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bit n bobs > Day 1 Cardiology > Flashcards

Day 1 Cardiology Flashcards

1
Q

How does Heparin work?

A

activates anti-thrombin III

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2
Q

How does Clopidogrel work?

A

antagonist of the P2Y12 adenosine diphosphate (ADP) receptor, inhibiting the activation of platelets

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3
Q

How does Abciximab work?

A

glycoprotein IIb/IIIa inhibitor

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4
Q

How does Dabigatran work?

A

direct thrombin inhibitor

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5
Q

How does Rivaroxaban work?

A

direct factor X inhibitor

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6
Q

How does naftidrofuryl work?

A

Naftidrofuryl is a 5-HT2 receptor antagonist which can be used for peripheral vascular disease

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7
Q

What is the most common cause of heart failure?

A

In the western world, the most common cause of heart failure is ischaemic heart disease

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8
Q

How does Warfarin work?

A

Warfarin interferes with fibrin formation by affecting carboxylation of glutamic acid residues in factors 2,7,9 and 10.

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9
Q

Which two types of infections are HF patients most at risk of?

(2)

A

Chest infections and ulcerated cellulitic legs

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10
Q

How does atenolol lower blood pressure?

A

Inhibits renin release from kidneys

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11
Q

What is the mechanism of action for amiodarone?

A

Blocks voltage-gated potassium gates

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12
Q

What is the mechanism of action of dipyridamole?

A

Phosphodiesterase inhibitor

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13
Q

Where in the body are baroreceptors that detect blood pressure located?

A

The carotid sinus (just superior to the bifurcation of the internal and external carotid arteries)

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14
Q

Which ECG abnormality is associated with QT prolongation?

A

Hypocalcemia is associated with QT interval prolongation;

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15
Q

Which electrolyte abnormality is associated with QT shortening?

A

Hypercalcemia is associated with QT interval shortening

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16
Q

On ECGs, which electrolyte imbalance causes:

  1. causes tall tented T waves
  2. small p waves
  3. wide QRS interval
A

Hyperkalaemia

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17
Q

What would a hypokalemic ECG look like?

A

Prolonged QT interval

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18
Q

Which mineral abnormality can cause third-degree heart block?

A

Hypermagnesemia

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19
Q

What is the usual physiological mechanism in response to a rise in blood pressure?

A

The vagus nerve regulates the baroreceptor reflex, correcting an acute decrease in arterial blood pressure

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20
Q

Which molecule does troponin I bind to?

A

Actin

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21
Q

What does troponin C binds to?

A

calcium ions

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22
Q

What does troponin T bind to?

A

troponin T: binds to tropomyosin

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23
Q

What does troponin I bind to?

A

troponin I: binds to actin

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24
Q

What increases the risk of Guillain-Barré syndrome?

A

Recent diarrhoeal illness may increase the risk.

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25
Q

What is Guillain-Barre syndrome?

A

immune-mediated demyelination of the peripheral nervous system often triggered by an infection

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26
Q

Which beta-blocker is the most lipid soluble?

A

Propranolol

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27
Q

What is the mechanism of action for Hydralazine?

(2)

A
  1. ‘older’ antihypertensive
  2. increases cGMP leading to smooth muscle relaxation
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28
Q

How does bendroflumethiazide work?

A

Blocks the Na/Cl co-transporter in the distal convoluted tubule

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29
Q

HOCM is associated with which condition?

A

Friedreich’s ataxia

30
Q

What is the Bainbridge reflex?

A

The Bainbridge reflex is the increase in heart rate mediated via atrial stretch receptors that occurs following a rapid infusion of blood.

31
Q

Defining feature of left-sided heart failure

A

Paroxysmal nocturnal dyspnoea

(suddenly waking up at night short of breath)

32
Q

Defining features of right-sided heart failure

(3)

A

raised JVP

ankle oedema

hepatomegaly

33
Q

What is the most important side effect of nicorandil?

A

It causes hypotension and contributes to pulmonary oedema

34
Q

Why does PEs occur frequently in surgery and from AF

A

Negative atrial pressures may allow air embolization to occur

35
Q

What are Aschoff bodies?

A

Aschoff bodies are granulomatous nodules found in rheumatic heart fever

36
Q

What is Eisenmenger’s syndrome?

A

High pulmonary blood pressure caused by left to right shunt from VSD

37
Q

Which emergency treatment is given for ventricular tachycardia?

A

electrical cardioversion which is synchronised to the R wave

38
Q

How do you decide whether a patient with AF needs anticoagulation therapy?

A

CHA2DS2-VASc score

0 = No treatment

1

Males: Consider anticoagulation
Females: No treatment

2+

Offer anticoagulation

39
Q

What are the effects of Endothelin?

A

Endothelin is an incredibly potent vasoconstrictor and bronchoconstrictor.

40
Q

What is the mechanism of action of ticagrelor?

A

Ticagrelor inhibits ADP binding to platelet receptors.

41
Q

How does warfarin work?

A

Warfarin inhibits vitamin K epoxide reductase complex?

42
Q

How does Nicorandil work?

A

Potassium channel activator through activation of guanylyl cyclase

43
Q

Which X-ray abnormality is described as a “wedge-shaped opacification”?

A

Pulmonary Embolism

44
Q

What are the effects of Angiotensin II?

(4)

A

Sodium/water retention

Reduced baroreflex

Thirst (hypothalamus)

Systemic vasoconstriction

45
Q

What is the function of Atrial natriuretic peptide?

A

Angiotensin II antagonist

46
Q

ECG signs of PE

(3)

A
  • Sinus tachycardia (the most common)
  • Signs of right heart strain (not left)
  • T wave inversion in the anterior leads
47
Q

How does adenosine work?

(3)

A

anti-arrhythmic drug which works by activating the G-coupled protein receptors, which, through a cascade of action, causes cell hyperpolarization.

48
Q

What is the mechanism of action of Dipyridamole?

A

antiplatelet agent that acts via phosphodiesterase inhibition.

It is used in combination with aspirin for secondary prevention following transient ischaemic attack if clopidogrel is not tolerated.

49
Q

How does rheumatic fever develop?

A

molecular mimicry of the bacterial M protein

50
Q

An ECG shows ST elevation in leads V1-V4

Which vessel is most likely to be occluded?

A

Anterior descending artery

51
Q

What is the mechanism of Naftidrofuryl?

A

5-HT2 receptor antagonist which can be used for peripheral vascular disease

52
Q

With which drug is amiodarone contraindicated?

A

erythromycin

(causing ventricular arrhythmias)

53
Q

What is Wolff-Parkinson-White (WPW)?

A

a congenital condition involving abnormal conductive cardiac tissue between the atria and the ventricles that provides a pathway for a reentrant tachycardia circuit, in association with supraventricular tachycardia (SVT).

54
Q

Where does noradrenaline bind in the heart?

A

Noradrenaline binds to β 1 receptors in the SA node

55
Q

What would Marfan’s patient have in their aortic dissection?

A

Cystic medial necrosis - basophils and mucoid material lie in between the intimal elastic fibres of the aorta

56
Q

Which electrolyte imbalance causes Long QT?

A

Hypokalaemia

57
Q

What does long QT syndrome eventually lead to?

Why is it a concern?

A

torsades de pointes

58
Q

What is an important contraindication of ACE inhibitors?

A

Any kidney disease

59
Q

Which antibiotic causes long QT?

A

Erythromycin

60
Q

What is the first line antihypertensive in white males under the age of 55-years-old?

A

Ace-Inhibitors

61
Q

What is the first line antihypertensive in black males or those over the age of 55-years-old?

A

Calcium Channel Blockers

62
Q

Which endocarditis bacterium can infect the heart in patients with poor dental hygiene?

A

Streptococcus viridans

63
Q

What causes the release of B-type natriuretic peptide

A

B-type natriuretic peptide is released in response to ventricular strain

64
Q

What are the effects of B-type natriuretic peptide

A
  • vasodilator
  • diuretic and natriuretic
  • suppresses both sympathetic tone and the renin-angiotensin-aldosterone system
65
Q

Which drugs reduced the efficacy of ACEi?

A

NSAIDs

66
Q

V1-V4

Location?

Artery?

A

Anteroseptal

Left anterior descending

67
Q

II, III, aVF

Location?

Artery?

A

Inferior

Right coronary

68
Q

V4-6, I, aVL

Location?

Artery?

A

Anterolateral

Left anterior descending or left circumflex

69
Q

I, aVL +/- V5-6

Location?

Artery?

A

Lateral

Left Circumflex

70
Q

Tall R waves V1-2

Location?

Artery?

A

Posterior

Usually left circumflex, also right coronary

71
Q

What is the mechanism by which nitrates act?

A

Nitrates cause a decrease in intracellular calcium which results in smooth muscle relaxation

72
Q

Which drug is used for orthostatic hypotension?

A

fludrocortisone

bit n bobs (6 decks)

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