Passmed Flashcards
What use to treat torsades de points
IV Magnesium sulphate - stabilise cardia membrane
What is adenosine used for
Revert patients back to sinus rhythm with SV tachycardias
What is amiodarone used in
Management of broad complex tachycardia in stable patients
Shockable and non shockable rhythms in resus scenrios
Prolongs QT interval
What is atropine
Anticholinergic - increases HR + improves AV conduction by blocking ParaNS on heart
Why is atropine not recommended in torsades de pointes
Can induce paradoxical bradycardia - worsening arrhtyhmia
Causes if long QT interval
Congenital
Antiarrhtyhmics - amiodarone, sotalol, class 1a AR drugs
TCAs
Antipsychotics
Chloroquine
Terfenadine
Erythromicin
Electrolye - Hypocalcemia, hypokalemia, hypoMg
Myocarditis
Hypothermia
SA haemorrhage
What can happen after large volume pneumothorac chest drain
Pulmonary oedema
What offer if GRACE score >3% in NSTEMI
Coronary angiopathy within 72 hours
What medication give in NSTEMI that is stable
300mg aspriin, ticragelor and fondaparinux
When should fibrinolysis be offered in a STEMI
should be offered within 12 hours of the onset of symptoms if primary PCI cannot be delivered within 120 minutes
When do you give fondaparinux in NSTEMI/unstable angina
If no immediate PCI planned
When give unfractionated heparin in NSTEMI
if immediate angiography is planned or a patients creatinine is > 265 µmol/
When do immediate coronary angiography in NSTEMI
patient unstable eg hypertensive
What meds give prior to PCI
Aspirin + prasurgrel or ticregalor
If already on anticoag - clopidegrel + aspirin
Which antiplatelt give depending on bleeding risk
Not high= ticregalor
High = clopidegrel
When should nitrates be used with caution in MI
Patient hypotensive
What cardiac marker is best for picking up re-infarcts after initial MI
CK-MB as returns ti noraml after 4 days - if another MI between 4-10 dyas CKMB is best If after 10 dyas troponin T
What size pneumothorax can discharge if clinically well
<2cm
What MOA of dabigatran
Direct thrombin inhibitor
What MOA of heparin
Activates antithrombin III
What factors does warfarin inhibit
Factor II, VII, IX, X
DOAC usage
Non valvular AF if prev stroke/TIA, >75, HPTN, DM, HF
Prevention VTE after hip.knee surgery
Treatment DVT nad PE
What side effect of hydroxychloroquine need to counsel patient about
Risk of retinopathy
What drug can affect thyroid function
Amiodarone
