Year 5 passmed Flashcards
what is a type 2 MI
A Type 2 heart attack happens when there is insufficient blood flow (therefore oxygen) to the heart muscle to meet the demand required at the time.
if blood pressure drop for long period can you damage all organs
yes
causes of syncope
Reflex syncope (neurally mediated)
vasovagal: triggered by emotion, pain or stress. Often referred to as ‘fainting’ - type of fainting that occurs when your body overreacts to a trigger and your blood pressure and heart rate suddenly drop - vagal nerve stimulation causes BP to drop and HR to drop
situational: cough, micturition, gastrointestinal
carotid sinus syncope
Orthostatic syncope
primary autonomic failure: Parkinson’s disease, Lewy body dementia
secondary autonomic failure: e.g. Diabetic neuropathy, amyloidosis, uraemia
drug-induced: diuretics, alcohol, vasodilators
volume depletion: haemorrhage, diarrhoea
Cardiac syncope
arrhythmias: bradycardias (sinus node dysfunction, AV conduction disorders) or tachycardias (supraventricular, ventricular)
structural: valvular, myocardial infarction, hypertrophic obstructive cardiomyopathy
others: pulmonary embolism
hypoglycaemia
summarised
Hypovolaemic
cardiogenic
distributive
obstructive vc
what is the consequence of taking BB and CCB together
heart block
nicorandil moa
relaxes coronary vascular smooth muscle by stimulating guanylyl cyclase and increasing cyclic GMP (cGMP) levels
potassium channel activator
used in treating angina
what drug to hold in sinus rythm - keep out of SVT
beta blockers
slow conduction at AV node
nearly all SVT in the nodes itself
A 65-year-old man with heart failure presents to his GP with some questions about some of his medications. He would like to know which of his drugs will help him to live longer and not just improve his symptoms.
Diuretics only improve symptoms of heart failure and have no effect on mortality
adults with chronic HF have a one off pnuemococal vaccine when might they need a booster every 5 yr
adults usually require just one dose but those with asplenia, splenic dysfunction or chronic kidney disease need a booster every 5 years
PCI what artery do you use
radial artery
side effects of GTN (3) -why
Hypotension + tachycardia + headache
he vasodilation causes hypotension (lowering of blood pressure), which can result in reflex tachycardia (increased heart rate) as the body tries to maintain adequate perfusion. Headache is also a common side effect due to the dilation of cerebral blood vessels.
what is takayasus arteritis
Takayasu’s arteritis is a large vessel vasculitis. It typically causes occlusion of the aorta and questions commonly refer to an absent limb pulse. It is more common in younger females (e.g. 10-40 years) and Asian people.
Features
systemic features of a vasculitis e.g. malaise, headache
unequal blood pressure in the upper limbs
carotid bruit and tenderness
absent or weak peripheral pulses
upper and lower limb claudication on exertion
aortic regurgitation (around 20%)
why do you get haemoptysis in mitral stensosi
due to pulmonary pressures and vascular congestion
may range from pink frothy sputum to sudden haemorrhage secondary to rupture of thin-walled and dilated bronchial veins
1st line for angina pectoris
CT angiography
The ECG shows sinus rhythm, but the patient has no pulse.
PEA
as non shcocktabel
give adrenaline
when do you give adrenaline in CPR
adrenaline 1 mg as soon as possible for non-shockable rhythms
during a VF/VT cardiac arrest, adrenaline 1 mg is given once chest compressions have restarted after the third shock
repeat adrenaline 1mg every 3-5 minutes whilst ALS continues
