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F year medicine facts > CVS > Flashcards

CVS Flashcards

1
Q

STM complications post MI

A
  • Ventricular fibrillation
  • myocardium rupture due to; free wall of ventricle rupturing (cardiac tamponade), papillary muscle rupture (acute mitral regurg and LVF); IV septum rupture
  • HF
  • Thrombus
  • acute pericarditis
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2
Q

LTM complications post MI

A
  • Dresslers
  • recurrent MI
  • Aneurysms
  • CCF
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3
Q

any new LBBB is what until proven otherwise

A
  • MI
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4
Q

Official ecg criteria for STEMI

A
  • Elevation >1mm in 2 contiguous limb leads or >2mm in 2 contiguous chest lead
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5
Q

what ix do you order for acute limb ischaemia

A
  • fbc, u and e, VBG for lactate, clotting, G and S, Glucose, troponin
  • CXR
  • USS
  • CTA - GS
  • thromobophilia screen if <50 years without known RF
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6
Q

acute limb ischaemia rx

A
  • ABCDE
  • High flow o2 and IV access
  • Heparin treatment dose. APPT monitoring
  • fluid resus + ix
  • opiate analgesia

then either; revascularisation/ embelectomy or amputation

manage complications e..g hyperk, acidosis, AKI = all = compartment syndrome, Cardiac arrest

LTM; Manage CVS RF, Antiplt

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7
Q

chronic limb ischaemia classification

A
  1. asympto
  2. intermittent claudication
  3. ischaemic rest pain
  4. ulcer/ gangrene or both

3/4 = critical limb ischaemia

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8
Q

critical limb ischaemia definition

A

ischaemic rest pain >2 weeks - needing opiates

or gangrene etc

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9
Q

in critical limb ischaemia, what does calf claudication indicate

A
  • femoral disease
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10
Q

in critical limb ischaemia what does buttock claudication indicate

A
  • iliac disease
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11
Q

severity classification of critical limb ischaemia using ABPI

A

> 0.9 = N
0.8 - 0.9 = mild
0.5-0.8 = moderate
<0.5 = severe

if >1.2 - false reading due to calcified and hardened arteries

must CTA after as this is diagnositc and GS

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12
Q

if a AAA has produced a large arteriovenous fistula with the SVC, what sx do you get

A
  • CCF
  • Tachy
  • leg swelling
  • abdo thrill
  • machinery type abdo bruit,
  • renal failure
  • peripheral ischaemia
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13
Q

how old do you have to be to get AAA screening in the uk

A
  • > 66 male

- >70 female

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14
Q

how often do you USS a AAA that is 3-4.4cm?

4.5-5.4?

A
  1. 2 yrly

2. 3 monthly

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15
Q

rx Ruptured AAA

A
  • ABCDE
  • Iv access = 2 large bore
  • ECG
  • Blood - FBC, U and E, VBG, G and S, clotting, amylase, crossmatch
  • IV fluids - SBP <100 but >90 aim
  • analgesia
  • catheter
  • surgery; EVAR/Open.
  • prophyalctic abx
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16
Q

type a vs type b aortic dissections

A
  • type a = ascending aorta; need surgery

type b : medical management

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17
Q

type a aortic dissection complications

A
  • stroke
  • MI
  • Exsanguination
  • Tamponade
  • aortic regurg
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18
Q

type b aortic dissecction complications

A
  • renal failure
  • gut ischaemia
  • LL ischaemia
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19
Q

what abx do you give in nec fasc/ gAS (group a haem strep) gangrene

A
  • benpen and clindamycin
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20
Q

define stages of HTN

A

Stage 1; 140/90 in clinic. ABPM = >135/85

stage 2: 160/100 –> at home >150/95

severe >180/110

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21
Q

1st line ix for angina

A
  • CT angio
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22
Q

rx stable anginga

A
  • lifestyle advice
  • GTN
  • BB/CCB . 1st one then both
  • treat co morbidities
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23
Q

stm tachycardia treatment alogrithm

A

if unstable ; caridovert/ shock then aiodarone

stable;

  • narrow complex
    1. AF - BB/digoxin
    2. A flutter - BB
    3. SVT - Vagal maneouvre then adenosine

broad

  • VT = amiodarone
  • SVT with BBB - rx like SVT
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24
Q

ltm rx Atrial flutter

A
  • BB
  • Treat condition
  • radiofreq ablation
  • anticaog with chadsvasc
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25
adenosine is CI in which patients
- athma - copd - HF - HB - Severe hypotension
26
wolf parkinson white accesory pathway name
- bundle of kent
27
wpw syndrome definitive rx
- radiofreq ablate
28
wpw ecg findings
- short pr interval - wide qrs - delta wave
29
rx of patients with wide complex tachycardia die to WPW and AF
CI = antiarrhymics
30
what is torsades du pointes
- polymorphic venetricular tacchyardia | - prolonged qt
31
causes of torsades du pointes
- anythign that can prolong qt
32
acute rx torsades du pointes
- mg infusion | - defib if in VT
33
ltm RX torsades du pointes
- BB | - Pacemaker/ ID
34
ecg findings in HB
- 1ST - prolonged PR constant - 2nd -T1 gradually prolonged PR interval resulting in a drop beat - 2nd T2 - normal PR interval but set dropped QRS e.g. 2:1 - 3rd - no relationship between P and QRS
35
rx AVN/bradycardia
stable - observe unstable - atropine 500mcg x2 max 3mg. then other inotropes, then transut pacing in thise at high risk of asystole e.g. mobitz t2, 3rd degree HB - temp transversous cardiac pacing
36
how long should you wait to cardiovert in a stable patient if >48hrs
- 3-4 weeks so they can have anticoag
37
nyha classification of HF
1. asympto 2. on moderate exertion sx 3. sx on mild exertion 4. sm on rest
38
what are the HACEK organisms that can cause infective endocarditis
- Haemophilius - actinobacillus - Cardiobacterium - eikenella - kingella
39
what are roth spots
foind in infective endocarditis | - boat shaped retinal haemorrhages with pale centres
40
in infective endocarditis, what happens to FBC and ESR
- High ESR | - FBC; normocytic normochromic anaemia and neutrophilia
41
ix for Infective endocarditis
- FBC - ESR/ CRP - U and E - LFT - Mg - urinalysis; haematuria - CXR - ECG M- Prolonged PR interval - TOE - Blood cultures 3x, 1hr apart
42
dukes criteria for endocarditis
2 major or one major and 3 minor or 5 minor for dx: major; 1. evidence on ECHo (new valve regurg, abscess, vegitation 2. positive blood cultures (3x1hr apart pr 2 with organisms usually in IE or persistent positive BC >12hrs apart) minor - fever >38 - embolic phenomena - vasculitic phenomena - predisposing valve/ cardiac abnormal - +ve BC doesnt meet major criteria - suggestive echo
43
empirical rx of IE
- amoxicillin +/- low dose gent if pen allergy - vanc +/- gent if prosthetic valve - vanc + gent + rif
44
endocarditis rx if strep
- benpen
45
aortic abscess is in endocarditis is indicated by hwat finding
- lenghtening PR interval
46
what type of valve replacement is preffered in pregnant ladies
- bioprosthetic as no need to give warfarin and less likely ot clot. give aspirin for antiplt. - if have mechanical, take of warfarin and give LMWH
47
noradrenaline binds to which receptors
alpha >beta | - use in sepsis
48
adrenaline binds to which receptors
beta >alpha - use inlow CO states, cardiac arrest SE: lactic acidosis, low k, ph
49
dobutamine binds to which receptors
- b1>a1
50
dopamine binds to which receptors
- D1/2>B1/Alpha - dose dependant low dose = dopaminergic medium dose = beta high dose = alpha
51
rx mitral regurg
acute: nitrates, diuretics, positive inotropes and intra-aortic baloon pump if in HF - Ace-i + BB +/- spironolactone - valve repair or replace
52
rx aortic stenosis
- asympto = observe - sympto = valve replace if asympto but valv gradient >40mmhg = replace - do angio prior to surgery
53
aortic regurg rx
acute; = surgical ermergency - replace/repair chronic; surgery if meet anny of the below criteria; - significant enlargement of ascending aorta - symtpomatic severe - severe with LVEF<50% - some marfans pts
54
mitral stenosis rx
- AF - rate control and anticoag - diuretics - balloon valvulopalsty
55
most common cause of renovascular disease
- developed worlld; atherosclerosis | - underdeveloped; takayasus
56
cardiac tamponade sx
- hypotension - muffled hear sounds - raised jvp - sob - tachycardia - absent y descent on jvp - pulsus apradoxus - kussmauls sign -ve - electrical allternans on ecg
57
what does -+ve trop with absence of mi indicate
- myocarditis
58
rx myocarditis
- acute; refer to ITU if needed - treat cause - bed rest for illness - 6months no sports - HF rx; BB + ACE-I, spiro - CI = nsaids
59
HOCM sx and rx
- = chest pain, spb, syncope, arrythmia, s4, jerky pulse - Ejection systolic murmur or pansystolic ECHO = dx rx - HF rx, ICD, amiodarone, surgery
60
dilated cardiomyopthy causes and rx
- alcohol - cocksackie - wet beri beri - doxorubicin rx - cardiac resycnh therap, transplant as causes HF
61
restrictive cardiomyopathy most common cause
- amyloidosis
62
cosntrictive pericarditis signs
- kussmauls | - pericardial calcification on CXR
63
rx for varicose veins
- lifestyle, elevate, stocking - radiofreq ablation - endovascular ablation by laser - sclerotherapy; liquid if below knee and saphenofemoral incompetence - ligation - stripping

F year medicine facts (19 decks)

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