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PPQ Learning > Cardio > Flashcards

Cardio Flashcards

1
Q

Mechanical valves target INR? Aortic and mitral

A

3.0: Aortic
3.5: Mitral

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2
Q

Drugs for fibrinolysis for a STEMI?

A

Antithrombin and fibrinolysis drugs
Alteplase and fondaparinux

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3
Q

Bronchiectass and dextrocardia is highly suggestive of what?

A

Kartagner’s syndrome

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4
Q

AF + acute stroke (non-haemorrhagic) should have anticoagulation therapy when?

A

2 weeks after event, antiplatelet therapy given in intervening period

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5
Q

Broad complex tachycardia + acute MI…what shouldn’t you give?

A

Verapamil
-Contraindicated as its a non-dihydropyridine CCB, which inhibits influx of extracellular Ca across myocardial membranes= inhibition of cardiac muscle contraction = dilation of main coronoary and systemic arteries

Basically:
Can precipitate marked haemodynamic deterioration, VF, and cardiac arrest

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6
Q

What does a pCO2 >6.0 kPa indicate?

A

Near fatal asthma
If patient is tachypnoeic, CO2 should be low as CO2 lost in ventilation. If it is high or normal: person is tiring and beginning to hypoventilate

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7
Q

Pr interval in 1st degree in Heart block?

A

> 200ms

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8
Q

Emergency management of patients in major haemorrhage on warfarin

A

Stop warfarin
Give IV vit K
Prothrombin complex conc

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9
Q

What does a GRACE score of more than 3 warrant?

A

Coronary angiography in NSTEMI

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10
Q

Organism for infective endocarditis amongst IVDU?

A

Staph aureus

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11
Q

Most common cause of mitral stenosis ?

A

Rheumatic fever

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12
Q

Aortic regurgitation causes what type of murmur?

A

Early diastolic

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13
Q

What is aortic regurg?

A

Leaking of aortic valve causing blood to flow in reverse direction during ventricular diastole

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14
Q

Features of aortic regurg?

A

Collapsing pulse
Wide pulse pressure
Quincke’s sign (nailbed pulsation)
De Musset’s sign (head bobbing)
Mid-diastolic austin flint murmut

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15
Q

What is De Musset’s sign?

A

Head bobbing

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16
Q

What is Quincke’s sign?

A

Nailbed pulsation

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17
Q

Common adverse SEs from thiazide diuretics?

A

Dehydration
Postural hypotension
Hypokalaemia
Hyponatraemia
Hypercalcaemia
Gout
Impaired glucose tolerance
Impotence

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18
Q

Hypercalcaemia ECG change?

A

Short QT interval

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19
Q

Common SEs of amiodarone?

A

Brady
Hyper/hypo-thyroid
Pulm fibrosis
Liver fibrosis
Jaundice
Taste change
Slate grey skin
Raised serum transaminase
Nausea
Constipation

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20
Q

Angina management if patient has inadequate response to verapamil?

A

Add long acting nitrate (isomorbide monnitrate)

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21
Q

When should you tell patients to take their statin?

A

At night

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22
Q

Young male smoker, symptoms similar to limb ischaemia think what?

A

Buerger’s disease

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23
Q

Patients with bradycardia and signs of shock require what?

A

500mcg of atropine (repeated to max 3mg)

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24
Q

What are the normal degrees of heart block expected in athletes?

A

2nd degree heart block Mobitz type 1
First degree heart block
Junctional rhythm
Sinus bradycardia

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25
Q

Bradycardia + signs of shock treatment?

A

IV Atropine

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26
Q

Mid-diastolic murmur at apex us what?

A

Mitral stenosis

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27
Q

Pan-systolic murmur loudest at left sternal edge of 4th ICS?

A

Tricuspid regurg

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28
Q

Radiation to carotids?

A

Aortic stenosis

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29
Q

Ejection systolic murmurs?

A

Aortic stenosis: Louder on expiration
Pulmonary stenosis: Louder on inspiration

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30
Q

Pansystolic murmurs?

A

Mitral regurg
Tricusp regurg: louder during inspiration

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31
Q

Early diastolic?

A

Aortic regug

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32
Q

Mid-late diastolic?

A

Mitral stenosis
Austin-Flint

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33
Q

Which side of heart murmur is heard best on inspiration?

A

Right sided murmur

RILE
Right sided heard best on Inspiration
Left sided heard best on expiration

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34
Q

1st line management of heart failure is ACEi and what? Then what would you add if they’re still struggling?

A

Beta blocker
-Spironolactone

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35
Q

High voltage QRS complex represent what?

A

LV hypertrophy

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36
Q

Inverted P wave in lead 1, Right axis deviation and loss of R wave progression?

A

Heart’s apex located on right hand side of body

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37
Q

Causes of LAD?

A

Left anterior hemiblock
LBBB
I MI
WPWS
Hyperkalaemia

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38
Q

Causes of Right axis deviation?

A

RVHT
Left posterior hemiblock
Lateral MI
Cor pulmonale
PE
WPWS (LHS)

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39
Q

Mechanical heart valves anti-coags?

A

Warfarin

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40
Q

Collapsing pulse, SOB, cardiac murmur…what you think it is? + what else might be present relating to the nails

A

Aortic regurg

Quincke’s sign

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41
Q

What is coarcation of aorta associated with

A

Bicuspid aortic valve

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42
Q

What type of murmurs in coarcation of aorta?

A

Systolic murmurs

43
Q

Heart failure severity score?

A

NYHA

44
Q

Sleep apnoea assessment score?

A

Epworth sleepiness scale

45
Q

Prostate symptom and prognosis scores?

A

IPSS
Gleason

46
Q

Most specific marker on ECG for pericarditis?

A

PR depression

47
Q

What CV drug interacts dodgily with erythro/clarithro?

A

Statins

48
Q

When should ivabradine be considered in patients with heart failure?

A

Sinus rhythm >75/min
LVEF <35%
Not respondd to ACEi, BB, aldosterone antagonist

49
Q

What drugs should all MI patients be offered?

A

Dual antiplatelet therapy (aspirin + tica/clopi
B blocker
ACEi
Statin

50
Q

What stage of life should you not take statins in?

A

Pregnancy

51
Q

Mid-diastolic low-pitched rumbling murmur?

A

Mitral stenosis
ESPESH if haemopytsis

52
Q

How long is PR interval in WPWS?

A

<120ms

53
Q

Hypercalcaemia ECG?

A

Short QT interval

54
Q

Tall R waves V1-2…means what?

A

Posterior MI

55
Q

Half-life of adenosine?

A

10 secs

56
Q

Protocol if patient has INR 5-8 with no bleeding?

A

Withhold 2 doses of warfarin
Reduce subsequent maintenance dose

57
Q

AB of choice for native valve endocarditis?

A

Amoxicillin

58
Q

Hypothermia ECG?

A

J waves

59
Q

Acute circulatory collapse at 2 days of age?

A

Coarctation of aorta

60
Q

1st line for regular broad complex tachy?

A

IV amiodarone

61
Q

When should B-blockers be stopped in a patient with heart failure?

A

HR <50
2nd or 3rd degree AV block
Shock

62
Q

Offer what in a ‘broad lifestyle’ manner (Vom) to patients with HF?

A

Influenza vaccine annually

63
Q

What can thiazides do in diabetics?

A

Worsen glucose tolerance

64
Q

What electrolyte abnormality do you think of?

-Small or absent T waves
-Prolong PR interval
-ST depression
-Long QT
-U waves

A

Hypokalaemia

65
Q

What ECG finding can SA haemorrhage cause?

A

Torsades de pointes
(Polymorphic ventricular tachy)

66
Q

Adenosine can cause?

A

Chest pain

67
Q

What do you give a warfarin ptnt about to undergo surgery?

A

4 factor PT complex concentrate 25-50 units/kg

68
Q

Treatment for an NTEMI?

A

300mg of aspirin

69
Q

Diastolic murmur + AF = ?

A

Mitral stenosis

70
Q

Persistent ST elevation after MI is suggestive of?

A

LV aneurysm

71
Q

What murmur is assoc with PCKD?

A

Mitral valve prolapse

72
Q

If atropine fails in symptomatic bradycardia what do you do next?

A

External pacing

73
Q

If warfarin patient minor bleeding (5-8) what do you want to do?

A

Stop warfarin
IV Vit K 1-3mg
Restart when INR <5

74
Q

Prophylaxis of PE?

A

Rivaroxaban

75
Q

Pulseless electrical activity shockable?

A

No

76
Q

ECG sign suggestive of cardiac tamponade?

A

Electrical alternans

77
Q

Single episode of AFib treatment?

A

Commence apixaban

78
Q

What CV drug is CIed in VFib?

A

CCB : Verapamil

79
Q

Acute mitral regurg secondary to MI indicates a rupture of what?

A

Papillary muscle

80
Q

Persistent ST elevation in anterior leads after MI + Pulmonary oedema?

A

LV aneurysm

81
Q

Most common cause of death following MI?

A

V Fib

82
Q

Dilated cardiomyopathy can be cause by what lifestyle?

A

Chronic alcoholism

83
Q

HT + diabetes?

A

ALWAYS ACEi or ARB regardless of age

84
Q

Non-shockable rhythms?

A

Asystole
PEA

85
Q

What do you do if non-shockable?

A

1mg of IV adrenaline

Then further adrenaline 1mg IV every 3-5 min

86
Q

Nitrates are CIed in what kind of patient?

A

Hypotensive

87
Q

Cardioversion of AF patient pre-op?

A

Anticoagulated + bisoprolol for 3 weeks then electrical cardioversion

88
Q

II, III, avF artery affected?

A

Right coronary artery

89
Q

Loud S2 signifies?

A

Pulmonary HT

90
Q

Treatment of acute onset of AFib <48 hours?

A

Rate control initially
Then if considered for long term rhythm control: delay cardioversion until maintained on therapeutic anti-coags for minimum 3 weeks

91
Q

What is false lumen in ascending aorta suggestive of?

A

Aortic dissection

92
Q

Marfan’s murmur?

A

Mitral regurg

93
Q

Eisenmenger’s syndrome is what?

A

Reversal of a left to right shunt

94
Q

Third heart sound is heard in what condition?

A

Dilated cardiomypathy

95
Q

What class is amiodarone?

A

Class III

96
Q

What can amiodarone cause?

A

Thrombophlebitis

97
Q

SEs of GTN spray?

A

Hypotension
Tachycardia
Headache

98
Q

What is CIed in Astenosis?

A

Nitrates

99
Q

2nd line treatment for rate in AFib?

A

Digoxin

100
Q

Aortic regug?

A

Pansystolic murmur

101
Q

How many shocks in hypothermia ALS?

A

3 and then commence again when patient returns to 30 degrees

102
Q

Test for all patients with sus heart failure?

A

B-type natriuretic peptide

103
Q

<4 weeks post valve replacement likely infective endocarditis organism?

A

Staph epidermis

104
Q
A

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