MSRA > Cardio > Flashcards

Cardio Flashcards

(69 cards)

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1
Q

Which antihypertensive is C/I in renovascular disease eg renal artery stenosis

A

ACEi

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2
Q

All ACS should get

A

aspirin 300mg

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3
Q

When is STEMI eligible for PCI

A

If <12h presentation (or ongoing ischaemia at presentation)
AND
<120 min availability of PCI

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4
Q

If an ACS patient has PCI they should get what medication extra

A

Prasugrel for DAPT
Or if already on an anticoag- clopi

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5
Q

Alternative to PCI for STEMI

A

fibrinolysis

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6
Q

What if STEMI had fibrinolysis and then the repeat ECG has persisting ischaemia

A

PCI

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7
Q

When should NSTEMI have immediate angio +/- PCI

A

unstable

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8
Q

When should NSTEMI get fonda?

A

If not having immediate angio and not bleed risk

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9
Q

When should NSTEMI have PCI within 72h

A

If GRACE >3%

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10
Q

If NSTEMI is medically managed what do you give

A

Ticagrelor

Or clopi if bleed risk

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11
Q

What is a normal ejection fraction

A

50-60%

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12
Q

In a witnessed arrest on a monitor what do you do differently in ALS

A

If the initial rhythm is VF/VT, give up to three quick successive (stacked) shocks. Start chest compressions immediately after the third shock and continue CPR for 2 min.

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13
Q

Heart failure 1, 2 3rd line drugs

A
  1. ACE and beta blocker
  2. Aldosterone agonist (spiro) or eplerenone
  3. Empagliflozin
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14
Q

angina worse on lying down

A

de cubitus

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15
Q

Further treatment if angina not controlled on a max dose beta blocker?

A

Add CCB such as amlodipine, modified-release nifedipine, or modified-release felodipine

(note not diltiazem or verapamil as they are rate limiting CCBs- not to use in combo with BB)

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16
Q

First line meds to start in angina

A

Aspirin, statin, GTN spray and beta blocker or CCB (if CCB used as monotherapy then rate limiting one eg verapamil/diltiazem. If in combo with BB then amlod/nifed)

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17
Q

valve most affected in endocarditis of IVDUs

A

tricuspid

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18
Q

MI causing a new left bundle branch block is most likely to be in what region?

A

anterior or anteroseptal

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19
Q

Alternating QRS amplitude on ecg shows

A

pericardial effusion

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20
Q

ECG change in hypocalcaemia

A

long qt

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21
Q

Post MI meds

A

ACE (or ARB)
Beta blocker
DAPT (one must be aspirin)
Statin

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22
Q

syphilis, marfans and elhers danlos can cause what valve disease

A

Aortic regurg

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23
Q

aortic valve disease- when is wide v narrow pulse pressure seen

A

wide in regurg
narrow in stenosis

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24
Q

which is the only bicuspid valve normally

A

mitral

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25
systolic murmur with mid systolic click or pansystolic
mitral regurg
26
most common cause of mitral stenosis
rheumatic fever
27
systolic snap and diastolic rumble murmur
mitral stenosis
28
malar flush in what valve disease
mitral stenosis
29
haemodynamically unstable AF rx
DC cardioversion or can do medical cardioversion with amiodarone IV or IV flecainide
30
leg ulcer that is shallow with irregular borders at the medial malleolus
venous
31
Venous ulcer rx
elevate compression
32
ABPI must be what for compression stockings
>0.6
33
when is AAA screening
men in 65th year
34
scan recalls for AAA
>3cm every year >4.5cm every 3 months >5.5 2ww vasc referral
35
most common site of aneurysm
popliteal
36
is lymphoedema pitting or non pitting
non pitting eventually
37
arm exercise resulting in neurology such as vertigo, diploplia
Subclavian steal syndrome
38
J waves seen in
hypothermia
39
U waves seen in
hypokalaemia
40
delta waves on ecg
WPW
41
Hypokalaemia ECG findings
U have no Pot and no T, but a long PR and a long QT U waves ST depression
42
Complete heart block following a MI- where is the lesion
Right coronary artery lesion
43
First line for angina
beta-blocker or a rate limiting calcium channel blocker
44
second line for angina
combine beta blocker and CCB but change CCB to NON RATE LIMITING If still no improvement add one of: a long-acting nitrate ivabradine nicorandil ranolazine
45
what increase in Cr is acceptable in initiating ACEi?
30%
46
Mx if ABPM is >= 135/85 mmHg (i.e. stage 1 hypertension)
treat if < 80 years of age AND any of the following apply; target organ damage, established cardiovascular disease, renal disease, diabetes QRISK 10% or greater
47
Mx if ABPM/HBPM >= 150/95 mmHg (i.e. stage 2 hypertension)
offer all drug rx
48
What to offer if HTN not controlled on triple therapy (ACE, CCB and TLD)
If K <4.5- spironolactone If K>4.5 - alpha or beta blocker
49
drug contraindicated in ventricular tachycardia
verapamil
50
recommended treatment for regular broad complex tachycardia without adverse signs
amiodarone
51
drug that can make clopi less effective
omeprazole (can use lansoprazole instead)
52
pericarditis ecg changes
Global ST and PR segment changes
53
Persistent ST elevation following recent MI, no chest pain, tired and breathless
left ventricular aneurysm
54
Post MI Pain on lying flat, widespread ST elevation and PR depression Fever
Dressler's syndrome (pericarditis)
55
Acute heart failure post MI with signs of tamponade
LV free wall rupture
56
Acute heart failure post MI with pan systolic murmur
VSD
57
Post MI acute hypotension and pulm oedema with an early-mid systolic murmur
Acute mitral regurg (papillary muscle rupture)
58
what disease can falsely elevate BNP
COPD
59
collapsing pulse
aortic regurg
60
how do you decide whether to anticoagulate an AF patient
CHADVASC, however if they also have valvular hear disease you must anticoagulate
61
cardio med to avoid in HOCUM
ACEi
61
Appearance of RHS on ECH
S1Q3T3 or TWI in V1-4
62
What to do with anticoag post cardioversion for AF?
Continue for at least 4 weeks. Redo CHADVASC, if still risk for stroke then continue anticoag life long
63
unequal arm pulses and BP with chest pain
aortic dissection
64
c/i to IV adenosine
asthma- give verapamil
65
preferred first line med in HF if the person has diabetes mellitus or has signs of fluid overload.
acei
66
preferred first line med in HF if the person has angina.
BB
67
What are the risks of asystole in the bradycardia algorithm
recent asystole Mobitz II block CHB + broad QRS Ventricular pause >3s
68
when to screen for secondary causes of HTN
under 40 who lack traditional risk factors for essential hypertension other signs and/or symptoms of secondary causes resistant hypertension.
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