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__Y6 Finals Revision > __Y6 Cardio > Flashcards

__Y6 Cardio Flashcards

1
Q

Causes of Aortic Regurg

A

Valvular - rheumatic, IE
Root - Connective tissues disease (Marfans)
Acute - post-aortic dissection

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2
Q

Austin Flint Murmur

A

MDM - due to fluttering from MV following turbulant flow from aortic jet

Heard with AR

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3
Q

Peripheral signs of AR

A 
Quinke's (nailbed)
Corrigans (carotids)
De Mussets (head bobbing)
Mullers (uvula)
Traubes (pistol shot femorals)
Wide pulse pressure 
Collapsing pulse
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4
Q

Marfan’s signs to demonstrate in exam

A

High arched palate
Arm span > height
Fingers around wrist (overlap)
Lax skin

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5
Q

Taping apex beat (palpable first HS) heard with?

+ describe mechanism

A

Mitral stenosis

Increased LA pressure, holds MV out wider than normal
so slams shut slightly later and from a greater distance with increased force

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6
Q

Loud S1
Opening snap
Mid-diastolic murmur

A

Mitral Stenosis

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7
Q

Mitral Stenosis exam findings

A

Loud S1
Opening snap
Mid-diastolic murmur

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8
Q

Common causes of AF

A

MI, valve disease, alcohol/caffeine, hyperthyroid

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9
Q

What else other than AF can cause an irregularly irregular pulse?

And how to differentiate between them

A

Ventricular ectopics

Differentiate by exercising the patient
Ventricular ectopics will go away as they are not conducted when there is less diastolic filling time

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10
Q

How do you know if AF is well controlled?

A

Pulse deficiet

Listen to heart and hear if everything is conducted down to radial pulse

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11
Q

Complications of valve replacement

A

Early - early IC, increased bleeding/bruising, failure of valve

Late - late IE, failure/dysfunction, bleeding, thromboembolism, MAHA

Or use FIBAT mnemonic

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12
Q

To complete examination of prosthetic valve pt?

A

EEE

Ensure INR checked (and HB for MAHA and bleeding)
Echo to check valve is working well
Endocarditis - advice about dental hygiene and red flags

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13
Q

Stages of clubbing

A

FACE

Fluctuancy of nail bed
Angle loss
Curvature increased
Expansion

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14
Q

Murmur loudest in aortic area, radiate to carotids, assoc features (BP narrow pulse pressure, slow rising carotid pulse)

A

Aortic stenosis

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15
Q

Murmur loudest in apex, radiates to axilla, assoc features (displaced apex beat), pansystolic

A

Mitral regurg

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16
Q

Murmur louder on inspiration, assoc features: elevated JVP, giant ‘v’ waves (earlobes), L parasternal heave, palpable liver

A

Tricuspid regurg

17
Q

Murmur loudest in left lower sternal edge, when sitting forward, breath held in expiration, BP wide pulse pressure, collapsing pulse, displaced/heaving apex beat

A

Aortic regurgitation

18
Q

irregularly irregular pulse, malar flush, tapping apex beat, left parasternal heave
Mid-diastolic murmur (after S2), opening snap

A

Mitral stenosis

19
Q

Saddle-shaped ST elevation (‘concave) on ECG, pleuritic CP improves on sitting forwards

A

Acute pericarditis

20
Q

Acute pericarditis ECG changes?

A

Saddle shaped ST elevation

21
Q

Causes of acute pericarditis?

A

viral infection, TB, uraemia, trauma, post MI, CTD, hypothyroid

22
Q

Signs of Infective Endocarditis

A

Hands - splinter haemorrhages, clubbing, petechiae
Chest - changing heart murmurs
Abdo - splenomegaly, microscopic haematuria

Other: fever, arthalgia, emboli, Roth spots, Janeway lesions, Osler’s nodes

23
Q

Acute rheumatic fever major criteria

A

Duckett Jones Major criteria
(CASES)

Carditis
Arthritis
Subcutaneous nodules
Erythema marginatum
Sydenham's chorea

plus rising ASO/+ve throat culture for Strep A

24
Q

Malar flush in cardio

A

Classically in mitral stenosis

Due to resulting CO2 retention and vasodilatory effects

25
Q

S3

A

Due to rapid venticular filling
Early diastole during passive filling of compliant LV
(can be normal)
KEN-TUC-KY

Seen with mitral regurg
As atria overfilled with regurg so more rapid filling

Also TR, VSD, post-MI, dilated CM

26
Q

S4

A

Caused by atria contracting forcefully to overcome an abnormally stiff ventricle (increased tubulent flow as atria contract)

Late diastole during active filling of non-compliant LV

TE-NESS-SEE

Often heard in LVH, AS
always abnormal

27
Q

STEMI V1-V6

A

Anterior - LAD

28
Q

STEMI II, III, aVF

A

Inferior - RCA

29
Q

Describe three different types of HB

A

1st degree – all conducted with long PR

2nd degree – irregular QRS pattern, some conducted (type 1 ratio, type 2 changing PR)

3rd degree – none conducted, no association, totally regular QRS but not in association with P

30
Q

STEMI management

A

ABCDE
O2, Aspirin 300mg PO
Nitrates/GTN
Diamorphine IV 2.5mg-5mg

Streptokinase 1.5 MU over 1 hour
BB if not in HF
± Thrombolysis

31
Q

ECG changes with PE

A 
Sinus tachy
RV strain (inverted T waves in V1-4)

Later - S1Q3T3

32
Q

Displaced apex beat due to:

A

DILATATION not hypertrophy

Dilatation due to volume overload (AR, MR, ASD/VSD)

Concentric hypertrophy due to pressure overload (AS, HTN)

33
Q

ECG changes in MI

A
  1. ST elevation in first 4-12 hours
  2. Pathologic Q waves (big) after 6 hours (indicate irreversible damage)
  3. T wave inversion as ST normalise

__Y6 Finals Revision (14 decks)

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