POINTS TO LEARN Flashcards
1
Q
what do muscarinic antagonists do and give an example of one?
A
atropine
increase HR
2
Q
what does levosimedan do?
A
increases contractility
3
Q
what do ACE inhibitors do?
A
vasodilation and arterial dilation
4
Q
what do calcium antagonists do?
A
decrease HR
5
Q
what do potassium channel blockers do?
A
relaxation of vascular smooth muscle
6
Q
how does warfarin work?
A
blocks clotting factors 2,3,7,10
7
Q
how does heparin work?
A
binds to antithrombin 3.
factor X3 activates thrombin IIa - fibrin - blood clot
8
Q
how do antiplatelets work?
A
prevent new thrombus
9
Q
how to fibrinolytics work?
A
dissolve formed clot
10
Q
what organism causes native valve endocarditis and what is the treatment?
A
viridans
amox + gent
11
Q
what organism causes prosthetic valve endocarditis and what is the treatment?
A
staph epidermis
vacno + gent + rifampicin
12
Q
what is the treatment for IDVU endocarditis?
A
fluclox
13
Q
QRISK3
A
predictor of future cardiovascualr events
14
Q
what is wells scroe
A
assess risk of PE
15
Q
what is PESI scroe
A
mortality risk of PE
16
Q
what thrombolytic agent is used in PE
A
altepase
17
Q
MOA of warfarin
A
vit k antagonist
18
Q
virchows triadd
A
hypercoaguability, stasis, endothelial damage
19
Q
cardiogenic shock
A
sustained hypotension caused by decreases cardiac contractility
20
Q
how much blood can be lost before compensatory mechanisms cannot maintain BP
A
30%
21
Q
neurogenic shock
A
loss of sympathetic tone to blood vessels and heart
22
Q
what does neurogenic shock cause
A
decreased HR (unique) and massive venous and arterial dilation leading to decreased CO
23
Q
vasoactvie shock
A
release of vasoactive mediators which causes massive arterial and venous dilation with increased capillary permeability
24
Q
OBSTRUCTIVE SHOCK
A
decreases venous return due to compression of the pericardium eg pneumothorax
25
normal intercranial pressure
8-13mmgh
26
arterial thrombus
white, platelet rich, treat with antiplatelet drugs
27
venous thrombus
red, fibrin rich, treat with anticoagulant drugs
28
when do platelets become activated
when they are exposed to collagen
29
what is the pathway of anticoagulant drugs
tenase - prothrombinase - thrombin - fibrinogen = fibrin
30
what order is heparin
0
31
what order is warfarin
1
32
where is IE most commonly seen
left side (right in drugs)
33
diagnostic criteria for IE
modified dukes criteria
34
what is the QT length in long QT syndrom
>440ms for men
| > 450 ms for women
35
what can long QT syndrome go on to cause
torsades de pointes (a polymorphic VT), brought on by sleep, hypokalaemia, mediation which prolongs QT length, exercise ect
36
what can be seen on an ECG of brugada syndrome
ST elevation and RBBB in v1-3
37
how do you treat HOCM
bb or verapamil
38
how do you treat AF secondary to HOCM
anticoagulatoin
39
how to treat aortic regurg
ACEi, ARBs
40
causes of mitral regurg
proplapse, rheumatic, myxotomatous, endocarditis, choardae rupture due to leaflet failure, papillary muscle rrupture, annular dilation
41
symtoms of mitral regurg
peipheral oedema, fatiguq
42
sound of mitral regurg
pansystolic
43
how to treat mirral ergurg
diurteics
44
sound of mitral stenosis
mid diastolic rumbling murmur
45
what does mitral stenosis look like on CXR
straightening of left heart border
46
what murmur is assocaited with AF
mitral stenosis
47
a 10% increase in LDL causes what
20% increase in CHD risk
48
normal TAG level
2.3
49
what are xantholasma madde of
foam cell
50
what is sinus pauses
transient lack of SA node activity
51
what is the physiology of triggered activity
after depolarisatoins
52
AVNRT vs AVRT
...
53
what is reflex syncope caused by
vasgovagal (emotional), carotid sinus - most common
54
what is orthostatic syncope causedby
priamry/secondary autonomic failure, drug induced, volume depletion
55
what is cardiac syncope caused by
arrhythmia, structural, PE
56
what is the mechanism of AF
sustained by macro-reentrant circuit - circuit is refined to the right atrium
57
what is net filtration
forces favourng filtration minus forces opposing filtration
58
normal PR
0.12-0.2
59
why is lymphatic drainage important in thelungs
pulmonary capilary hydrostatic pressure is lower than osmotic pressure so there is excess interstitial fluid to be drained
60
location of 1st degree heart block
atria
61
location of mobits 1 HB
AV node
62
location of mobitz 2 HB
after AV node in bundle of his
63
ABCDE in HF
```
alveoar oedema
bat wings
cardiomegaly
dilated vessels
effusion pleural
```
64
what noises can be heard on auscultation of HF
S3/S4 gallop
65
what drugs improve symptoms of HF
furosemide and digoxin
66
NYHA
1. no limitation
2. slight limitation
3. marked limitation
4. HF symptoms at rest
67
ischaemic stroke
clot blocks blood flow to brain
68
haemorrhagic stroke
bleeding inside or around brain tissu
69
treatment for ischaemic stroke
statin therpay + thrombolysis
70
what is dresslers syndrome
when damaged heart muslce releases proveiously unencountered material that stimulates an autoimmune response
71
GS for aortic dissection
transoesophageal echocardiography
72
the heart block poem
r is far from p - first degree
longer longerlonger drop - mobitz 1
some ps dont get through - mobitz 2
ps and qs dont agree - mobitz 3
73
risk factors for aortic aneurysm
smoking, hypertension, marfans, atherosclerosis
74
GS for cardiac tamponade
ECHO
75
treatment for cardiac tamponade
pericardiocentesis
76
what shape is the ventricle in HOCM
bananna
77
what are the causes of restirctive myocardiopathy
amyloidosis, sarcoidosis
78
what are the causes of dilatied myocardiopathy
alcoholics, viral infection, autoimmune disease, x linked
79
what is arrythmogenic right ventricular cardiomyopathy
heart muscle replaced by fibrous and faty tissue - right ventricle, autosomal dominantt,
80
what gene is mutated in brugada
SCN5a
81
what are the 4 features of fallots tetralogy
ventricular septal defect, pulmoary stenosis, right ventriular hypertrophy, aorta overriding the VSD
82
what are the investigations for IE
bloods and ECHO
83
what causes myocarditis
coxsackie A and B, enterovirus, echovirus
84
how do you diagnose myocarditis
viral culture or PCR
85
treatment for acute LS HF
sit up, O2, IV furosemide, IV diamorphine
86
treatment for SVT
vagal manouvers, adenosine/verapamil
| dc if compromised
87
treatment of torsades de pointes
magensium sulphate
88
treatment of VT
stable - IV amiodarone or lidocaine
| unstable - DC cardioversion
89
treatment of WPW
electrophysiology and ablation of accessory pathway
90
when to do IVC in DVT
if a patient is bleeding and anticoagulation is contraindicated
91
0-4 acute limb ischamie
white foot
92
4-12 acutelimb ischaemia
mottled, blanches on pressure, partially reversible
93
>12 acute limb ischamia
fixed mottling, non-blanching, compartments, red/tender, paralysis
94
HDL particles contain
apoA1 and ApoA2
95
LDL particls contain
apob100
96
VLVL particles contrain
apob100
97
chylomicrons contain
abob48
98
what do aopb100 proteins lipoproteins do
deliver TAG to msucle for ATP biogenesis and adipocytes for storage
99
what is the exogeonus pathway
chylomicrons are formed in interstitial cells and transport dietry triglycerides
100
what is the endogenous pathway
VLDL particles are formed in the liver cells and transport TAGs synthesised by the liver
101
what is the function of apoc11
activated chylomicrons and vldl particles
102
what are roth spots
retinal haemorrhages
103
what do nitrates do
decrease preload and afterload and improve perfusion to ischaemic zones
104
what is streptokinase
a fibrinolytic drug
105
how do you do HMBP
take 2 consecutive measurements while seated, 1 min apart, record 2x daily for 4-7 days. discard 1st day measurements and use average of rest
106
how to use AMBP
at least 2 measurements are taken per hour during 14 hours. use average of these hours to diagnose hypertension
107
what makes up the superficial venous system
saphenous and perforator
108
how do varicose veins arrise
due to back pressure due to incompetent valves causing blood to pool in superficial veins
109
what causes AF in young people
cytomegalo virus
110
in exercise ECG when in bp recorded
after every 3 mins - bruce protocol
111
fibrates
agonist of PPAR - increase lipoprotein lipase expression
112
ECG of AVNRT
normal QRS, P wave not visible/directly after QRS, long PR interval
113
ECG of AVRT
narrow QRS, P waves after QRS, before T
114
S3
diastolic filling of ventricle
normal in <30yr olds
heard in left ventricular failure
115
S4
may be heard in aortic stenosis, HOCM
116
what do ANPs do
increases glomerular function and causes kidneys to excrete more Na and more H20
117
what do ARBs block
ANG 2
118
anterior surface of heart
RV
119
base surface of heart
left atrium
120
inferior surfaace of heart
left and right ventricles
121
rigth border
RA
122
leftborder
LV
123
infeiror border
R and L V
124
superior border
right and Left atrium and great vessels
125
reversible causes of cardiac arrest
```
Hypovolaemia
Hypothermia
Hyper/hypo- kalaemia
Hypoxia
Tamponade
Tension pneumothorax
Thromboembolism
Toxin
```
126
tall tented t waves
hyperkalaemia
127
rib notching on CXR
coraction of the aorta
128
which way does sympathetic shift the FSC
left
129
what is afterload
the resistence into which the heart is pumping against (blood left in the heart after the heart has contracted)
130
JVP a
atrial contraction
131
JVP c
bulding of tricuspid valve into atrium during contraction
132
JVP v
the rise of atrial pressure durng atrial filling, released as AV valve opens
133
how to calculate regular rhythm
number of large squares within R-R /300
134
how to calculate irregular rhythm
number of QRSs on rhythm strip x 6
135
causes of AF
MI, hypertension, heart failure
136
acute vetricular heat fialure treatment
sit up, O2, IV furodsemide, morphine
137
ECG changes in PE
A large S wave in lead I, a Q wave in lead III and an inverted T wave in lead III together indicate acute right heart strain.
