Amir sam 1 Flashcards
What are some cardiac causes of chest pain. (3)
IHD.
Aortic dissection.
Pericarditis.
What are some respiratory causes of chest pain. (3)
PE.
Pneumonia.
Pneumothorax.
What are some GI causes of chest pain. (3)
Oesophageal spasm.
Oesophagitis.
Gastritis.
What is a musculoskeletal cause of chest pain.
Chostochondritis.
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.
ECG.
Where will ECG changes be visible on an anterior MI.
V1-V4.
What coronary artery is involved in an anterior MI.
LAD.
Where will ECG changes be visible on a lateral MI.
V5, V6, I, aVL.
What coronary artery is involved in a lateral MI.
Circumflex.
What coronary artery is involved in an inferior MI.
RCA.
Where will ECG changes be visible in an inferior MI.
II, III, aVF.
What is the cardiac enzyme that is most elevated during a large MI.
Troponin.
What are some common causes of collapse. (6)
Hypoglycaemia. Vasovagal causes. Arrhythmias. Outflow obstruction. Postural hypotension. Seizure.
What are some examples of arrhythmias. (2)
Tachycarida.
Bradycardia.
What are some causes of outflow obstruction. (3)
Left: aortic stenosis, HOCM.
Right: PE.
What is long QT syndrome. (2)
Abnormal ventricular repolarization.
Long QT inrval on ECG.
What is the cause of long QT syndrome.
Congenital - eg mutations in potassium channels.
What is an important aspect of family history if you suspect long QT syndrome.
FH of sudden death.
What are some causes of a raised JVP. (3)
Right heart failure.
Tricuspid regurgitation.
Constrictive pericarditis.
What are some causes of right heart failure. (2)
Secondary to left heart failure.
Pulmonary hypertension.
What is a cause of left heart failure.
Congestive heart failure.
What are some causes of pulmonary hypertension. (2)
PE.
COPD.
What are some causes of tricuspid regurgitation. (2)
Valve leaflets.
Right ventricle dilatation.
What are some causes of constrictive pericarditis. (3)
Infection.
Inflammation.
Malignancy.
What are some causes of a systolic murmur. (4)
Aortic stenosis.
Mitral regurgitation. Tricuspid regurgitation. Ventral septal defect.
What are some causes of sinu tachycardia. (3)
Sepsis.
Hypovolaemia.
Endocrine (Thyrotoxicosis, phaeochromocytoma).
What is a cause of supra ventricular tachycardia.
Re-entry circuit.
What are some causes of AF. (8)
Thyrotoxicosis. Alcohol. Ischaemic heart disease. Valvular heart disease. Pericarditis. Chest infection (pneumonia). Lung cancer. PE.
What are some causes of ventricular tachycardia. (3)
Ischaemia.
Electrolyte abnormality.
Long QT.
What is the characteristic of AVRT on an ECG.
Delta wave.
How are SVTs managed. (3)
Vagal manouvers.
Adenosine.
DC cardioversion if evidence of haemodynamic compromise.
What are the two aspects of AF management. (2)
Rhythm control.
Rate control.
What drugs are used to rate control AF. (4)
Beta blockers.
Digoxin.
Treatment of the underlying cause.
Prevention of complications (anti-coagulate).
How do you manage ventricular tachycardia. (3)
If no haemodynamic compromise give IV amiodarone.
Look for and treat underlying cause.
ICD.
How do you manage a pulseless VT.
Defibrillate.
What is the voltage criteria for left ventricular hypertrophy. (2)
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.
What is S1 due to.
Closure of mitral valve.
What is S2 due to.
Closure of aortic valve.
What is the cause of a fixed wide splitting of S2.
Atrial septal defect.
What is S3 associated with.
Associated with ventricular filling.
What is S4 associated with.
Associated with ventricular hypertrophy.
How do you manage acute heart failure. (6)
Sit the patient up. Oxygen. GTN infusion. Diamorphine. Furosemide (IV). Treat the underlying cause.
How do you manage VF/pulseless VT. (5)
Shock the patient. CRP (2mins). Assess rhythm. Adrenaline every 3-5mins. Correct reversible causes.
How do you manage asystole/PEA. (2)
CRP.
Correct reversible causes.
What are the causes of pleuritic chest pain. (6)
Pericarditis. PE. Pneumonia. Pneumothorax. Plerural pathology. Sub-diaphragmatic pathology.
