Rubgy cardio revision Flashcards Preview

Cardio > Rubgy cardio revision > Flashcards

Flashcards in Rubgy cardio revision Deck (26)
Loading flashcards...
1
Q

In an OSCE what is the most important first question?

A

Are you in pain just now?

Allows you to identify whether this is ample or a full history

2
Q

In a history what would you want to know about palpitations?

A

When?
How long for?
Any other symptoms?

3
Q

What is the positioning of the precordial ECG leads?

A

V1: 4th intercostal space at right border of sternum
V2: 4th intercostal space at left sternal edge
V4: 5th intercostal space midclavicular line
V3: between V2 and V4
V6: 5th intercostal space mid-axillary line
V5: between V4 and V6

4
Q

Occlusion of which arteries affect which surfaces of the heart?

A
Lateral = circumflex
Anterior = LAD
Septal = LAD
Inferior = RCA
5
Q

Elevation of which leads indicates an MI on the septal, anterior, lateral and inferior surfaces?

A

Septal: V1 and V2
Anterior: V3 and V4
Lateral: V5, V6, I and aVL (L=lateral)
Inferior: II, III, aVF (F= foot - at the bottom)

6
Q

What do ACE inhibitors do?

A

Prevent the conversion of angiotensin I to angiotensin II by blocking the angiotensin converting enzyme
Can cause a dry cough (25%)

7
Q

How do ARBs work?

A

Block the angiotensin II receptor (so no effect on the levels on angiotensin II)

8
Q

Name 2 calcium channel blockers and state which type of muscle they are effective against

A

Amlodipine + nifedipine

Smooth muscle channel blockers

9
Q

What is the major side effect of Ca channel blockers?

A

Swollen ankles

10
Q

Name and give an example fo the 2 types of diuretic

A

Thiazides: bendroflumethiazide
Loop: furosemide (not used for hypertension - good for HF)

11
Q

What are B-blockers used to treat?

A

Angina (first line),
Hypertension (rarely),
Congestive cardiac failure (caution)
Post MI

12
Q

Name 2 nitrates and explain what they are used to treat?

A

Glyceryltrinitrate (GTN) - short acting
=> used for angina/IV in MONA+T

Isosorbide mononitrate - long acting
=> acute coronary syndrome/prophylaxis of angina

13
Q

What is the main symptom of digoxin toxicity?

A

Blurred yellow visioning headache

14
Q

How is a murmur described?

A
  1. Systole or diastole?
  2. Type (ejection or pansystolic?)
  3. Where is it loudest?
  4. Where does it radiate to?
  5. What grade?
  6. Influenced by respiration?
15
Q

What is the most common murmur?

A

Aortic stenosis

16
Q

What is the grading of murmurs?

A

Grade 1: Very quiet - may not be audible
Grade 2: Quiet - audible
Grade 3: Moderately loud
Grade 4: Loud - palpable thrill
Grade 5: Very loud + thrill - audible with stethoscope partially of chest
Grade 6: Very loud + thrill - audible without stethoscope

17
Q

What is the post MI treatment?

A

Dual antiplatelet therapy
ACEI
B-blocker
Statin

18
Q

What is heart failure and what are it symptoms?

A

Inadequate cardiac output for the bodies needs

SOB, fatigue, poor exercise tolerance, ankle oedema, nocturnal cough, sleep on pillows (pulmonary oedema)

19
Q

What are the main causes of congestive cardiac failure?

A

Coronary artery disease,
Hypertension,
Valvular disease,
Post MI

20
Q

How is acute heart failure initially treated?

A
Sit upright
O2 (high flow)
Investigations
Diamorphine IV
Furosemide IV
GTN (2 puffs)
21
Q

How is the management of acute heart failure increased?

A

Increase furosemide

CPAP (continuous positive airway pressure)

22
Q

How is chronic heart failure managed?

A
Furosemide,
ACE inhibitor,
B-blocker,
Spironolactone,
(increase to include digoxin and vasodilators - isosorbine mononitrate)
23
Q

In cardiac arrest which rhythms are shockable and which are not?

A

SHOCKABLE: pulseless ventricular tachycardia, ventricular fibrillation

NOT SHOCKABLE: asystole, pulseless electrical activity

24
Q

What are the signs of acute limb ischaemia?

A
6 Ps:
Pain,
Pulseless,
Paraesthesia,
Paralysis,
Pallor,
Perishingly cold
25
Q

What is the difference and the difference in treatment between an arterial and a venous thrombus?

A

Arterial: white thrombus (PLT rich) - anti platelets (aspirin, clopidogrel, ticegralor)
Venous: red thrombus (RBC rich) - anticoagulants (heparin, warfarin, apixiban)

26
Q

What are the important clotting factors?

A

2, 7, 9, 10