CARDIO 2

Question 1

mitral regurg

Answer 1

pan systolic murmur -> axilla

ECHO

Question 2

mitral stenosis

Answer 2

mid diastolic rumbling. tapping apex. molar flush

Question 3

aortic stenosis

Answer 3

ejection systolic -> carotids

slow rising pulse

Question 4

aortic regurg

Answer 4

early diastolic. displaced apex. collapsing pulse

Question 5

mitral valvel prolapse symptoms
murmur
treatment
complication

Answer 5

atypical chest pain on palpitations.
mid diastolic click. late systolic murmur
surgery (can cause MR), anti arrhythmic drugs
emboli - sudden death

Question 6

pulmonary stenosis cause and assoc with what
symptoms
treatmetn

Answer 6

congenital. carcinoid syndrome
fatigue. syncope. HF. ejection systole
balloon valvoplasty - rare to replace

Question 7

tricuspid regurg cause
symp
treatment

Answer 7

usually function. secondary to dilatation of tricuspid annulus following LV dilation
pan systolic best heard at lower left sternal edge
underlying cause/surgery

Question 8

ASD cause
symp
rx

Answer 8

congenital
usually asymp till childhood. palpitations dyspnoea. cyanosis. ejection systolic. splitting of S2
surgical closure

Question 9

VSD usually where
cause
symp
rx

Answer 9

membranous portion
downs
cyanosis. clubbing. loud pan systolic murmur
surgery

Question 10

PDA symo

Answer 10

bounding pulse

machine gun murmur

Question 11

coarctation of aorta

Answer 11

headaches
nosbleeds
decreased lower limb pulses
CXR rib notching

Question 12

long QT

Answer 12

QTc 480 or over ms

or LQTS score is over 3

Question 13

hypertrophic CM what
symp
leading cause of what

Answer 13

LV outflow obstruction due to assymetrical septal hypertrophy
sudden death HF angina AFib
leading cause of sudden death in young athletes

Question 14

dilated CM cause

Answer 14

alcohol coxsachie virus B

Question 15

arrhythmogenic right Mis what

symp

Answer 15

fibrofatty replacement of myocytes

ventricular arrhythmias

Question 16

restrictive CM cause

symp

Answer 16

amyloidosis. sarcoidsoiss. haemachrom. idiopathic

eventually heart failure

Question 17

infect endocarditis commonly which side. when on other side
cause
acute symp
chronic symp

Answer 17

commonly L. RS in IVDU

valvular disease, prosthetic valves, IVDU, immunosuppression. DM

new murmur and fever. septic signs. cardiac failure. haematuria. petechial rash, splinter haem, roth spots.

low grade fever, fatigue, SOB, murmur, clubbing, janeway lesions, osler nodes

Question 18

DUKES major:
minor:

when is the diagnosis of endo made:

Answer 18

2 positive blood culture. ECHO proof. new valve regurgitation

predisposing heart disease/IVDU, temperature over 38, vascular phenomenon, immunological phenomenon, microbiology evidence

Question 19

ix for endocarditis

Answer 19

SEPSIS 6. 2 blood culture sets for native acute within 1h. in native subacute 3 sets 6 hours in between if patient stable. ECG, CXR, ECHO, urinalysis

Question 20

SA
strep viridins
staph epidermis

Answer 20

IV fluclox
benzylpenicillin and Gent
Vanc and Gent

Question 21

myocarditis is what 
symp
cx
ix
treatment

Answer 21

inflammation of myometrium. post viral illness/infection
SOB, pain, fever, chest pain
MI, HF
ECG, CXR, increased CK/trop
underlying, bed rest, ABs where appropriate

Question 22

pericarditis symptoms
cause
ECG and other ix
cx - 3

Answer 22

pleuritic chest pain relieved by sitting forward, cough, flu like symptoms, pericardial rub, tachypnoea, tacky

viral infection, uraemia, post MI, dresslers, CTD, hypothyroid

ECG - saddle shapes STE
FBC, CRP, ECHO if effusion if suspected

pericardial effusion, cardiac tamponade, constrictive pericarditis

Question 23

pericardial effusion is what

symp

Answer 23

accusation of fluid in pericardial sac

SOB, pain, compression of local structure, muffled HS

Question 24

cardiac tamponade is what
symp
JVP

Answer 24

pericardial effusion leading to increased intracranial pressure leading to decreased ventricular filling and decreased CO

presents acutely. increased HR, JVP, low BP muffled HS, pulses paradox
BECKS train - falling BP increased JVP and muffled heart sounds

JVP prom X decent but absent Y descent

Question 25

constrictive pericarditis is what
symp
cause

Answer 25

pericardium hard fibroses and calcified. kussmous sign
prominent X and Y descent in JVP
TB commonest cause - can occur post open heart surgery

Question 26

what is dresslers syndrome
symptoms
treatment

Answer 26

AI reaction against antigenic proteins formed as myometrium recovers

2-6w post MI, fever, pleuritic chest pain, pericardial effusion, increased ESR

NSAIDs