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Cardio Flashcards

1
Q

What does RAAS do in relation to HTN

A

It causes vasoconstriction and

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2
Q

Causes of secondary HTN

A

Renovascular disease
Hyperaldosteronism
Adrenal adenoma (Conns syndrome)
Pheochromocytoma
Obstructive sleep apnea
Hyperthyroidism
Cushings syndrome
Steroids. OCPs, cocaine , NSAIDs

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3
Q

HTN with sweating, headache and palpitations

A

Pheochromocytoma

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4
Q

HTN with heat intolerance and weight loss

A

hyperthyroidism

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5
Q

HTN with daytime sleeping

A

Obstructive sleep apnea

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6
Q

180/20

A

Hypertensive urgency

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7
Q

HTN with Diabetic

A

ACEI/ARB regardless

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8
Q

Complication of ACEI

A

Cough

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9
Q

patients >= 55-years-old or of black African or African-Caribbean origin: drug of choice in HTN

A

Calcium channel blocker (C)

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10
Q

Auscultation finding of pulmonary HTN

A

Pericardial heave
Loud P2
Tricuspid regurgitation
Raised JVP with a waves

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11
Q

Physical findings in Pulmonary HTN

A

Progressive exertional dyspnea
Exertional syncope
Peripheral edema
Exertional chest pain
Cyanosis

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12
Q

intravenous epoprostenol or inhaled nitric oxide.

A

Vasodilators given for acute vasodilator therapy in PHTN

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13
Q

Vave commonly affected in infective endocarditis

A

Mitral valve
Aortic

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14
Q

Criteria for diagnosis of infective endocarditis

A

Dukes criteria
2 major
1 major 3 minor
5 minor

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15
Q

now the most common cause of infective endocarditis
particularly common in acute presentation and IVDUs

A

Staphylococcus aureus

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16
Q

endocarditis caused by these organisms is linked with poor dental hygiene or following a dental procedure

A

Strep Viridans

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17
Q

most cause of endocarditis in patients following prosthetic valve surgery,

A

Staph epidermidis

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18
Q

non infective causes of infective endocarditis

A

systemic lupus erythematosus (Libman-Sacks)
malignancy: marantic endocarditis

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19
Q

IE associated with colorectal cancer

A

Strep bovis
(now called Streptococcus gallolyticus)

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20
Q

vascular phenomena: major emboli, splenomegaly, clubbing, splinter haemorrhages, Janeway lesions, petechiae or purpura

A

minor criteria of duke

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21
Q

immunological phenomena: glomerulonephritis, Osler’s nodes, Roth spots

A

minor criteria for duke

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22
Q

ECG finding of stable and unstable angine

A

ST segment depression

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23
Q

ECG finding of prinzmetal angina

A

ST segment elevation

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24
Q

Treatment for angina

A

Nitroglycerine (vasodilator) and for prinzmetal add CCB

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25
Q

Gold standard for assessing coronary arteries

A

CT coronary angiography

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26
Q

Types of lipids

A

Cholestrol
Triglycerides
Phospholipids

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27
Q

Side effects of niacin

A

Flushing
Gout
Liver toxicity

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28
Q

Side effect of fibrates

A

Rhabdomyolysis
Myopathy
GI disturbances

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29
Q

side effects of bile acid sequestrans

A

GI upset

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30
Q

Labs to check with statins?

A

LFTs for raised transaminases

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31
Q

Contraindication of statins

A

Patient with a history of intracerebral haemorrhage
macrolides (e.g. erythromycin, clarithromycin) are an important interaction. Statins should be stopped until patients complete the course
pregnancy

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32
Q

Target INR for metallic prosthetic valve

A

aortic: 3.0
mitral: 3.5
with lifelong warfarin

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33
Q

Side effects of B blockers

A
  • Bronchospasm (especially in asthmatics)
  • Fatigue
  • Cold peripheries
  • Sleep disturbances
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34
Q

Side effect of CCB

A
  • Headache
  • Flushing
  • Ankle oedema

Verapamil also commonly causes constipation

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35
Q

Side effect of nitrates

A
  • Headache
  • Postural hypotension
  • Tachycardia
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36
Q

side effect of nicorandil(anti anginal)

A
  • Headache
  • Flushing
  • Anal ulceration
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37
Q

Dyspnea on exertion
Syncope on exertion
Exertional dyspnea

A

Aortic stenosis

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38
Q

ECG finding of aortic stenosis

A

Left ventricular hypertrophy

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39
Q

GOld standard for valvular heart disease

A

Transthoracic echo

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40
Q

ejection systolic murmur (ESM) is classically seen in

A

aortic stenosis

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41
Q

Atrial fibrillation patients are at high risk for what

A

Stroke

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42
Q

Sign of Afib

A

an irregularly irregular pulse

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43
Q

There are two key parts of managing patients with AF:

A
  1. Rate/rhythm control
  2. Reducing stroke risk
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44
Q

Absent P waves

A

A Fib

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45
Q

Diagnostic for afib

A

Holter monitoring
ECG

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46
Q

ALternate to cardioversion in afib is

A

beta blockers
CCB
Digoxin

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47
Q

used first-line to control the rate in AF.

A

A beta-blocker or a rate-limiting calcium channel blocker (e.g. diltiazem)

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48
Q

CCBs given with beta blockers

A

diltiazem and verapamil

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49
Q

first-line anticoagulant for patients with AF.

A

DOACS

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50
Q

What’s the target INR for patients on Warfarin?

A

2-3

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51
Q

Rate control is done by

A

cardioversion

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52
Q

pharmacological cardioversion

A

amiodarone if structural heart disease, flecainide or amiodarone in those without structural heart disease

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53
Q

a common contraindication for beta-blockers is

A

asthma

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54
Q

What echocardiographic finding is often associated with atrial fibrillation?

A

Left atrial enlargement.

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55
Q

LHF results in

A

pulmonary edema

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56
Q

First line labs for HF

57
Q

Effects of BNP

A

vasodilator
diuretic and natriuretic
suppresses both sympathetic tone and the renin-angiotensin-aldosterone system

58
Q

Kaussmal sign positive in

A

Constrictive pericarditis

59
Q

Pericardial knock loud S3 seen in

A

Constricitve pericarditis

60
Q

Pulsus paradoxicus present in

A

Cardiac tamponade

61
Q

CXR finding of constrictive pericarditis

A

Pericardial calcification

62
Q

Hypotension
Raised JVP
Muffled heart sound
(Becks Triad)

A

Cardiac tamponade

63
Q

ECG finding of cardiac tamponade?

A

electrical alternans

64
Q

Leading cause of sudden cardiac death in young athletes

65
Q

Echo findings of HOCM

A

include MR, systolic anterior motion (SAM) of the anterior mitral valve and asymmetric septal hypertrophy

66
Q

Endocrine causes of cardiomyopathy

A

Diabetes mellitus
Thyrotoxicosis
Acromegaly

67
Q

Infective causes of cardiomyopathy

68
Q

Autoimmune causes of cardiomyopathy

69
Q

Neurologica causes of cardiomyopathy

A

Friedreich’s ataxia
Duchenne-Becker muscular dystrophy
Myotonic dystrophy

70
Q

Infective causes of cardiomyopathy

A

Coxsackie B virus
Chagas disease

71
Q

Nutritional causes of cardiomyopathy

A

wet beri beri

72
Q

Storage causes of cardiomyopathy

A

Haemochromatosis

73
Q

Dilated cardiomyopathy is what defect

A

Systolic defect

74
Q

Balloon appearance of heart on CXR

A

Dilated cardiomyopathy

75
Q

Octopus trap

A

Takotsubo cardiomyopathy

76
Q

Genetic mutatuions associated with dilated cardiomyopathy

A

Duchenne muscuar dystrophy
Haemochromatosis

77
Q

Drugs causing DCM

A

Doxurubicin (chemo drug)
Coacaine
ALcohol

78
Q

Cause of peripartum DCM

A

Pregnancy induced hypertension

79
Q

Imaging findings in Takotsubo cardiomyopathy

A

Echocardiography in Takotsubo reveals apical hypokinesis with basal hypercontractility (apical ballooning), unlike regional wall motion abnormalities correlating with coronary anatomy in MI. Cardiac MRI shows no late gadolinium enhancement in Takotsubo.

80
Q

Broken heart syndrome

A

Takotsubo cardiomyopathy

81
Q

ECG finding of takotsubo cardiomyopathy

A

ST-elevation

82
Q

chest pain
features of heart failure
ECG: ST-elevation
normal coronary angiogram

A

takotsubo cardiomyopathy

83
Q

prominent apical pulse
absence of pericardial calcification on CXR
the heart may be enlarged
ECG abnormalities e.g. bundle branch block, Q waves

A

Restrictive cardiomyopathy

84
Q

ECG finding of restrictive cardiomyopathy

A

low amplitude QRS

85
Q

Drug contraindicated in HOCM

A

Digoxin, nitrates, ACEI, inotropes as in increase force of contraction causing more obstruction

86
Q

Disarray fibrocytes is a characteristic feature of

87
Q

jerky pulse, large ‘a’ waves, double apex beat

88
Q

Neurodegenerative associations of HOCM

A

Friedreich’s ataxia
Wolff-Parkinson White

89
Q

an autosomal recessive variant of ARVC
a triad of ARVC, palmoplantar keratosis, and woolly hair

A

Naxos disease

90
Q

SCN5A gene mutation

A

Burguada syndrome

91
Q

Lightheadedness
Syncope
SOB
Palpitations
Headache
Chest pain

A

Burguada syndrome

92
Q

Arrythmias after meal or during fever or alcohol abuse

A

Burguada syndrome

93
Q

investigation of choice in suspected cases of Brugada syndrome

A

the ECG changes may be more apparent following the administration of flecainide or ajmaline

94
Q

downsloping ST segment and an inverted T wave

A

Brugada syndrome

95
Q

Autosomal dominant, SCN5A, downsloping ST into negative T (V1-3), ICD

A

Burguada syndrome

96
Q

Murmur in HOCM

A

Pansysytolic murmur

97
Q

Deep Q waves specially in inf and lateral leads
LVH
seen on ecg of

98
Q

Severe complication of eclampsia

99
Q

condition seen after 20 weeks gestation
pregnancy-induced hypertension (new onset)
proteinuria
edema

A

pre eclampsia

100
Q

Hemolysis
Elevated liver enzymes
low plateletes (<100)

A

HELLP syndrome

101
Q

cardinal feature of severe pre eclampsia

A

upper epigastric pain

102
Q

Fetal complications of Pre eclampsia

A

IUGR
Prematurity

103
Q

Anti hypertensive used in pregnancy

A

beta blocker (labetolol)

104
Q

avoiding _______ in patients with a history of intracerebral haemorrhage

105
Q

Myopathies common with what kind of statins

A

lipophilic statins (atorvastatin, simvastatin)

106
Q

Osmotic diuretics act on

A

PCT
Loop of Henle

107
Q

Loop diuretics (Bumedonide, Furosemide) act on

A

Thick ascending limb

108
Q

Gout is a complication of ____ diuretic

109
Q

Major complication of thiazide diuretic

110
Q

Indications for loop diuretics

A

heart failure: both acute (usually intravenously) and chronic (usually orally)
resistant hypertension, particularly in patients with renal impairment

111
Q

They should be used with caution in patients taking ACE inhibitors as they precipitate hyperkalaemia.

A

K sparing diuretics

112
Q

Indications of Amiadrione

A

Ventricular tachycardia
Ventricular fibrillation
Atrial flutter
In Afib for cardioversion for rhythm control

113
Q

D/D of MI

A

Pericarditis
Aortix aneurysm
Infective endocarditis
Pericardial effusion
Cardiac tamponade
Anxiety
Pulmonary embolism
Esophageal rupture

114
Q

Arteries involved in MI

A

LAD
LCX
RCA

115
Q

The two most important investigations when assessing a patient with chest pain are:

A

ECG
cardiac markers e.g. troponin

116
Q

First line in STEMI

A

PCI (within 12 hours of attack)

117
Q

Second line for STEMI

A

Fibrinolysis (within 120 minutes of fibrinolysis PCI can be done)

118
Q

Gold standard treatment for STEMI

119
Q

most common cause of death following a MI

A

Ventricular fibrillation

120
Q

A non-pulsatile JVP is seen in

A

superior vena caval obstruction.

121
Q

Kussmaul’s sign describes a paradoxical rise in JVP during inspiration seen in

A

constrictive pericarditis.

122
Q

a wave absent in

123
Q

seen in complete heart block, ventricular tachycardia/ectopics, nodal rhythm, single chamber ventricular pacing

A

Cannon a waves

124
Q

Giant v waves in

A

tricuspid regurgitation

125
Q

PDA is common in

A

Premature babies
Babies born at high altitude
Mlother having rubella infection

126
Q

Continuous machinery murmue
Left subclavicular thrill
large volume, bounding, collapsing pulse
wide pulse pressure
heaving apex beat

127
Q

Drugs for PDA closure in preterm infants

A

Ibuprofen
Indomethacin (rare)
Paracetamol

128
Q

PDA closure in term infants

A

Transcatheter PDA closure and never pharmacological in term babies

129
Q

Drug to keep PDA patent

A

Prostaglandin E1

130
Q

PDA and aortic regurd murmur diff

A

this is holosystolic, aortic regurg is early diastolic

131
Q

aortic regurgitation
patent ductus arteriosus
hyperkinetic states (anaemia, thyrotoxic, fever, exercise/pregnancy

A

Collapsing pulse seen in

132
Q

Severe LVF pulse

A

Pulsus alternans

133
Q

Drug that should not be used in VT

134
Q

Drug therapy for VT

A

amiodarone: ideally administered through a central line
lidocaine: use with caution in severe left ventricular impairment
procainamide

135
Q

Congenital defect caused by exposure to Lithium in utero

A

Ebstiens anomaly

136
Q

tachycardia with rate of 150 b/m

A

atrial flutter

137
Q

management for torsades pointes

138
Q

commonly used to treat MRSA and Clostridium difficile.

A

vancomycin

RCP (4 decks)

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