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Phase 3 > Cardiovascular pathology 2 > Flashcards

Cardiovascular pathology 2 Flashcards

1
Q

What are some indications in claudication to referral to a specialist:

A

impacting on lifestyle

impacting on walking distance

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2
Q

What two things would very suggestive of a person NOT having critical limb ischemia?

A

Being able to walk
- even a couple of yards

Being able to sleep through the night without being woken up by pain

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3
Q

What clinical sign is particularly worrying in limb ischemia and should motivate further treatment?

A

Muscle tenderness

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4
Q

Outline the immediate management for a critically ischemic limb:

A

Imaging:

  • CT
  • MRI
  • arteriogram

*arteriogram may be useful if there is going to immediate invasive intervention

Viable limb:

  • Aspirin/ Clopidogrel
  • Morphine
  • Alteplase
  • Surgical revascularization

Non Viable Limb:
- Surgical amputation
+
Morphine

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5
Q

Prior to treatment for limb ischemia, what must one consider?

A

Do the symptoms justify investigation? majority don’t need intervention

What treatment is available?

  • bypass
  • stenting

Is there evidence of muscle necrosis?
- if so no delay can be left

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6
Q

What drugs should be avoided in PVD?

A

Beta blockers

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7
Q

In acute MI when do you give oxygen?

A

If stats are <94%

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8
Q

If there is ST depression inferior, where will the reciprocal changes take place?

A

Lateral leads

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9
Q

If PCI can’t be done - what is the treatment?

A

IV tenecteplase

IV heparin

\+
Aspirin 
Ticagrelor
Metoclopramide
Morphine 
\+/- Oxygen
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10
Q

In order to have 1st degree heart block, what must be present?

A

P-Q interval of >0.2seconds

one large box

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11
Q

What tests should be done following a PCI?

A

Troponins

Cholesterol levels

Glucose

X-ray

Echocardiogram

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12
Q

How long is tricagerlor prescribed for following the MI?

A

6 months

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13
Q

How long after an MI, until someone can,
Drive
Have sex
Return to work

A

Drive - least 1 week, and 4 weeks if evidence of LVHF

Sex - briskly walk two flights of stairs without being breathless
~2-3 weeks

Return to work:
- 1-2 months

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14
Q

In the setting of unstable Angina, what tests should be done?

A

Coronary angiogram

Exercise testing

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15
Q

What are some absolute contraindications for thrombolytic therapy?

A

History of intracranial bleeds

Recent surgery <3 weeks

Ischemic stroke <6months

Bleeding disorders

Pancreatitis

Suspected aortic dissection

Active internal bleeding <1 month

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16
Q

What is the criteria for LVH? and what is it often associated with?

A

> 35mm QRS wave

Aortic stenosis
Hypertension

17
Q

Name a medication that can be used as a positive inotrope in cardiac failure:

A

Dobutamine

*also used to stress the heart

18
Q

What shape is the normal aortic valve?

A

Mercedes Benz

19
Q

If you want to see the four chambers of the heart, where do you place the probe?

A

Apex

20
Q

What is the most common cause of valvular disease?

and what is the most common cause of non-cyanotic congenital heart defect?

A

Wear and tear, leading to calcification

Most common non - cyanotic heart defect is Bicuspid Aortic valves

21
Q

What tests are done to establish aortic stenosis?

A

Transthoracic echo

  • apical view
  • parasternal view
  • doppler use

ECG

Chest x-ray
- may seen enlarged ventricle

Stress test

  • exercise test
  • dobutamine

Cardiac Catheterisation

22
Q

If someone presented with acute limb ischemia and didn’t have previous history of claudication (which would be suggestive of atheroma rupture), what would the most likely etiology be?

A

Embolism

- most likely cause from AF

23
Q

If there is atheroma present in the lowering limb - where else is likely to have them?

A

Coronary artery

carotids

Renal

Mesenteric

24
Q

Whats the immediate treatment for Severe ischemic limb?

A

Heparin
Analgesics
Rest

angiogram - after which arterial thrombolysis
with possible angioplasty and stenting

25
Q

In a patient presenting with AF for the first time, what would be the considering factors to carry out cardioversion? what other factors need to be considered?

A

If they were symptomatic

There good chance cardioversion could be achieved

if it has occurred >48hrs. if so then anti-coagulation is needed

26
Q

Which patients may be suitable for catheter ablation of AF? and where is it typically done?

A

Those who have recurrent paroxysmal AF with symptoms.

The pulmonary vessels

27
Q

In someone with permanent AF, what would your management be?

A

Rate control

  • Beta blockers
  • Verapamil (not HF patients)
  • digoxin

Anti-coagulation

Phase 3 (50 decks)

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