4. Surgery
394
Q

What are the medications for MR?

A
  1. Vasodilator e.g. ACEI
  2. BB/CCB/digoxin
  3. Anticoagulant
  4. Diuretics
395
Q

What is aortic regurgitation (AR)?

A

Leakage of blood into LV during diastole due to ineffective coaptation of aortic cusps

396
Q

What is the aetiology of chronic AR?

A
  1. Bicuspid aortic valve
  2. Rheumatic
  3. Infective endocarditis
397
Q

What is the pathophysiology of AR?

A
  1. Combined pressure and volume overload

2. Compensatory: LV dilation, LVH

398
Q

What are the signs of AR?

A
  1. Wide pulse pressure
  2. Diastolic blowing murmur
  3. Austin flint murmur
  4. Systolic ejection murmur
399
Q

When does AR typically present?

A

4th or 5th decade

400
Q

What are the symptoms of AR?

A
  1. Dyspnoea

2. Palpitations

401
Q

What are the investigations for AR?

A
  1. CXR (enlarged heart and aortic root)

2. Echo

402
Q

What is the management for AR?

A
  1. IE prophylaxis
  2. Vasodilators e.g. ACEI
  3. Serial echo
  4. Surgical replacement
403
Q

What is mitral stenosis?

A

Obstruction of LV inflow that prevents proper filling during diastole

404
Q

What is the aetiology for mitral stenosis?

A
  1. Rheumatic heart disease
  2. Infective endocarditis
  3. Mitral annular calcification
405
Q

What is the pathophysiology for mitral stenosis?

A
  1. Progressive dyspnoea
  2. Increased transmittal pressures
  3. Right HF symptoms
  4. Haemoptysis
406
Q

What are the signs of mitral stenosis?

A
  1. Prominent a wave in jugular venous pulsations
  2. Signs of right-side HF
  3. Mitral facies
  4. Diastolic murmur
  5. Loud opening S1 snap
407
Q

What is the investigation for mitral stenosis?

A
  1. ECG (AF, LA enlarged)
  2. CXR (LA enlarged, pulmonary congestion)
  3. Echo
408
Q

What is the Tx for mitral stenosis?

A
  1. Serial echo
  2. BB/CCB/digoxin
  3. Diuretics
  4. Percutaneous mitral balloon valvotomy
  5. IE prophylaxis
  6. Mitral valve replacement
409
Q

What is infective endocarditis?

A

Infection of heart valve(s) or other endocardial lined structures within heart

410
Q

What are the types of IE?

A
  1. Left sided native IE
  2. Left sided prosthetic IE
  3. Right sided IE
  4. Device related IE
  5. Prosthetic
411
Q

What is the aetiology of IE?

A
  1. Abnormal valve
  2. Surgical infection
  3. Teeth
  4. Previous IE
412
Q

Who does IE typically effect?

A
  1. Elderly with degenerative heart valves
  2. PWID
  3. Young with congenital heart disease
  4. Prosthetic heart valves
413
Q

What is the presentation of IE?

A
  1. Systemic infection signs
  2. Embolisation
  3. Valve dysfunction
  4. HF
  5. Arrhythmia
414
Q

What are the major criteria for IE?

A
  1. Bugs grown from blood cultures

2. Evidence of endocarditis on echo, or new valve leak

415
Q

What are the minor criteria for IE?

A
  1. Predisposing factors
  2. Fever
  3. Vascular phenomena
  4. Immune phenomena
  5. Equivocal blood cultures
416
Q

How is definite IE diagnosed?

A

2 major, 1 major + 3 minor, 5 minor

417
Q

How is possible IE diagnosed?

A

1 major, 1 major + 1 minor, 3 minor

418
Q

What is the investigation for IE?

A
  1. Transthoracic echo

2. Transoesophageal echo

419
Q

What are the peripheral stigmata in IE?

A
  1. Petechiae rash
  2. Splinter haemorrhages
  3. Osler’s nodes
  4. Janeway lesions
  5. Roth spots
420
Q

What is the diagnosis for IE?

A
  1. Raised CRP
  2. ECG
  3. TTE/TOE
421
Q

What is the Tx for IE?

A
  1. Antimicrobials IV 6wk
  2. Treat complications
  3. Surgery
422
Q

When is surgery indicated in IE?

A
  1. Abx can’t cure infection
  2. Complications
  3. Remove infected devices
  4. Replaced valve after infection cured
  5. Remove large vegetations before they embolise
423
Q

What are the symptoms in long QT syndrome?

A
  1. Syncope
  2. Seizures
  3. Sudden death
  4. Heart palpitations
424
Q

What is the investigation in long QT syndrome?

A

ECG - QT interval >460-470ms (M:F)

425
Q

What is the Tx in long QT syndrome?

A
  1. BB e.g. propranolol

2. Pacemaker or ICD

426
Q

What test is required following acute anaphylaxis?

A

Serum tryptase levels (rise)

427
Q

What is septic shock?

A

When sepsis causes low BP and abnormalities in cellular metabolism

428
Q

What are the symptoms for septic shock?

A
  1. Confusion/slurred speech
  2. Blue, pale or blotchy skin
  3. Rash that doesn’t fade with a glass
  4. SOB, breathing fast
429
Q

What are the investigations for sepsis?

A
  1. Microbiology bloods
  2. USS/CT/x-ray
  3. WCC
  4. Platelet count (low)
  5. Acidosis in bloods
  6. LFT, U&E
430
Q

What is the Tx for sepsis?

431
Q

What is cardiogenic shock?

A

When your heart sudden can’t pump enough blood to meet body’s needs

432
Q

What are the cardiogenic shock symptoms?

A
  1. Rapid breathing
  2. SOB
  3. Tachycardia
  4. Loss of consciousness
433
Q

What is the cardiogenic shock investigation?

A
  1. BP (low)
  2. Angiogram
  3. ECG
  4. Echo
  5. CXR
434
Q

What is the cardiogenic shock Tx?

A
  1. Aspirin
  2. Adrenaline
  3. Thrombolytic e.g. alteplase
  4. Antiplatelet e.g. clopidogrel
435
Q

What are the symptoms of haemorrhagic shock?

A
  1. Anxiety
  2. Blue lips and fingers
  3. Low urine output
  4. Sweating
  5. SOB
436
Q

What is the investigation for haemorrhagic shock?

A
  1. CT/USS
  2. Bloods
  3. Echo/ECG
437
Q

What is the Tx for haemorrhagic shock?

A
  1. Transfusion
  2. Dopamine
  3. Adrenaline
438
Q

What are the symptoms for neurogenic shock?

A
  1. Difficulty breathing
  2. Chest pain
  3. Weakness
  4. Bradycardia
439
Q

What is the investigation for neurogenic shock?

A
  1. CT
  2. MRI
  3. Angiogram
440
Q

What is the Tx for neurogenic shock?

A
  1. Vasopressor e.g. adrenaline

2. Atropine

441
Q

How many live births have a cardiac defect?

442
Q

What is scan is done at 18-22 weeks if a parent has cardiac defects?

A

Foetal ECG

443
Q

What is the maternal mortality in pt. with cardiac defects?

A

50% - advice against

444
Q

Which cardiac defects cause high risk in pregnancy?

A
  1. Pulmonary HT
  2. Severe left heart obstruction
  3. Systemic ventricular impairment
  4. Marfans syndrome
445
Q

What is the tetralogy of fallot pathophysiology?

A
  1. Ventricular septal defect
  2. Pulmonary stenosis
  3. Hypertrophy of RV
  4. Overriding aorta
446
Q

What is the result of stenosis of RV outflow?

A
  1. RV is higher pressure than LV
  2. Deoxygenated blood passes from RV to LV
  3. Blue baby
447
Q

What gene mutation is associated with tetralogy of fallot?

A

22q11 deletion

448
Q

What is the Rx for tetralogy of fallot?

A

Surgical repair

449
Q

What is a ventricular sept defect (VSD)?

A

Abnormal connection between the two ventricles

450
Q

What is the pathophysiology of VSD?

A
  1. High pressure LV
  2. Low pressure RV
  3. Blood flows to RV from LV
  4. Increased blood flow to lungs
451
Q

What are the symptoms are large VSD?

A
  1. Breathless
  2. Poor feeding
  3. Failure to thrive
452
Q

How is large VSD treated in infancy?

A
  1. PA band

2. Complete repair

453
Q

What may VSD result in?

A

Eisenmenger’s syndrome

454
Q

What are the clinical signs for large VSD?

A
  1. Small breathless skinny baby
  2. Increased RR
  3. Tachycardia
  4. Big heart CXR
  5. Murmur
455
Q

What are the clinical signs for small VSD?

A
  1. Loud systolic murmur
  2. Thrill
  3. Well grown
  4. Normal HR
  5. Normal heart size
456
Q

What is the pathophysiology of Eisenmenger’s syndrome?

A
  1. High pressure pulmonary blood flow
  2. Damage to pulmonary vasculature
  3. Resistance to blood flow through lungs increases
  4. RV pressure increases
  5. Shunt direction reverses
457
Q

What are the types of atrial septal defect (ASD)?

A
  1. Primum
  2. Secundum
  3. Sinus venosus
458
Q

What is the pathophysiology of ASD?

A
  1. High pressure in LA than RA
  2. Shunt left to right
  3. Increase blood flow to right heart and lungs
459
Q

What are the signs of ASD?

A
  1. Pulmonary flow murmur
  2. Fixed split second heart sound
  3. Big pulmonary arteries on CXR
  4. Big heart on CXR
460
Q

How are ASDs closed?

A
  1. Surgical

2. Percutaneous

461
Q

What condition are atrioventricular septal defects (AVSD) associated with?

A

Down syndrome

462
Q

What is involved in AVSD?

A
  1. Ventricular septum
  2. Atrial septum
  3. Mitral valves
  4. Tricuspid valves
463
Q

What are the signs of complete AVSD?

A
  1. Breathlessness as neonate
  2. Failure to thrive
  3. Torrential pulmonary blood flow
464
Q

What are the signs of patent ductus arteriosus?

A
  1. Continuous machinery murmur
  2. Large heart
  3. SOB
  4. Eisenmenger’s syndrome
465
Q

What are the signs of Eisenmenger’s syndrome?

A

Clubbed and blue toes

466
Q

What is coarctation of the aorta?

A

Narrowing of aorta at the site of insertion of ductus arteriosus

467
Q

What is the pathophysiology of coarctation of the aorta?

A

Complete or almost complete obstruction to aortic flow

468
Q

What are the signs of coarctation of aorta?

A
  1. Right arm HTN
  2. Bruits over scapulae and back
  3. Murmur
469
Q

What are the long term problems of coarctation?

A
  1. HTN
  2. Re-coarctation
  3. Aneurysm at site of repair
470
Q

How is coarctation repaired?

A
  1. Subclavian flap repair
  2. End to end repair
  3. Coarctation angioplasty
471
Q

What are bicuspid AV valves associated with?

A
  1. Coarctation

2. Dilatation of ascending aorta

472
Q

What is pulmonary stenosis?

A

Narrowing of outflow of RV

473
Q

What are the types of pulmonary stenosis?

A
  1. Valvar
  2. Sub valvar
  3. Supra valvar
  4. Branch
474
Q

What are the signs of severe pulmonary stenosis?

A
  1. RV failure as neonate
  2. Collapse
  3. Poor pulmonary blood flow
  4. RV hypertrophy
  5. Tricuspid regurgitation
475
Q

What is the Rx for pulmonary stenosis?

A
  1. Balloon valvuloplasty
  2. Open valvotomy
  3. Open trans-annular patch
  4. Shunt
476
Q

What is fontan procedure?

A

Plumb SVC into pulmonary artery to allow baby to grow and have passive circulation to lungs

477
Q

What is the 5yr mortality in mild peripheral arterial disease (PAD)?

478
Q

What is the most common place for atherosclerosis?

A

Femoropopliteal bifurcation

479
Q

What are the complications of atherosclerotic plaque?

A
  1. Progression
  2. Haemorrhage
  3. Plaque rupture
  4. Overlying thrombosis
  5. Dissection
  6. Aneurysm
480
Q

What causes atherosclerotic aneurysms?

A

Medial thinning beneath plaque

481
Q

What is the commonest aneurysm site?

A

Infrarenal abdominal artery

482
Q

What are the investigations for aneurysm?

A
  1. BGL
  2. Lipids
  3. Vasculitic screen
  4. BP
  5. Duplex
  6. CT/MRA
483
Q

What is the Rx for aneurysm?

A
  1. Open aneurysm repair (Dacron graft)

2. Endovascular aneurysm repair (stent graft)

484
Q

What are the organ-specific symptoms for ischaemia?

A
  1. Exercise induced angina
  2. Gangrene
  3. Ischaemic cardiac failure
  4. Intermittent claudication
  5. Vascular dementia
485
Q

What are the common clinical presentations of peripheral vascular disease (PVD)?

A
  1. Intermittent claudication
  2. Critical leg ischaemia
  3. Acute limb ischaemia
  4. Carotid artery disease
  5. Abdominal aortic aneurysm
486
Q

What are the symptoms of acute limb ischaemia?

A

6 Ps

  1. Pain
  2. Pale
  3. Paralysis
  4. Paraesthesia
  5. Perishing cold
  6. Pulseless
487
Q

What is the pathophysiology of intermittent claudication?

A
  1. Anaerobic metabolism occurs when O2 demand exceeds supply

2. Lactic acid formed - pain

488
Q

Describe the pain in intermittent claudication

A
  1. Pain on exertion
  2. Classically affects calves
  3. Resolves on resting
489
Q

What is the pathophysiology for critical ischaemia?

A
  1. Blood supply barely adequate for basal metabolism

2. No reserve for increased demand

490
Q

Describe the pain for critical ischaemia

A
  1. Rest pain
  2. Nocturnal
  3. Dependency rubor
491
Q

What is the Rx for acute limb ischaemia?

A
  1. Revascularisation
  2. Amputation
  3. Aspirin
492
Q

How can revascularisation be done in critical leg ischaemia?

A
  1. Vein bypass
  2. Percutaneous balloon
  3. Stent

Phase 2a Medicine (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions