cardio Flashcards
which type of ventilation is used in patients with type 2 respiratory failure
Bipap adn in type 1(hypoxia with normal c02) resp failure the ventilation should be cpap
which medication can be used in patient with family history of ventilation difficulty and having trouble ventilation during anaesthetic
rocuronium
which anti-emetic drug is good for post op nausea and vomiting
odansterone which is a centrally acting 5ht3 inhibitor.
Coved st elevation in V1 and v2 of >2mm and followed by negative t waves is a characteristic of
brugada syndrome
what is the management of narrow complex tachycardia? in a patient wh has asthma
verpamil and if no asthma then adenosin 6mg bolus….first vasalva should be tried then these
what is the normal length of pr interval
120 to 200ms…..from beging of p wave to beginning of qrs….and qt is start of the q wave to the end of the t wave
downslopping st segment depression is seen in
digoxin therapy…reverse tick st segments
what is the treatment for rheumatic fever
iv benzylpenicillin followed by phenoxymethylpenicillin
mid systolic click with a late systolic murmur is suggestive of
mitral valve prolapse,,,,,,,,marafan syndrome
when do you choose CABG over angina in a patient with stable angina
over 65, 3 vessel disease or has diabtes…Note that PCI may be more cost-effective than CABG, but CABG has a mortality advantage over patients who:
what are the 3rd line management for stable angina
long acting nitrate, ivabradin(cannpt use if hr <70), ranolazine or nicorandil
which drug is known for shortening th eqt interval?
digoxin
ejection systolic murmur which i squiter on valsalva or squatting is
HOCM (left ventricle outflow obstruction) it can also have pan systolic murmur due to mitral regurg
Pan systolic murmur heard best on the apex after anterior wall mi is due to
mitral regurgitation
wat is the maximum dose atropine that can be used in bradycardia and what is the next step
500mcg 6 doses. transcutaneous pacing should be tried first before transvenous pacing.
wpw causes
preexcitation of the ventricles
what is the management of infective endocarditis caused by streptococcus(gram positive coccus in chain)
benzylpenicillin and gentamycin(6weeks)////PR interval prolongation in a patient with Infective Endocarditis is an indication for surgery as it can be secondary to aortic root abscess
for infective endocarditis caused by gram positive cocci in cluster
staph aureus- flucox plus gentamycin
ST Segment depression with chest pain but normal trop will be
unstable angina and treated as per acs protocol….for it to nstemi the troponin level should be positive
mid diastolic rumbling murmur heard best on the left sternal border is most likely
acute aortic regurg
BNP is released by
ventricles in the stress of overwork
in a patient who has strep bbovis causing tricuspid vegetation what Is the investigation that can be done to find the source of infection?
colonoscopy becasue s bovis is normallyy implicated in colorectal cancer and if here is a breach n the gut then the bateraemia can cause infective endocarditis.
which anti coag is licensed for valvular AF
warfrin
what is the axis deviation expected in inferior wall mi?
left (-30 to -90 degree) (lead 1 is positive an dlead 2 is negative)…..right axis is when 1 is negative and 2 is positive then right axis(+90 to +180)////////normal axis is -30 to +90
which kind of heart block is seen in professional athletes
mobitz type 1 where there is gradual prolonging of the pr interval with a subsequent missed qrs. it is also seen in people who are on bet blocker and digoxin
what is the management of ventricular tachy who is stable?
iv 300mg amiodarone with later 900mg in 24 hr if they are unstable then go for cardioversion
what is the management of aortic stenosis in 80 year old
TAVI(transcatheter aortic valve implant) is preferred over surgical valve replacement in 75 year sand aboe
treatment of af in a heart failure patient is
digoxin
what is the HASBLED score cuttoff for anticoag
should be less than 3…. hypertension, renal or liver(2), stroke, bleeding episode, labile inr, elderly more than 65 and drugs or alcohol
in a young patient whi gets paroxysmal af what is the management ?
pill in the pocket strategy- prescribe either flecanide or sotolol
In terms of ACS what is the first line anti hypertesnive that should be used
iv GTN
what are the rules regarding cardioversion in AF for a patient where the symptoms started quite early
anti coagulate minimum 3 weeks before the cardioversion and anti coagulate till 4 weeks after the event.
In a patient with irregular narrow complex tachycardia.
with a past medical history of asthma.
What is the single most appropriate management at this stage?
diltiazem or verapamil…..normaly we use beta blocker.
chest pain on exertion in a young man who does cociane is most likely due to
coronary artery vasospasm
what are the causes of high output cardiac failure?
anaemia, thyrotoxicosis, pregnancy, thiamine deficiency
what kind of ecg would you see in a patient with right ventricular pacing
spike before qrs and m shaped pattern in V5.V6
In atrial pacing the pacing spike precedes the P wave.
In ventricular pacing the pacing spike precedes the QRS complex.
In right ventricular pacing the QRS morphology is similar to left bundle branch block.
In left ventricular pacing the QRS morphology is similar to right bundle branch block.
In dual chamber pacing there may be features of atrial pacing, ventricular pacing, or both.
what is considered as prolonged qt in woman and man
woman >460 and man >440ms
eye manifestation of infective endocarditis>
roth spots- which is small retinal haemorrhage
ABCDEF of the chest xray in chronic heart failure is
alveolar edema, b kerley b line, cardiomegaly, diiversion of blood in the upper lobe, pleural effusion and fluid in the horizontal fissure
which electrolyte imbalance can give j waves on the ecg?
hypercalcemia
pulmonary stenosis is seen in which syndrome?
noonans
in a patient wth heart failure who are on maximum medical therapy and ecg shows wide qrs what could b the management?
cardiac resynchronisation therapy device
dvla rule regarding implantable defib
6months no driving
apical to radial pulse delay is seen in
AF
antidote of beta blocker
glucagon
what is the first line of management of dresslers syndrome?
high dose aspirin
pan systolic murmur that radiates to the axilla
mitral regurgitation is due to papillary muscle rupture.
what i ste management of AF IN acute setting if the af started 3 days ago
you try to rate control first
in a patient with angina on exercising who has renal impairment what is the imaging that can be used?
myocardial perfusion scan or stress echo as the contrast would not be tolerated well.
