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Amir Sam DPD Lectures > Amir sam 1 > Flashcards

Amir sam 1 Flashcards

1
Q

What are some cardiac causes of chest pain. (3)

A

IHD.
Aortic dissection.
Pericarditis.

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2
Q

What are some respiratory causes of chest pain. (3)

A

PE.
Pneumonia.
Pneumothorax.

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3
Q

What are some GI causes of chest pain. (3)

A

Oesophageal spasm.
Oesophagitis.
Gastritis.

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4
Q

What is a musculoskeletal cause of chest pain.

A

Chostochondritis.

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5
Q 
60 year old man. 
Complaining of chest pain, tight for the past two hours. 
Nausea and vomiting. 
PMH: hypertension. 
DH: amlodipine. 
Temp: 37. 
Cheat clear. 
Abdomen SNT. 
BP: 120/80L, 118/75R. 
HS present, no added sounds.

What is the next most appropriate investigation.

A

ECG.

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6
Q

Where will ECG changes be visible on an anterior MI.

A

V1-V4.

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7
Q

What coronary artery is involved in an anterior MI.

A

LAD.

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8
Q

Where will ECG changes be visible on a lateral MI.

A

V5, V6, I, aVL.

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9
Q

What coronary artery is involved in a lateral MI.

A

Circumflex.

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10
Q

What coronary artery is involved in an inferior MI.

A

RCA.

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11
Q

Where will ECG changes be visible in an inferior MI.

A

II, III, aVF.

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12
Q

What is the cardiac enzyme that is most elevated during a large MI.

A

Troponin.

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13
Q

What are some common causes of collapse. (6)

A 
Hypoglycaemia. 
Vasovagal causes. 
Arrhythmias. 
Outflow obstruction. 
Postural hypotension. Seizure.
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14
Q

What are some examples of arrhythmias. (2)

A

Tachycarida.

Bradycardia.

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15
Q

What are some causes of outflow obstruction. (3)

A

Left: aortic stenosis, HOCM.
Right: PE.

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16
Q

What is long QT syndrome. (2)

A

Abnormal ventricular repolarization.

Long QT inrval on ECG.

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17
Q

What is the cause of long QT syndrome.

A

Congenital - eg mutations in potassium channels.

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18
Q

What is an important aspect of family history if you suspect long QT syndrome.

A

FH of sudden death.

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19
Q

What are some causes of a raised JVP. (3)

A

Right heart failure.
Tricuspid regurgitation.
Constrictive pericarditis.

20
Q

What are some causes of right heart failure. (2)

A

Secondary to left heart failure.

Pulmonary hypertension.

21
Q

What is a cause of left heart failure.

A

Congestive heart failure.

22
Q

What are some causes of pulmonary hypertension. (2)

A

PE.

COPD.

23
Q

What are some causes of tricuspid regurgitation. (2)

A

Valve leaflets.

Right ventricle dilatation.

24
Q

What are some causes of constrictive pericarditis. (3)

A

Infection.
Inflammation.
Malignancy.

25
Q

What are some causes of a systolic murmur. (4)

A

Aortic stenosis.

Mitral regurgitation. Tricuspid regurgitation. Ventral septal defect.

26
Q

What are some causes of sinu tachycardia. (3)

A

Sepsis.
Hypovolaemia.
Endocrine (Thyrotoxicosis, phaeochromocytoma).

27
Q

What is a cause of supra ventricular tachycardia.

A

Re-entry circuit.

28
Q

What are some causes of AF. (8)

A 
Thyrotoxicosis. 
Alcohol. 
Ischaemic heart disease. 
Valvular heart disease. 
Pericarditis.  
Chest infection (pneumonia). 
Lung cancer. 
PE.
29
Q

What are some causes of ventricular tachycardia. (3)

A

Ischaemia.
Electrolyte abnormality.
Long QT.

30
Q

What is the characteristic of AVRT on an ECG.

A

Delta wave.

31
Q

How are SVTs managed. (3)

A

Vagal manouvers.
Adenosine.
DC cardioversion if evidence of haemodynamic compromise.

32
Q

What are the two aspects of AF management. (2)

A

Rhythm control.

Rate control.

33
Q

What drugs are used to rate control AF. (4)

A

Beta blockers.
Digoxin.
Treatment of the underlying cause.
Prevention of complications (anti-coagulate).

34
Q

How do you manage ventricular tachycardia. (3)

A

If no haemodynamic compromise give IV amiodarone.
Look for and treat underlying cause.
ICD.

35
Q

How do you manage a pulseless VT.

A

Defibrillate.

36
Q

What is the voltage criteria for left ventricular hypertrophy. (2)

A

Deep S in V1/2 and tall R in V5/6.

OR.

S in V1 and R in V5/6 (whichever is larger) >7 large squares.

37
Q

What is S1 due to.

A

Closure of mitral valve.

38
Q

What is S2 due to.

A

Closure of aortic valve.

39
Q

What is the cause of a fixed wide splitting of S2.

A

Atrial septal defect.

40
Q

What is S3 associated with.

A

Associated with ventricular filling.

41
Q

What is S4 associated with.

A

Associated with ventricular hypertrophy.

42
Q

How do you manage acute heart failure. (6)

A 
Sit the patient up. 
Oxygen. 
GTN infusion. 
Diamorphine. 
Furosemide (IV). 
Treat the underlying cause.
43
Q

How do you manage VF/pulseless VT. (5)

A 
Shock the patient. 
CRP (2mins). 
Assess rhythm. 
Adrenaline every 3-5mins. 
Correct reversible causes.
44
Q

How do you manage asystole/PEA. (2)

A

CRP.

Correct reversible causes.

45
Q

What are the causes of pleuritic chest pain. (6)

A 
Pericarditis. 
PE. 
Pneumonia. 
Pneumothorax. 
Plerural pathology. 
Sub-diaphragmatic pathology.

Amir Sam DPD Lectures (6 decks)

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