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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
Q

adenosine is CI in which patients

A
  • athma
  • copd
  • HF
  • HB
  • Severe hypotension
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26
Q

wolf parkinson white accesory pathway name

A
  • bundle of kent
27
Q

wpw syndrome definitive rx

A
  • radiofreq ablate
28
Q

wpw ecg findings

A
  • short pr interval
  • wide qrs
  • delta wave
29
Q

rx of patients with wide complex tachycardia die to WPW and AF

A

CI = antiarrhymics

30
Q

what is torsades du pointes

A
  • polymorphic venetricular tacchyardia

- prolonged qt

31
Q

causes of torsades du pointes

A
  • anythign that can prolong qt
32
Q

acute rx torsades du pointes

A
  • mg infusion

- defib if in VT

33
Q

ltm RX torsades du pointes

A
  • BB

- Pacemaker/ ID

34
Q

ecg findings in HB

A
  • 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
Q

rx AVN/bradycardia

A

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
Q

how long should you wait to cardiovert in a stable patient if >48hrs

A
  • 3-4 weeks so they can have anticoag
37
Q

nyha classification of HF

A
  1. asympto
  2. on moderate exertion sx
  3. sx on mild exertion
  4. sm on rest
38
Q

what are the HACEK organisms that can cause infective endocarditis

A
  • Haemophilius
  • actinobacillus
  • Cardiobacterium
  • eikenella
  • kingella
39
Q

what are roth spots

A

foind in infective endocarditis

- boat shaped retinal haemorrhages with pale centres

40
Q

in infective endocarditis, what happens to FBC and ESR

A
  • High ESR

- FBC; normocytic normochromic anaemia and neutrophilia

41
Q

ix for Infective endocarditis

A
  • FBC
  • ESR/ CRP
  • U and E
  • LFT
  • Mg
  • urinalysis; haematuria
  • CXR
  • ECG M- Prolonged PR interval
  • TOE
  • Blood cultures 3x, 1hr apart
42
Q

dukes criteria for endocarditis

A

2 major or one major and 3 minor or 5 minor for dx:

major;
1. evidence on ECHo (new valve regurg, abscess, vegitation

  1. 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
Q

empirical rx of IE

A
  • amoxicillin +/- low dose gent

if pen allergy

  • vanc +/- gent

if prosthetic valve
- vanc + gent + rif

44
Q

endocarditis rx if strep

A
  • benpen
45
Q

aortic abscess is in endocarditis is indicated by hwat finding

A
  • lenghtening PR interval
46
Q

what type of valve replacement is preffered in pregnant ladies

A
  • 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
Q

noradrenaline binds to which receptors

A

alpha >beta

- use in sepsis

48
Q

adrenaline binds to which receptors

A

beta >alpha
- use inlow CO states, cardiac arrest

SE: lactic acidosis, low k, ph

49
Q

dobutamine binds to which receptors

A
  • b1>a1
50
Q

dopamine binds to which receptors

A
  • D1/2>B1/Alpha - dose dependant

low dose = dopaminergic
medium dose = beta
high dose = alpha

51
Q

rx mitral regurg

A

acute: nitrates, diuretics, positive inotropes and intra-aortic baloon pump

if in HF - Ace-i + BB +/- spironolactone

  • valve repair or replace
52
Q

rx aortic stenosis

A
  • asympto = observe
  • sympto = valve replace
    if asympto but valv gradient >40mmhg = replace
  • do angio prior to surgery
53
Q

aortic regurg rx

A

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
Q

mitral stenosis rx

A
  • AF - rate control and anticoag
  • diuretics
  • balloon valvulopalsty
55
Q

most common cause of renovascular disease

A
  • developed worlld; atherosclerosis

- underdeveloped; takayasus

56
Q

cardiac tamponade sx

A
  • hypotension
  • muffled hear sounds
  • raised jvp
  • sob
  • tachycardia
  • absent y descent on jvp
  • pulsus apradoxus
  • kussmauls sign -ve
  • electrical allternans on ecg
57
Q

what does -+ve trop with absence of mi indicate

A
  • myocarditis
58
Q

rx myocarditis

A
  • acute; refer to ITU if needed
  • treat cause
  • bed rest for illness
  • 6months no sports
  • HF rx; BB + ACE-I, spiro
  • CI = nsaids
59
Q

HOCM sx and rx

A
  • = chest pain, spb, syncope, arrythmia, s4, jerky pulse
  • Ejection systolic murmur or pansystolic

ECHO = dx

rx
- HF rx, ICD, amiodarone, surgery

60
Q

dilated cardiomyopthy causes and rx

A
  • alcohol
  • cocksackie
  • wet beri beri
  • doxorubicin

rx
- cardiac resycnh therap, transplant as causes HF

61
Q

restrictive cardiomyopathy most common cause

A
  • amyloidosis
62
Q

cosntrictive pericarditis signs

A
  • kussmauls

- pericardial calcification on CXR

63
Q

rx for varicose veins

A
  • 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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