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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
What is Guillain-Barre syndrome?
**immune-mediated demyelination** of the peripheral nervous system often **triggered by an infection**
26
Which beta-blocker is the most lipid soluble?
Propranolol
27
What is the mechanism of action for Hydralazine? (2)
1. 'older' antihypertensive 2. increases cGMP leading to smooth muscle relaxation
28
How does bendroflumethiazide work?
Blocks the Na/Cl co-transporter in the distal convoluted tubule
29
HOCM is associated with which condition?
Friedreich's ataxia
30
What is the Bainbridge reflex?
The Bainbridge reflex is the increase in heart rate mediated via atrial stretch receptors that occurs following a rapid infusion of blood.
31
Defining feature of left-sided heart failure
Paroxysmal nocturnal dyspnoea (suddenly waking up at night short of breath)
32
Defining features of right-sided heart failure (3)
raised JVP ankle oedema hepatomegaly
33
What is the most important side effect of nicorandil?
It causes hypotension and contributes to pulmonary oedema
34
Why does PEs occur frequently in surgery and from AF
Negative atrial pressures may allow air embolization to occur
35
What are Aschoff bodies?
Aschoff bodies are granulomatous nodules found in rheumatic heart fever
36
What is Eisenmenger's syndrome?
High pulmonary blood pressure caused by left to right shunt from VSD
37
Which emergency treatment is given for ventricular tachycardia?
electrical cardioversion which is **synchronised to the R wave**
38
How do you decide whether a patient with AF needs anticoagulation therapy?
CHA2DS2-VASc score ## Footnote 0 = No treatment **1** Males: Consider anticoagulation Females: No treatment **2+** Offer anticoagulation
39
What are the effects of Endothelin?
Endothelin is an incredibly potent vasoconstrictor and bronchoconstrictor.
40
What is the mechanism of action of ticagrelor?
Ticagrelor inhibits ADP binding to platelet receptors.
41
How does warfarin work?
Warfarin inhibits vitamin K epoxide reductase complex?
42
How does Nicorandil work?
Potassium channel activator through activation of guanylyl cyclase
43
Which X-ray abnormality is described as a "wedge-shaped opacification"?
Pulmonary Embolism
44
What are the effects of Angiotensin II? | (4)
Sodium/water retention Reduced baroreflex Thirst (hypothalamus) Systemic vasoconstriction
45
What is the function of Atrial natriuretic peptide?
Angiotensin II antagonist
46
ECG signs of PE | (3)
* Sinus tachycardia (the most common) * Signs of right heart strain (not left) * T wave inversion in the anterior leads
47
How does adenosine work? | (3)
**anti-arrhythmic** drug which works by activating the **G-coupled protein receptors,** which, through a cascade of action, **causes cell hyperpolarization.**
48
What is the mechanism of action of Dipyridamole?
**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
How does rheumatic fever develop?
**molecular mimicry** of the bacterial M protein
50
An ECG shows ST elevation in **leads V1-V4** Which vessel is most likely to be occluded?
**Anterior descending artery**
51
What is the mechanism of Naftidrofuryl?
5-HT2 receptor antagonist which can be used for peripheral vascular disease
52
With which drug is amiodarone contraindicated?
erythromycin | (causing ventricular arrhythmias)
53
What is Wolff-Parkinson-White (WPW)?
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
Where does noradrenaline bind in the heart?
Noradrenaline binds to β 1 receptors in the SA node
55
What would Marfan's patient have in their aortic dissection?
**Cystic medial necrosis** - basophils and mucoid material lie in between the intimal elastic fibres of the aorta
56
Which electrolyte imbalance causes Long QT?
Hypokalaemia
57
What does long QT syndrome eventually lead to? Why is it a concern?
torsades de pointes
58
What is an important contraindication of ACE inhibitors?
Any kidney disease
59
Which antibiotic causes long QT?
Erythromycin
60
What is the first line antihypertensive in white males under the age of 55-years-old?
Ace-Inhibitors
61
What is the first line antihypertensive in **black** males or those **over the age of 55-years-old?**
Calcium Channel Blockers
62
Which endocarditis bacterium can infect the heart in patients with poor dental hygiene?
Streptococcus viridans
63
What causes the release of B-type natriuretic peptide
B-type natriuretic peptide is released in response to ventricular strain
64
What are the effects of B-type natriuretic peptide
* vasodilator * diuretic and natriuretic * suppresses both sympathetic tone and the renin-angiotensin-aldosterone system
65
Which drugs reduced the efficacy of ACEi?
NSAIDs
66
**V1-V4** Location? Artery?
**Anteroseptal** **Left anterior descending**
67
**II, III, aVF** Location? Artery?
**Inferior** **Right coronary**
68
V4-6, I, aVL Location? Artery?
Anterolateral Left anterior descending or left circumflex
69
I, aVL +/- V5-6 Location? Artery?
Lateral Left Circumflex
70
Tall R waves V1-2 Location? Artery?
Posterior Usually left circumflex, also right coronary
71
What is the mechanism by which nitrates act?
Nitrates cause a decrease in intracellular calcium which results in smooth muscle relaxation
72
Which drug is used for orthostatic hypotension?
fludrocortisone

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