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Year 6 Written > Cardio > Flashcards

Cardio Flashcards

1
Q

Stable angina Ix

A

CT Angiogram

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2
Q

Aortic dissection ECG

A

Can lead to st elevation

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3
Q

Aortic dissection ix

A

Ct aortogram

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4
Q

Which drugs provide prognostic benefits in heart failure?

A

Acei and cardioselective beta blockers - asthma & COPD are NOT CIs

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5
Q

VTE & risk of bleed

A

Iv heparin

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6
Q

Pericarditis ECG

A

Saddle shape

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7
Q

Cha2ds2 vasc score

A

Congestive heart failure
Hypertension
Age > = 75
Diabetes
Stroke
Vascular disease
Age >= 65
Sex female

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8
Q

Calculating lifetime risk of stroke (chadsvasc)

A

[(average life expectancy e.g., 85)-current age] x annual stroke risk (%)

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9
Q

Atrial fibrillation mx - haemodynamically stable

A

Clear, reversible cause // younger pt acute onset <48h
- DC cardio version
- Chemical cardio version (Flecainide or amiodarone - for pt w ischaemic/structural heart disorder)

Unclear cause
- Rate control
1) Beta blocker (CI: asthma/COPD)
2 ^if CI, Rate limiting Ca channel blocker - digoxin/diltiazem

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10
Q

SVT Mx - haemodynamically stable

A
  1. Vagal manoeuvre
  2. IV adenosine 6mg
  3. IV adenosine 12mg
  4. IV adenosine 12mg
    (verapamil is alt to adenosine)
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11
Q

STEMI mx

A

Up to 12h:
1st line: PCI
2nd line: Thrombolysis (if >2h to get to PCI centre)

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12
Q

NSTEMI & UA mx

A

SC Fonaparinux 2.5mg + aspirin 300mg

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13
Q

Thrombolysis CI

A
  • Active bleeding
  • Oesophageal varices
  • Prev intracranial bleed
  • Suspected SAH
  • Pregnancy
  • HTN > 200/10
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14
Q

When would you use Warfarin or LMWH over DOAC for VTE Mx

A
  • At extreme of body weight
  • Renal function impairment
  • Mechanical valve
  • Antiphospholipid
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15
Q

VTE mx

A

Provoked
- 3/12 DOAC then stop

Unprovoked (or provoked +cancer)
- 6/12 DOAC and maybe lifelong depending on thrombophilia screening etc

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16
Q

Raised BP in young person ddx

A

Primary hyperaldosteronism

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17
Q

HTN treatment
MHx of diabetes

A

ARB or ACEi

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18
Q

HTN Mx
Under 55y/o and not Afrocaribbean

A

ACEi or ARB

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19
Q

HTN Mx
55 or over, and/or Afrocaribbean

A

CCB

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20
Q

Fat emboli features

A
  • Recent multiple fractures
  • Hypoxia + SOB + tachypnoea
  • Confusion + altered consciousness
  • +/- Petechial rash
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21
Q

VF/VT (broad complex tacy) Mx - haemodynamically unstable

A
  1. DC shock x3
  2. IV amiodarone 300mg
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22
Q

Non-shockable rhythms

A
  • Asystole on ECG
  • Pulseless electrical activity
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23
Q

Mx sinus bradycardia

A

Atropine
And eventually cardiac pacemaker

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24
Q

What is used to reverse warfarin in medical emergencies?

A

Prothrombin complex concentrate

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25
Q

Aortic stenosis mx

A

Aortic valve replacement

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26
Q

When would you consider withholding warfarin?

A

Elevated INRs between 4.5 and 10, and not associated with bleeding or a high risk of bleeding

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27
Q

HF features

A
  • Worsening breathlessness
  • Bibasal creps
  • Bilat pleural effusions
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28
Q

What is the dx?

A

Premature ventricular beats

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29
Q

Common cause of radio-femoral delay

A

Coarctation of the aorta

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30
Q

Cardiac tamponade - beck’s triad

A

1) hypotension
2) elevated jugular venous pressure
3) muffled heart sounds

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31
Q

Papillary muscle rupture features

A
  • Following PCI
  • Sudden onset SOB
  • CP
  • New murmur
  • HF
  • Pulm oedema
32
Q

Which are the systolic murmurs?

A

Aortic stenosis and mitral regurg

33
Q

Mechanical valve INR goal

A

2.5-3.5

34
Q

Torsades de Pointes (form of VT) ECG changes

A

Prolonged QT

35
Q

!! double check with notes!! Haemodynamically unstable VT Mx

A

DC cardioversion

36
Q

Early diastolic murmur AND mid diastolic murmur

A

Tricuspid regurg

37
Q

Cardiac tamponade mx

A

pericardiocentesis

38
Q

Definitive mx for WPWS

A

Accessory pathway ablation

39
Q

Angina mx

A
  1. BBlocker or CCblocker
  2. GTN

(uptitrate for 1. before switching, then before trying combined)

40
Q

Anticoag mx for haemodynamicaly unstable pt

A

Unfractionated heparin infusion

41
Q

what must you keep in mind if widened QRS ++?

A

Complete heart block

42
Q

Heart block
- First degree
- Second degree
- Third degree

A
  • First degree: prolonged PR interval
  • Second degree (Type 1: Mobitz I / Wenckebach): PR interval gradually increases until a QRS is dropped
  • Second degree (Type 2: Mobitz II): regular PR interval with dropped QRS complexes
  • Third degree (complete): no relationship, ± widened QRS
43
Q

Draw out an ECG strip with areas that correlate to different affected vessels

A
44
Q

What type of mumur do you hear with-
1. Aortic stenosis
2. Aortic regurg
3. Mitral stenosis
4. Mitral regurg

A
  1. Ejection systolic
  2. Mid diastolic
  3. Early diastolic
  4. Pan systolic
45
Q

Which murmur is associating with slow rising, narrow pulse pressure / crescendo-descendo?

A

Aortic stenosis

46
Q

Where is there radiation to of murmur in aortic stenosis?

A

Carotid

47
Q

Which murmur is associated with Mueller’s sign/de musset’s sign & quincke’s sign? What are each of these signs?

A

Aortic regurg
- Mueller’s: systolic pulsation of uvula
- De Musset’s: Nodding head
- Quincke’s: nail bed pulsing

48
Q

Which murmur is associated with wide pulse pressure?

A

Aortic regurg

49
Q

How do you accentuate the AR murmur?

A

Lean forward

50
Q

Which murmur is associated with AF?

A

Mitral regurg (can also be mitral sten)

51
Q

Which murmur is associated with malar flush?

A

Mitral stenosis

52
Q

How do you accentuate murmur in Mitral stenosis?

A

Lie on their LHS

53
Q

Which murmur is associated with collapsing pulse?

A

Aortic regurg

54
Q

What ECG change might you see in mitral stenosis?

A

P mitrale: bifid P wave (suggestive of LA enlargement)

55
Q

Which murmur radiates to axilla?

A

mitral regurg

56
Q

SVT Mx - haemodynamically unstable

A
  1. DC shock x3
  2. IV Amiodarone 300mg
57
Q

VF/VT (broad complex tacy) Mx - haemodynamically stable

A

If regular
- IV amiodarone 300mg
- IV adrenaline

If known hx SVT/BBB, treat as SVT

58
Q

Atrial fibrillation mx - haemodynamically unstable

A

Urgent DC cardioversion

59
Q

Dabigatran (DOAC) reversal agent

A

Idarucizumab

60
Q

If elective cardioversion for AF, what anticoag is needed?

A

DOAC (or warfarin) 3 weeks before and 4 weeks after - prevent clots fro going to brain and causing stroke:)

61
Q

Which drug provides symptomatic benefit in HF?

A

Furosemide

62
Q

Mx for HF with preserved EF

A

loop diuretic, e.g., furosemide or bumetanide

63
Q

First line ix for HF

A

NT-proBNP (then ECHO + cardio ref)

64
Q

What EF is considered preserved and reduced?

A

> 50% = preserved
<40 = reduced

65
Q

Dressler’s syndrome

A

autoimmune pericarditis ~4-6 weeks post acute MI
- pleuritic CP
- Fever

66
Q

Post ACS mx

A
  • lifestyle changes
  • B blocker
  • ACEi
  • Atorvastatin 80mg
  • DAPT
67
Q

If ACS and pt had PCI, which DAPT?

A

If on PO anticoag: clopidogrel + aspirin
If not on PO anticoag: prasugrel + aspirin

68
Q

If ACS + fibrinolysis, which DAPT?

A

Aspirin + ticagrelor

69
Q

If PCI with stent, how long on DAPT?

A

12 months at least

70
Q

What could be cause if bradycardia + AV nodal block?

A

Inferior MI

71
Q

ACS initial mx

A
  • 300mg aspirin
  • analgeisa
  • antiemetics
    ±O2
72
Q

Stage 1 HTN figures

A

Clinic: >140/90
Home: > 135/85

If less, recheck in 5 years

73
Q

Severe HTN features

A

> 180/120, or syx HTN

74
Q

Severe HTN hospital mx

A
  • IV GTN
  • IV Beta blocker, e.g., labetalol
  • IV nitroprusside
75
Q

Skin necrosis after warfarin

A

Protein C deficiency

76
Q

What is S1Q3T3?

A

Can be seen in PE (rare)
Deep S waves lead 1
Q waves and T wave inversion in lead 3

77
Q

Confirmed PE + haemodynamically usntable mx

A

UFH infusion and consider thrombolysis

Year 6 Written (26 decks)

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