Week 2 Flashcards
Causes of cardiac arrhythmia
Coronary artery disease, htn, cardiomyopathy, valve disorders, electrolyte imbalance, injuries from MIs, post-surgical healing.
left sided heart failure: causes what, signs, reasons: murmur, cough, pndysp+dizzy (5)
Lshf makes blood pool in lungs > inc pressure > oedema and resp symp from lack of reception of o2 blood.
Crackles heard in bases but everywhere if pulmonary oedema. Cyanosis, dsypnoea, Orthopnea, laterally displaced apex beat if cardiomegaly/ left vent hypertrophy or dialation.
Murmur indicate valve disease- aortic stenosis as a cause or mitral regurgitation as a result.
Cough and wheeze can come from congestive failure. Paraoxysmal nocturnal dyspnea attacks can indicate left sided heart failure
Compromise of left sided systemic flow makes dizzy, confused, cool extremities. Often on exertion.
Right sided heart failure signs (5)
Associated with issues of pulmonary circulation- eg pulmonary htn/stenosis.
fixed pitting oedema
Ascites, effusion, liver and spleen enlargement. Raised JVP sometimes.
Rvent pressure inc can give a parasternal heave.
Sacral oedema
nocturia
Liver issues go to congestive heart failure, jaundice and coagulation issues.
High output failure + causes (2)
Hf from more blood circulating than the heart can cope with.
Transfusion, kidney disease, severe chronic anaemia, vitamin B, hyperthyroidism, cirrhosis, pagets disease multiple myeloma, arteriovenous fistula or malformation
Pericarditis signs, cause, treatment (4)
Symptoms include stabbing chest pain, pain in neck spreading to shoulders/arms, fever, nausea, shortness of breath.
Worse when lying down and better when leaning forward.
Mostly idiopathic. Some causes are viral/bacterial infection, an autoimmune disease, myocarditis rubbing against pericardium eg after surgery or MI.
Diagnose anti inflammatory drugs like colchicine, painkillers, pericardial window surgery.
Pericardial effusion, cause, signs, treatment (4)
Build up of fluid in the pericardial space. Too much can put pressure of the heart known as cardiac tamponade, restricting heart expansion and O2 delivery.
Causes include metastasised cancer, bacterial or viral infection or inflammation of the pericardium, immune disease, kidney failure with uremia, medication reaction and radiation.
Symptoms are chest pain, enlarged jvp, fainting, tachycardia, nausea, urq pain, short of breath, limb swelling, hypotension if severe.
Antibiotics or pericardiocentresis
Pleural effusion, signs, causes, treatment, association (6)
Build up of fluid in pleural space. Dense white on X-ray.
Can be transudate ultra filtered plasma from eg heart failure or cirrhosis. Or can be exudate from inflammation which is difficult to treat. Stuff like pneumonia, lung cancer.
Signs are dyspnea, fast breathing, chest pain on inspiration/exhalation and cough.
Major causes: congested heart failure, kidney failure, pulmonary embolism, hypoalbuminemia, cirrhosis, trauma
Exudate looks like ldh > 0.45 of upper limit norm blood value, protein > 2.9g/dl and cholesterol > 45mg/dl (all in the pleural fluid)
Can give thoracentresis, surgery to separate tissue, or pleural desis
Congestive heart failure is associated to atherosclerosis, htn,thyroid bc blood x be pumped out. Backflowmakes swelling and vessels leak
Pulmonary oedema, causes c or not, symptoms, flash po. (5)
Also pulmonary congestion, liquid accumulation in the bronchioles. Makes impaired gas exchange and possible resp failure or cardiac arrest
Cardiogenic/left ventricular or non cardiogenic
Cardiogenic = congestive heart failure eg valve to ventricular failure, arrhythmia, fluid overload eg kidney failure, hypertensive crisis
Non cardiogenic = from negative pressure eg inhaling against an upper airway obstruction rupturing capillaries. Also caused by pe, acute lung injury or seizure
Symptoms are dyspnea, pink sputum, sweating, orthopnea, and paroxysmal nocturnal dyspnea, peripheral oedema, raised jvp, hepatomegaly, crackles, third heart sound
Flash pulmonary oedema is caused by acute MI, aortic regurgitation, raised left vent pressure, htn, renal artery stenosis
Direct acting oral anticoagulant names, reversals, MU, contraindicated (5)
Risk of bleeding. Includes apixaban, dabigatran, edoxaban and rivaroxaban.
Dabigatran reversal = idarucizumab
Apixaban/rivaroxaban = andexanet alfa
Anticoagulant. Prevents MU when with acetylsalylic acid (+ clopidogrel or ticlipidine)
X for antiphospholipid syndrome or prosthetic heart valves
Vitamin K antagonist, contracondition, risks (4)
Eg warfarin. Don’t use with hep c now either, not many antibiotics or antivirals. Risk of bleed. Risk bacterial endocarditis
Verapamil hydrochloride uses, contraind (3)
Is a calcium channel blocker for htn and arrhythmia like supra ventricular, paroxysmal tachy, angina. Also for prevention of cluster headaches, acute porphyria ( aflut or afib with accessory pathway), bradycardia, hf with red ef, 2/3rd degree heart block
Not good for postural hypotension nor early on MI
Procainamide uses, risks (2)
Anti arrhythmia for ventricular ectopy, tachycardia, supra ventricular arrhythmia, reentry tachycardia,afib. Sodium channel blocker
Risk bradycardia, hypotension, shock, drug lupus erythema
Isoprenaline/isoproterenol uses, when, not (4)
Treatment for bradycardia, asthma and heart block. Beta agonist. Adjunct treatment for hypovolemic and septic shock.
Not good tachy arrhythmia.
What does the congenital and perinatal infection acronym ToRCHeS stand for?
Toxoplasmosis Rubella Cytomegalovirus Herpes simplex Syphilis
Necrotising enterocolitis, treatment, abx, xray, symptoms (5)
Too little o2 or perfusion to the intestine at birth or later. The intestinal wall becomes damaged and it is eroded by the growth of bacteria or viruses.
Treatment is for stage one or two. Involves stopping enteral feedings, giving nasogastric decompression and broad spectrum antibiotics.
Ampicillin, gentamicin and metronidazole
X-ray shows multiple small bubbles on the wall of the intestine
Symptoms abdominal pain, swelling, bloody diarrhoea, green or yellow vomit, lethargy and no appetite
Retinopathy of prematurity/retrolental fibroplasia RLF/ Terry syndrome (3)
Prem baby after o2 therapy have disordered growth of retinal vessels leading to scarring and detachment sometimes. Main treatment is peripheral retinal ablation
Cerebral palsy, risk, 3 classes
Group of movement disorders presenting at childhood
Poor coordination, stiff or weak muscles, tremors, sensory and speech impairment. Often don’t roll or sit at their milestones. Can have seizures.
Risk is preterm, being a twin, infection in pregnancy, hard delivery or early head trauma
Can be spastic, ataxic or dyskinetic
Perinatal asphyxia, dates, signs, risk, treatment (5)
Being o2 deprived at birth or in the womb enough to cause harm usually to the brain. Sometimes specific organs. From 28th week gestation to 7 days old
Shows hypoxia damage and metabolic acidosis
Can sometimes lead to hypoxia ischemia encephalopathy or intraventricular haemorrhage
Adrenaline and a to e
Perinatal cord prolapse signs and treat
C section treats with cord decompression. Signs are low fetal heart rate that doesn’t resolve
Anticoagulant vs antiplatelet
Anticoagulants interfere with clotting factors in the blood. Eg stops thrombin from working by binding to antithrombin, or inhibiting vitamin k.
For people with prior history of blood clots like dvt, coronary artery clots, PE and atrial fibrillation which gives high risk of clots.
Side effects are haemorrhage, high potassium levels, thrombocytopenia. Examples include heparin, warfarin, rivaroxaban, apixaban and dabigatran.
Antiplatelets stop platelets sticking in the blood stream. Good for those who had ischemic strokes, coronary artery issues, heart valve surgery, bypass surgery, stents and those presently having a heart attack, angina, TIA and PAD.
Side effects are haemorrhage, GI upset and dizziness. Examples include aspirin, clopidogrel dipyridamole and abciximab
Prophylaxis or stable cvd- anticoagulant. Secondary prev or very high risk- both
NV Afib- 2antip+antic, 6 m then one of each for 6m then antip
Valve disease- antic or both if super high clot risk
Dvt- both then after 3m antic
Lower dose antic when with antip
What is hepatitis, symptoms (3)
Acute parenchymal liver damage caused by drugs, bugs, autoimmune disorders and metabolic disorders
Alcoholic liver disease is one of the most common causes for alcoholic cirrhosis and alcoholic hepatitis that leads to cirrhosis also. This leads to hepatocellular carcinoma
Symptoms of alcoholic liver disease include asymptomatic elevated transaminases. Steatosis disappears after 3 months of alcohol abstinence.
Presentation of alcoholic hepatitis
Jaundice and hepatomegaly. 1/3 die in acute presentation, particularly if has hepatic encephalitis or prolonged prothrombin time. If abstain, 70% survive to 5 yrs.
Presentation of alcoholic cirrhosis, cells, leads to
Only presents with complications: varceal haemorrhage or ascites. If presents with severe complications, 50% survive to 5 yrs. There’s also inc risk of hepatocellular carcinoma.
Cirrhosis includes diffuse fibrosis, distorted hepatic vasculature. Can give portal htn and affects enzymes, clotting and filtration functions.
Leads to: dec factors, hepatic encephalopathy (confusion with raised icp from neurotoxins not metabolised), ascites, varices, hepatorenal syndrome - renal vasoconstriction due underfilled systemic circulation when there’s portal htn and ascites.
Acute liver disease: causes, presentation and cell changes.
Acute liver disease is likely Hep A or E enterally transmitted.
Presents malaise, nausea, anorexia, couple weeks in jaundice. Also hepatomegaly and lymphadenopathy. Will have raised AST and ALT before jaundice.
Hepatocytes swell, vacuolate, cytoplasmic granulation and necroses. Patchy and multiacinar all over but worst on the outside of the organ at periphery.
