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Flashcards in Revision Powerpoint Cardio Deck (67)
1

general rules for endocarditis antibiotics?

needs high dose (IV)
long course (4-6 weeks)
bactericidal
synergistic effect of combination

2

what organisms cause native valve endocarditis?

staph aureus (most common)
strep viridans
enterococcus
staph epidermidis

3

what organisms cause endocarditis in IV drug users?

staph aureus

4

what organisms cause prosthetic valve endocarditis?

staph epidermidis
staph aureus

5

endocarditis after dentist?

strep viridans

6

endocarditis after line insertion?

staph epidermidis

7

treatment for prosthetic valve endocarditis?

vancomycin
rifampicin
gentamicin
valve replacement usually needed

8

normal P wave?

0.0-0.1 secs

9

normal QRS?

<0.1

10

PR interval?

AV node delay
0.12-0.2 secs

11

QT interval?

diastole
0.36-0.44 secs)

12

where is angiotensinogen produced?

liver

13

where is renin produced?

kidney

14

where is ACE produced?

lung surface

15

how do thiazide diuretics work?

reduce blood volume by increasing Na, Cl and H2O excretion

16

side effects of thiazide diuretics?

hypokalaemia
electrolyte disturbance

17

how do beta blockers work?

reduce sympathetic activity, reducing CO, reducing renin release from kidney

18

beta blocker side effects?

cold peripheries
asthma
fatigue

19

how do CCBs work?

block L type calcium channels, reducing Ca2+ entry into vascular smooth muscle, reducing contraction

20

side effects of CCBs?

ankle oedema

21

how do alpha blockers work?

block alpha 1 adrenoceptors causing vasodilation
reduces sympathetic transmission

22

side effects of alpha blockers?

dizziness
confusion

23

what is stage 1 hypertension?

BP > 14/90 in clinic
OR
ABPM average of 135/85

24

what is stage 2 hypertension?

clinic BP > 160/100
OR
ABPM average >150/95

25

causes of left sided heart failure?

ischaemid heart disease
cardiomyopathy
valvular disease

26

symptoms of left sided heart failure

dyspnoea on exertion/rest
orthopnoea
paroxysmal nocturnal dyspnoea
pink frothy sputum

27

signs of left heart failure?

tachycardia
fine crepatations
pleural effusion
S3 (gallop rhythm - S3 + tachycardia)

28

heart failure on CXR?

cardiomegaly
bat wing shadows (esp. lower zones)
interstitial fluid

29

right heart failure is usually 2ndary to left, true or false?

true

30

what can cause primary right heart failure?

cor pulmonale
congenital heart disease

31

symptoms of right heart failure?

body oedema

32

signs of right heart failure?

oedema
elevated JVP
hepatomegaly
ascites
CXR

33

when are thiazide diuretics used for heart failure?

mild CCF only
loop diuretics more commonly used (furosemide)

34

what is the main side effect of furosemide and how is this counteracted?

hypokalaemia
coincidental drugs (ACE and spironolactone) help retain and normalise K

35

what drugs are used in heart failure?

diuretics
spironolactone
ACE inhibitors
Beta blockers
Ivabradine
Digoxin

36

what are the initial risks of Beta blockers in HF?

hypotension
worsening dyspnoea

37

what kind of drug is spironolactone?

aldosterone receptor antagonist

38

side effects of spironolactone?

hyperkalaemia
renal dysfunction
gynaecomastia

39

what does ivabradine do and when is it used for HF?

slows HR
only used if HR fast despite B blockers

40

what is the sign of digoxin poisoning?

yellow vision

41

signs of patent foramen ovale?

machine like murmur

42

how is a patent foramen ovale diagnosed and treated?

ECHO, Doppler US
treated with surgery

43

signs of patent ductus arteriosus?

laboured breathing

44

how is a PDA treated?

NSAIDs

45

signs of persistant pulmonary hypertension of the newborn?

sick at birth or in hrs following
cyanosis
tachycardia
low blood sats on high flow O2
pre and post ductal saturations

46

how is persistent pulmonary hypertension of the newborn treated?

nitric oxide

47

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

48

how is DDC treated?

IVPGE2
(prostaglandin E2 - keeps duct open until surgery as baby is dependant on open duct)

49

what is the main use for antiplatelets?

arterial thrombosis

50

how does aspirin work?

irreversibly blocks COX in platelets preventing TXA2 synthesis
also blocks COX in endothelial cells inhibiting production of antithrombotic prostaglandin I2

51

side effect of aspirin?

GI bleeding
ulceration

52

how does clopidogrel work?

links to P2Y12 receptor via disulphide bridge producing irreversible inhibition
(usually used when aspirin allergic or alongside aspirin)

53

how does tirofiban work?

binds to factor IIb/IIIa
prevents MI in high risk unstable angina

54

what are anticoagulants mainly used for?

venous thrombosis

55

how does warfarin work?

inhibits Vit K reductase preventing conversion of epoxide to active hydroquinone
inactivates factors II, Vii, IX and X

56

how does rivaroxiban work?

direct thrombin inhibitor
factor Xa inhibitor

57

how does LMWH work?

inhibits Xa
(not thrombin IIa)

58

4 Hs and 4 Ts of reversible causes of cardiac arrest?

Hypothermia
Hyperkalaemia/hypokalaemia
Hypovolaemia
Hypoxia
Tamponade
Tension pneumothorax
Thromboembolism
Toxin

59

saddle shaped ST elevation?

pericarditis

60

continuous machine like murmur?

PDA

61

diminished or absent lower limb pulses?

coarctation of aorta

62

radio-femoral delay?

coarctation of aorta

63

slow rising pulse?

aortic stenosis

64

collapsing pulse?

aortic regurgitation

65

JVP rising on inspiration?

cardiac tamponade or constrictive pericarditis

66

tapping apex beat, loud S1?

mitral stenosis

67

drug causing gout?

thiazide diuretics