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Y3 symptoms > cardiac > Flashcards

cardiac Flashcards

1
Q

palpable pulsatile abdominal mass, abdo/back pain, HTN

A

AAA

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2
Q

central crushing chest pain that radiates to arms/neck/jaw, pallor + sweating

A

ACS (unstable angina, STEMI, NSTEMI)

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3
Q

unexplained weight loss, fatigue, oedema that is resistant to diuretic therapy, periorbital purpura, neuropathy, waxy skin, easy bruising

A

amyloidosis

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4
Q

punched out, elliptical ulcer with defined edges and grey base on feet / legs. night pain relieved by dangling legs off bed

A

Arterial ulcer

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5
Q

cetral tearing chest pain that may radiate to between shoulder blades. BP difference between arms of >20mmHg

A

aortic dissection

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6
Q

end-diastolic soft murmur, louder at sternal border or when pt sits forward, louder at end of expiration,
water hammer pulse (rapidly appearing and disappearing pulse at corotid)
visible pulsation on nail bed/in eyes/neck
head nodding in time with pulse

A

aortic regurgitation

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7
Q

worsening SOB (esp on exertion), high pitched ejection systolic murmur, heaving apex beat, slow rising pulse, narrow pulse pressure, exertion syncope, leg swelling

A

aortic stenosis

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8
Q

irregularity irregular tachycardia with no p waves

A

AF

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9
Q

young athletes with no PMH presenting with syncopal episodes

angina, palp, jerky carotid pulse, double apex beat but not displaced, ejection systolic murmur

A

hypertrophic cardiomyopathy

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10
Q

tricuspid +mitral regurge murmur, apex beat displaced

association with alcohol

A

dilated cardiomyopathy

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11
Q

painless swollen leg, erythema, skin colour changes. calf pain when forced dorsiflexion of ankle
RF - recent surgery, immobile, obese

A

DVT

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12
Q

area of oedema/erythema, blisters, extreme out of proportion pain, signs of sepsis/systemic inflam

A

necrotising fascitis

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13
Q

orthopnoea, exertion dyspnoea, paroxysmal nocturnal dyspnea, fatigue, nocturnal cough (w/ pink frothy sputum), wheeze, displaced apex beat, S3 gallop rhythm

A

LHF

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14
Q

oedema, weight gain, nocturia, dec exercise tolerance, inc JVP, facial swelling

A

RHF

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15
Q

fever with sweats and chills, malaise, arthralgia, confusion, signs of anaemia, pyrexia, tachycardia, vasculitis, rheumatoid factor in blood

A

infective endocarditis

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16
Q

high pitched pan-systolic murmur louder in inspiration, S3, displaced apex beat

A

Mitral regurg

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17
Q

mid diastolic, low-pitched rumbling murmur at apex, louder when pt lies on left side, loud S1, opening snap
associated with AF and malar flush

A

mitral stenosis

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18
Q

flu like prodrome, SOB, palp, positional chest pain (worse when lying down)
bloods - raised CK and troponins

A

myocarditis

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19
Q

sharp, central pleuritic chest pain relieved by sitting forward , pericardial friction rub, tamponade
widespread saddle shaped ST elevation

A

pericarditis

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20
Q

painfull, pulseless, paralysed, perishingly cold, pale limb with paraesthesia

A

acute limb ischaemia

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21
Q

progressive SOB, weakness, dizziness, angina, RV heave, tricuspid regurg, raised JVP

A

pulmo HTN

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22
Q

fever, joint pain, malaise, SOB, chest pain, palp, recent sore throat, chorea, small painless SC nodules seen on joints/tendons, erythematous rash with raised edges

A

rheumatic fever

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23
Q

regular, narrow complex tachycardia with no p waves,

A

SVT

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24
Q

slurred upstroke QRS on ECG

A

WPW syndro

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25
Q

pan systolic murmur heard at lower left sternal border, louder on inspiration, inc JVP, pulsatile liver

A

tricuspid regurg

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26
Q

large, shallow painless ulcers with an ire margin situated above the medial malleoli, swelling and itching

A

venous ulcers

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27
Q

irreg, broad complex tachycardia that can cause cardiac arrest and SCD, pulseless

A

vent fibrilation

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28
Q

regular broad complex tachycardia, symptoms of heart failure

A

vent tachycardia

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29
Q

Whats the management for STEMI

A

MONA BASH

morphine, oxygen, nitrates, anti-platelets (aspirin + clopidogrel), BB, ACEi, statins, heparin

30
Q

Management for NSTEMI/unstable angina

A

1 - aspirin + clopidogrel
2 - fondapurinux if low bleeding risk
3 - unfractionated heparin if coronary angiogram plannned

31
Q

What is the investigation of choice for an arterial ulcer

A

Duplex USS of lower limbs

32
Q

what CXR changes would you see with an aortic dissection

A

widened mediastinum

33
Q

what is an austin-flint murmur`

A

mid-diastolic rumbling murmur heard at apex. associated with aortic regurg

34
Q

what is the management plan for AF

A

If haemodynamically unstable - DC cardioversion

1 rhythm control - DC or chemical cardioversion
2 - rate control - verapamil, BB, digoxin
3 - check stroke risk, high - warfarin

35
Q

What drugs can be used for a chemical cardioversion

A

flecainide (contraindicated if prev Hx of IHD) or amialdarone

36
Q

What ECG changes would you see with atrial flutter

A

SAW tooth

37
Q

What would you use to check the risk of stroke in AF

A

CHAD2 score

CHF (+1), HTN (+1), Age >75 (+2), DM (+1), prev stroke/TIA (+2)

If 0 or 1 - aspirin, if >2 then warfarin

38
Q

What are the 8 main causes of cardiac arrest

A

4H - hypothermia, hypoxia, hypovolaemia, hypokalaemia

4T - toxins, thromboembolic, tamponade, tension pneumothorax

39
Q

what is homan’s sign

A

forced dorsiflexion of ankle -> calf pain

indicates DVT

40
Q

what is the most common cause of recurrent DVTs at a young age

A

inherited disorer

Factor V lieden - mut of factor 5 makes it resistance to degradation by protein C -> inc F5 -> procoagulant state -> DVT

41
Q

What JVP signs can be seen with complete heart block

A

Cannon A waves - large volume pulses

42
Q

What is the first step of management fo acute heart block

A

IV atropine

43
Q

what are the steps of management for chronic heart failure

A 
1 - ACEi (enalapril)
2 - BB (bisoprolol)
3 - duretics - if evidence of fluid retention
4 - Digoxin 
5 - treat cause
44
Q

what 5 CXR changes can be seen with chromic heart failure

A

Alv oedema, B-lines, Cardiomegaly, Dilated upper lobe vessels, pleural Effusion

45
Q

what is cor pulmonale

A

enlargement and failure of RV due to inc lung pressure/vasc resistance

46
Q

What are the management steps for acute HF

A 
Sit Pt up and give high flow O2
furosemide (loop diuretic)
GTN infusion
CPAP
treat cariogenic shock if hypotensive
47
Q

how would you manage HTN if <55 and not afro-caribbean

A

1 - ACEi (switch to ARB if develop cough)
2 - ACEi/ARB + CCB
3 - + thiazide diuretic

48
Q

how would you manage HTN if >55 or AC

A

1 - CCB
2 - CCB + ACEi/ARB
3 - + thiazide diuretics

49
Q

what type of drugs end in -pril

A

ACEi

50
Q

what type of drugs end in -tan

A

ARB

51
Q

what type of drugs end in -dipine

A

CCB

52
Q

what type of drugs end in -ide

A

thiazide diuretic

53
Q

what type of drugs end in -olol

A

BB

54
Q

what type of drugs end in -osin

A

Alpha B

55
Q

what are the complications of ACEi

A

cough, inc potassium/creatinine

56
Q

what are the complications of CCB

A

swelling +angiooedema

57
Q

what level is considered level 3 HTN and a medical emergency

A

180/120

58
Q

what’s the target BP for someone <80

A

140/90

59
Q

what’s the target BP for someone >80

A

150/90

60
Q

what are the most common causes of infective endocarditis

A

strep (40%)
staph (35%)
enterococci (20%)

61
Q

what autoantibody is found in the blood with inf endocarditis

A

rheumatoid factor

62
Q

what murmur is often associated with AF

A

mitral stenosis - mid diastolic low pitched murmur

63
Q

how can you tell the difference between myocarditis and pericarditis

A

cardiac biomarkers raised in myocarditis but not pericarditis (CK and troponins)

64
Q

pain in calf on exercise

A

PVD - intermittent claudation of femoral a.

65
Q

pain in buttock on exercise

A

PVD - intermittent laudation of iliac a

66
Q

what inv would confirm pulmo HTN

A

R H catheterisation

67
Q

what causes rheumatic fever

A

Group A strep throat inf

68
Q

what is the management of SVT

A

if haemo unstable - DCC

1 - vagal manœuvres + chemical cardioversion
2 - adenosine

69
Q

when is adenosine contraindicated

A

in asthma - use verapamil

70
Q

what murmur is associated with infective endocarditis

A

Tricuspid regurg - pan-systolic

71
Q

what is the management of VF

A

urgent defib and cardioversion

72
Q

what ECG change is seen in WPW syndro

A

delta wave

Y3 symptoms (15 decks)

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