Brainscape's Knowledge GenomeTM

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


See full index

Year 3 > Cadiac TCD Notes > Flashcards

Cadiac TCD Notes Flashcards

1
Q

Which murmurs are present in systole

A

‘Flow murmurs’

  • Aortic/ pulmonary stenosis
  • mitral/tricuspid regurgitation
  • Ventricular septal defect
  • Aortic outflow tract obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which murmurs occur in diastole

A
  • Aortic/ pulmonary regurgitation

- Mitral/ Tricuspid Stenosis

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

Which murmurs are continuous

A

Patent ductus arteriosis (only happens in children)

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

What are the gradings of murmurs

A

Grade one: barely audible
Grade two: soft, but easily heard
Grade three: loud
Grade four: associated with a thrill

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

What are the here basic shapes of murmurs?

A

Crescendo-decrescendo
Decrescendo (often in diastole)
Uniform

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

When does Aortic regurgitation happens?

A

Diastole

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

When does mitral regurgitation happen?

A

Holosytolic

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

When does mitral stenosis happen?

A

Holodiastolic

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

Three most common causes of diabetes

A

Ischaemic
Hypertension
Diabetes (diabetic cardiomyopathy or vis CAD)

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

Name for when breathlessness causes a patient to wake up suddenly in the middle of the night

A

Paroxysmal nocturnal dyspnoea

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

Scale to use to describe heart failure gradings

A

New York Heart Association
Four classes
No symptoms and no limitation in normal activity all the way to severe symptoms at rest

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

Signs of heart failure

A 
Pulmonary oedema or pleural effusion 
Raised JVP 
Pitting oedema 
Ascites 
Tachycardia 
S3 gallop
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What sort of diagnosis is heart failure?

A

A clinical diagnosis

  • symptoms
  • signs
  • Objective evidence of structural or functional cardiac abnormalities at rest

ECHO ALONE DOES NOT DIAGNOSE HEART FAILURE

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

Is heart failure a diagnosis or a syndrome?

A

Syndrome not a diagnosis. It is always se on dart or the cause of something

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

Investigations for heart failure

A 
Bloods
- anaemia and b12 can be a cause 
U+E 
TFT as hyper and hypo can be a cause 
Glucose for diabetes

BNP

  • normal levels rule out heart failure
  • provides prognostic information
  • RAISED IS NOT SPESIFIC

CXR for pulmonary effusions and oedema

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

Uses of Echocardiogram in HF

A

Provides info on ejection fraction - normal is 60%

Helps look at ateology
Valves
Chamber size - dialated atrium

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

HF with preserved LV function

A

EF >45%

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

HF with LV systolic dysfunction

A

EF <45%

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

AF ECG

A

No P waves

Irregularly irregular

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

What does LVH on ECG suggest?

A

Hypertension, aortic stenosis, HOCM

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

Treatment of heart failure with impaired systolic function?

A 
Diuretics
ACE inhibitors 
B-Blockers 
Aldosterone receptor antagonists 
Devices: CRT/ ICD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Treatment of heart failure with preserved LV function

A

Diuretics

Treatment of co-morbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Three ways that ACE-I help HF

A

Inhibit LVH and remodelling
Inhibit vasoconstriction
Decrease water and salt retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which BBlockers is not licensed for heart failure?

A

Atenolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does ICD stand for?

A

Implantable cardia defibrillators, which treats sudden cardiac death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Why are LFTs important when investigating heart failure?

A

Pulmonary congestion can cause associated liver congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is atrial myxoma?

A

A tumour in the atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What do you hear in mitral stenosis?

A

Mid diastolic rumbling murmur
Loudest at apex with bell of stethoscope
Loudest with patient rolled onto left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Long rumbling murmur in kids

A

Patient foramen ovale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What type of calcium channels are in the heart?

A

L type calcium channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is early after depolarisation or EAD?

A

Abnormal depolarisation and following action potentials after normal repolarisation has happened

Causes long QT syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the signs of infective endocarditis?

A
  • Petechiae
  • Splinter haemorrhages
  • Oslr nodes
  • Janeway lesions
  • Roth spots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do you diagnose infective endocarditis?

A

Duke Criteria

Two major or one major plus three minor or five minor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

When is BCNEI most likely?

A

After antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Chain of clinical investigations following symptoms of AF?

A

Feel pulse, if irregular:
Do an ECG, if AF:
do TTecho or TOecho

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the clinical scoring system for stroke risk?

A

CHA2DS2-VASC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the clinical scoring system for bleeding risk?

A

HAS-BLED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

When do you not give anti stroke medication in AF?

A

If under 65 and no risk factors of CHA2DS2-VASC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What do you do if AF and CHA2DS2-VASC great than or equal to 2?

A

Give anti coagulation medication e.g apixaban, dabigatran, wafrin, rivaroxiban

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

If high stroke risk and AF but anti coagulation isn’t possible what should you do?

A

Consider left atrial appendage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What do you give for suitable patients in New or reversable AF with no HF?

A

Give rate control drugs. Beta blockers or calcium channel blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

If paroxysmal or persistant AF and risk factors for stroke what do you give?

A

Dronedarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What value of BNP rules out heart failure?

A

less than 100ng/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What should you do next if you suspect heart failure in a patient with BNP over 100ng/L?

A

Perform TTecho for cardiac abnormalities

45
Q

Flow chart for acute HF

A

once diagnosed by TTecho give diuretics if acute

Once stable give beta blockers unless second or third degree heart blocker or cardiogenic shock

Restart or start BB in LVD once IV diuretics no longer needed.

46
Q

What do you give in HF if reduced LV ejection fraction?

A

ACE-I and aldostrone antagonist

47
Q

What should you monitor after enitial treatment of acute HF?

A

HR, BP, U+E, renal function

48
Q

What is the new clinical measure for heart failure?

A

NT-proBMP

49
Q

If proBMP over 2000?

A

urgent referral for TTecho

50
Q

If proBMP less than 400

A

Dx HF unlikely

51
Q

What can cause low levels of proBMP?

A

Obesity, african, afro-carrib, diuretics, ACE-I, BBlockers, ARBs, MRAs

52
Q

What can cause a high level of BMP?

A

old age, LVH, tachycardia, hypoxemia, renal dysfunction (eGFR less than 60), COPD and sepsis

53
Q

What medication should you avoid in HF with reduced EF?

A

verapamil, diltazem

54
Q

What medication is contraindicated in liver failure?

A

amiodarone

55
Q

What do you have to do in AF before cardioversion to rule out clots?

A

TTecho

56
Q

what do you give for AF with HF?

A

Digoxin

57
Q

When can’t you give DOACs?

A

renal insufficiency

58
Q

How long do you give anti coagulation for after AF cardiovascular

A

four weeks

59
Q

If there is a thrombus in AF how long do you give hep/warf before cardioversion?

A

FOur weeks

60
Q

What type of diuretic is strongest?

A

Loop diuretics

61
Q

If HF with LVEF less than 35% with no left bundle branch block

A

Give ICD

62
Q

If HF with LVEF less than 30% with LBBBlock what do you do?

A

cardiac resynch thrapy or CRT

63
Q

How to diagnose ST elevation in 12 lead ECG

A

> /= 1mm ST elevation in leads II and III

64
Q

Ejection systolic murmur heard loudest in the aortic area radiating to the carotids. Answer:

A

Aortic stenosis

65
Q

Mid-diastolic rumbling murmur, heard best with the bell of the stethoscope at the apex with the patient in the left lateral position. Answer:

A

Mitral stenosis

66
Q

Pansystolic murmur heard loudest at the apex of the heart radiating to axilla. Answer:

A

Mitral regurgitation

67
Q

Early diastolic murmur heard best at the left 4th intercostal space with the patient sat forward in expiration. Answer

A

Aortic regurgitation

68
Q

Secondary prevention of ACS

A 
aspirin
a second antiplatelet if appropriate (e.g. clopidogrel)
a beta-blocker
an ACE inhibitor
a statin
69
Q

Once MONA has been used for ACS, if a ECG shows NSTEMI what should you give patients STAT?

A

LMWH

70
Q

Differential for hypotension, arrhythmias or pulmonary oedema?

A

silent MI - common in diabetes and elderly

71
Q

ECG leads in inferior infarcts

A

Leads II, III and AVF.

72
Q

ECG leads in lateral infarct

A

AVL and V5-V6

73
Q

ECG leads in anterior infarcts

A

V2-V4

74
Q

ECG changes posterior infarct

A

all R waves, ST depression in V1 and V2

75
Q

Investigations for MI

A 
ECG 
Troponins 
CXR 
FBC 
Serum urea and electrolytes 
Lipids - 12 hours from onset window 
Glucose
76
Q

Time window for MI thrombolysis

A

12 hours from onset

77
Q

What drugs should patients be on post MI

A 
Asperin 
Second antiplatelet 
ACE-I 
B blockers 
Statins 
Aldosterone antagonist if heart failure with reduced ejection fraction
78
Q

If post MI with heart failure with reduced ejection fraction, what additional drug can be given?

A

Aldosterone antagonist e.g eplerenone 25mg/day

79
Q

Type of MI associated with post bradycardia?

A

Acute inferior wall MI

80
Q

Treatment for ventricular tachycardia?

A

I.V amiodarone if vagal vagal fail

81
Q

Anti hypertensives you can use in pregnancy

A

Methyl dopa
Labetalol
Nifedepine

82
Q

Side effects of calcium channel blockers

A

Flushing
Ankle swelling
Headache

83
Q

Side effects of ACE I

A

cough

hyperkalaemia

84
Q

Side effects of Thiazide type diuretics

A

Hyponatraemia
Hypokalaemia
Dehydration
(thiazide leads to hypos)

85
Q

Side effects of A2RB

A

Hyperkalaemia

86
Q

Stage one hypertension

A

Clinic BP >= 140/90 mmHg and subsequent ABPM daytime average or HBPM average BP >= 135/85 mmHg

87
Q

Stage two hypertension

A

Clinic BP >= 160/100 mmHg and subsequent ABPM daytime average or HBPM average BP >= 150/95 mmHg

88
Q

Severe hypertension

A

Clinic systolic BP >= 180 mmHg, or clinic diastolic BP >= 110 mmHg

89
Q

If there is a difference in BP in both arms, which one should be used?

A

Higher BP arm

90
Q

If there are higher and lower readings for BP from both arms, which reading should you use?

A

Lowest

91
Q

Signs of phaeochromocytoma in hypertension

A

labile or postural hypotension, headache, palpitations, pallor and diaphoresis

92
Q

When to medically treat stage two hypertension

A

; target organ damage, established cardiovascular disease, renal disease, diabetes or a 10-year cardiovascular risk equivalent to 20% or greater

93
Q

Age of patient for consideration of secondary cause of hypertension

A

Less than 40 years

94
Q

Which thiazide diuretics to use in hypertension

A

chlorthalidone or indapamide

95
Q

define treatment resistant hypertension

A

Higher than 140/90 after three drugs, add forth drug and consider referral

96
Q

Step four hypertension treatment if potassium < 4.5 mmol/l

A

spironolactone

97
Q

step four hypertension treatment if potassium >4.5

A

add higher-dose thiazide-like diuretic treatment

98
Q

BP targets in hypertension

A

Age < 80 years 140/90 mmHg 135/85 mmHg

Age > 80 years 150/90 mmHg 145/85 mmHg

99
Q

Define pre-eclampsia

A

Pregnancy-induced hypertension in association with proteinuria (> 0.3g / 24 hours)

100
Q

Most common reason for hypertension in children

A

Renal paranchymal disease (80%)

101
Q

Most common cause of secondary hypertension

A

Primary hyperaldosteronism

102
Q

NICE recommend the following blood pressure targets for diabetics:

A

if end-organ damage (e.g. renal disease, retinopathy) < 130/80 mmHg
otherwise < 140/80 mmHg

103
Q

Idiopathic intracranial hypertension management

A

Weight loss, diuretics e.g. acetazolamide and topiramate

104
Q

Which type of calcium channel blockers are safest to use in heart block and heart failure?

A

Nifedipine, amlodipine, felodipine as they are dihydropyridines

105
Q

Which calcium channel blocker can’t be used with beta blockers due to causing heart block and heart failure?

A

Verapamil

106
Q

What blood pressure medication can cause gout

A

thiazide diuretics

107
Q

Three drugs that cause hypertension

A

combined oral contraceptive pill
corticosteroids
ciclosporin

108
Q

Pulmonary hypertension and the JVP

A

a large A wave in the JVP

109
Q

Causes of raised ICP by drugs

A

lithium
corticosteroids
isotretinoin

Year 3 (26 decks)

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