Tough stuff Flashcards
1
Q
AA class 1 (rhythm) use
A
Na+ channel blockers (phase 0) - slow conduction, prolong repolarisation
2
Q
AA class 1 examples
A
lignocaine
flecainide
3
Q
AA class 2 (rate) use
A
B-adrenoceptor blockers (phase 4)
4
Q
AA class 2 examples
A
Atenolol
Propranolol
5
Q
AA class 3 (rhythm) use
A
K+ channel blockers (phase 3) - prolong repolarisation
6
Q
AA class 3 examples
A
amiodarone
sotalol
7
Q
AA class 4 (rate) use
A
Ca2+ channel blockers (phase 2)
8
Q
AA class 4 examples
A
verapamil
diltazem
9
Q
treatment for bradycardia
A
IV atropine
temporary/ permanent pacing
10
Q
treatment for acute SV tachycardias
A
vagal manœuvres carotid massage IV adenosine IV verapamil anticoagulate (warfarin)
11
Q
ECG for SV tachycardia?
A
normal QRS - they arise form the atrium
12
Q
treatment for SV tachycardias
A
- get back to NSR - DC cardioversion and class 1 (lignocaine) or 3 AA drugs (amiodarone)
- rate control - accept the AF but control the ventricular rate –> digoxin, B-blocker or verapamil
- anticoagulation
- AV node ablation
13
Q
ECG of VT
A
broad QRS complex
14
Q
treatment of VT
A
- DC cardioversion if haemydynamic compromise
- Defib if pulseless VT
- amiodarone and lignocaine (class 3 and 1 rhythm AA drugs)
15
Q
ECG of VF
A
shapeless, unorganised QRS complexes, a shambles🤦🏼♂️
16
Q
treatment of VF
A
- basic life support
- defib
- magnesium chloride
- amiodarone
17
Q
name 4 gram -ive bacilli
A
haem.influenza
enterobacter
pseudomonas auriginosa
bordtella pertussis
18
Q
name 1 gram -ive cocci
A
neisseria
19
Q
name 3 gram +ive cocci
A
staphylococcus
streptococcus
enterococci
20
Q
name 1 gram +ive bacilli
A
clostridia
21
Q
what is the incubation time for paratyphoid/typhoid and how do you treat it
A
3 weeks
azithromycin
22
Q
how does E.Coli work
A
- produced by a shiga-like toxin and acts in the same way as shiga
- produces a verotoxin that causes RBC/kidney damage
- can lead to haemolytic ureamic syndrome (HUS)
- no treatment for (HUS), just supportive
23
Q
what is the most common cause of endocarditis
A
strep viridians
24
Q
what is the causative organism in prosthetic valve endocarditis?
A
staph. epidermidis
25
how to treat C. Diff
1st occurrence = fidaxomycin
non-severe = metronidazole
severe = vancomycin
26
treatment for peritonitis, billiary tract/ intra-abdominal infection
IV amoxicillin
metronidazole
gentamicin
27
treatment for acute gastroenteritis and pancreatitis
NONE!! 😁
28
difference in treatment between non-severe and severe HAP
treat with amoxicillin and metronidazole for both-
| add gentamicin for severe
29
CAP with CURB 0-2 treatment
amoxicillin
30
CAP with CURB 3-5
IV co-amoxiclav + doxycycline oral
31
what do b-lactams target
bacterial cell wall
32
target of flucloxacillin
narrow spec
only gram +ive
staph and strep
33
target of amoxicillin
wide spec
| gram +ive and -ive
34
antibiotics that inhibit nucleic acid synthesis
metronidazole
| fluroquinolones
35
antibiotics that inhibit protein synthesis
tetracycline
macrolides (clarithromycin, erythromycin)
aminoglycosides
36
whit is gentamicin
an aminoglycoside
| works on gram -ive aerobic like coliforms and pseudomonas aeuriginosa
37
what is vancomycin
a glycopeptide
not a B-lactam
only works on gram +ive cell wall
no activity on gram -ive
38
what can metronidazole work on
clostridium
bacteriosides
anerobes
protozoa
39
what pneumonia will likely arise in an exacerbation of COPD
haem. influenzae
40
which pneumonia causes a dry cough, atypical chest signs and haemolytic anaemia
mycoplasma pneumoniae
41
how is S1 affected by mitral stenosis an mitral regurg
mitral stenosis = soft S1
| mitral regurg = loud S1
42
what happens to S2 in aortic stenosis
aortic stenosis = soft S2
43
conditions that cause life threatening acidosis
life threatening asthma
COPD
opiate overdose
obesity hypoventilation syndrome
44
conditions that cause life threatening alkalosis
```
hyperventilation
PE
alitiude
CNS disorders
pregnancy
```
45
treatment of acute exacerbation of COPD
1. ABCD
2. oxygen
3. steroids - IV hydrocortisone or oral prednisone
4. antibiotics - amoxicillin or doxycycline
5. nebuliser SABA
46
what is dressler syndrome
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
what is a parodoxus pulse?
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
what areas of the heart does the RCA perfuse
the inferior part of LV
49
what area of the heart does the circumflex artery perfuse
the left free wall of LV
50
what area does the LAD perfuse
septum, apex and anterior wall
51
ECG of ANTERIOR stemi
V2- V5
52
ECG of INFERIOR stemi
aVF, II, III
53
ECG of ANTERIOSEPTAL stemi
V1 - V3
54
ECG of ANTERIOLATERAL stemi
aVL, I, V4-6
55
which murmur causes a collapsing pulse
aortic regurgitation
56
what causes a bounding pulse
septic shock
57
MABP = ??
MABP = diastolic pressure + 1/3 (systolic - diastolic)
58
mid-diastolic murmur at apex of heart
mitral stenosis
59
pan systolic murmur at apex of heart
mitral regurgitation
60
how to diagnose hypertension
BP > 140/90 mmHg = ABPM is required
| BP > 180/110 mmHg = start anti-hypertensive drugs IMMEDIATELY
61
brain natriuretic peptide (BNP)
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
ejection systolic radiating to carotids
Aortic stenosis
63
high pitched and blowing, early diastolic
aortic regurgitation
64
pan-systolic murmur radiating to apex
mitral regurgitation
65
mid/late diastolic rumbling murmur
mitral stenosis
66
which murmur causes a narrow pulse pressure, slow rising pulse and soft S2
Aortic stenosis
67
which murmur can cause AF, has a soft S1 and a displaced apex
mitral regurgitation
68
which murmur has a wide pulse pressure and a collapsing pulse
aortic regurgitation
69
which murmur can cuase exertion dyspnoea, orthopnoea and PND
aortic regurgitation
70
which murmur has a tapping, non-displaced apex beat
mitral stenosis
