Block 2 - Cardiology Flashcards

1
Q

Symptoms of left sided heart failure?

A

Orthopnea - increased venous return from lying down

Paroxysmal nocturnal dyspnea - increased venous return from edema reabsorption

Pulmonary edema

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2
Q

Symptoms of right sided heart failure?

A

Hepatomegaly - increased central venous pressure

Jugular venous distension - increased CVP

Peripheral edema

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3
Q

What are the side effects of ACEi?

A

Diarrhea

Muscle pain

Rabdomyolysis - break down of muscle

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4
Q

What virus causes spenomegaly?

A

EBV

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5
Q

What are the triad of symptoms of pyelonephritis

A

Fever

Pain at costo-vertebral junction

nausea or vomiting

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6
Q

Whats is POTS

A

Postural Orthostatic Tachycardic Syndrome

ALso known as syautonomia. Main symptom is widely variable blodd pressure and can lead to syncopy, dizziness etc. Is part of a wider ANS dysfunction syndrome.

Treatment: High salt intake of salt, stockings, Low dose ß blockers, avoid standing up for long times

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7
Q

What is cardio-renal syndrome?

A

Where both the heart and kidneys are dependent on each other. This is through:

Heamodynamic stability

Renal-cardiac connectors e.g: BNP and inflammatory markers

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8
Q

Treatment of acute heart failure?

A

Patient at 45° and O2

Morphine

ECG

FLurosemide

CXR and ABG

Nitrates if systolic > 100 mmHg

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9
Q

What is the advantage of morphine apart from pain relief.

A

Anxiolytic

Vasodilator with quick onset

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10
Q

How long does it take IV flurosemide to take effect?

A

20 mins

This is why morphine is given as a vasodilator first.

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11
Q

Triad of cogestive heart failure?

Ft - Ryan Bartar CT1

A

Raised JVP

Crepitations at lung bases

Ankle oedema

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12
Q

Symptoms and signs of Arotic stenosis?

A

Triad of heart failure, angina and sncopy

Patient experiences - Chest pain, exertional dyspnoea and syncopy

Signs - slow rising pulse, displaced apex and systolic ejection mumur ( and ejection click?)

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13
Q

Symptoms and signs of Mitral regurgitation?

A

Symptoms include dyspnoea fratigue and palpitations

Signs: AF, displaced apex, pansystolic murmur.

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14
Q

What is the anion gap?

A

[Na+] - ([Cl-] + [HCO3-])

> 17 confirms there is a metabolic acidosis

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15
Q

What are the causes for a raised anion gap?

KARMEL

A

Ketosis

Asprin (also paracetamol and other toxins)

Renal failure

Methanol

Ethylene Glycol

Lactate

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16
Q

When do you use Flecanide for cardioeversion?

A

No structural change or ischaemia (usually younger people) who are in AF

17
Q

What is the treatments for SVT?

A

Adenosine - slows the heart rate

Has a half life of 8s

18
Q

What can cause LBBB?

A

Digitalis intoxication

Hyperkalaemia

Hypertrophy

ischaemia

Aortic stenosis

19
Q

What causes RBBB?

A

Hypertrophy/ Cor pulmonale

PE

Ischaemia

Myocarditis

Rheumatic heart disease

Artial septal defect

20
Q

What is P pulmomale and what are its causes?

A

Right atrial hypertrophy due to portal hypertension.

Causes:

Chronic lung disease

Tricuspid stenosis

Congenital heart disease

21
Q

What is P mitrale and what causes it?

A

Left artial hypertrophy.

Causes:

LV hypertrophy, Mitral stenosis

22
Q

What features of a ECG indicate p pulmonale?

A

Peaked T waves in V1/2, II, III, AvF

23
Q

What features of a ECG indicate p mitrale?

A

Bifid P waves

T wave > 40 ms

24
Q

What feature on ECG indicates Hypokaleamia?

A

Porminant U wave

25
Q

What feature on ECG can indicate Hyperkalaemia?

A

Peaked T waves

26
Q

What types of AF are there?

A

First degree

Paroxysmal

Persistant

Perminant

27
Q

What is the difference between paroxysmal and persistant AF?

A

Both have 2 or more episode however paroxysmal self terminate spontaneously where as persistant has to be cardioverted.

28
Q

What is Dresslers syndrome?

A

Usually 2-6 weeks post MI.

Autoimmune attack on myocardium

29
Q

What does the ECG image indicate

A

Digitalis toxicity. Usually acompinied by hypekalaemia, GI dystress arrythmias.

Digibindin is used as treatment.

30
Q

What are SVTs and how are they treated?

A

Artrial tachycardia, Atrial flutter and Atrialventricular nodal ventrant tachycardias (AVNRT).

Haemodynamically stable use Carotid sinus masage and adenosine.

If haemodynamically unstable then try DC cardioeversion.

31
Q

What qualifies someone as haemodynamically unstable?

A

HR

BP

Hypoxic

Heart failure

32
Q

What criteria is used for heart failure?

A

Framingham Criteria

33
Q

How is heart failure diagnosed using the Framingham Criteria?

A

2 Major symptoms

1 Major and 2 Minor symptoms

34
Q

What are major symptoms of the Framingham Criteria?

A

SAW PANIC

S3

Acute pulmonary oedema

Weight loss

PND

Abdominal hepatic reflux

Neck dystension

Increased cardiac shadowing on CXR

Crackles on lung bases

35
Q

What are minor symptoms of the Framingham Criteria?

A

HEARTVN

Hepatomegaly

Effusion

Ankle oedema bilaterally

exeRtional dyspnoea

Vital capactiy (1/3)

Nocturnal cough

36
Q

What is the management of Torsades de pointes (haemodynamically stable)?

A

IV magnesium sulphate

37
Q
A