Cardio Flashcards
1
Q
- What operations might a midline sternotomy scar indicate ?
A
- Coronary artery bypass graft
- Aortic valve replacement
- Mitral valve replacement
2
Q
- What scars may indicate a CABG surgery ?
A
- Midline sternotomy
- Saphenous vein harvesting scar on the inner calf
3
Q
- What is the gold standard investigation for stable angina ?
A
- CT coronary angiography
4
Q
- What medications are given for long term symptoms control of stable angina ?
A
- Beta blockers e.g. bisoprolol
- CCBs e.g. amlodipine
5
Q
- What medication can be given for secondary prevention of stable angina ?
A
- Aspirin 75 mg OD
- Atorvastatin 80 mg OD
- ACE-I e.g. ramipril
- Beta blocker e.g. bisoprolol
6
Q
- What procedures or surgical options can be given for stable angina ?
A
- Percutaneous coronary intervention (PCI)
- Coronary artery bypass graft
7
Q
- Which ECG leads are anterolateral ?
A
- I, aVL and V3-V6
8
Q
- Which ECG leads are anterior ?
A
- V1-V4
9
Q
- Which ECG leads are lateral ?
A
- I, aVL, V5-V6
10
Q
- Which ECG leads are inferior ?
A
- II, III and aVF
11
Q
- How is a NSTEMI treated ?
A
- Aspirin
- Then calculate GRACE score (6 month mortality)
- Low risk = ticagrelor
- High risk = Prasugrel or ticagrelor + un-fractionated heparin + PCI (drug-eluting stents should be sued in preference)
12
Q
- What are complications of an MI ?
A
- DREAD
- Death
- Rupture
- Edema
- Arrhythmia
- Dressler’s syndrome
13
Q
- Which coronary artery supplies the anterolateral area ?
A
- LCA
- (leads I, aVL, V3-V6)
14
Q
- Which coronary artery supplies the anterior area ?
A
- LAD
- (Leads V1-V4)
15
Q
- Which coronary artery supplies the lateral area ?
A
- Circumflex
- (I, aVL, V5-V6)
16
Q
- Which coronary artery supplies the inferior area ?
A
- RCA
- (Leads II, III and aVF )
17
Q
- 83 yo with acute SOB and low sats. Pt has had 3L of fluid in the last 24 hours. What is the diagnosis ?
A
- Acute left ventricular failure with pulmonary oedema
18
Q
- What are potential triggers for acute left ventricular failure ?
A
- Iatrogenic e.g. IV fluids
- Sepsis
- MI
- Arrhythmias
19
Q
- What are X-ray findings for heart failure ?
A
- Alveolar oedema
- Kerley B lines
- Cardiomegaly
- Dilated upper lobe vessels
- Effusion
20
Q
- What is acute management of heart failure ?
A
- Treat cause e.g. stop IV fluids
- Sit up
- Oxygen
- Diuretics e.g. Furosemide
21
Q
- What is the name for pts with heart failure waking up breathless ?
A
- Paroxysmal nocturnal dyspnoea
22
Q
- What are HF causes ?
A
- Ischemic heart disease
- Valvular heart disease
- Hypertension
- Arrhythmias
23
Q
- What BNP level would prompt referral ?
A
- BNP > 2000
24
Q
- What are HF treatments ?
A
- ACE-I e.g. ramipril
- Beta blockers e.g. bisoprolol
- Aldosterone antagonist e.g. spiralactone
- Loop diuretic e.g. furosemide
25
Q
- Secondary causes of HTN ?
A
- Renal disease
- Obesity
- Pregnancy
- Endocrine
26
Q
- What would be first line in a 52yo white man ?
A
- Ramipril
27
Q
- What would it be in an over 55 or Afro-Caribbean man ?
A
- Amlodipine
28
Q
- What is a BP treatment target in under 80 ?
A
- 140/90
29
Q
- What valve pathology would cause left atrial hypertrophy ?
A
- Mitral stenosis
30
Q
- What valve pathology would cause left ventricular dilatation ?
A
- Aortic regurgitation
31
Q
- What valve pathology would cause Malar Flush ?
A
- Mitral stenosis
32
Q
- What valve pathology would cause a slow rising pulse ?
A
- Aortic stenosis
33
Q
- What valve would cause a collapsing pulse ?
A
- Aortic regurgitation
34
Q
- What valve would cause a mid-diastolic, low pitch rumbling murmur ?
A
- Mitral stenosis
35
Q
- What valve would cause a pan-systolic high pitched whistling murmur ?
A
- Mitral regurgitation
36
Q
- What valve would cause an early diastolic soft murmur ?
A
- Aortic regurgitation
37
Q
- What valve would cause AF ?
A
- Mitral stenosis
38
Q
- What would an aortic stenotic murmur sound like ?
A
- Ejection systolic, high pitched, crescendo-decrescendo murmur heard loudest over the aortic area (radiating into the neck)
39
Q
- What kind of pulse is associated with aortic stenosis ?
A
- Narrow pulse pressure
40
Q
- What are the causes of aortic stenosis ?
A
- Idiopathic
- Age related calcification
- Rheumatic heart disease
41
Q
- What management options are available for aortic valvular pathology ?
A
- Transcatheter aortic valve replacement
- Open heart valve replacement
42
Q
- What are shockable rhythms ?
A
- VF and Ventricular tachycardia
43
Q
- What are unshockable rhythms ?
A
- Asystole + pulseless electrical activity
44
Q
- What are the most common causes of AF ?
A
- Mitral valve pathology
- Ischemic heart disease
- Sepsis
- Thyrotoxicosis
- Hypertension
45
Q
- What are options for pharmacological cardioversion in AF?
A
- Flecainide
- Amiodarone
46
Q
- Scoring system for risk of stroke in AF ?
A
- CHA2 DS2 VASc
47
Q
- Options for anticoagulation in AF ?
A
- Warfarin
- DOAC e.g. apixaban
48
Q
- Initial Non-pharmacological managed of supraventricular tachycardia
A
- Valsalva manoeuvre
- Carotid sinus massage
49
Q
- Contraindications for adenosine
A
- Asthma/COPD
- HF
- Heart block
- Severe HTN
50
Q
- Common side effects of adenosine
A
- Flushing
- Feeling of impending doom
51
Q
- Doses of Adenosine
A
- 6mg 12 mg 18 mg
52
Q
- Procedure to prevent recurrent episodes of SVT ?
A
- Radiofrequency ablation
53
Q
- Types of pacemaker ?
A
- Single chamber
- Dual chamber
- Biventricular chamber (triple chamber)
- Implantable cardioverter defibrillators
54
Q
- Indications for a pacemaker ?
A
- Symptomatic bradycardias
- Mobitz type 2 AV block
- 3rd degree heart block
- Severe heart failure
- Hypertrophic obstructive cardiomyopathy
55
Q
What scoring system can be used to calculate the risk of a major bleed in a patient who is anticoagulated ?
A
- HAS-BLED
56
Q
For NSTEMI treatment what should be given pre-PCI if there is a high risk of bleeding ?
A
- Give ticgrelor instead of prasugrel
- Swap Ticagrelor for clopidogrel
- If patient is taking oral anticoagulants swap praugrel/ticagrelor for clopidogrel
