Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Specialty Blocks > 5. Cardio 1 > Flashcards

5. Cardio 1 Flashcards

1
Q

What is the most common cause of mitral stenosis?

A

Rheumatic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of hypersensitivity reaction causes rheumatic heart disease?

A

Type II (molecular mimicry) after group A strep (pyogenes) infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give 3 examples of type II hypersensitivity reactions.

A

HDN
Goodpasture’s disease / anti-GBM (alpha-3 chain of type IV collagen on BM, only present in alveoli and glomeruli)
AIHA (cell surface antigen on rbcs)
Rheumatic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which antibody mediates type II hypersensitivity, and what is the time frame?

A

IgG or IgM mediated cytotoxic reaction
Hours to days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Marfan syndrome is an AD condition. Which type of collagen is affected in this condition?

A

Type I collagen (mutation in FBN1 gene)
Type I collagen is found in bone, skin and tendons.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common form of cardiomyopathy?

A

Dilated CMO (90%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How long can you not drive for post MI?

A

1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List 4 drug classes included in secondary prevention post-MI.

A

ACEi (/ARB if not tolerated)
DAPT (aspiring + P2Y12i e.g. clopidogrel *based on bleeding risk)
BB (/diltiazem / verapamil if not tolerated )
Statin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the symptoms and time of onset of Dressler’s Syndrome, and how is it treated?

A

Pleuritic chest pain
Fever
Raised ESR
Pericardial / Pleural effusion

Usually 2-6 weeks post MI

Treat with NSAIDs e.g. Aspirin. Steroids if severe.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which coronary artery supplies the SAN and the AVN?

A

Right coronary artery

Complete occlusion of this may cause heart block and precipitate the need for temporary pacing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

State some complications of MI using the DARTH VADER mnemonic.

A

Death
Arrhythmias; tachy eg. VT, brady e.g. AV block in inf. STEMI
Rupture
Tamponade
Heart failure chronic
Valve disease
Aneurysm of LV
Dressler’s syndrome + immediate pericarditis
Embolism
Regurgitation mitral, recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the time frame for delivering PCI in the acute setting?

A

Symptom onset <12 hours
Can be delivered within 120 mins

Consider if presenting >12 hours but ongoing myocardial ischaemia / cardiogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Give 5 conditions that can also cause a raised troponin.

A

Triple A rupture
PE
Hypertensive crisis / pre-eclampsia
Chemotherapy
IE COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Give 2 cardiac and 3 non-cardiac differentials for ACS.

A

Aortic dissection
Acute pericarditis

Acute pancreatitis
Cholecystitis
MSK chest pain
GORD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the top 3 modifiable risk factors for coronary artery disease?

A

Smoking
Hypertension
Hypercholesterolaemia

(Diabetes, obesity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

List 3 patient groups who may present with atypical symptoms of ACS, and list some atypical features.

A

Women
Elderly
Diabetics

Vomiting
Acute confusion
Epigastric pain
Hyperglycaemia
Hypotension
Pulmonary oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Management of NSTEMI / unstable angina is complicated and depends on patient factors and a risk assessment. Which risk assessment tool is commonly used, and what factors are included in it?

A

GRACE score; estimates 6 month mortality

Age
Heart rate
BP
ECG findings
Cardiac (Killip class) and renal function (serum creatinine)
Cardiac arrest on presentation
Troponin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A patient comes in and you diagnose an NSTEMI. They are clinically stable. You calculate their GRACE score and it comes out as 4% mortality. What interventions should be considered for them?

A

Angiography within 72 hours with PCI if necessary (their GRACE score is >3%).

If the patient was unstable e.g. hypotensive, immediate coronary angiography would be indicated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Give 7 side effects of amiodarone:

A

Deranged thyroid function tests
Deranged LFTs
N&V
Interstitial lung disease
Bradycardia
Jaundice
Sleep disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where are beta-adrenoceptors located?

A

Heart and bronchi

General rule; B1 = heart, B2 = lung.
Also in brain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

At what age are men invited for triple A screening US?

A

65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type of ulcer is relieved of pain on elevation?

A

Venous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A patient presents with lower back pain, abdominal pain and anaemia; what is it important to exclude before continuing with investigations?

A

Triple A, via US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Give 2 conditions where morphine is contraindicated.

A

Head injury
Acute respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Give 5 common side effects of morphine.
Respiratory depression N&V Confusion Constipation Hypotension
26
Describe the MOA of aspirin and give 5 common side effects.
Inactivates COX enzyme, resulting in reduced production of TXA2, which reduces platelet aggregation. Also reduces PG12 production which decreases nociceptive sensitisation. Bleeding Peptic ulceration Angioedema Bronchospasm Reye's syndrome (children)
27
Describe the MOA of amiodarone.
Blocks K+ channels and efflux of potassium, prolonging the repolarisation phase of the cardiac cycle, restoring regular sinus rhythm and slowing AVN conduction.
28
Describe the MOA of statins and give 3 common side effects.
Inhibits HMG-CoA reductase which results in increased LDL receptor expression on hepatocytes, which increase cholesterol uptake and lowers plasma cholesterol. Diarrhoea Myalgia (could lead to rhabdo but this is dose related, so titrate up) Thrombocytopaenia
29
Give 3 examples of rate controlling drugs used in AF.
Beta blocker e.g. bisoprolol Rate limiting CCB e.g. verapamil Digoxin
30
Give 4 contraindications to digoxin.
Heart block VT/VF Pregnancy SVTs involving accessory pathways e.g. WPW
31
Give the 3 actions of digoxin on the cardiac cycle, and which ion channel it inhibits.
1. Lengthens cardiac action potential 2. Increases contractility 3. Stimulates PNS via vagus nerve to reduce AVN conduction, reducing heart rate. Na/K channel inhibitor
32
Give 4 symptoms of toxicity / side effects of digoxin.
Confusion N&V Hyperkalaemia Visual disturbance - yellow/green vision The therapeutic index of digoxin is narrow and the toxicity symptoms are quite vague, which means it needs monitoring.
33
State some contraindications for DOACs (6).
Pregnancy Previous ICH Active / recent bleeding Coagulopathy e.g. severe liver disease Falls risk e.g. elderly, alcohol abuse Peptic ulcer
34
Which clotting factors are vitamin K dependent?
II, VII, IX, X Warfarin is a vitamin K antagonist.
35
What rhymes are there for remembering P450 inducers and inhibitors?
CRAP GPS induce P450. (INR decreases). Inhibition of P450 gives SICK FACES . COM. (INR increases).
36
Give 4 signs of haemodynamic compromise that warrant medication in bradycardia:
Shock (hypotension <90mmHg, clammy, pallor, sweating, cold, confusion, impaired consciousness) Syncope Myocardial ischaemia Heart failure
37
Which patient groups should not receive prasugrel as part of their DAPT post MI?
Age >75 Weight <60kg Hx of stroke or TIA Appears to only benefit in invasively managed patients e.g. stenting.
38
What is the MOA of clopidogrel, prasugrel and ticagrelor?
P2Y12 ADP-receptor inhibitors, inhibiting the activation of platelets.
39
Give a triad of symptoms associated with aortic stenosis (SAD).
Syncope Angina Dyspnoea
40
2 shockable and 2 non-shockable rhythms:
Shockable = VT/VF Non-shockable = PEA, including sinus without a pulse, asystole
41
Life-threatening features associated with adult tachycardia, and what is the immediate management if any of them are present?
Shock Syncope Myocardial Ischaemia Severe heart failure Sedation / anaesthesia if conscious Synchronised DC shock x3 Amiodarone 300mg IV over 10-20 mins Repeat synchronised DC shock
42
Tachycardia, broad complex and regular, suspicion of VT; management?
Amiodarone 300mg IV over 10-60 mins
43
In adult bradycardia you should assess for evidence of life-threatening signs. If they ARE present, what is the first line medication?
Atropine 500 micrograms IV
44
If there is not a satisfactory response to atropine, what are the options available to you whilst expert help is on the way? What might the expert instigate on arrival?
Repeat atropine up to 3mg Isoprenaline / adrenaline Alternative drugs include aminophylline dopamine glycopyrrolate Or transcutaneous pacing
45
A patient has bradycardia with no evidence of life-threatening signs. Which 4 clinical features would indicate that they are at risk of asystole, and how would they be managed if they are?
Recent asystole Mobitz II AV block Complete heart block and broad QRS Ventricular pause >3 seconds Manage as life threatening e.g. atropine then further options
46
Discuss atrial vs ventricular rate in atrial flutter:
Atrial flutter is a re-entrant signal in either atrium, self perpetuating loop due to extra electrical pathway in atria. Signal goes round and round, atrial rate about 300bpm. Signal does not usually enter ventricles every cycle due to the long refractory period of the AV node, usually 2:1, so ven. rate is 150bpm.
47
2 potential outcomes of torsades de pointes if not managed:
Remit spontaneously Deteriorate into VT
48
Discuss prolonged QT interval and how it can lead to torsades de pointes.
Long QT = prolonged repolarisation of a contraction. This can result in spontaneous depolarisation in some muscle cells, known as 'afterdepolarisations'. These spread throughout the heart and cause contraction. Recurrent contractions without proper repolarisation = torsades.
49
Congenital causes of a long QT interval, including specific features of LQT1, 2 and 3:
Long QT syndrome: Autosomal dominant, LQT1, 2, 3 1 = exertional syncope 2 = emotional stress, exercise or auditory stimuli causes syncope 3 = occur at night or rest Romano Ward syndrome Jerval-Lange-Nielsen (K+ channel defect, +deafness)
50
Drug causes of long QT interval:
Ondansetron Haloperidol Sotalol Fleicanide Amiodarone Macrolides e.g. erythromycin, TCA Citalopram Antihistamine e.g. terfenadine
51
Other electrolyte / medical causes of a long QT interval:
Hypocalcaemia Hypokalaemia Hypomagnaesaemia Acute MI Myocarditis Hypothermia SAH
52
Management of long QT syndrome:
Avoid exacerbating drugs BB but NOT sotalol ICD
53
What does bigeminy refer to?
An ectopic beat occurring after every other QRS
54
What does sick sinus syndrome refer to?
Dysfunction of the SAN. Often caused by idiopathic degenerative fibrosis of the SAN. Can result in sinus bradycardia, sinus arrhythmias and prolonged pauses.
55
RFs for infective endocarditis:
IVDU CKD esp diaysis Structural heart disease e.g. valvular heart disease, congenital, hypertrophic CMO, prosthetic valve ICD Immunocompromised e.g. HIV
56
Organisms that cause infective endocarditis, and their associations. +2 non-infective causes of endocarditis.
Staph aureus most common , IVDU Strep viridans = dental CONS e.g. staph epidermis; indwelling lines and prosthetic valve surgery (normal spectrum returns to normal after 2 months) Strep bovis = CRC, strep gallolyticus Also SLE and malignancy
57
Culture negative organisms that can cause infective endocarditis:
Coxiella burnetti Bartonella Brucella HACEK
58
Blood culture requirements for IE:
3 samples, separated by 6hrs, from different sites Interval lessened if urgent need for abx e.g. septic
59
TOE is the usual imaging investigation for IE, being more sensitive and specific than TTE. However, special imaging may be required in patients with prosthetic heart valves;
18F-FDG PET /CT SPECT CT
60
Poor prognostic factors in IE:
Culture negative Staph aureus has mortality of 30% Prosthetic valve esp early e.g. acquired during surgery Low complement levels
61
Describe the Modified Duke criteria for IE:
1 major 3 minor // 5 minor Major criteria Adequate blood cultures positive Echo = visible vegetations Minor criteria Predisposition e.g. IVDU, prosthetic Vascular phenomena - splenic infarction, ICH, Janeway lesions of palms and soles, splinter haemorrhage Immunological phenomena - osler nodes painful, roth spots eye, GN Microbiology not enough for major Fever>38
62
Length of abx for native and prosthetic valve in IE:
4 weeks, 6 weeks

Specialty Blocks (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions