Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DPD > Amir Sam - Chest Pain > Flashcards

Amir Sam - Chest Pain Flashcards

1
Q

What investigations do you do if someone comes in with chest pain?

A

ECG
Troponin

if positive coronary angiography
Exercise tolerance test
Echocardiography

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

Differential diagnosis for chest pain?

A

Cardiac
Respiratroy
GI
MSK

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

Cardiac causes of chest pain + what features/risk factors you’d look out for

A

IHD - look at risk factors
Aortic dissection - ask for blood pressure in two arms
Pericarditis - ask for fever

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

Resp causes of chest pain

A

PE
Pneumonia
Pneumothorax

Ask about sputum, temperature, recent travel, onset etc

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

GI causes of chest pain

A

Oesophageal spasm
Oesophagitis
Gastritis

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

MSK causes of chest pain

A

Costrochondritis

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

ST elevation is seen in Inferior

A

2,3, AVF

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

Which artery is affected in anterior MI and which leads show ST elevation?

A

LAD

V1-4

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

Which artery is affected in lateral MI and which leads show ST elevation?

A

Circumflex

V5,6, aVL

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

Which artery is affected in inferior MI and which leads show ST elevation?

A

Inferior MI
RCA
2,3, aVF

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

Differentials for collapse

A

Hypoglycemia

Vasovagal
Arrthymias
Outflow obstructions (AS, HOCM, PE)
Postural hypotension

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

What might lead to tachyarrythmias?

A

Long QT syndrome (abnormal ventricular repolarisation)

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

Causes of long QT syndrome + how to work it out on an ECG

A

Congenital mutation in potassium channels
Acquired - low potassium or magnesium
T wave should be before half way point between two R complexes

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

Aortic stenosis features + where the murmur radiates to

A

Slow rising pulse
Ejection systolic murmur

radiates to carotids

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

Murmur louder on inspiration

A

Right sided

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

Differentials for raised JVP

A

RHF
Tricuspid regurg
CONSTRICTIVE PERICARDITIS

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

Causes of RHF

A

Secondary to LHF

Pulmonary hypertension e.g. COPD

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

Tricuspid regurgitation causes

A

Valve abnormalities

Right ventricular dilation

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

Causes of constrictive pericarditis

A

Infection - TB
Inflammation - connective tissue diseases
Malignancy

ALSO DRESSLER’S
Metabolic - myxoedema, uremia,

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

Differentials for systolic murmur

A

Ejection systolic - AS

Pansystolic - MR/TR/VSD

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

Where does a VSD murmur radiate?

A

Left sternum

22
Q

Where does MR murmur radiate?

A

Axilla

23
Q

Heaves - centre of chest means

left of chest means

A

Centre - RVH

Left - LVhypertrophy

24
Q

Sinus tachycardia differentials

A

Sepsis
Hypovolaemia
PE
Endocrine (thyrotoxicosis, phaeochromocytoma)

25
Q

Causes of AFIB

A

Thyrotoxicosis
Alcohol

Heart - problems with muscle, valve or pericardium
Lung - pneumonia, PE, cancer

AKA
Ischemia
Infection

26
Q

SVT on an ECG

A

NO p waves

Regular fast QRS complexes

27
Q

SVT classifications

A

Reentry circuit due to
AVNRT
AVRT

28
Q

AVRT ECG (WPW)

A

Short PR interval

Slurred upstroke due to depolarisation down accessory pathway

29
Q

AVNRT vs AVRT on ecg

A

AVNRT - no slurred upstroke

but you do get the shortened PR interval

30
Q

VT ecg (compared to SVT)

A

BROAD COMPLEX tachycardias because the action potential is coming from ventricles, therefore takes a while to actually depolarise (unlike in SVT)

31
Q

Causes of VT

A

Ischemia
Electrolyte abnormality
Long QT

32
Q

SVT management and what to do if haemodynamically unstable

A

Valsalva manoeuvre
Adenosine whilst on cardiac monitor
DC cardioversion of haemodynamic compromise (AKA BP low)

33
Q

When do you do DC in SVT

A

Only if BP is dropping

34
Q

Management of AF if haemodynamically stable

A

DC

If over 2 days, anticoagulate for 3-4 weeks before DC

Rate control - beta blocker, digoxin

TREAT UNDERLYING CAUSE
AND ANTICOAGULATE FOR COMPLICATIONS (CHADVASCS)

35
Q

Causes of Afib

A

Infection in heart or lung
Cancer
Thyrotoxicosis
Alcohol

36
Q

Management of VT if patient has a pulse

A

If BP stable - IV amiodarone
+ treat cause
ICD

37
Q

If the patient has PULSELESS VT, what do you do?

A

DEFIBRILATE

38
Q

LVH in ECG

A

Deep S in V1/V2
Tall R in V5/6

If more than 7 large squares in total, suggests LVH

39
Q

On an ECG, ischemia is shown as?

A

ST elevation
Inverted T waves
Pathological Q waves

40
Q

What do pathological Q waves indicate?

A

Previous MI

Q wave more than 1mm wide or 2mm deep or more than 1/4 of QRS depth

41
Q

What would need to look for on ECG for arrhythmias

A

Rate, rhythm

Broad QRS - BBB
QT
PR interval

42
Q

What would you look at on ECG for hypertrophy

A

Axis
R
S

43
Q

What is S3 associated with?

A

Rapid ventricular filling

44
Q

What is S4 associated with?

A

Ventricular hypertrophy

45
Q

Acute heart failure management

A 
Sit pt up
Oxygen
Furosemide IV 
Morphine and metoclopramide
GTN infusion if needed
Treat underlying cause
46
Q

Chronic heart failure management

A

ACEi
BB
Loop diuretic

47
Q

Cardiac arrest - what does the management depend on?

A

Whether it’s shockable or not

Shockable = VT or VF
Non shockable = PEA (pulseless electrical activity) or asystole

48
Q

What is PEA?

A

When the heart isn’t actually contracting due to lack of blood to myocytes from coronary arteries, but there is still electrical activity

49
Q

Management of cardiac arrest when there is shockable rhythm

A 
Defib 
CPR 
Check ecg again 
If no improvement, repeat defib
Then give ADRENALINE
Then CPR
Repeat cycle

If by third defib, no improvement, give amiodarone

+ treat reversible causes

50
Q

Management of cardiac arrest when there is NO shockable rhythm

A

CPR (2 min)
Adrenaline every 3-5 min

Atropine if <60bpm

51
Q

Causes of cardiac arrest

A

Four Hs + Four Ts

toxin
tamponade
tension pneumothorax
thrombosis

Hypo/hyperkalemia
Hypothermia
Hypoxia
Hypovolemia

DPD (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions