Cardio

Question 1

Aortic regurg signs

Answer 1

Quincke’s sign
Collapsing pulse
Wide pulse pressure (dynamic movements globally due to pulses)
EDM murmur (best heard in expiration with patient sitting forward)

Question 2

Aortic stenosis signs

Answer 2

Slow rising pulse

Narrow pulse pressure

Question 3

3rd heart sound

Answer 3

Big dilated ventricle (blood hitting the wall) (associated with heart failure)

Question 4

4th heart sound

Answer 4

More common when the ventricle is thick (atria contract forcefully) (associated with long standing hypertension )

Question 5

Left ventricular hypertrophy diagnosis

Answer 5

ECG tall R waves, deep S waves due to ventricle working really hard

Question 6

When would a patient have a gallop rhythm? (S1 + S2 + S3 + S4)?

Answer 6

Hypertensive heart failure

Question 7

Acute rheumatic fever is an

Answer 7

Autoimmune disease

Question 8

Give another name for Sydenham’s chorea

Answer 8

St Vitus dance

Question 9

2 signs on examination of Aortic dissection

Answer 9

Difference between bp in two arms

Early diastolic murmur- aortic regurg

Question 10

ST elevation in an Anterior MI shows on which leads?

Answer 10

V1-V4 leads

Question 11

ST elevation in an Inferior MI shows on which leads?

Answer 11

II III and aVF

Question 12

ST elevation in a Lateral MI show on which leads?

Answer 12

I aVL V5 and V6

Question 13

Anterior MI which artery is affected?

Answer 13

LAD

Question 14

Inferior MI which artery is affected?

Answer 14

RCA

Question 15

Lateral MI which artery is affected?

Answer 15

Circumflex of LCA

Question 16

Type of tachycardia associated with Long QT syndrome

Answer 16

Torsades de pointes (Polymorphic VT)

Question 17

DDx of pansystolic murmur

Answer 17

Tricuspid regurgitation
Mitral regurgitation
Ventricular septal defect

Question 18

Causes of raised JVP

Answer 18

R sided heart failure
Tricuspid regurgitation
Constrictive pericarditis

Question 19

Mitral regurg signs

Answer 19

Pansystolic murmur loudest in mitral area
Radiates to axila
Displaced apex beat

Question 20

Sinus tachycardia causes

Answer 20

Anxiety
Sepsis
Hypovolaemia

Question 21

ECG: Tachycardia, regular, no p waves

Answer 21

SVT (AVNRT or AVRT)

Question 22

AF causes

Answer 22

Thyrotoxicosis, alcohol
Pericarditis, IHD, Hypertensive heart disease, valve problems
Pneumonia, PE, cancer

Question 23

ECG: broad complex tachycardia

Answer 23

Ventricular tachycardia (until proven otherwise)

Question 24

Causes of VT

Answer 24

IHD
Electrolyte abnormality
Long QT

Question 25

Cardioversion vs Defibrillation

Answer 25

Cardioversion needs to be synced with the cardiac cycle otherwise it could have negative effect (In cardiac arrest you just deliver the shock)

Question 26

Acute SVT management

Answer 26

Haemodynamic compromised -> cardioversion Vagal manoeuvres Adenosine (contraindicated in asthmatics)

Question 27

Acute AF management

Answer 27

If less than 48 hours --> Cardiovert CANT cardiovert if more than 48 hours ``` If not --> treat underlying cause + Rate control (b blocker, digoxin), anticoagulate to reduce risk of stroke ```

Question 28

Acute VT management

Answer 28

Haemodynamic compromised -> cardioversion If not --> IV amiodarone Look for underlying cause (electrolytes)

Question 29

Chest X-Ray signs of heart failure

Answer 29

Dilated, prominent upper lobe vessels Cardiomegaly Peri-hilar shadowing (Bat's wings) due to alveolar oedema Kerley B lines (interstitial oedema) Blunt costophrenic angles (Pleural effusions)

Question 30

Aortic regurg hyperdynamic circulation signs

Answer 30

Quinkes sign (pulsating nailbeds) Corrigan's sign (pulsating carotids) De Mussets sign (head noding with each heart beat) Traubes sign (murmur heard over arteries) Duroziez (diastolic murmur when femoral artery pressed with bell of stethoscope) Muller's sign (pulsating uvula)

Question 31

Mid systolic click followed by late systolic murmur heard at the apex

Answer 31

Barlow syndrome (mitral valve prolapse)

Question 32

Low pitched, mid diastolic rumble at the apex

Answer 32

Austin Flint murmur | associated with aortic regurgitation

Question 33

Constant machinery murmur

Answer 33

Patent ductus arteriosus

Question 34

High pitched early diastolic at left sternal edge

Answer 34

Graham Steell murmur | pulmonary regurgitation

Question 35

Short, mid diastolic rumble at the apex. Associated with rheumatic fever

Answer 35

Carey Coombs murmur

Question 36

How do you measure PR interval and what is normal?

Answer 36

Start of P-wave to start of QRS | 0.12-0.20 s

Question 37

Aortic coarctation signs

Answer 37

Hypertension Radio-radial/ radio-femoral delay Mid-systolic murmur at aortic area, radiating to the back Left ventricular hypertrophy common

Question 38

What is a heave and what is a thrill?

Answer 38

Heave: very strong heartbeat you can feel Thrill: palpable murmurs

Question 39

What is Kussmaul's sign?

Answer 39

Paradoxical rise in JVP with inspiration (should fall with inspiration) Associated with Constrictive Pericarditis, Restrictive cardiomyopathy, RH failure etc

Question 40

DDx of pleuritic chest pain

Answer 40

``` PE Pneumothorax Pneumonia Pleural pathology Pericarditis ```

Question 41

Hyperkalaemia ECG changes

Answer 41

Tall tented T waves Prolonged PR Decreased or disappearing P waves Wide QRS

Question 42

Major criteria for rheumatic fever

Answer 42

``` Carditis Arthritis Sydenham's chorea Erythema marginatum Subcutaneous nodules ```