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Year 6 > Cardio > Flashcards

Cardio Flashcards

1
Q

Long term Medical treatment of MI

A

ACEi
Beta blocker
Statin
Dual AP

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2
Q

Immediate treatment of MI

A

DAPT- 300mg aspirin, 180mg ticagrelor
Anticoagulate- LMWH
Morphine
BB- not if low BP/HR

PCI- <12 hrs and <120 mins of fibrinolysis
Fibrinolysis <12hours too

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3
Q

4Hs and 4Ts of cardiac arrest

A

Hypothermia
Hypokalaemia
Hypoxia
Hypovolaemia

Tension Pneumothorax
Thrombosis
Tamponade
Toxins

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4
Q

Posterior MI on ECG

A

Tall R V1-2
Or ST depression on anterior leads

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5
Q

When should you give PCI after thrombolysis

A

If ST elevation persists after 60 mins

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6
Q

NSTEMI with a GRACE score >3% management

A

CA within 72 hours

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7
Q

Contraindications to thrombolysis

A

ABC SHIP

Aortic dissection
Bleeding
Coag disorders
Stroke <3 months
Hypertension (severe)
Intracranial neoplasm/injury
Pregnancy

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8
Q

Which marker to use for assessing re-infarction

A

CK-MB

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9
Q

Treatment of HF

A

ACEi and Beta blocker- poor EF - <45
Furosemide- normal - 45-60

Add SGLT2 inhibitor
Add Entresto- angiotensin receptor-neprilysin inhibitor

Spironolactone added

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10
Q

Management of Acute pulmonary oedema

A

o (1) Sit them up  high-flow O2 (if SpO2 decreased)
o (2) IV diamorphine (3mg) + IV metoclopramide (10mg) [caution in liver failure and COPD]
o (3) IV furosemide (40-80mg) [larger dose in renal failure]
o (4) SL GTN spray x2 [if SBP ≥100mmHg, use IV GTN]

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11
Q

Treatment of angina

A

BB
Aspirin
Artovostatin
GTN spray

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12
Q

Q risk score and statin dose

A

Q risk above 10%- offer
Above 20%
20mg artovostatin

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13
Q

Pericarditis sign and symptoms

A

Pericardial rub
Widespread PR depression
Saddle back
Trops raised
Previous Inf

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14
Q

LBBB on ecg

A

Wide QRS complez
W in V1
M in V6

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15
Q

ECG of hypokalaemia

A

U waves after T waves

T waves absent or sine like

Prolonged PR

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16
Q

Hypothermia ECG and shocks

A

J waves, bradycardia
Causes VF

Shock 3 times- then only when body temp >30

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17
Q

Management of VF/VT with adverse signs

A

Shock 3 times
Amiodarone 300mg IV

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18
Q

Management of SVT

A

Vagal manoeuvres
Adenosine- 6,12,18mg
May cause chest pain

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19
Q

Cause of Torsades de pointes

A

Macrolides
Amiodarone

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20
Q

Normal PR

A

120-200ms
3-5 small squares

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21
Q

Normal QRS

A

80-100ms
2-3 small squares

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22
Q

Normal QT interval

A

350-450ms

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23
Q

Step 4 intervention of HTN

A

Spironolactone if K <4.5
If K>4.5 BB or AB

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24
Q

Treatment of bradycardia

A

Atropine IV 0.5mg

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25
Q

Investigations and features of IE

A

3 blood culture
Echo

Urine dipstick

Splenomegaly
TIA, complete HB, HF, AKI
Positive RF

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26
Q

S3 vs S4 causes and sound

A

S3- normal if <30- Kentucky
Dilated- forced blood hitting compliant ventricle
S4- contracted- Tennessee
Non compliant ventricle- restrictive

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27
Q

Treatment of Rheumatic fever

A

IM benzene then Pen

Surgery if severe carditis/CF

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28
Q

Feature of mitral stenosis

A

RF big cause
Tapping beat - due to loud s1
Often in A fib

Open snap after s2- then decrescendo- crescendo
Loud s1- due to stiff valve

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29
Q

Features of aortic stenosis

A

Radiates to neck
Under 60- bicuspid
Require replacement

Forceful apex beat, non displaced

Severe
SAD- syncope, angina, dyspnoea

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30
Q

Feature of aortic dissection

A

Often hypertensive then shock
Widened mediastinum and dilated aorta

Can present with neuro deficits- compression of symp branch- horners
Type 1- ascending, arch, descending
2- ascending
3- descending

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31
Q

Takotsubo cardiomyopathy features

A

After stressor
Raised trops
ST eleveation in anterior leads
Octopus

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32
Q

Wellens syndrome features

A

LAD stenosis
Inverted/biphasic T waves
Chest pain

Self resolving

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33
Q

How MI can present in older patient

A

Without chest pain
Sweating
SOB
Tachycardia and pneoa

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34
Q

Tx of paroxysmal AF

A

AC even if short

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35
Q

CHADSVASc score

A

CHF
HTN
Age- 75-2 or 65-1
Diabetes
Stroke- or TIA 2
Vascular
Sex- female

If 1- consider if male
2- AC

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36
Q

Aortic regurgitation sx

A

Wide pulse pressure
Head nodding
Quinckes sign- nail pulse
Collapsing
Early diastolic

Displaced apex beat

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37
Q

Acute heart failure causes

A

CHAMP
ACS
HTN crisis
Arrythmia
Mechanical- valve
PE

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38
Q

AHF treatment

A

O2
Frusemide
Nitrites
Inotropes
NIV

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39
Q

Mx of cocaine induced ACS

A

Benzo to calm
GTN to dilate
Sodium bicarb if arrhythmic, or mgso4 for torsades

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40
Q

Left ventricular aneurysm sx and ix

A

HF symptoms - crackles- s3 +4
Persistent ST elevation after MI

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41
Q

Ix of stable angina

A

CT angiogram

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42
Q

Tx of aortic stenosis

A

MDT
RF modification- statin, AP, HTN

Treat if gradient >40mmHg or symptomatic

Surgical - TAVI- >75
SAVR- <75

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43
Q

Tx of Aortic regurg

A

MDT
RF Modification
Reduce afterload- ACEi, BB- less regurg

If symptomatic
Surgical- valve replacement before LV dilatation

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44
Q

Tx of Aortic regurg

A

MDT
RF Modification
Reduce afterload- ACEi, BB

Surgical- before LV dilatation

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45
Q

Tx of Mitral stenosis

A

Rhf Prophylaxis
AF rate and DOAC

If symptomatic
Surgical- moderate to severe- balloon valvuloplasty- not if calcified valve

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46
Q

ECG signs on mitral stenosis

A

Atrial fibrillation
P mitrale- left atrial enlargement- biphasic p wave

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47
Q

P pulmonale

A

Peaked/high p waves
Right atrium enlargement- increased pulmonary circulation pressure or pulmonary stenosis

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48
Q

Features of mitral regurg

A

Dyspnoea, AF

Left parasternal heave- RVH
Displaced Apex

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49
Q

CI drugs in HF

A

Glucocorticoids- fluid
NSAIDs- fluid
Verapamil
Thiozoladinediones- PPAR- fluid

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50
Q

Dukes criteria

A

BE FEVER- 2 major, 1 major 3 minor, 5 minor

Blood cultures- 2 12 hours
Echo- vegitation, new murmur

Fever
Echo- not major
Vascular- embolism, splinter, janeway
Evidence- immunological- osler, roth, GN, RF, micro- 1 culture
RF- IVDU

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51
Q

Rheumatic fever classification and path

A

GAS- s pyogenes

JONES
Joint, carditis, nodules, erythema marginatum, Sydenham chorea

Minor
raised ESR or CRP
pyrexia
arthralgia (not if arthritis a major criteria)
prolonged PR interval

1 major 2 minor
or 2 major

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52
Q

Tx of IE

A

Strep viridans- BP- sub acute
S aureus- flucloxacillin- acute- IVDU

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53
Q

Pericarditis Causes and Tx

A

Post MI, Viral, malignancy, uraemia, drugs, inflammatory- rheumatoid, SLE, Behcets, sarcoid

NSAIDs or Colchicine

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54
Q

Drugs that inhibit CYP- interactions

A

AAACDE V

Acute alcohol
Allopurinol
Azoles
Cipro/ cimetidine
Disulifram
Erythromycin
Valproate

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55
Q

Cause of long QT

A

Antipsychotic
Antibiotics- clarithromycin, erythromycin
Antidepressants- SSRI- citalopram, TCA
Amiodarone

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56
Q

Pacemaker vs ICD on CXR

A

ICD- thicker

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57
Q

Types of pacemaker

A

Single chamber- 1 lead in right atrium through vein- sinus node disease- problem with SA
Or ventricular- AV node

Dual chamber- right atrium and right ventricle- heart block

Bi-ventricular- 3 leads- left through coronary vein
Atrial lead not always needed

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58
Q

Pacemaker ECG

A

Sharp line before p- atrial
Before QRS- ventricular
Before both- dual chamber

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59
Q

What is Pulsus paradoxes and its causes

A

When inspiration causes a lower systolic BP
increase return- bulges into left- reducing outflow

Tamponade, severe asthma

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60
Q

Tx of angina

A

BB/CCB, statin and aspirin
If symptoms continue add in CCB/BB- if on BB add amlodipine
If on CCB and asthmatic add in long acting nitrate

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61
Q

If ACEi causes cough

A

Stop ACEi and prescribe ARB

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62
Q

Causes of Torsades de pointes

A

Long QT interval

Medications
TCA, AP, erythromycin,

Hypocalcaemia, hypomagnesium, hypokalaemia

Hypothermia

SAH

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63
Q

When to admit because of BP

A

> 180/120
AND

life-threatening symptoms such as new-onset confusion, chest pain, signs of heart failure, or acute kidney injury

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64
Q

Infective Endocarditis Sx

A

Roth spots
Petechiae
Splenomegaly
Haematuria
Janeway lesions
Osler nodes

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65
Q

Rheumatic fever presentation over time

A

Acute- JONES
Chronic- hear valves- 20 years later

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66
Q

Why viridians affects mitral valve

A

Due to it being weak and can only affect damaged valve

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67
Q

What to see on CXR of mitral stenosis

A

left atrial dilatation
Splattered dense opacities - haemosiderin

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68
Q

Women presents with rosey cheeks and dyspnoea what does she have

A

Malar flush
Mitral stenosis

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69
Q

What is a tapping apex and what condition causes it

A

Due to high pressure in atrium when systole hits, slams it shut- causing it to be loud
Mitral stenosis

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70
Q

Causes of A fib

A

II HAEM

Infection
IHD

Hyperthyroidism
Alcohol
PE
Mitral stenosis

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71
Q

Present ECG

A

Rate
Rhythm
Axis

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72
Q

Determine axis of ECG

A

Lead 1 and aVF
If both positive- normal

If Lead 1 positive and aVF negative- LAD

1 negative and avF posiitve- RAD

If lead 1 + and 2 and 3 negative- LAD- inferior MI

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73
Q

Septal MI leads

A

V1 and V2

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74
Q

LAD complication

A

HF

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75
Q

Inferior infarct complication - right coronary artery

A

Rhythm disturbance
Can lead to posterior

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76
Q

Rhythm of 3rd degree HB

A

R waves are completely regular

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77
Q

Calculating rate in irregular rhythm

A

Rhythm strip
No. of r waves
x6

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78
Q

Tx of complete heart block and STEMI

A

Pacemaker and PCI

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79
Q

Treatment of cariogenic shock

A

Dobutamine

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80
Q

Causes of dilation and hypertrophy of the heart

A

Dilatation- fluid overload
AR, MR

Hypertrophy- growth inwards
HTN, AS

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81
Q

What can you see after treatment of SVT

A

If shows block
Can mean pre excitation in the opposing branch

For example- if see M in V1
Can eat pre excitation in left- WPW- need ablation

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82
Q

Third line for HF Tx

A

Hydralazine
ivabradine

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83
Q

SE for BB

A

Bronchoconstriction
Insomnia
ED

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84
Q

Murmur in ASD

A

Ejection systolic due to high flow right side
Greater with inspiration

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85
Q

JVP in pericarditis

A

Increases with inspiration due to poor compliance of heart

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86
Q

Normal JVP waves

A

Measures pressure in right atrium
2 pulses per heartbeat

Atrial contraction- a wave- pushes blood back up
C wave- start of systole- bulge of tricuspid causes small rise
V wave- atrial full of blood

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87
Q

Abnormal JVP waves

A

No A waves in AF- not coordinated contraction

Large A wave- due to atrial contracting hard- tricuspid stenosis, RVH (PLM HTN)

Large V wave- tricupid regurgitation

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88
Q

When are nitrates contraindicated

A

Hypotension <90

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89
Q

Types of shock and when to use

A

Unsync- VF or pulseless VT
Sync- if have pulse- pulse VT, unstable atrial fibrillation, atrial flutter, atrial tachycardia, and supraventricular tachycardias

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90
Q

Types of VT

A

Monomorphic
Polymorphic- torsades due to long QT or non- not long QT

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91
Q

Calcium affect on QT

A

Hypo- long
Hyper- short

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92
Q

How to determine whether LBBB or RBBB easily

A

Look at V1- if wide QRD

If upgoing- RBBB
if downing LBBB

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93
Q

Normal EF

A

50-70

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94
Q

Driving after MI

A

No driving for 4 weeks

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95
Q

Follow up After MI

A

Smoking cessation
Cardiac rehab
Post infarct clinic

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96
Q

Medications for HF

A

ACEi
BB
MCA- spironolactone
SGLT2

Start low but titrate up fairly fast

Can add sascubritil/valsartan- neprilysin inhibitor- breakdown naturetic peptides- stop ACEi if doing so

97
Q

Invasive procedure for some HF and when indicative

A

Cardiac resynchronisation therapy

Since RV and LV are desynced

Only used if LBBB

Also give ICD

98
Q

NSTEMI ECG

A

ST depression
Major T wave inversion
With chest pain

99
Q

Mx of SVT after regained sinus rhythm

A

Conservative
Or SVT ablation

100
Q

Mx of SVT after regained sinus rhythm

A

Conservative
Or SVT ablation

101
Q

Place of insertion for PCI

A

Radial artery

102
Q

Only liscensed CCB for HF

A

Amlodipine

103
Q

NSTEMI vs posterior MI ECG

A

Posterior MI- tall R waves

104
Q

HF with spironolactone and gynaec switch to what

A

Eplerenone

105
Q

Ix of palpitations

A

ECG, bloods
Then holter monitor

106
Q

Which drugs are CI in AS

A

Nitrites

107
Q

Suspected HF what tests to order

A

NT BNP first
Echo 2nd

108
Q

Sudden onset headache with loss of visual fields and hypotension

A

Pituitary apoplexy
Can present with adrenal insufficiency- like hypotension

109
Q

Unstable patient with suspected dissection Ix

A

TOE

110
Q

Target BP

A

<80
<140/90 clinic
<135/85- APBM

> 80
<150/90
<145/85

111
Q

Types of heart block

A

Bifasicular block- RBB and LAFB/LPFB
Tri- incomplete- Bi + 1/2nd HB
Tri complete- Bi + 3rd

112
Q

ECG of bifasicular block

A

RBBB + LAD

113
Q

Types of murmurs in rheumatic fever

A

Acute- mitral regurg
Chronic- mitral stenosis

114
Q

Acute rheumatic fever dx

A

Recent sore throat
Rash- marginatum- ring
Arthritis
Murmur

115
Q

Stent used in PCI

A

Drug eluting stent

116
Q

What type of branch block is always abnormal

A

New LBBB

117
Q

Which antihypertensive should you avoid in poorly controlled DM

A

Thiazides
Worsen glucose tolerance

118
Q

HF 5 days after MI with systolic murmur

A

Ventricle septal defect
Echo diagnoses

119
Q

MOA of LMWH

A

Activated antithrombin 3

120
Q

How often can you give adrenaline in ALS

A

Every 3-5 mins

121
Q

When to give adrenaline or amiodarone in ALS

A

Give adrenaline for non shockable
Or after 3rd shock

Amiodarone and adrenaline after 3rd shock for VF and pulseless VT and 150 for 5 shocks

122
Q

Digoxin toxicity sx

A

Lethargy, green vision, arrhythmia
Gynaecomastia

123
Q

Factors causing digoxin toxicity

A

Hypokalaemia
Amiodarone

124
Q

Alternate loop diuretic

A

Bumetanide

125
Q

ECG changes for PCI/thrombo

A

> 2mm 2 small squares in 2 consecutive anterior leads

Or 1mm in inferior leads

Or new LBBB

126
Q

MOA of alteplase

A

Converts plasminogen to plasmin

127
Q

What do big QRS complexes mean

A

Hypertrophy

128
Q

HOCM ECG

A

Hypertrophy- large QRS
Deep ST depression
T waves inversion

129
Q

Left vs right hypertrophic changes

A

Left- large R waves in lateral sided leads

Right- deep S in lateral
Large R in septal

130
Q

Actions required after thrombolysis

A

ECG after 60-90 mins
Urgent PCI if not resolved

131
Q

Patient With chronic HF with new AF <48hrs tx?

A

Amiodarone

132
Q

When to offer rate vs rhythm control first for AF

A

Rate normally
Rhythm if reversible cause- infection

133
Q

Tx of aortic dissection

A

Type A- surgical but BP management whilst waiting
B- conservative- beta blocker IV and analgesia

134
Q

How long do chronic subdural take to present

A

4-7 weeks

135
Q

What drug can be used instead of amiodarone in ALD

A

Lidocaine

136
Q

Notching of inferior border of ribs means

A

Aortic coarctation
Dilated vessels

137
Q

Reversal agent of dabigatran

A

Idarucizumab
Anti 2

138
Q

Reversal of apixiban

A

Adexanet alfa
Recombinant of X

139
Q

Bleeding with warfarin

A

Check INR
If 5-8- withhold 1-2 doses
Give Vit K
Resart when <5

140
Q

Tx of valvular AF

A

Warfarin

141
Q

Pacing in bradyarrythmia and tachy

A

Mobitz 2 and Complete- require pacing
Permanent Brady caused by MI

Transcutaneous- if resistant to atropine

You pace in teaches if resistant to pharmo

142
Q

Drug useful in AF with HF

A

Digoxin

143
Q

When to give HF resynchronise or ICD

A

Give ICD if EF <35%, optimal medical therapy and good QoL
Give resync if sinus with prolonged QRS

144
Q

Indications for surgery with Infective endocarditis

A

Haemodynamically unstable
Cardiac failure
Repeated emboli
Aortic valve abcess

145
Q

Hypertrophic cardiomyopathy sx

A

Jerky pulse
Displaced apex
Ejection systolic murmur
Large QRS

146
Q

Sign of digoxin on ECG

A

Downward sloping ST

147
Q

If resistant HTN on 4 Anti hypertensives and has CKD what should the next step be

A

Refer to nephrology

148
Q

Elderly patient with RF and sweating, trops are normal what should you do

A

Repeat trops as takes 2-3 hours to rise

149
Q

Tx of HTN over 80

A

Stage 1- 140-150 - lifestyle
Stage 2- >150/95 abpm, 160/100 clinic- CCB

150
Q

Burgers disease sx

A

Vasculitis young smokers
Claudication
Thrombophlebitis

151
Q

Post MI, muffled heart sounds hypotension

A

Free ventricle ruputre

152
Q

Post MI pan systolic murmur at apex

A

Acute Mitral regurg

153
Q

If African- 2nd line intervention HTN

A

ARB >ACEi

154
Q

Warfarin with big red patch on leg, what has happened

A

If Deranged INR- interaction with other meds?

If normal INR- skin necrosis

155
Q

NSTEMI medical treatment

A

Aspirin and tica/clopi if high risk bleeding

Morphine
GTN spray

fondaparinux - unless risk of bleeding

GRACE score- if high- anagram within 96 hrs

156
Q

Ix of pericarditis

A

All patients should have Transthoracic Echo

157
Q

When to temporarily stop statins

A

If taking clarithromycin macrolide

Can cause myopathy

158
Q

Ix of TIA

A

Usually just give aspirin
But if on AC- CT head

159
Q

When to be assessed by TIA clinic

A

If TIA if last 7 days- 24 hours
>7 days- within 1 week

160
Q

SE of furosemide

A

Hypokalaemia
Ototoxicity
Hypocalcaemia

161
Q

If in VF and suspect PE what do you do

A

CPR with alteplase

162
Q

Thiazide SE

A

Hypercalcaemia- due to sodium exchange
Hypokalaemia
Hyponatraemia

Gout
Impaired glucose tolerance

163
Q

Which anti anginal do you develop resistance to and what should you do about it

A

Isosorbride mononitrate

Asymetric dosing regime
Nitrate free interval- take 2nd earlier or swap to once modified release

164
Q

When do you not give fondaparinum in STEMI/NSTEMi

A

If PCI available

165
Q

Treatment pathway for STEMI

A

Aspirin, O2 if hypoxic, Nitrates, Morphine

PCI if <120 mins, <12hours onset - prasugrel
Thrombolysis- antithrombin, after give ticagrelor

166
Q

HOCM murmur

A

Systolic
Valsava increases
Squatting decreases

167
Q

Ivabradine SE

A

Visual disturbances

168
Q

How to differentiate between constrictive pericarditis and tamponade

A

Tamponade- pulsus paradoxus.

CP- Kussmaul’s sign, a paradoxical rise in JVP during inspiration.

169
Q

PCI vs CABG

A

PCI- 1 or 2 vessels not including LAD
CABG- 2 or 3 including LAD

170
Q

Papillary muscle rupture sx

A

After MI
Acute mitral regurg- early to mid systolic murmur
HF

Need surgical repair

171
Q

When should BB be stoped in AHF

A

If HR <50
Second or third degree HB
or Shock

172
Q

If in ITU with adequate fluid but hypotensive what do you give

A

Noradrenaline

173
Q

SVCO sx and tx

A

Breathless, facial swelling, oedema

Dexamethasone and SVC stenting

174
Q

How to remember hypokalaemia on ECG

A

U have no K or no T
But a long PR and QT

175
Q

Hyperkalaemia ECG

A

Tinted T waves
Short QT but QRS prolongation
St depression
Long PR

176
Q

Where should amiodarone be given and why

A

Central vein due to thrombophlebitis

177
Q

Dressler syndrome sx and tx

A

Widespread ST
PR depression

Tx With aspirin

178
Q

Severe aortic stenosis on echo

A

<1cm
Elevated pressure gradient >40
Needs replacing

179
Q

If INR low and on warfarin mx

A

Increase warfarin dose and give LMWH until adequate

180
Q

What can mobitz 2 progress to

A

3rd degree

181
Q

SVT in asthmatics

A

Give verapamil

182
Q

Coarctation murmur

A

ESM- AS

183
Q

Drug to avoid in VT

A

Verapamil

184
Q

Brugada tx

A

ICD

185
Q

Brugada sx

A

St elevation V1-3
Negative T
Partial RBBB

186
Q

What is pulmonary arterial pressure a measure of

A

Preload

187
Q

Low preload, low CO and high vascular resistance shock

A

Hypovolaemic

188
Q

High preload, low CO, high VP shock

A

Cardiogenic

189
Q

Low PAP, high CO, low VP shock

A

Septic

190
Q

When to admit BP

A

If 180/120 + retinal haemorrhage or papiloedema

191
Q

Organism causing IE if <2m since valve surgery

A

Staph epidermis

192
Q

Echo of alcoholic

A

LVEF- low, dilated LV

193
Q

If allergic to atropine what to give in acute setting of bradycardia

A

Adrenaline infusion

194
Q

If on AP and start AF what should you do

A

Give AC and stop AP

195
Q

When to admit with chest pain

A

Current in last 12 hours- with abnormal ecg- admit emergency
Pain 12-72 horsed ago- same day assessment
>72 hours- full assess, trips, decide

196
Q

Pacing on ECG

A

See spike before p or qrs depending if atrial or ventricle

197
Q

After acutely treating HF what other things do you need to do to monitor the patient

A

Catheter- urine output
Fluid balance, daily weight
U+E review- ARF due to diuretics
Review- heart failure nurse

198
Q

What do you have to do if you are going to cardiovert AF that started >48 hours ago

A

TOE
To assess if left atrial appendage

199
Q

What condition is associated with coarctation

A

Turners

200
Q

If need to give adrenaline for ALS but cant access vein what do you do

A

Intaosseosu via tibia

201
Q

If acute HF not responding to furosemide what next tx

A

CPAP

202
Q

VT with pulse tx

A

Amiodarone

203
Q

How can diabetic patients with MI present

A

Without chest pain

204
Q

If muffled heart sounds, raised JVP after MI what has happened

A

Free ventricle wall rupture- causing tamponade

205
Q

Third line for HF

A

Ivabradine- HR >75, LECF <35

Sacubitril-valsartan- <35%

Cardiac resync- wide QRS

206
Q

If had ablation of AF do they still need AC

A

Yes through their CHADVASC

207
Q

How long should CPR be continued for If given thrombolytic drugs

A

60-90 mins

208
Q

HOCM associated cardio pathology and its ecg

A

WPW
PR <120
QRS >120

209
Q

Pulmonary HTN ascultation

A

Loud S2

210
Q

Cause of splitting H1

A

Inspiration
Due to high venous return

211
Q

AF treatment algorithm

A

BB- if >65 or hx of IHD
Second line digoxin

If no- fleccanide
2nd amiodarone

212
Q

Third line for HF in afro

A

Hydralazine with nitrate

213
Q

When to give morphine in ACS

A

Severe pain- give paracetamol otherwise

214
Q

CHAD score of 0 with AF Ix

A

Arrange echo

215
Q

RBBB + LAD vs RBBB + RAD

A

RBBB + LAD- left ant block - bifascular
RBBB + RAD- post block - bifasicular

Tri- RBBB + LAD/RAD + 1st degree HB

216
Q

Pericarditis vs myocarditis sx

A

Peri- movement changes pain- ST changes

Myo- T wave inversion

217
Q

Ix for someone having collapse at rest

A

Holter monitor

218
Q

NSTEMI anti platelet choice after PCI

A

Oral AC- clopidogrel

Not- ticagrelor or prasugrel

219
Q

Atypical angina classication

A

Constricting , aided by GTN, precipitated by physical exertion

220
Q

Causes of Aortic regurg

A

Bicuspid
Connectvie diseases- RhA, SLE, Marfans, Ehler
Tertiary syphillis

221
Q

Cause of rasised BNP

A

Cardiac failure and renal failure
Due to stress of the LV

BNP- can increase water excretion
Neprilysin degrades these- so inhibitors are good

222
Q

Pedunculated heterogeneous mass on echocardiogram

A

Atrial myxoma

223
Q

ASD signs

A

Systolic murmur radiating through to the back with fixed S2 splitting

Stroke with DVT

224
Q

When to start diabetic on ACE

A

If ACR >3

225
Q

Medication for orthostatic hypotension

A

Fludrocortisone

226
Q

Witnessed arrest on monitor mx

A

3 successive shocks before CPR

227
Q

V7-9 shows what STEMI

A

Inferior and Posterolateral

228
Q

Tamponade on ECG

A

Electrical alternans

229
Q

Digoxin therapy ecg

A

Scoped ST depression

230
Q

Atrial flutter ecg

A

Saw like
Might be 2 in-between QRS

231
Q

Most important RF of aortic dissection

A

HTN

232
Q

Only BBs to improve mortality in HF

A

Bisoprolol and cavediol

233
Q

PEA features and tx

A

Sinus rhythm with no pulse

CPR- adrenaline

233
Q

PEA features and tx

A

Sinus rhythm with no pulse

CPR- adrenaline

234
Q

When are long acting nitrates CI

A

Isosorbide mononitrate is CI if on sildenafil

235
Q

Sawtooth pattern irregular rhythm on ECG

A

Atrial flutter with variable block

236
Q

Confusion, syncope, ECG shows long QT, tx

A

IV calcium gluconate for hypoclaaemia

237
Q

What should all patients with CKD be given

A

Statin

Year 6 (28 decks)

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