Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Medicine - Finals > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

AF rate management (in asthmatics)

A

Diltiazem

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

AF rate management

A

Beta-blockers and calcium channel blockers are first line for rate control in patients with atrial fibrillation.

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

Hypercalcaemia ECG changes

A

QT shortening

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

Which medications increase risk of VTE?

A

COCP, hormone replacement (especially if with progesterone), raloxifene/tamoxifen, antipsychotics (especially olazapine)

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

What is HOCM associated with?

A

WPW syndrome
T wave inversion
ST depression
Tall broad QRS complexes

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

Acute management of cardiac chest pain

A 
Morphine 
Oxygen
Nitroglycerin
Aspirin
Ticargrelor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute management of ACS

A

Aspirin 300mg
ECG within 10 minutes of arrival
PCI
Further telemetry monitoring + 300mg clopidogrel/ticagrelor

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

Management of Angina

A

Antiplatelet in in all patients
B-blocker in some patients (+/- CCB ; +/- Nitrates)
If severe - vascular revascularisation

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

What are the ECG findings associated with wrong limb placement?

A

aVR - upwards

Lead II - downwards

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

What is new onset LBBB a sign of?

A

ACS

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

Contraindications to an exercise tolerance test

A

replacement joints, poor mobility, chest pain at rest, bbb changes on ECG, aortic stenosis, HOCM

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

Which protocol is used to assess patients using an exercise tolerance test?

A

Bruce

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

When is PCI considered the gold-standard treatment following MI?

A

if deliverable within 120 minutes and within 12 hours of symptom onset

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

What is the biggest risk factor for developing AF?

A

Hypertension

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

Different types of AF

A

Paroxysmal - self-terminating episodes (>1) each lasting less than a week
Persistent AF - non-self-terminating and last more than 7 days
Permanent AF - persistent symptoms that cannot be reverted to sinus rhythm

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

What is the anticoagulant of choice in AF patients with a prosthetic metal valve?

A

Warfarin

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

What is the anticoagulant of choice in AF patients?

A

Edoxiban

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

Rate control for AF

A

1 - B-blocker
2 - CCB
3 - Digoxin
4 - Pacemaker + SAN ablation

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

Rhythm control for AF

A

Cardioversion if less than 48 hours from symptom onset otherwise anticoagulate for 3 weeks and then cardiovert

Then commence rhythm drugs e.g.,
1 - Flecainide (unless Hx of IHD or obstructive coronary disease)
2 - Sotalol
3 - Amiodarone (most potent and toxic - for use in patients with IHD)

Note - anti-coagulation should continue post-treatment

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

What is fast AF (HR >200bpm) suggestive of? Management?

A

Accessory pathway

Manage with B-blocker/Amiodarone/ Felcainide
Pathway ablation

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

What conditions/medications are associated with orthostatic syncope?

A

Parkinson’s, Multiple System Atrophy, Diabetes, Amloidosis, Uramia, Anti-hypertensives and vasodilators

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

Diagnosis of Orthostatic Hypotension

A

drop in SBP of >20mmHg and DBP of >10mmHg within 3 mins of standing

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

What should you do in the GP setting for patients that presents with a transient loss of consciousness (T-LOC)?

A

Refer to T-LOC clinic

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

Poor prognostic factors of palpitations

A

Short history, prolonged episode, clear trigger, feeling poorly, on activity, syncope, chest pain, poor FHx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How would you attempt to record episodes of palpitation that occur daily/1-2 weekly/more than fortnightly/on exercise?
- Daily episodes - Holter - 1-2 weeks - event recorder - >2 weeks - implantable loop recorder - On exercise - ETT
26
When are implantable ICDs used?
chronic bradycardia or VT
27
What is the difference between implantable defibrillator and cardiac resynchronisation pacemaker?
ICD - lead to RV apex to deliver shock | CRP - additional leads to coronary sinus, atrial pacing lead and RV defibrillating lead
28
What is the success of RF ablations?
Accessory pathway SVR - 95% Atrial Flutter - 95% AF - 65%
29
What are the windows for hyperacute treatment of stroke?
<4.5 hours for thrombolysis followed by thrombectomy | <6 hours for thrombectomy
30
Define neuroplasticity
reorganisation of neuronal tissue to relearn tasks that were lost due to stroke
31
Difference between arteriosclerosis and atherosclerosis
Arteriosclerosis - thickening of blood vessel walls due to hypertension Artherosclerosis - lumin plaques due to hypercholesterolaemia
32
Are large vessel strokes embolic or thrombotic?
Embolic - thrombus would take long to occlude a large vessel by which time collaterals can compensate
33
Can small vessel strokes can affect the cortex?
Not really - due to multiple collaterals supplying blood to the cortex, usually a large vessel stroke is required to cause ischaemia
34
Left cortex deficit and cortical signs
R-sided motor weakness +/- dysphasia +/- agnosia
35
Which large vessel supplies both brocas and wernickes area?
MCA
36
Right cortex deficit and cortical signs
``` L-sided motor weakness +/- hemispatial neglect +/- personality changes +/- sensory inattention +/- apraxia ```
37
Criteria for TACS/PACS/LACS and POCS
LACS - Unilateral weakness - Homonymous hemianopia - High cerebral function (dysphasia) PACS - Two of the LACS criteria LACUNAR Stroke - Pure sensory - Pure motor POCS (One of the following) - Cranial nerve palsy - Bilateral motor or sensory deficit - Conjugate eye movement disorder - Cerebellar dysfunction - Isolated hemianopia
38
What is considered a long PR interval?
>0.2
39
What are the different types of second-degree heart block?
Mobitz 1 - PR interval increases until conduction is missed | Mobitz 2 - PR interval constant but every nth beat missed
40
Define TIA
Lack of brain damage - not defined in terms of time anymore
41
What on an echo is a sign of AF?
RA dilatation
42
Describe antiplatelet therapy post stroke
Aspirin 300mg for 14 days followed by clopidogrel 75mg lifelong (or aspirin 75mg + Dipyridamole MR 200mg) Note: Lansoprazole for gastroprotection (not other PPIs as may interfere with antiplatelet function)
43
Describe anti-hypertensive therapy post stroke
For use immediately after haemorrhagic stroke if >140 (do not use acutely in ischaemic stroke) ACEI Thiazide CCB
44
Describe statin therapy post stroke
low/mod risk --> Simvastatin 40mg | high risk --> Atorvastatin 80mg
45
Co-therapy of Simvastatin and which antibiotic is contraindicated
Clarithromycin - risk of myopathy or rhabdomyolysis
46
Describe anti-coagulant therapy post stroke
Anti-coagulate immediately after TIA and 2 weeks following a stroke to avoid bleed. - Warfarin or DOAC Epixaban is best
47
Initial management of acute heart failure
``` Sit up give O2 give furosemide vasodilator to offload heart iv morphine ``` Note: avoid B-blocker
48
Referral of heart failure from primary care
Cardiac rehab nurses and HF nurses
49
Management of Chronic HF
Loop Diuretic, B-blocker, ACEI e.g., Furosemide, Bisoprolol, Ramipril
50
Management of Native valve IE (incl, for penicillin allergic)
Amoxicillin (Vancomycin) and Gentamicin
51
Management of PWID native valve IE
Flucloxacillin
52
Management of Prosthetic valve IE
Vancomycin + Gentamicin + Rifampicin
53
Ix for IE
TTEcho | TOEcho - diagnostic used if TTE negative but high clinical suspicion
54
Acute management of SVT
Acute management vagal manoeuvres: e.g. Valsalva manoeuvre, carotid sinus massage intravenous adenosine 6mg → 12mg → 12mg: contraindicated in asthmatics - verapamil is a preferable option electrical cardioversion
55
Persistent ST elevation following recent MI, no chest pain
left ventricular aneurysm
56
ECG changes in cocaine use
QRS widening and QT prolongation
57
Associations of Coarctation of the aorta
Remember BANT Bicuspid aortic valve berry Aneurysms Neurofibromatosis 1 Turner's syndrome
58
Features of coarctation of the aorta
infancy: heart failure adult: hypertension radio-femoral delay mid systolic murmur, maximal over back apical click from the aortic valve notching of the inferior border of the ribs (due to collateral vessels) is not seen in young children
59
Acute SOB and desaturation following MI
Mitral Regurgitation due to tendinous cord rupture This causes pulmonary congestion and oedema
60
Treatment of symptomatic bradycardia
IV atropine 3mg | If fails external pacing
61
What is the CHA2DS2-VASc score for?
Anticoagulation for AF
62
CHA2DS2-VASc score
Congestive HF (1), Hypertension (1), Age >= 75 (2), Age 65-74 (1), Diabetes (1), Prior Stroke or TIA (2), Vascular disease (1), Sex Female (1) 2 or more offer anticoagulation
63
What do you do if CHA2DS2-VASc score indicate no need for anticoagulation?
Transthoracic echocardiogram to exclude valvular disease
64
CHA2DS2-VASc score 0 + valvular disease + AF = what treatment?
Anticoagulation
65
What is the HASBLED Scoring for
Estimates risk of major bleeding for patients on anticoagulation to assess risk-benefit in atrial fibrillation care
66
HASBLED Score
Hypertension, uncontrolled, systolic BP > 160 mmHg (1), Abnormal renal function (dialysis or creatinine > 200) (1) Or Abnormal liver function (cirrhosis, bilirubin > 2 times normal, ALT/AST/ALP > 3 times normal (1) Stroke (1) Bleeding (history of/tendency) (1) Labile INRs (1) Elderly >65 (1) Drugs Predisposing to Bleeding (Antiplatelet agents, NSAIDs) (1) Or Alcohol Use (>8 drinks/week) (1) >=3 total points means high risk of bleeding
67
New onset weak thready pulse, systolic murmur and elevated JVP post-MI
Rupture of the papillary muscle due to a myocardial infarction can lead to acute mitral regurgitation
68
Kussmaul's sign
In constrictive pericarditis, the JVP will rise on inspiration
69
Difference between typical and atypical chest pain
Typical meets all criteria Atypical as it only meets 2 out of the 3 criteria of stable angina. Sharp chest pain (rather than constricting) Precipitated by physical exertion Relieved by GTN spray within 5 minutes
70
AAA screening and monitoring
Screening: single abdominal ultrasound for males aged 65. Monitoring: - <3cm no further action - 3 - 4.4cm scan every 12 months - 4.5 - 5.5cm scan every 3 months - >5.5cm Refer within 2 weeks to vascular surgery for probable intervention - elective endovascular repair (EVAR) If monitoring shows an increase of >1cm/year then refer within 2 weeks
71
In which patients should cyclizine be used with caution?
Heart failure - it may reduce CO
72
Causes of raised BNP
Anything that precipitates LV dysfunction Heart failure, MI, valvular disease, CKD
73
Effects of BNP
Reduce load on LV therefore; vasodilator, diuretic, natriuretic, suppresses sympathetic tone and the RAA system
74
When if hypertonic saline indicated?
Severe hyponatraemia <120
75
Primary and secondary prevention of hyperlipidaemia
Primary - Atorvastatin 20mg od (if non-HDL not ≤40% the up the dose to 80mg) Secondary - Atorvastatin 80mg od
76
Which heart failure medications have no effect on mortality?
Furosemide (Loops) - symptom relief
77
Which heart failure medications reduce mortality?
ACEI, B-blocker, Spironolactone
78
Adrenaline in Cardiac arrest
10ml 1 in 10,000 adrenaline via IV or 1ml 1 in 1,000 adrenaline via IV
79
Management of Angina
All should be given aspirin and a statin Sublingual GTN for symptoms Beta-blocker or CCB (Verapamil or Diltiazem) to reduce attack frequency If suboptimal response add the other (switch CCB to modified release nifedipine to avoid heart block) - if does not tolerate look at other therapies below Last line - add third agent e.g. long-acting nitrate, ivabradine, nicorandil or ranolazine - whilst awaiting PCI or CABG
80
Adverse effects of Ivabradine therapy for Angina
visual effects, particular luminous phenomena, are common headache bradycardia, heart block
81
First-line in acute pericarditis
Ibuprofen and Colchicine
82
Absolute contraindications to thrombolysis
- Previous intracranial haemorrhage - Seizure at onset of stroke - Intracranial neoplasm - Suspected subarachnoid haemorrhage - Stroke or traumatic brain injury in preceding 3 months - Lumbar puncture in preceding 7 days - Gastrointestinal haemorrhage in preceding 3 weeks - Active bleeding - Pregnancy - Oesophageal varices - Uncontrolled hypertension >200/120mmHg
83
Initial conservative antiplatelet management of NSTEMI
aspirin, plus either: ticagrelor, if not high bleeding risk clopidogrel, if high bleeding risk
84
STEMI management: for patients undergoing PCI
- dual antiplatelet therapy - unfractionated heparin - bailout glycoprotein IIb/IIIa inhibitor (GPI) if radial access used
85
Factors that lower BNP levels
``` Obesity Diuretics ACE inhibitors Beta-blockers Angiotensin 2 receptor blockers Aldosterone antagonists ```
86
Long-term management of Chronic Failure
First-line: Beta-blocker and ACEI (either started one at a time) + Loop (Furosemide - for fluid overload) Second-line: Aldosterone Antagonist (spironolactone and eplerenone) Third-line: ivabradine (HR >75bpm), sacubitril-valsartan, hydralazine (particularly in afro-caribeans) in combination with nitrate, digoxin (coexisting AF) and cardiac resynchronisation therapy (if widened QRS -> LBBB)
87
Acute management of heart failure
``` oxygen IV loop diuretics opiates vasodilators inotropic agents CPAP ultrafiltration mechanical circulatory assistance: e.g. intra-aortic balloon counterpulsation or ventricular assist devices stop beta-blockers ```

Medicine - Finals (21 decks)

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