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CV > Week 3 > Flashcards

Week 3 Flashcards

1
Q

Why is blood flow in capillaries slow?

A

Allow adequate time for exchange

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2
Q

What can pass through the pores of the capillary wall?

A

Small water soluble substances
Na, K, glucose, amino acids

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3
Q

What can pass through the endothelial cells of the capillary wall?

A

Lipid soluble substances
O2, CO2

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4
Q

How are exchangeable proteins transported across the capillary wall?

A

Vesicular transport

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5
Q

What law of diffusion does movement of gas and solutes follow?

A

Fick’s Law

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6
Q

What is net filtration pressure?

A

Forces favouring filtration - forces opposing filtration

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7
Q

What is Kf?

A

Filtration coefficient

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8
Q

What forces favour filtration?

A

Capillary hydrostatic pressure
Interstitial fluid osmotic pressure

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9
Q

What forces oppose filtration?

A

Capillary osmotic pressure
Interstitial fluid hydrostatic pressure

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10
Q

What does a positive net filtration pressure favour?

A

Filtration

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11
Q

What does a negative filtration pressure favour?

A

Reabsorption

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12
Q

Would filtration or reabsorption be favoured at the arteriolar end?

A

Filtration

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13
Q

Would filtration or reabsorption be favoured at the venular end?

A

Reabsorption

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14
Q

What happens to fluid that accumulates in the interstitium?

A

Lymphatic system helps to drain

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15
Q

Is resistance higher or lower in the pulmonary circulation than systemic?

A

Lower

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16
Q

What is oedema?

A

Accumulation of fluid in interstitial space

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17
Q

Does lung compliance increase or decrease in pulmonary oedema?

A

Decrease

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18
Q

In HF is the RAAS upregulated or downregulated and what does this result in?

A

Upregulated
More fluid retention

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19
Q

What signs may be seen in R ventricular failure?

A

Peripheral oedema

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20
Q

Why is angina affected by the cold?

A

Cold causes vasoconstriction and increases afterload of the heart

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21
Q

What are the acute coronary syndromes?

A

Unstable angina
NSTEMI
STEMI

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22
Q

What immediate deadly arrhythmia may occur in a STEMI?

A

Ventricular fibrillation

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23
Q

What HF can be caused after STEMI?

A

L due to scar tissue affecting pumping

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24
Q

What features may be seen on a STEMI ecg?

A

ST elevation
T wave inversion

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25
Q

What ecg changes are needed to diagnose a STEMI?

A

> 1mm ST elevation in 2 adjacent limb leads
or
2mm elevation in at least 2 continuous precordial leads
or
New onset bundle branch block with associated symptoms

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26
Q

Give examples of thrombolysis medications?

A

Streptokinase
tpa

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27
Q

What are the absolute contraindications to thrombolytic therapy?

A

Previous haemorrhagic stroke
Stroke within 6 months
CNS damage or neoplasm
Active internal bleeding
Aortic dissection
Recent major surgery or trauma
Known bleeding disorder

28
Q

What is the early treatment for STEMI patients?

A

Aspirin 300mg
Clopidogrel 600mg
Morphine
Anti-emetic
GTN if BP <90
Angioplasty or thrombolysis

29
Q

What is the travel time for PCI over thrombolysis?

A

90 minutes

30
Q

What structural complications can result from MI?

A

Cardiac rupture
Ventricular septal defect
Mitral valve regurgitation
Left ventricular aneurysm
Mural thrombus
Acute pericarditis
Dressler’s syndrome

31
Q

What functional complications can occur after MI?

A

Acute ventricular failure
Cardiogenic shock
HF

32
Q

What is the KILLIP classification used in?

A

In hospital mortality following MI

33
Q

What may be seen in an NSTEMI ECG?

A

ST depression
T wave inversion
May be normal

34
Q

What troponins are specific to the heart?

A

Troponin I and T

35
Q

What anti platelet therapy is used after a stent?

A

Dual anti platelet therapy

36
Q

What conditions other than MI may raise troponin?

A

CCF
HTN crisis
Renal failure
PE
Sepsis
CVA
Pericarditis/ myocarditis

37
Q

What are the 2 types of HF?

A

Heart failure with reduced ejection fraction
Heart failure with preserved ejection fraction

38
Q

What is the most useful diagnostic test in HF?

A

Echocardiography

39
Q

What type of echo tends to be used in HF?

A

Transthoracic

40
Q

What blood test may be used in identifying HF?

A

BNP

41
Q

What value would be a normal Nt-proBNP?

A

<400

42
Q

What BNP value would suggest standard echo waitlist and what would suggest urgent?

A

Standard: 400 - 2000
Urgent: >2000

43
Q

What conditions can lead to HF?

A

HTN
Diabetes
Coronary heart disease
Tachy arrhythmias
Dilated cardiomyopathy

44
Q

What is a normal ejection fraction?

A

> 50%

45
Q

What is ivabradine?

A

SGLT2 inhibitor

46
Q

Does ivabradine work in AF?

A

No

47
Q

What impact does ivabradine have on HR?

A

Slows

48
Q

What are the 4 pillars of HF treatment?

A

ARNI
BB
MRA
SGLT2i

49
Q

What does ectopy mean in relation to arrhythmia?

A

Single beats

50
Q

In SVT where does the arrhythmia originate?

A

Above the ventricle - SAN, Atria, AVN, His

51
Q

What may be seen in ECG of SVT?

A

Rapid P wave or ‘f’ waves of AF
Narrow WRS

52
Q

What are the common types of SVT?

A

Atrial - AF, atrial flutter, ectopic atrial tachycardia
Bradycardia - Sinus bradycardia, sinus pauses

53
Q

What occurs in AF?

A

Atrial depolarisation random and fast losing all meaningful contractions
AV node blocks so ventricles much lower rate

54
Q

Where does ventricular tachycardia originate from?

A

Ventricular myocardium (common)
Fascicles of the conduction system (uncommon)

55
Q

What does the QRS look like in ventricular tachycardia?

A

Wide QRS

56
Q

What does the ECG look like in ventricular tachycardia?

A

QRS rapid, wide and distorted
T waves large with deflections opposite the QRS complexes
Usually regular ventricular rhythm
Usually no visible P waves
PR interval not measurable

57
Q

What is the cardiothoracic ratio?

A

Maximum diameter of the heart divided by maximum diameter of the thorax
Normal >50%

58
Q

What type of x-ray will exaggerate the heart size?

A

AP

59
Q

What are the 4H and 4T causes of cardiac arrest?

A

Hypoxia, hypovolaemia, hypothermia, hypokalaemia/ hyperkalaemia
Tension pneumothorax, tamponade, toxins, thrombus

60
Q

What depth should chest compressions reach?

A

At least 5cm no more than 6cm

61
Q

What rhythms are shockable?

A

Ventricular fibrillation
Pulseless ventricular tachycardia

62
Q

Is asystole a shockable rhythm?

A

No

63
Q

What drugs are given in line with defibrillation?

A

Amiodarone after 3 shocks
Adrenaline every 3-5 minutes

64
Q

How is adrenaline given in non-shockable rhythm?

A

Immediately and repeated every 3-5 minutes

65
Q

When should CPR be terminated?

A

Valid and relevant advanced directive
Obvious mortal injury/ irreversible death
Safety threat to ALS provider
Persistent asystole >20 mins despite ALS without reversible cause identified

66
Q
A

CV (5 decks)

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