Simvastatin

Drug Class Statin Mechanism Reversibly inhibits HMG CoA reductase - the rate limiting enzyme in cholesterol synt…

Dual antiplatelet therapy

Aspirin + ticagrelor for low bleeding risk Aspirn + clopdogrel for high bleeding risk  Prasugrel used when patients a…

Stroke symptoms per artery

    PICA - vertigo, vomiting dysphagia, ipsilateral facial pain & temperature loss, contralateral limb pain & t…

Hyperkalaemia

Causes  Medications ACEis ARBs Potassium sparing diuretics Trimethoprim Beta blockers Suxa…

Different vasculitis

Vasculitis Vessels Lab Findings Key Features Henoch-Schonlein Purpur…

Intermediate Life Support

  Patients in VF/pulseless VT should receive one shock followed by two minutes of CPR. If they are witnessed having the cardiac arrest and ar…

Pleural Effusion

Transudate tame - fluids leak from intact vessels so low protein  Exudates extreme - from pathological capillaries so high protein   …

Anticoagulants

Heparin Increases the ability of antithrombin molecule to irreversibly inhibit thrombin, IXa, Xa, XIa. LMWH - mainly inhibits FXa only, less mo…

Aneurysm

Localised abnormal dilation of blood vessel or the wall of the heart True aneurysm - all three layers of artery are involved False/pseudoaneury…

Giant Cell Arteritis (Temporal)

Type of vasculitis (hypersensitivity type IV) affecting large arteries in head - can lead to blindness Older individuals, F>M, PMH of polymy…

Endocarditis

Infection and inflammation of the endocardium, mainly involving valves Structurally abnormal valves (rheumatic heart disease etc) Foreign mat…

Pericarditis

Inflammation of pericardial sac - reduces effectiveness of contractions Acute - serofibrinous, caseous, haemorrhagic & purulent Chronic -…

Myocarditis

Inflammation of myocardium Electrical dysfunctions - arrhythmias/sudden death Mechanical dysfunction - heart failure Viruses, Post Group …

Rheumatic Fever

Complication of Group A Strep pharyngitis (Strep pyogenes) Children in developing countries Untreated Strep pyogenes + immune cross reactivit…

Anti-coagulation in Stroke with AF

If the CHADVASc score is higher than ORBIT anticoagulate

Aortic Stenosis

Syncope Angina Dyspnoea

Pulmonary oedema due to HF exacerbation

Symptomatic relief - PODMAN Position Oxygen Diruetics Morphine Antiemetic Nitrates 

Bundle Branch Block

In any BBB the T waves should be in the opposite direction to the last QRS deflection If this is not the cases - there is likely another cause f…

PE ECG changes

Some non-specific changes but in combination PE should be considered Sinus tachycardia – the most common abnormality (seen in 4…

T waves

Upright in all leads except aVR and V1 Amplitude < 5mm in limb leads, < 10mm in precordial leads (10mm males, 8mm females) Duration rela…

BNP

Released from cardiomyocytes in ventricule Can also be raised in sepsis  

Arrhythmias

Normal Conduction Regular rhythm tachycardia Sinus tachycardia - from SAN - infection, pain, exercise, anxiety, dehydration, hypovo…

Vasovagal Syncope

Autonomic nervous system - vagus nerve stimulation, sudden parasympathetic nervous system stimulation due to event   BEFORE …

Syncope vs Seizure

Syncope Seizure Prolonged upright position before the event Epilepsy aura (smells,…

Arterial thrombosis

Mitral valve disease

Mitral stenosis Restricting blood flow from the left atrium to ventricle Mid-diastolic low-pitched "rumbling" murmur due to low blood…

Right heart valve disease

Tricuspid regurgitation Pan-systolic murmur - split second heart sound due to the pulmonary valve closing earlier than aortic as the right ventric…

ECG territory lead changes

Septal MI relates to leads V1 and V2. An anterior MI would cause changes suggestive of MI in leads V3 and V4.   Tall R waves in leads V…

Alpha and beta receptors

Alpha Receptors: Generally found on smooth muscle cells. Subtypes: α1 and α2. α1 receptors primarily mediate smooth muscl…

HRT in ischemic heart disease

The evidence base surrounding hormone replacement therapy and ischaemic heart disease is complicated but it should certainly be avoided in patients w…

Determining the valve

R(ight sided murmurs) I(nspiration) L(eft sided murmurs) E(xpiration) For IVDU, the first valve that the venous system interacts with is the tr…

Furosemide

Drug Class Loop diuretic Mechanism Inhibits Na/K/2Cl pump in ascending loop of Henle  Inhib…

Bendroflumethiazide

Drug Class Thiazide diuretic Mechanism Inhibits Na/Cl reabsorption in distal tubules Stimulate K excr…

Spironalactone

Drug Class Potassium sparing diuretic Mechanism Aldosterone antagonist Competes for receptors in DCT…

Atenolol

Drug Class Beta blocker Mechanism Acts on β1 receptors in the heart ↓ HR and force of …

Diltiazem

Drug Class Calcium channel blocker Mechanism Interfere with the inward movement of calcium ions into cells …

Ramipril

Drug Class ACE inhibitor Mechanism Inhibits angiotensin converting enzyme - ↓ angiotensin II synthesis…

Losartan

Drug Class Angiotensin 1 blocker Mechanism Displace angiotensin II from the angiotensin I receptor Typica…

Isosorbide Mononitrate

Drug Class Nitrate Mechanism Metabolised to NO in smooth muscle cells Causes vascular smooth muscle relaxa…

Digoxin

Drug Class Cardiac glycoside Mechanism Inhibits Na/K pump - ↑ intracellular Na conc inhibiting N…

Amiodarone

Drug Class Anti-dysrhythmic (Class III) Mechanism Prolongs refractory period in all parts of conduction system - …

Aspirin

Drug Class Anti-platelet agent Mechanism Irreversible COXI and COXII inhibitor Typical Dose 75g OD - …

Clopidogrel

Drug Class Anti-platelet agent Mechanism Irreversibly to the platelet P2Y12 receptor, inhibiting ADP-mediated pl…

Streptokinase

Drug Class Thrombolytic Mechanism Binds to circulating plasminogen forming activator complex Converts…

Enoxaparin

Drug Class Low molecular weight heparin Mechanism Activation of antithrombin causing inactivation of coagulation…

Critical vs Acute Limb Ischaemia

Acute limb ischaemia - limb MI Critical limb ischaemia - unstable angina  Claudication - stable angina