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Flashcards in Cardio Bible Deck (60)
1

what are the side effects of ACE inhibitors?

dry cough
hyperkalaemi

2

when are ACE inhibitors contraindicated?

pregnancy
renal artery stenosis

3

what are tall tented T waves and wide QRS complexes indicative of?

hyperkalaemia

4

what does rib notching on CXR indicate?

coarctation of the aorta

5

what does radial-radial delay indicate?

aortic dissection/coarctation of aorta

6

collapsing pulse?

aortic regurgitation

7

slow rising pulse?

aortic stenosis

8

crescendo-decrescendo murmur?

aortic stenosis

9

who gets staph aureus endocarditis?

prosthetic valves
IV drug users

10

who gets strep viridans endocarditis?

post dental surgery

11

how is AF treated?

treat underlying cause
Control ventricular rate with:
- Beta blocker/Ca blocker
- Add digoxin or amiodarone
Anticoagulate
- heparin

12

how does clopidogrel work?

binds to P2Y12 receptor via disulphide bond so ADP cant bind, GP not expressed, reduced platelet aggregation

13

how does heparin work?

binds to AT3 and increases affinity for clotting factors to inactivate

14

what is the ductus arteriosus?

connection between pulmonary artery and descending aorta during foetal development to bypass the lungs
should close

15

what is a patent ductus arteriosus and what is the main sign of it?

connection between the pulmonary artery and descending aorta due to failure of the closure of ductus arteriousus
continuous machine like murmur

16

what does strawberry milkshake coloured blood indicate?

hyperlipidaemia

17

which dermatome does the herpes zoster virus (shingles) affect?

rash at level T4/T5

18

what is the rate limiting enzyme in the production of cholesterol?

HMG - CoA - Reductase

19

what do cholesterol lowering drugs target?
Give an example?

HMG - CoA - Reductase enzyme
Statins = competitive inhibitor of HMG - CoA - Reductase

20

what are 2 side effects of statins?

rhabdomyolysis (death of muscle fibres and contents released into blood affecting the kidneys)
myositis (inflammation of muscles of movement)

21

what are the symptoms of an AAA?

expansile pulsatile mass
central abdominal pain

22

how is an AAA treated, depending on size?

only intervene if >5cm or grown more than 0.5cm in past 6 months/1cm in past year

23

what is an aneurysm?

vessel dilated more than 50% of normal diameter

24

true vs false aneurysm?

true = vessel wall intact just swollen
false = breach in vessel wall, surrounding structures act as vessel wall

25

3 types of aneurysm?

saccular (berry)
fusiform (in line with artery)
mycotic (2ndary to infectious process, all 3 layers)

26

how is AAA diagnosed?

Doppler US
CT ( better as shows whether ruptured)

27

how is an AAA managed?

open repair
EVAR (better - excludes from inside artery)

28

salvageable acute limb ischaemia?

- 0-4 hrs
- white foot
- painful
- sensorimotor deficit

29

partly salvageable acute limb ischaemia?

4-12 hrs
mottled appearance
blanches on pressure

30

non-salvageable acute limb ischaemia?

>12 hrs
fixed mottling
non-blanching
paralysis
compartments tender/red

31

what is the triad of diabetic foot problems and what can it cause?

diabetic neuropathy
peripheral vascular disease
infection
can cause necrosis, ulceration and gangrene

32

what is kussmaul's breathing?

sign of severe metabolic acidosis
indicated diabetic problem (eg. DKA)

33

how is diabetic foot sepsis managed?

vascular surgical emergency - remove infected tissue
appropriate antibiotics

34

how is diabetic foot sepsis managed?

vascular surgical emergency - remove infected tissue
appropriate antibiotics

35

what is the main innervation of the heart at rest?

parasympathetic via vagus nerve (to keep the HR low)

36

what effect does parasympathetic stimulation have on the heart?

negative chronotropic effect
(slows heart rate)

37

how does the sympathetic nervous system innervate the heart and what effect does it have?

via adenosine B1 receptors
positive chronotropic effect (increases HR)

38

what is the longest vein in the body?

great saphenous

39

which artery supplys the SA node?

right coronary artery

40

which artery supplies the AV node?

AV nodal branch of right coronary artery

41

name a potassssium sparring diuretic

spironolactone

42

what are the components of tetralogy of fallot?

RV hypertrophy
ventricular septal defect
Overriding aorta
Pulmonary stenosis

43

which side of the heart is generally affected in IV drug users?

right side

44

what are the anterior branches of the thoracic aorta?

bronchial
oesophageal
mediastinal
pericardial
phrenic arteries

45

what is the counter regulatory mechanism to the RAAS system?

Atrial natriuretic peptide
(ANP)

46

what does ANP do?

released in response to atrial distension/hypervolaemia
acts as vasodilator and decreases renin release

47

what is the carotid sinus?

dilated area at base of internal carotid just above bifurcation
detects stretching of walls for BP changes
monitors blood gas and pH

48

what nerve innervates the carotid sinus?

glossopharyngeal (CN IX)

49

a 4th heart sound is always pathological, true or false?

true
active filling of stiff ventricle by atrial contraction

50

what does a 4th heart sound often indicate?

LVH

51

what causes a splitting of the 2nd heart sound?

due to inspiration
pulmonary being behind aortic compartment
usually normal

52

name 3 orally given anticoagulants

warfarin
digoxin
rivaroxaban

53

which murmur is associated with AF?

mitral regurgitation

54

what is the treatment for ventricular tachycardia?

adenosine/Ca blocker/Beta blocker
amiodarone
cardioversion

55

what is atropine?

competitive antagonist of muscarinic ACh receptors
blocks parasympathetic reversing bradycardia after MI

56

where does the azygous vein lie?

right side of thoracic vertebrae
loops around lung root

57

which drug causes a slate grey rash as a side effect?

amiodarone

58

what is metoclopramide?

antiemetic given for gastroparesis or post MI

59

characteristics of aortic regurgitation?

SOB/chest pain
high volume collapsing pulse
early diastolic
wide pulse pressure
left lower sternal edge leaning forward on expiration

60

which murmur is associated with IV drug users?

tricuspid regurgitation