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Cardiology > Core > Flashcards

Core Flashcards

1
Q

AF - Mx post DC cardioversion

A
  1. High risk of stroke (raised CHADSVASC) - continue lifelong anticoagulation
  2. Low risk of stroke - continue anticogaulation for 4 weeks the stop
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2
Q

Third degree HB

A
  1. P waves not related to QRS
  2. Ventricular escape rhythm : 35-40 bpm
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3
Q

GRACE score

A

Helps to decide mx of Unstable angina and STEMI

<3% : Low
Conservative mx
Dual antiplatelet therapy for 12 months
aspirin, plus either:
ticagrelor, if not high bleeding risk
clopidogrel, if high bleeding risk
3-6% : Intermediate
>6% : High

  1. Clinically unstable - Immediate PCI
  2. Grace score >3% - Coronary angiogram with PCI withi 72 hours
    * 300mg asprin - then give Fondaparinux, prasugrel or ticagrelor, and refer for coronary angiography within 72 hours
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4
Q

Ace inhibitors SE

A

Used in hypertension and HF
1. Cough
2. Angio-odema
3. Hyperkalaemia
4. U+Es checked before starting - baseline increase of creatinine up to 30% from baseline
4. Avoid in ;
* Pregnancy and breast feeding
* Renovascular disease - bilateral renal artery stenosisa

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5
Q

PEA

A
  1. Start Chest compressions before starting IV adrenaline
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6
Q

Amiodone ALS

A

Amiodarone should be given to patients in ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT).

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7
Q

Hypokalaemia

A

U waves
small or absent T waves (occasionally inversion)
prolong PR interval
ST depression
long QT

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8
Q

Hypertrophic obstructive cardiomyopathy : Genes

A

(HOCM) is an autosomal dominant disorder of muscle tissue caused by defects in the genes encoding contractile proteins.

most common cause of sudden cardiac death in the young.most commonly due to ventricular arrhythmias

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9
Q

hypertrophic obstructive cardiomyopathy (HOCM) : Mx

A

Management
Amiodarone
Beta-blockers or verapamil for symptoms
Cardioverter defibrillator
Dual chamber pacemaker
Endocarditis prophylaxis*

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9
Q

hypertrophic obstructive cardiomyopathy (HOCM) : CI drugs

A
  • Angiotensin-converting enzyme (ACE) : educe afterload which may worsen the LVOT gradient.
  • nitrates
  • inotropes
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10
Q

BP classification

A
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11
Q

Hypertension - When to treat

A
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12
Q

First-degree heart block is a normal variant in an athlete. It does not require intervention

A
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13
Q

Anal ulceration may be caused by nicorandil

A
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14
Q

Statin - interactions

A

Clarithromycin inhibits CYP3A4, an enzyme involved in the metabolism of many drugs including simvastatin. When CYP3A4 is inhibited by clarithromycin, it can lead to increased levels of simvastatin in the body,

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15
Q

Ventricular Tachycardia : CI

A

Verapamil is contraindicated in VT as intravenous administration of a calcium channel blocker can precipitate cardiac arrest.

16
Q

PE - OP mx

A

The Pulmonary Embolism Severity Index (PESI) score is recommended by BTS guidelines to be used to help identify patients with a pulmonary embolism that can be managed as outpatients

17
Q

Heart failure : Drugs which reduce mortality in LV Heart failure

A

The following drugs have all been shown to reduce mortality in patients with left ventricular failure:
ACE-inhibitors
Beta-blockers
Angiotensin receptor blockers
Aldosterone antagonists
Hydralazine and nitrates

18
Q

Heart failure : Use of digoxin

A
  1. Heart failure with AF
  2. Worse ing heart failure despite first or second line treatments
19
Q

AF : Anticoaulation

A

ONLY COMMENCED IF INDICATED BY CHADSVASC SCORE - IF ZERO, ONLY CONTROL RATE/RHYM WITHOUT ANTICOAGULATION
3. 1. DOAC
2. Warfarin : poor renal function

20
Q

Posterior MI

A

Changes in V1-3

Reciprocal changes of STEMI are typically seen:
horizontal ST depression
tall, broad R waves
upright T waves
dominant R wave in V2

20
Q

Mx of HF with reduced Ejection fraction

A
21
Q

Newly diagnosed patient with hypertension who has a background of type 2 diabetes mellitus - add an ACE inhibitor or an angiotensin receptor blocker regardless of age

A
22
Q

Warfarin : lifelong anticoagulant therapy in
1. valvularr heart disease
2. Second episode of AF and risk factors for stroke

A
23
Q

AF - TRANSOESOPHAGEAL ECHO for thrombus

A
24
Q

CHADSVASC SCORE

A
25
Q

Digoxin reduces hospitalisation but not mortality in heart failure.

A
26
Q

Heart failure : Intervention therapy

A

Cardiac resynchronisation therapy is indicated in patients with
* left ventricular dysfunction
* ejection fracture <35%
* QRS duration >120ms.

Implantable cardiac defibrillator (ICD) is indicated in patients with
* previous sustained ventricular tachycardia
* ejection fraction <35%
* symptoms no worse than class III of of the New York Heart Association functional classification.

27
Q

Anterior MI complication

A

Anterospectal MI - complicated by Ventricular septam defect
1. Ejection systolic murmur
2. Left parasthernal edge
2. Thrill

28
Q

Exercise ECG testing : CI

A
  1. Pulomonary oedema 2nd to HF
  2. MI within 2-7 days
  3. Electrolyte disturbance
  4. Aortic stenosis
  5. Heart failure
  6. Not sutiable for angina
29
Q

Ambulatory ECG monitoring : Indications

A
  1. Chest pain
  2. Palpitations
  3. Syncope
30
Q

Digoxin toxicity

A
  1. N+V, Diarrhea
  2. Bradycardia/Potentiated by hypokalaemia
  3. Arrythmia
  4. Tx - withold drug, correct electrolyte - Digibind antibodies if very severe
31
Q

Cardiac catheterisation - Comaplications

A
  1. Haemorrhage
  2. Contrast - renal dysfunction
  3. Angina/MI/Pericardial effusion
32
Q

Aortic dissection - Ix

A

Transoesophageal echo -

33
Q

Mycocardial ischaemia - Ix

A
  1. CT angiography
  2. Non invasive - Single photol emmission computed tomorhraphy (MPS with Spect)
  3. Stress Echocardiography
  4. First pass contransed enhanse MR perfusion
34
Q

VT
1. Polymorphic VT - normal QT and beat to beat variability
2. Torsade de Pointes : Q-T elongated, and beat to beat variablity

A
35
Q

CABG - complications

A
  1. Loss of memory
  2. Renal failure
  3. MI/Stroke
  4. Brain damage
36
Q

Mx of aortic stenosis

A
  1. Balloon angioplasty
  2. Second line : Surgical valve replacement

Cardiology (25 decks)

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