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Cardiology > POINTS TO LEARN > Flashcards

POINTS TO LEARN Flashcards

1
Q

what do muscarinic antagonists do and give an example of one?

A

atropine

increase HR

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2
Q

what does levosimedan do?

A

increases contractility

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3
Q

what do ACE inhibitors do?

A

vasodilation and arterial dilation

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4
Q

what do calcium antagonists do?

A

decrease HR

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5
Q

what do potassium channel blockers do?

A

relaxation of vascular smooth muscle

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6
Q

how does warfarin work?

A

blocks clotting factors 2,3,7,10

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7
Q

how does heparin work?

A

binds to antithrombin 3.

factor X3 activates thrombin IIa - fibrin - blood clot

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8
Q

how do antiplatelets work?

A

prevent new thrombus

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9
Q

how to fibrinolytics work?

A

dissolve formed clot

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10
Q

what organism causes native valve endocarditis and what is the treatment?

A

viridans

amox + gent

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11
Q

what organism causes prosthetic valve endocarditis and what is the treatment?

A

staph epidermis

vacno + gent + rifampicin

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12
Q

what is the treatment for IDVU endocarditis?

A

fluclox

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13
Q

QRISK3

A

predictor of future cardiovascualr events

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14
Q

what is wells scroe

A

assess risk of PE

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15
Q

what is PESI scroe

A

mortality risk of PE

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16
Q

what thrombolytic agent is used in PE

A

altepase

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17
Q

MOA of warfarin

A

vit k antagonist

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18
Q

virchows triadd

A

hypercoaguability, stasis, endothelial damage

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19
Q

cardiogenic shock

A

sustained hypotension caused by decreases cardiac contractility

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20
Q

how much blood can be lost before compensatory mechanisms cannot maintain BP

A

30%

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21
Q

neurogenic shock

A

loss of sympathetic tone to blood vessels and heart

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22
Q

what does neurogenic shock cause

A

decreased HR (unique) and massive venous and arterial dilation leading to decreased CO

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23
Q

vasoactvie shock

A

release of vasoactive mediators which causes massive arterial and venous dilation with increased capillary permeability

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24
Q

OBSTRUCTIVE SHOCK

A

decreases venous return due to compression of the pericardium eg pneumothorax

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25
Q

normal intercranial pressure

A

8-13mmgh

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26
Q

arterial thrombus

A

white, platelet rich, treat with antiplatelet drugs

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27
Q

venous thrombus

A

red, fibrin rich, treat with anticoagulant drugs

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28
Q

when do platelets become activated

A

when they are exposed to collagen

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29
Q

what is the pathway of anticoagulant drugs

A

tenase - prothrombinase - thrombin - fibrinogen = fibrin

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30
Q

what order is heparin

A

0

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31
Q

what order is warfarin

A

1

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32
Q

where is IE most commonly seen

A

left side (right in drugs)

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33
Q

diagnostic criteria for IE

A

modified dukes criteria

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34
Q

what is the QT length in long QT syndrom

A

> 440ms for men

> 450 ms for women

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35
Q

what can long QT syndrome go on to cause

A

torsades de pointes (a polymorphic VT), brought on by sleep, hypokalaemia, mediation which prolongs QT length, exercise ect

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36
Q

what can be seen on an ECG of brugada syndrome

A

ST elevation and RBBB in v1-3

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37
Q

how do you treat HOCM

A

bb or verapamil

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38
Q

how do you treat AF secondary to HOCM

A

anticoagulatoin

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39
Q

how to treat aortic regurg

A

ACEi, ARBs

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40
Q

causes of mitral regurg

A

proplapse, rheumatic, myxotomatous, endocarditis, choardae rupture due to leaflet failure, papillary muscle rrupture, annular dilation

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41
Q

symtoms of mitral regurg

A

peipheral oedema, fatiguq

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42
Q

sound of mitral regurg

A

pansystolic

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43
Q

how to treat mirral ergurg

A

diurteics

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44
Q

sound of mitral stenosis

A

mid diastolic rumbling murmur

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45
Q

what does mitral stenosis look like on CXR

A

straightening of left heart border

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46
Q

what murmur is assocaited with AF

A

mitral stenosis

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47
Q

a 10% increase in LDL causes what

A

20% increase in CHD risk

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48
Q

normal TAG level

A

2.3

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49
Q

what are xantholasma madde of

A

foam cell

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50
Q

what is sinus pauses

A

transient lack of SA node activity

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51
Q

what is the physiology of triggered activity

A

after depolarisatoins

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52
Q

AVNRT vs AVRT

A

…

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53
Q

what is reflex syncope caused by

A

vasgovagal (emotional), carotid sinus - most common

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54
Q

what is orthostatic syncope causedby

A

priamry/secondary autonomic failure, drug induced, volume depletion

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55
Q

what is cardiac syncope caused by

A

arrhythmia, structural, PE

56
Q

what is the mechanism of AF

A

sustained by macro-reentrant circuit - circuit is refined to the right atrium

57
Q

what is net filtration

A

forces favourng filtration minus forces opposing filtration

58
Q

normal PR

A

0.12-0.2

59
Q

why is lymphatic drainage important in thelungs

A

pulmonary capilary hydrostatic pressure is lower than osmotic pressure so there is excess interstitial fluid to be drained

60
Q

location of 1st degree heart block

A

atria

61
Q

location of mobits 1 HB

A

AV node

62
Q

location of mobitz 2 HB

A

after AV node in bundle of his

63
Q

ABCDE in HF

A 
alveoar oedema
bat wings
cardiomegaly
dilated vessels
effusion pleural
64
Q

what noises can be heard on auscultation of HF

A

S3/S4 gallop

65
Q

what drugs improve symptoms of HF

A

furosemide and digoxin

66
Q

NYHA

A
  1. no limitation
  2. slight limitation
  3. marked limitation
  4. HF symptoms at rest
67
Q

ischaemic stroke

A

clot blocks blood flow to brain

68
Q

haemorrhagic stroke

A

bleeding inside or around brain tissu

69
Q

treatment for ischaemic stroke

A

statin therpay + thrombolysis

70
Q

what is dresslers syndrome

A

when damaged heart muslce releases proveiously unencountered material that stimulates an autoimmune response

71
Q

GS for aortic dissection

A

transoesophageal echocardiography

72
Q

the heart block poem

A

r is far from p - first degree
longer longerlonger drop - mobitz 1
some ps dont get through - mobitz 2
ps and qs dont agree - mobitz 3

73
Q

risk factors for aortic aneurysm

A

smoking, hypertension, marfans, atherosclerosis

74
Q

GS for cardiac tamponade

A

ECHO

75
Q

treatment for cardiac tamponade

A

pericardiocentesis

76
Q

what shape is the ventricle in HOCM

A

bananna

77
Q

what are the causes of restirctive myocardiopathy

A

amyloidosis, sarcoidosis

78
Q

what are the causes of dilatied myocardiopathy

A

alcoholics, viral infection, autoimmune disease, x linked

79
Q

what is arrythmogenic right ventricular cardiomyopathy

A

heart muscle replaced by fibrous and faty tissue - right ventricle, autosomal dominantt,

80
Q

what gene is mutated in brugada

A

SCN5a

81
Q

what are the 4 features of fallots tetralogy

A

ventricular septal defect, pulmoary stenosis, right ventriular hypertrophy, aorta overriding the VSD

82
Q

what are the investigations for IE

A

bloods and ECHO

83
Q

what causes myocarditis

A

coxsackie A and B, enterovirus, echovirus

84
Q

how do you diagnose myocarditis

A

viral culture or PCR

85
Q

treatment for acute LS HF

A

sit up, O2, IV furosemide, IV diamorphine

86
Q

treatment for SVT

A

vagal manouvers, adenosine/verapamil

dc if compromised

87
Q

treatment of torsades de pointes

A

magensium sulphate

88
Q

treatment of VT

A

stable - IV amiodarone or lidocaine

unstable - DC cardioversion

89
Q

treatment of WPW

A

electrophysiology and ablation of accessory pathway

90
Q

when to do IVC in DVT

A

if a patient is bleeding and anticoagulation is contraindicated

91
Q

0-4 acute limb ischamie

A

white foot

92
Q

4-12 acutelimb ischaemia

A

mottled, blanches on pressure, partially reversible

93
Q

> 12 acute limb ischamia

A

fixed mottling, non-blanching, compartments, red/tender, paralysis

94
Q

HDL particles contain

A

apoA1 and ApoA2

95
Q

LDL particls contain

A

apob100

96
Q

VLVL particles contrain

A

apob100

97
Q

chylomicrons contain

A

abob48

98
Q

what do aopb100 proteins lipoproteins do

A

deliver TAG to msucle for ATP biogenesis and adipocytes for storage

99
Q

what is the exogeonus pathway

A

chylomicrons are formed in interstitial cells and transport dietry triglycerides

100
Q

what is the endogenous pathway

A

VLDL particles are formed in the liver cells and transport TAGs synthesised by the liver

101
Q

what is the function of apoc11

A

activated chylomicrons and vldl particles

102
Q

what are roth spots

A

retinal haemorrhages

103
Q

what do nitrates do

A

decrease preload and afterload and improve perfusion to ischaemic zones

104
Q

what is streptokinase

A

a fibrinolytic drug

105
Q

how do you do HMBP

A

take 2 consecutive measurements while seated, 1 min apart, record 2x daily for 4-7 days. discard 1st day measurements and use average of rest

106
Q

how to use AMBP

A

at least 2 measurements are taken per hour during 14 hours. use average of these hours to diagnose hypertension

107
Q

what makes up the superficial venous system

A

saphenous and perforator

108
Q

how do varicose veins arrise

A

due to back pressure due to incompetent valves causing blood to pool in superficial veins

109
Q

what causes AF in young people

A

cytomegalo virus

110
Q

in exercise ECG when in bp recorded

A

after every 3 mins - bruce protocol

111
Q

fibrates

A

agonist of PPAR - increase lipoprotein lipase expression

112
Q

ECG of AVNRT

A

normal QRS, P wave not visible/directly after QRS, long PR interval

113
Q

ECG of AVRT

A

narrow QRS, P waves after QRS, before T

114
Q

S3

A

diastolic filling of ventricle
normal in <30yr olds
heard in left ventricular failure

115
Q

S4

A

may be heard in aortic stenosis, HOCM

116
Q

what do ANPs do

A

increases glomerular function and causes kidneys to excrete more Na and more H20

117
Q

what do ARBs block

A

ANG 2

118
Q

anterior surface of heart

A

RV

119
Q

base surface of heart

A

left atrium

120
Q

inferior surfaace of heart

A

left and right ventricles

121
Q

rigth border

A

RA

122
Q

leftborder

A

LV

123
Q

infeiror border

A

R and L V

124
Q

superior border

A

right and Left atrium and great vessels

125
Q

reversible causes of cardiac arrest

A 
Hypovolaemia
Hypothermia 
Hyper/hypo- kalaemia 
Hypoxia 
Tamponade 
Tension pneumothorax 
Thromboembolism 
Toxin
126
Q

tall tented t waves

A

hyperkalaemia

127
Q

rib notching on CXR

A

coraction of the aorta

128
Q

which way does sympathetic shift the FSC

A

left

129
Q

what is afterload

A

the resistence into which the heart is pumping against (blood left in the heart after the heart has contracted)

130
Q

JVP a

A

atrial contraction

131
Q

JVP c

A

bulding of tricuspid valve into atrium during contraction

132
Q

JVP v

A

the rise of atrial pressure durng atrial filling, released as AV valve opens

133
Q

how to calculate regular rhythm

A

number of large squares within R-R /300

134
Q

how to calculate irregular rhythm

A

number of QRSs on rhythm strip x 6

135
Q

causes of AF

A

MI, hypertension, heart failure

136
Q

acute vetricular heat fialure treatment

A

sit up, O2, IV furodsemide, morphine

137
Q

ECG changes in PE

A

A large S wave in lead I, a Q wave in lead III and an inverted T wave in lead III together indicate acute right heart strain.

Cardiology (40 decks)

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