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A OSCE MD4003 > The Practice of Treating Cardiovascular Patients > Flashcards

The Practice of Treating Cardiovascular Patients Flashcards

1
Q

What drugs can be given in hypertension?

A
  • ACE Inhibitors
  • Beta Blockers
  • Calcium antagonists
  • Diuretics
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2
Q

What drugs can’t be given in heart failure?

A

Calcium antagonists

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3
Q

What drugs can’t be given in angina?

A

Diruetics

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4
Q

What is the order drugs are given in hypertension?

A
  • A - ACEI or ARB
  • B - [Beta Blocker] - religated
  • C - Calcium Antagonist
  • D - Diruetic
  • Spiromolactone

*8Alpha blocker (doxazosin)

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5
Q

Sequence of treating hypertension in a patient younger than 55

A
  • Start A
  • Add C
  • Add D
  • Thein either, B, alpha blocker or spironolactone (preferance)
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6
Q

Sequence of treating hypertension if the patient is older than 55 or of African/Caribbean descent

A
  • Start C
  • Add A
  • Add D
  • Then either B, alpha blocker or spinonolactone
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7
Q

What is recommended treatment in chronic heart failure?

A

Give DAB to all

  • Diruetic
  • ACE I or ARB
  • Beta blocker

Spironoloactone/eplerenone

**Selected treatments may be required

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8
Q

What are the selected treatments in chronic heart failure?

A
  • Cardiac resynchronisation therapy (biventricular pacing) to those with a long QRS
  • Sacubitril/Valsartan to replace ACEI/ARB
  • Implantable cardiac defibrillators;
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9
Q

What is a severe side effect of ACEI or sacubitril-valsartan

A

angioneurotic oedema

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10
Q

What is the action of valsartan

A

ARB - angiotensin receptor blocker

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11
Q

What is the action of sacubitril?

A

inhibits neprilysin which degrades BNP and other vasoactive peptides

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12
Q

What do patients with angina get to prolong survival?

A
  • ASpirin
  • Statin
  • ACE I
  • Beta blocker

**SAAB

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13
Q

What do patients with angina sequentially recieve to relieve symptoms?

A
  • Beta blocker
  • Calcium antagonists or nitrates
  • Coronary angiplasty
  • New antianginals
    • Ivabradine
    • Ranolazine
  • Coronary artery surgery
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14
Q

What are the 4 entities of chest pain?

A
  • ST elevation MI (STEMI)
  • Non-ST evelation MI (NSTEMI)
  • Troponin negtaive unstable angina/ACS
  • Non cardiac chest pain
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15
Q

How to treat a STEMI in an emergency

A
  • Aspirin
  • Angioplasty (if near hospital)
  • Thrombolysis (if far away)
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16
Q

What is given post emegerency for a STEMI?

A
  • Aspirin and clopidogral/ticagreglor
  • Low MW heparin/fondaparinaux
17
Q

What is the subsequent treatment after a STEMI?

A
  • Statin
  • Beta blocker
  • ACE I
  • Aspirin

**SAAB

18
Q

What is fondaparinux?

A

synthetic pentasaccharide that inhibits activated factor X

19
Q

What is the treatment for an NSTEMI?

A
  • Aspirin and clopidogrel/ticagrelor
  • Fondaparinaux
  • Angioplasty (not as am emergency)
  • SAAB

No thrombolysis in an NSTEMI

20
Q

What is given in the treatment of Unstable Angina?

A
  • Aspirin and clopidogrel
  • Selective use of angioplasty
  • SAAB
21
Q

What is given in atrial fibrilation to prevent emboli?

A

Warfarin/DOCAs

22
Q

What is given in atrial fibrillation to control rate?

A
  • Beta blocker
  • Digoxin
23
Q

What is given in atrial fibrillation to control rhythm

A
  • DC cardioversion
  • Amiodarone (if in heart failure)
  • Sotalol (II/III) possible
  • Flecainide (Ic) only if heart structure/function is normal
24
Q

CVA =

A

Cerebral vascular accident

25
Q

Causes of a stroke

A
  • Cerebral thrombosis
  • Cerebral embolus
  • Cerebral haemorrhage
26
Q

What medical image must be taken for patients having a stroke? and WHY?

A

CT scan

To differentiate between haemorrhage and clot

27
Q

What procedure is carried out of it is a cerebral thrombosis?

A

emergency thrombolysis with streptokinase and TPA

28
Q

Subsequent treatment of a stroke

A

First: aspirin and clopidogrel

Second: Statin, ACE I, Indapamide

29
Q

What is indapamide?

A

anti-hypertensive drug that can help prevent future strokes

30
Q

What are the common side effects of ACE inhibitors?

A
  • Cough
  • Renal dysfunction
  • Angioneurotic oedema
  • Never give in pregnancy
31
Q

What are the common side effects of ARBs?

A
  • Renal dysfunction
  • Never give during pregnancy
32
Q

What are the common side effects of beta blockers?

A
  • Bradycardia/Heart Block
  • Tired
  • Asthma
33
Q

What are the common side effects of calcium antagnoists?

A
  • Ankle oedema in amolodipine
  • Heart block for diltiazem and verapamil
34
Q

What are the common side effects of direutics?

A
  • Hypokalaemia
  • DIabetes
  • Gout

A OSCE MD4003 (44 decks)

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