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Neds revision > Tough stuff > Flashcards

Tough stuff Flashcards

1
Q

AA class 1 (rhythm) use

A

Na+ channel blockers (phase 0) - slow conduction, prolong repolarisation

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2
Q

AA class 1 examples

A

lignocaine

flecainide

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3
Q

AA class 2 (rate) use

A

B-adrenoceptor blockers (phase 4)

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4
Q

AA class 2 examples

A

Atenolol

Propranolol

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5
Q

AA class 3 (rhythm) use

A

K+ channel blockers (phase 3) - prolong repolarisation

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6
Q

AA class 3 examples

A

amiodarone

sotalol

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7
Q

AA class 4 (rate) use

A

Ca2+ channel blockers (phase 2)

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8
Q

AA class 4 examples

A

verapamil

diltazem

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9
Q

treatment for bradycardia

A

IV atropine

temporary/ permanent pacing

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10
Q

treatment for acute SV tachycardias

A 
vagal manœuvres 
carotid massage 
IV adenosine 
IV verapamil 
anticoagulate (warfarin)
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11
Q

ECG for SV tachycardia?

A

normal QRS - they arise form the atrium

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12
Q

treatment for SV tachycardias

A
  1. get back to NSR - DC cardioversion and class 1 (lignocaine) or 3 AA drugs (amiodarone)
  2. rate control - accept the AF but control the ventricular rate –> digoxin, B-blocker or verapamil
  3. anticoagulation
  4. AV node ablation
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13
Q

ECG of VT

A

broad QRS complex

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14
Q

treatment of VT

A
  1. DC cardioversion if haemydynamic compromise
  2. Defib if pulseless VT
  3. amiodarone and lignocaine (class 3 and 1 rhythm AA drugs)
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15
Q

ECG of VF

A

shapeless, unorganised QRS complexes, a shambles🤦🏼‍♂️

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16
Q

treatment of VF

A
  1. basic life support
  2. defib
  3. magnesium chloride
  4. amiodarone
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17
Q

name 4 gram -ive bacilli

A

haem.influenza
enterobacter
pseudomonas auriginosa
bordtella pertussis

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18
Q

name 1 gram -ive cocci

A

neisseria

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19
Q

name 3 gram +ive cocci

A

staphylococcus
streptococcus
enterococci

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20
Q

name 1 gram +ive bacilli

A

clostridia

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21
Q

what is the incubation time for paratyphoid/typhoid and how do you treat it

A

3 weeks

azithromycin

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22
Q

how does E.Coli work

A
  1. produced by a shiga-like toxin and acts in the same way as shiga
  2. produces a verotoxin that causes RBC/kidney damage
  3. can lead to haemolytic ureamic syndrome (HUS)
  4. no treatment for (HUS), just supportive
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23
Q

what is the most common cause of endocarditis

A

strep viridians

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24
Q

what is the causative organism in prosthetic valve endocarditis?

A

staph. epidermidis

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25
Q

how to treat C. Diff

A

1st occurrence = fidaxomycin
non-severe = metronidazole
severe = vancomycin

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26
Q

treatment for peritonitis, billiary tract/ intra-abdominal infection

A

IV amoxicillin
metronidazole
gentamicin

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27
Q

treatment for acute gastroenteritis and pancreatitis

A

NONE!! 😁

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28
Q

difference in treatment between non-severe and severe HAP

A

treat with amoxicillin and metronidazole for both-

add gentamicin for severe

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29
Q

CAP with CURB 0-2 treatment

A

amoxicillin

30
Q

CAP with CURB 3-5

A

IV co-amoxiclav + doxycycline oral

31
Q

what do b-lactams target

A

bacterial cell wall

32
Q

target of flucloxacillin

A

narrow spec
only gram +ive
staph and strep

33
Q

target of amoxicillin

A

wide spec

gram +ive and -ive

34
Q

antibiotics that inhibit nucleic acid synthesis

A

metronidazole

fluroquinolones

35
Q

antibiotics that inhibit protein synthesis

A

tetracycline
macrolides (clarithromycin, erythromycin)
aminoglycosides

36
Q

whit is gentamicin

A

an aminoglycoside

works on gram -ive aerobic like coliforms and pseudomonas aeuriginosa

37
Q

what is vancomycin

A

a glycopeptide
not a B-lactam
only works on gram +ive cell wall
no activity on gram -ive

38
Q

what can metronidazole work on

A

clostridium
bacteriosides
anerobes
protozoa

39
Q

what pneumonia will likely arise in an exacerbation of COPD

A

haem. influenzae

40
Q

which pneumonia causes a dry cough, atypical chest signs and haemolytic anaemia

A

mycoplasma pneumoniae

41
Q

how is S1 affected by mitral stenosis an mitral regurg

A

mitral stenosis = soft S1

mitral regurg = loud S1

42
Q

what happens to S2 in aortic stenosis

A

aortic stenosis = soft S2

43
Q

conditions that cause life threatening acidosis

A

life threatening asthma
COPD
opiate overdose
obesity hypoventilation syndrome

44
Q

conditions that cause life threatening alkalosis

A 
hyperventilation 
PE 
alitiude 
CNS disorders 
pregnancy
45
Q

treatment of acute exacerbation of COPD

A
  1. ABCD
  2. oxygen
  3. steroids - IV hydrocortisone or oral prednisone
  4. antibiotics - amoxicillin or doxycycline
  5. nebuliser SABA
46
Q

what is dressler syndrome

A

complication of an MI that occurs weeks after initial infarction
symptoms:
mild fever, pleuritis chest pain relived by leaning forward, friction rub

occurs due to formation of antibodies against cardiac antigens released from necrotic myocytes during infarct

47
Q

what is a parodoxus pulse?

A

an abnromally large decrease in SV, systolic BP and pulse wave amplitude during inspiration

commonly due to cardiac tamponade, can also be cos of PE or hypovolemic shock

48
Q

what areas of the heart does the RCA perfuse

A

the inferior part of LV

49
Q

what area of the heart does the circumflex artery perfuse

A

the left free wall of LV

50
Q

what area does the LAD perfuse

A

septum, apex and anterior wall

51
Q

ECG of ANTERIOR stemi

A

V2- V5

52
Q

ECG of INFERIOR stemi

A

aVF, II, III

53
Q

ECG of ANTERIOSEPTAL stemi

A

V1 - V3

54
Q

ECG of ANTERIOLATERAL stemi

A

aVL, I, V4-6

55
Q

which murmur causes a collapsing pulse

A

aortic regurgitation

56
Q

what causes a bounding pulse

A

septic shock

57
Q

MABP = ??

A

MABP = diastolic pressure + 1/3 (systolic - diastolic)

58
Q

mid-diastolic murmur at apex of heart

A

mitral stenosis

59
Q

pan systolic murmur at apex of heart

A

mitral regurgitation

60
Q

how to diagnose hypertension

A

BP > 140/90 mmHg = ABPM is required

BP > 180/110 mmHg = start anti-hypertensive drugs IMMEDIATELY

61
Q

brain natriuretic peptide (BNP)

A

released by myocardium when its being excessively stressed
main function- decrease systemic vascular resistance of body, DECREASING AFTER LOAD
increases diereses - decreases BV, reducing PRELOAD

62
Q

ejection systolic radiating to carotids

A

Aortic stenosis

63
Q

high pitched and blowing, early diastolic

A

aortic regurgitation

64
Q

pan-systolic murmur radiating to apex

A

mitral regurgitation

65
Q

mid/late diastolic rumbling murmur

A

mitral stenosis

66
Q

which murmur causes a narrow pulse pressure, slow rising pulse and soft S2

A

Aortic stenosis

67
Q

which murmur can cause AF, has a soft S1 and a displaced apex

A

mitral regurgitation

68
Q

which murmur has a wide pulse pressure and a collapsing pulse

A

aortic regurgitation

69
Q

which murmur can cuase exertion dyspnoea, orthopnoea and PND

A

aortic regurgitation

70
Q

which murmur has a tapping, non-displaced apex beat

A

mitral stenosis

Neds revision (4 decks)

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