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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
Aortic stenosis mx
Aortic valve replacement
26
When would you consider withholding warfarin?
Elevated INRs between 4.5 and 10, and not associated with bleeding or a high risk of bleeding
27
HF features
- Worsening breathlessness - Bibasal creps - Bilat pleural effusions
28
What is the dx?
Premature ventricular beats
29
Common cause of radio-femoral delay
Coarctation of the aorta
30
Cardiac tamponade - beck's triad
1) hypotension 2) elevated jugular venous pressure 3) muffled heart sounds
31
Papillary muscle rupture features
- Following PCI - Sudden onset SOB - CP - New murmur - HF - Pulm oedema
32
Which are the systolic murmurs?
Aortic stenosis and mitral regurg
33
Mechanical valve INR goal
2.5-3.5
34
Torsades de Pointes (form of VT) ECG changes
Prolonged QT
35
!! double check with notes!! Haemodynamically unstable VT Mx
DC cardioversion
36
Early diastolic murmur AND mid diastolic murmur
Tricuspid regurg
37
Cardiac tamponade mx
pericardiocentesis
38
Definitive mx for WPWS
Accessory pathway ablation
39
Angina mx
1. BBlocker or CCblocker 2. GTN (uptitrate for 1. before switching, then before trying combined)
40
Anticoag mx for haemodynamicaly unstable pt
Unfractionated heparin infusion
41
what must you keep in mind if widened QRS ++?
Complete heart block
42
Heart block - First degree - Second degree - Third degree
- 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
Draw out an ECG strip with areas that correlate to different affected vessels
44
What type of mumur do you hear with- 1. Aortic stenosis 2. Aortic regurg 3. Mitral stenosis 4. Mitral regurg
1. Ejection systolic 2. Mid diastolic 3. Early diastolic 4. Pan systolic
45
Which murmur is associating with slow rising, narrow pulse pressure / crescendo-descendo?
Aortic stenosis
46
Where is there radiation to of murmur in aortic stenosis?
Carotid
47
Which murmur is associated with Mueller's sign/de musset's sign & quincke's sign? What are each of these signs?
Aortic regurg - Mueller's: systolic pulsation of uvula - De Musset's: Nodding head - Quincke's: nail bed pulsing
48
Which murmur is associated with wide pulse pressure?
Aortic regurg
49
How do you accentuate the AR murmur?
Lean forward
50
Which murmur is associated with AF?
Mitral regurg (can also be mitral sten)
51
Which murmur is associated with malar flush?
Mitral stenosis
52
How do you accentuate murmur in Mitral stenosis?
Lie on their LHS
53
Which murmur is associated with collapsing pulse?
Aortic regurg
54
What ECG change might you see in mitral stenosis?
P mitrale: bifid P wave (suggestive of LA enlargement)
55
Which murmur radiates to axilla?
mitral regurg
56
SVT Mx - haemodynamically unstable
1. DC shock x3 2. IV Amiodarone 300mg
57
VF/VT (broad complex tacy) Mx - haemodynamically stable
If regular - IV amiodarone 300mg - IV adrenaline If known hx SVT/BBB, treat as SVT
58
Atrial fibrillation mx - haemodynamically unstable
Urgent DC cardioversion
59
Dabigatran (DOAC) reversal agent
Idarucizumab
60
If elective cardioversion for AF, what anticoag is needed?
DOAC (or warfarin) 3 weeks before and 4 weeks after - prevent clots fro going to brain and causing stroke:)
61
Which drug provides symptomatic benefit in HF?
Furosemide
62
Mx for HF with preserved EF
loop diuretic, e.g., furosemide or bumetanide
63
First line ix for HF
NT-proBNP (then ECHO + cardio ref)
64
What EF is considered preserved and reduced?
>50% = preserved <40 = reduced
65
Dressler's syndrome
autoimmune pericarditis ~4-6 weeks post acute MI - pleuritic CP - Fever
66
Post ACS mx
- lifestyle changes - B blocker - ACEi - Atorvastatin 80mg - DAPT
67
If ACS and pt had PCI, which DAPT?
If on PO anticoag: clopidogrel + aspirin If not on PO anticoag: prasugrel + aspirin
68
If ACS + fibrinolysis, which DAPT?
Aspirin + ticagrelor
69
If PCI with stent, how long on DAPT?
12 months at least
70
What could be cause if bradycardia + AV nodal block?
Inferior MI
71
ACS initial mx
- 300mg aspirin - analgeisa - antiemetics ±O2
72
Stage 1 HTN figures
Clinic: >140/90 Home: > 135/85 If less, recheck in 5 years
73
Severe HTN features
>180/120, or syx HTN
74
Severe HTN hospital mx
- IV GTN - IV Beta blocker, e.g., labetalol - IV nitroprusside
75
Skin necrosis after warfarin
Protein C deficiency
76
What is S1Q3T3?
Can be seen in PE (rare) Deep S waves lead 1 Q waves and T wave inversion in lead 3
77
Confirmed PE + haemodynamically usntable mx
UFH infusion and consider thrombolysis

Year 6 Written (26 decks)

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