cardiac conditions

Question 1

1st degree heart block on ECG

Answer 1

prolonged PR interval

Question 2

2nd degree heart block mobitz I on ECG

Answer 2

PR interval gets longer and longer until missed QRS complex

Question 3

2nd degree heart block mobitz II on ECG

Answer 3

QRS regularly missed

Question 4

3rd degree heart block on ECG

Answer 4

P wave and QRS complex independent of each other

Question 5

Causes of 1st and 2nd degree heart block

Answer 5

IHD, acute myocarditis, drugs (digoxin)

Question 6

Dressler syndrome

Answer 6

autoimmune-mediated pericarditis 2-6 weeks post MI

Question 7

coarctation of the aorta

Answer 7

congenital narrowing of the descending aorta

associations bicuspid aortic valce, turners syndrome

Question 8

Cardiac tamponade

Answer 8

pericardial cavity fills with blood putting pressure round the heart

Question 9

pericardiocentesis

Answer 9

removes fluid from pericardial cavity

needle inserted infer sternal angle

Question 10

two branches of right coronary artery

Answer 10

right marginal artery

posterior interventricular artery

Question 11

branches of left coronary artery

Answer 11

left anterior descending artery
left marginal artery
circumflex artery

Question 12

venous drainage of the heart

Answer 12

coronary sinus- short venous conduit which receives deoxygenated blood for cardiac veins

Question 13

branches of the aorta

Answer 13

coronary arteries > brachiocephalic trunk > left common carotid artery > left subclavian artery

Question 14

atherosclerosis causes

Answer 14

primary endothelial injury (smoking, hypertension, hyperlipidaemia)
accumulation of lipids and macrophages
migration of smooth muscle cells
increase in size

Question 15

Angina

Answer 15

pain or discomfort in the chest due to insufficient blood flow to the heart muscles

Question 16

angina causes

Answer 16

atheroma

rarely caused by anaemia, coronary artery spasm

Question 17

presentation of stable angina

Answer 17

pain brought on by exertion and relieved by rest

Question 18

presentation of unstable angina

Answer 18

unpredictable and can occur on mild exertion or none at all

Question 19

types of ACS

Answer 19

unstable angina
NSTEMI
STEMI

Question 20

causes of ACS

Answer 20

due to plaque rupture, thrombosis and inflammation

Question 21

Acute limb ischaemia

Answer 21

sudden decrease in arterial blood flow to a limb, that threatens its viability

Question 22

causes of acute limb ischaemia

Answer 22

thrombosis- malignancy, hypotension
embolism- AF, MI
traume- iatrogenic

Question 23

risk factors for acute limb ischaemia

Answer 23

smoking 
diabetes
obesity 
hypertension
hypercholesterolaemia

Question 24

presentations of acute limb ischaemia

Answer 24

6Ps
perishingly cold
pallor
pain 
pulselessness
pale 
paralysis

Question 25

investigations for acute limb ischaemia

Answer 25

ABI- ankle brachial index (claudication- 0.4-0.85 or severe <0.4)
Doppler US
ECG- AF

Question 26

complication of acute limb ischaemia

Answer 26

extensive tissue necrosis

limb amputation

Question 27

treatment of acute limb ischaemia

Answer 27

medical- IV heparin converted to oral anti-coagulants if ciable
surgical- embolectomy
endovascular- aspiration, catheter

Question 28

Varicose veins

Answer 28

valves connecting deep and superficial systems become incompetent > blood flows backwards > venous dilatation

Question 29

Patent ductus arteriosus

Answer 29

form of congenital heart defect

connection between the pulmonary trunk and descending aorta

Question 30

signs of patent ductus arteriosus

Answer 30

left subclavicular thrill
continuous 'machinery' murmur
large volume, bounding, collapsing pulse
wide pulse pressure
heaving apex beat