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TI year > Emergency Medicine - Cardiology > Flashcards

Emergency Medicine - Cardiology Flashcards

1
Q

Causes of cardiac arrest

think structural heart

A
  • Coronary Ischemia (most common)
  • Cardiomyopathy
  • Heart lesions/structural
  • Electrical conduction abnormalities
  • Metabolic disturbances
  • Toxic ingestion
  • Other
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2
Q

Collapsed patient - Structure of approach

A
  1. Call for help
  2. CABs (pulse)
  3. No pulse –> CPR (30:2)
  4. Check rhythm, defib
  5. Cycle 2 min CPR, check rhythm
  6. Epinephrine 1mg (1ml) IV 1:1000
  7. Continue cycle

-Get IV access

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3
Q

Causes of PEA and management

A 
H's and T's 
Hypovolaemia
Hypoxia
H+ acidosis 
Hyperkalaemia
Hypotermia

Tamponade, MI
Tension pneumothorax
Toxins
Thrombosis (PE)

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4
Q

Lift threatening causes of Chest pain

A 
MI 
PE
Aortic dissection
AAA 
Tension pneumothorax
Tamponade
Esophageal rupture

PAATTE M

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5
Q

Tachy-arythmia

Unstable signs

A

Unstable

  • Hypotensive
  • AMS/loss of consciousness
  • Chest pain/SOB
  • Acute heart failure

OMI
ABCs
TREATMENT - CARDIO VERT always (+analgesia/sedation)
Brady - Pacemaker

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6
Q

Identifying rhythm - tachy

A
  1. Wide (VT) or narrow
  2. narrow - regular, irregular (afib, aflut)
  3. Regular - p waves normal (sinus tachy) or not (SVT)
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7
Q

VT treatment
Afib/aflut
SVT treatment
Brady

A

VT - Amiodarone (Am I going to die)
Afib/aflut - fix underlying cause, CCB, BB (anticoag)
SVT - adenosine (adison from greys anatomy had SVT)
Bradycardia - atropine (AT bus goes slow - Brady)

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8
Q

Types of heart block on ECG

A

Type 1 - Wide PR interval (equal)
Type 2 - mobitz 1 - PR widening, QRS drop
Mobitz 2 - PR equal, QRS dropped
Type 3 - P equal, QRS equal, no association with P and QRS.

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9
Q

Types of shock

A

Carcinogenic (ACS, drugs, toxins, cardiomyopathies, vavular disease, dsyarthmias)
Distributive (sepsis, anyphylaxis, neurogenic)
Hypovolaemic (hemorhage, dehydration)
Obstructive (tamponade, tension pneumothroax, PE)

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10
Q

AFib - causes

A

mneumonic - look up
PIRATES

PE
IHD, infection
Rhematic /vavles
Anaemia
Thyroid
Elevated vitals (BP, temp)
Stimulants, sleep apnea
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11
Q

Equation - For Oxygen delivery to tissue

Definition of preload and after load

A

D02 = CO x Ca02 (arterial oxygen content)
-look at diagram

Preload - Volume of blood in ventricles at end of diastole (end diastolic pressure)

After load - resistance that the LV has to overcome to eject blood

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12
Q

Sepsis 6

A

Take 3

  • Blood cultures
  • Lactate + bloods
  • Urine output

Give 3

  • Abx
  • Fluids
  • Oxygen
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13
Q

Causes for right and left axis deviation

A

Left

  • LVH
  • LBBB
  • Inferior MI
  • WPW syndrome

Right

  • RVH
  • RBBB
  • PE
  • WPW
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14
Q

Causes for

  • Bifid P wave
  • peaked p wave
  • prolonged PR
  • shortened PR
  • wide QRS
  • Q wave
  • T wave upright except which leads
A 
P mitrale - left atrial enlargement 
Peaked P wave - R atrial enlargement 
Prolonged - First degree HB
Shortened - accessory pathway 
Wide QRS - conduction delay
Q wave - prior MI
T wave - aVR, V1
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15
Q

Leads in correspondence to MI territory

A

Anterior V3, V4 (LAD)
Septal V1, V2 (LAD)
Lateral leads V5, V6, I, aVL (circumflex artery)
Inferior leads - II, III, aVF (Right coronary arteries)

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16
Q

Axis rules

A

look up

17
Q

Contraindications of Thrombolysis

A

Absolute

  • Active bleed
  • Head injury in last 3 months
  • Suspected AD
  • PMHx intracranial hemorrhage
  • Ischaemic stroke < 3 months
  • AVM
  • Brain cancer

Relative

  • Anticoagulated
  • recent major surgery
  • recent bleed in past 1 month
  • Peptic ulcer
  • Pregnant
  • hypertension poorly controlled
  • Ischemic stroke >3months ago
18
Q

AF treatment <48hrs or >48hrs rate >120bpm

without haemodynamic instability

A

<48hr (rhythm control)

  • amiodarone IV
  • enoxaparin
  • electrocardioversion if above does not work

> 48hr (rate only)

  • enoxaparin
  • BB or CCB or (digoxin for reduced LV function)

AF <100bm ventricular rate
-anticoagulate

SVT

  • valsalva manneuver
  • Carotid sinus massage - make sure no carotid bruts first, always use atropine with this and ECG montoring
  • Adneosine
19
Q

Causes of torsades de points

A
  • electrolyte abnormality (hypokalaemia, hypomagnesia, hypocalcaemia, drug toxicity, drug interactions
  • Give MgSu
  • correct underlying cause
  • cardioversion if unstable

TI year (16 decks)

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