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Finals passmed > Cardio > Flashcards

Cardio Flashcards

1
Q

An MI in which area of the heart is most likely to cause an AV block?

A

Inferior MI

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2
Q

What are the common complications of an MI?

A

Cardiac arrest, cardiogenic shock, brady/tachycardias, pericarditis, dressler’s syndrome

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3
Q

In which leads would you see changes in an inferior MI?

A

II, III and aVF

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4
Q

What are the characteristic features of acute mitral regurgitation?

A

acute onset SOB, bibasal crackles, hypotension and a systolic murmur

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5
Q

What are the presenting features of a left ventricular wall aneurysm?

A

Acute-onset SOB, bilateral infiltrates, S3 heart sound, persistent ST elevation

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6
Q

What are the features of superior vena cava obstruction?

A

facial and upper limb swelling, with distended veins, breathlessness

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7
Q

What is P mitrale?

A

A bifid P wave, due to left atrial hypertrophy e.g. in mitral valve stenosis

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8
Q

What are the risk factors in the CHA2DS2VASc score acronym?

A

Congestive HF, Hypertension, Age >75 or age >65, diabetes, prior stroke/TIA/DVT, vascular disease, Sex (female)

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9
Q

What chadvasc score requires anticoagulation?

A

> 2

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10
Q

What are the signs of cardiac tamponade?

A

Beck’s triad: hypotension, elevated JVP, diminished heart sounds.
Pulsus paradoxus (drop in BP during inspiration)
Can be after trauma

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11
Q

What is the management of aortic dissection?

A

ascending aorta - IV labetalol and surgery
descending aorta - IV labetalol

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12
Q

When would you use unsynchronised cardioversion?

A

When the patient is in cardiac arrest or pulseless ventricular tachycardia

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13
Q

When would you use synchronised cardioversion?

A

For haemodynamically unstable tachyarrhythmias

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14
Q

What would classify as unstable signs?

A

hypotension <90 systolic, syncope, clammy etc, myocardial ischaemia, heart failure.

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15
Q

How can you tell the difference between aortic dissection in the ascending vs descending aorta?

A

Ascending - you get changes in heart sounds (diastolic murmur over the 2nd intercostal space, right sternal edge)

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16
Q

What are the X-Ray findings of aortic dissection?

A

widened mediastinum

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17
Q

What is the management of aortic dissection?

A

Ascending: surgical management, BP controlled
Descending: conservative management, IV labetalol

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18
Q

Why do you get a soft ejection systolic murmur in anaemia?

A

Anaemia makes blood thinner causing turbulent flow in the aorta which creates a murmur

19
Q

Why do people with CKD get anaemia?

A

reduced EPO and reduced absorption of iron

20
Q

What are the features of hypertrophic obstructive cardiomyopathy?

A

Autosomal dominant - FH. Often asymptomatic, can get exertional dyspnoea, angina, syncope,

21
Q

What are the finding of hypoertrophic obstructive cardiomyopathy on echo?

A

MR SAM ASH. Mitral regurgitation, systolic anterior motion of anterior mitral valve, asymmetric hypertrophy

22
Q

What is Wellen’s syndrome?

A

ECG pattern seen due to stenosis of LAD - biphasic or deep T-wave inversion in V2-3, minimal ST elevation

23
Q

What is the first line management of heart failure?

A

ACE-I and beta-blocker

24
Q

What is the second line management of heart failure

A

add an aldosterone antagonist (spironolactone, eplerenone)
or SGLT-2 inhibitors (dapaglifozin)

25
Q

What vaccines should you offer those with heart failure?

A

annual flu vaccine, one of pneumococcal vaccine

26
Q

What is the management of new onset AF?

A

anticoagulation and DC cardioversion (if within 48 hours of AF starting)

27
Q

What investigation should you do before cardioversion in AF?

A

transoesophageal echo to exclude left auricular appendage thrombus

28
Q

Which score should be used to assess whether patients with AF should be on anticoagulation?

A

ORBIT

29
Q

What are the 5 parts of the ORBIT score?

A
  • Haemoglobin <140 for men, <120 for females (2)
  • Age > 74 (1)
  • Bleeding history (2)
  • Renal Impairment (1)
  • Treatment with anti-platelets (1)
30
Q

Which haemodynamic changes are seen in hypovolaemic shock?

A
  • decreased cardiac output
  • increased heart rate
  • reduced left ventricular filling pressure
  • reduced blood pressure
  • increased systemic vascular resistance
31
Q

What commonly causes neurogenic shock?

A
  • decreased sympathetic tone or increased parasympathetic tone - marked decrease in peripheral vascular resistance due to vasodilation - decreases preload and CO causing reduced tissue perfusion and therefore shock
32
Q

Which murmur is associated with a VSD?

A

pansystolic

33
Q

What is the management of angina?

A

BB or CCB, if symptoms not controlled on one, start both

34
Q

What investigations should be done in suspected pericarditis?

A

ECG, transthoracic echo, bloods (inflammatory markers, troponin)

35
Q

What is the medical management of pericarditis?

A

NSAIDs and Colchicine until symptoms resolution

36
Q

What does an opening snap sound indicate?

A

mitral valve leaflets are still mobile

37
Q

what murmur is heard in mitral stenosis?

A

mid-late diastolic murmur (best heard in expiration)

38
Q

What is takotsubo cardiomyopathy?

A

Paralysis at the apex of the heart, can cause transient reduction in CO, may present with chest pain or collapse in stressful situation

39
Q

What are the common causes of dilated cardiomyopathy?

A

alcohol, coxsackie B, wet beri beri, doxorubicin

40
Q

What are the common causes of restrictive cardiomyopathy?

A

amyloidosis, post-radiotherapy, endocarditis

41
Q

What is the management of a patient with peripheral arterial disease?

A

Clopidogrel and atorvastatin

42
Q

What ABPI value confirms peripheral arterial disease?

A

< 0.9

43
Q

Which valvular disease is associated with quinke’s sign?

A

Aortic regurgitation

44
Q

What is the murmur in aortic regurgitation?

A

Early diastolic

Finals passmed (23 decks)

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