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Capsule notes > Cardio > Flashcards

Cardio Flashcards

1
Q

AF is likely indicated in which valve problem?

A

Mitral problems

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2
Q

most common cause of mitral stenosis?

A

rheumatic fever

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3
Q

signs on examination of mitral stenosis

A 
tapping apex beat (palpable and loud first sound)
low rumbling mid-diastolic murmur
Malar rash
AF
low volume pulse
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4
Q

signs of mitral stenosis on ECG

A

bifid P waves (P mitrale, left atrial enlargement) or no P waves

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5
Q

ECG changes in hypokalaemia

A

U waves
flattened/inverted T waves
tall p waves
ST depression

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6
Q

ECG changes in WPW

A

Delta waves

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7
Q

Management of viral pericarditis

A

NSAIDs (aspirin or ibuprofen)
PPI
Colchicine
Bed rest

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8
Q

where is the needle inserted for pericardiocentesis

A

subcostally in midline aiming for left shoulder

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9
Q

what % of acute pericarditis recurs

A

15-30%

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10
Q

signs of aortic stenosis

A

slow rising pulse
narrow pulse pressure
ES murmur radiating to neck

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11
Q

treatment of choice for severe aortic stenosis

A

valve replacement
valvuloplasty/transcatheter aortic valve implantation may be attempted if pt unfit for open surgery

long term Abx

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12
Q

most common cause of aortic stenosis in <60

A

bicuspid valve

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13
Q

management for post-MI VSD

A

analgesia
inotropes
balloon pump (counterpulsation inside aorta to augment BP during diastole)
Closure of defect (percutaneous or can be surgery)

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14
Q

structural abnormalities associated with WPW

A

ventricular hypertrophy

Ebstein’s anomaly

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15
Q

what bloods is most important in WPW

A

thyroid function

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16
Q

medical management of WPW

A

flecainide
Amiodarone

avoid drugs that block AV node alone (digoxin, verapamil, bblockers etc)

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17
Q

if a patient has heart failure leading to pulmonary oedema and low blood pressure, how do you manage?

A

CPAP - allows lung fluid to be pushed back into vasculature

can’t use furosemide due to low BP
can’t give fluids due to pulmonary oedema

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18
Q

what medicines should patients be on post-MI

A

aspirin + clopi
bisoprolol
statin
ramipril

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19
Q

most common branches of aorta affected in dissection

A

renal, spinal, coronary or iliac arteries

can also dissect back into aortic valve causing regurg

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20
Q

what is the cause of death in HOCM

A

arrhythmia due to increased metabolic demand of muscle and reduced blood supply

also obstruction to aortic outflow

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21
Q

inheritance pattern of HOCM

A

AD

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22
Q

Management of HOCM

A

beta blockers + CCB to reduce load on left ventricle
amiodarone to reduce chance of arrhythmia
ICD in high risk patients
Cardiac surgery if aortic outflow obstruction severe

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23
Q

symptoms of HOCM

A 
mostly symptomless
angina
dyspnoea
syncope
systolic murmur (thickened septum leads to mitral valve problems and obstructed aortic outflow)
24
Q

3 investigations for DVT diagnosis

A

couler USS doppler
D-dimer
Venometry

25
Q

INR range for uncomplicated DVT

A

2-3

26
Q

INR range for prosthetic heart valve

A

3.5-4.5

27
Q

infections that can cause sinus bradycardia

A

Legionnaire’s
typhoid
lyme disease

28
Q

investigations for infective endocarditis

A 
ECG - heart block
TTE - valvular vegetations
mid-stream urine MC&S
USS abdo - splenic infarcts
3 sets of blood cultures
may do serology for atypical organism
29
Q

major criteria for infective endocarditis

A

typical organism from 2 BC OR persistent positive blood culture
Evidence of endocardial involvement

culture NOT to be taken from indwelling line

30
Q

minor criteria for infective endocarditis

A 
fever
risk factors
vascular phenomena (stroke etc.)
immunological phenomena (RhF, glomerulonephritis, osler nodes etc.)
micro evidence
echo
31
Q

complications of infective endocarditis

A 
heart block
TIA
AKI
HF
vertebral osteomyelitis
32
Q

ECG changes in digoxin

A

downsloping ST depression in V5/6
flattened, inverted or biphasic T waves
short QT itnerval

frequent premature ventricualr contractions, sinus brady, av block in toxicity

33
Q

Symptoms of digoxin toxicity

A 
altered bowel function
visual disturbance
headache
dizziness
confusion
34
Q

how to confirm digoxin toxicity

A

measure 6h post dose blood level

35
Q

how long can you not drive for post-infarct with deranged LVEF/symptomatic heart failure

A

4w

36
Q

how long can you not drive for post-infarct with normal LVEF

A

1w

37
Q

management of type B aortic dissection

A

conservative (pain and blood pressure management) if stable

urgent surgery if unstable

38
Q

management of type A aortic dissection

A

urgent surgery

39
Q

heart failure drugs

A 
beta blocker
acei/arb
spironolactone
statin
SGLT2i
ezetimibe
PCSK9i
dual antiplatelet if MI
PPI
40
Q

which leads are the high lateral vessels

A

I and aVL

41
Q

management of NSTEMI

A

aspirin + ticagrelor
LMWH/fondaparinux
morphine and metoclopramide
anti-anginal medication (GTN beta blocker amlodipine)
revascularisation doesn’t necessarily need to be done immediately
echo

42
Q

what drug held for 48h before and 48h after angio

A

metformin, fucks kidneys

43
Q

symptom control in stable angina

A

1:GTN

2: add bisoprolol
OR rate limiting CCB (verapamil, dilt)

3: add GTN + BB + NON-rate limiting CCB (amlod)
4: Add ivabradine OR nicorandil OR ranolazine

Also get atorvastatin for long-term mortality

44
Q

contraindication for ivabradine

A

AF, as it disrupts If

45
Q

contraindication to adenosine

A

asthma, so give verapamil if SVT

46
Q

management of SVT

A

1) vagal manoeuvres
2) adenosine or verapamil
3) DC cardiovert if unstable
if first presentation and treated, give conservative mx
svt ablation if recurrent or bisoprolol

47
Q

what drugs can cause extremis

A

flecainide

48
Q

what is the pill in the pocket

A

carry around fleicainide for paroxysmal AF

49
Q

management for VT

A

magnesium
amiodarone
dc cardiovert

NOT FLECAINIDE

50
Q

causes of raised JVP

A 
RHF
fluid overload
SVC compression - non-pulsatile 
pericardial effusion
Tricuspid regurg
complete heart block
51
Q

complications of prosthetic heart valves

A 
endocarditis
PE
infection
bleeding
anaemia
failure
52
Q

causes of irregularly irregular pulse

A

ventricular ectopics

flutter with variable block

53
Q

describe mitral stenosis

A

low pitched rumbling mid-diastolic murmur best heard in left lateral position on expiration

54
Q

complications of mitral stenosis

A

pulmonary hypertension

AF

55
Q

signs of pulmonary hypertension

A

loud p2
left parasternal heave
graham steel murmur (early diastolic)

Capsule notes (7 decks)

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