Flashcards in Revision Powerpoint Cardio Deck (67)
general rules for endocarditis antibiotics?
needs high dose (IV)
long course (4-6 weeks)
synergistic effect of combination
what organisms cause native valve endocarditis?
staph aureus (most common)
what organisms cause endocarditis in IV drug users?
what organisms cause prosthetic valve endocarditis?
endocarditis after dentist?
endocarditis after line insertion?
treatment for prosthetic valve endocarditis?
valve replacement usually needed
normal P wave?
AV node delay
where is angiotensinogen produced?
where is renin produced?
where is ACE produced?
how do thiazide diuretics work?
reduce blood volume by increasing Na, Cl and H2O excretion
side effects of thiazide diuretics?
how do beta blockers work?
reduce sympathetic activity, reducing CO, reducing renin release from kidney
beta blocker side effects?
how do CCBs work?
block L type calcium channels, reducing Ca2+ entry into vascular smooth muscle, reducing contraction
side effects of CCBs?
how do alpha blockers work?
block alpha 1 adrenoceptors causing vasodilation
reduces sympathetic transmission
side effects of alpha blockers?
what is stage 1 hypertension?
BP > 14/90 in clinic
ABPM average of 135/85
what is stage 2 hypertension?
clinic BP > 160/100
ABPM average >150/95
causes of left sided heart failure?
ischaemid heart disease
symptoms of left sided heart failure
dyspnoea on exertion/rest
paroxysmal nocturnal dyspnoea
pink frothy sputum
signs of left heart failure?
S3 (gallop rhythm - S3 + tachycardia)
heart failure on CXR?
bat wing shadows (esp. lower zones)
right heart failure is usually 2ndary to left, true or false?
what can cause primary right heart failure?
congenital heart disease
symptoms of right heart failure?
signs of right heart failure?
when are thiazide diuretics used for heart failure?
mild CCF only
loop diuretics more commonly used (furosemide)
what is the main side effect of furosemide and how is this counteracted?
coincidental drugs (ACE and spironolactone) help retain and normalise K
what drugs are used in heart failure?
what are the initial risks of Beta blockers in HF?
what kind of drug is spironolactone?
aldosterone receptor antagonist
side effects of spironolactone?
what does ivabradine do and when is it used for HF?
only used if HR fast despite B blockers
what is the sign of digoxin poisoning?
signs of patent foramen ovale?
machine like murmur
how is a patent foramen ovale diagnosed and treated?
ECHO, Doppler US
treated with surgery
signs of patent ductus arteriosus?
how is a PDA treated?
signs of persistant pulmonary hypertension of the newborn?
sick at birth or in hrs following
low blood sats on high flow O2
pre and post ductal saturations
how is persistent pulmonary hypertension of the newborn treated?
what are the signs of duct dependant circulation (DDC-also known as patent ductus arteriosus)?
present at 3-5 days
suddenly pale, tachypnoeic and distressed
how is DDC treated?
(prostaglandin E2 - keeps duct open until surgery as baby is dependant on open duct)
what is the main use for antiplatelets?
how does aspirin work?
irreversibly blocks COX in platelets preventing TXA2 synthesis
also blocks COX in endothelial cells inhibiting production of antithrombotic prostaglandin I2
side effect of aspirin?
how does clopidogrel work?
links to P2Y12 receptor via disulphide bridge producing irreversible inhibition
(usually used when aspirin allergic or alongside aspirin)
how does tirofiban work?
binds to factor IIb/IIIa
prevents MI in high risk unstable angina
what are anticoagulants mainly used for?
how does warfarin work?
inhibits Vit K reductase preventing conversion of epoxide to active hydroquinone
inactivates factors II, Vii, IX and X
how does rivaroxiban work?
direct thrombin inhibitor
factor Xa inhibitor
how does LMWH work?
(not thrombin IIa)
4 Hs and 4 Ts of reversible causes of cardiac arrest?
saddle shaped ST elevation?
continuous machine like murmur?
diminished or absent lower limb pulses?
coarctation of aorta
coarctation of aorta
slow rising pulse?
JVP rising on inspiration?
cardiac tamponade or constrictive pericarditis
tapping apex beat, loud S1?