Cardio questions

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Cardio questions

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Cardio questions. What is shock?. Acute failure of circulation resulting in impaired or absent perfusion to tissues and subsequent insufficient oxygen provision to cells (hypoxia). What are the 5 main types of shock?. Hypovolaemic Cardiogenic Neurogenic Septic Anaphylactic. - PowerPoint PPT Presentation

Transcript of Cardio questions

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Cardio questions

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What is shock?• Acute failure of circulation resulting in

impaired or absent perfusion to tissues and subsequent insufficient oxygen provision to cells (hypoxia).

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What are the 5 main types of shock?• Hypovolaemic• Cardiogenic• Neurogenic• Septic• Anaphylactic

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Hypovolaemic shock• Causes

• Blood loss• Massive vomiting and/or diarrhoea

• Pathophysiology• Loss of circulating volume, reduced venous return, reduced SV, reduced CO, lower BP, reduced O2

delivery, impaired cellular function• S&S

• Cold, clammy peripheries• Tachycardia• Prolonged cap refill time• Empty Veins

• Management• Fluids

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Cardiogenic• Causes

• Pump failure – e.g. ischaemia, arrhythmias, electrolyte disturbances

• Pathophysiology• Backlog of blood builds up in the lungs

• S&S• Cold, clammy peripheries• MAY have tachycardia• Prolonged cap refill time• MAY have raised JVP

• Management• Inotropes (venodilators)

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Septic/Anaphylactic• Septic shock

• Infection of the blood results in systemic inflammatory response and mass vasodilation – fluids leaks out

• Anaphylactic shock• IgE mediated – type I hypersensitivity• Allergen stimulates IgE to bind mast cells which then degranulate and release histamine.• Vasodilation and increased capillary permeability.

• S&S• Warm, dry peripheries• Tachycardia• Short cap refill time• BOUNDING pulse

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Management of sepsis?• FBC & serum lactate• High flow oxygen• IV fluids• Accurate urine output measurement• Blood culture• IV empirical antibiotics

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Management of anaphylaxis?• Adrenaline• Oxygen

• Fluids if needed• Steroids and antihistamines for support

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Name the three shunts in foetal circulation…• Ductus arteriosus

• collapses after birth, becomes ligamentum arteriosum• Foramen ovale

• closes after birth, becomes fossa ovalis• Ductus venosus

• collapses after birth, becomes ligamentum venosum

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Tetralogy of Fallot?1. Pulmonary stenosis

2. RV Hypertrophy

3. Over-riding aorta

4. VSD

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What are the 3 layers of blood vessels?• Tunica intima• Tunica media• Tunica adventitia

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Murmurs• Systolic?

• MR• Pansystolic

• AS• Ejection systolic

• Diastolic?• MS

• Late diastolic• AR

• Early/mid diastolic

• Continuous?• PDA

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Describe where you would auscultate for murmurs…

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What is this?

Would you shock it?Ventricular Tachycardia

IF PULSELESS

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What is this?

Would you shock it?Ventricular Fibrillation

YES

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What are these?

Atrial Fibrillation

Atrial Flutter

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Where would you find this action potential?Pacemaker cells

1. Na ‘funny channels’ open and Na moves out

2. Na channels close and t-type Ca channels open

3. T-type Ca channels close and L-type open

4. L-type Ca channels close and K channels open (repol)

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Where would you find this action potential?Cardiomyocytes

0. Depol – fast Na channels open1. Early repol – Na channels close

and K channels open2. Plateau – Ca channels open3. Repol – Slow K channels open

and Ca channels close4. Resting

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What are the 2 types of hypertrophy in the heart?• Concentric• Wall thickness increases• No increase in volume• Usually caused by high pressure

• Eccentric• Volume increase• Usually caused by mitral/aortic regurg

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What is pericarditis? (5 Ps)• Pleuritic positional pain with a preceding pyrexial illness

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3 Degrees of heart block?• First Degree• Slowed impulse >PR interval

• Second Degree• Wenckebach = progressively

increasing PR interval until dropped beat

• Mobitz type 2 = P:QRS fixed ratio e.g. 2:1, 3:1 etc.

• Third Degree• Complete heart block = no

relationship between P and QRS rhythms

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What would you use to reverse Warfarin?• Vitamin K

• Prothrombin Complex Concentrates• FFP

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What would you use to reverse heparin?• Protamine sulphate

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Causes of chest pain?• Cardiovascular: Ischaemia, Pericarditis, Aortic dissection• Respiratory: Infection, PE, Pneumothorax• Neuromuscular: intercostal muscle myositis / strain• Arthritic/Orthopaedic: costochondritis, rib fracture, metastasis• GI: Reflux oesophagitis, Oesophageal spasm, Gastritis• Excitement: anxiety attack, hyperventilation

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That’s all folks!

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