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Resp > Cardio > Flashcards

Cardio Flashcards

1
Q

Atypical angina Ix (3)

A

CT coronary angiography
Functional imaging
Invasive coronary angiography

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2
Q

Gold standard Ix for aortic dissection

A

Cat aortogram

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3
Q

Pericarditis

Viral causes:

A

Coxsackie,flu, EBV and mumps

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4
Q

Pericarditis

Bacterial causes

A
  1. Strep viridans (native, non IVDU)
  2. Steph aureus - IVDU, RH involvement
  3. Staph epidermidis ( prosthetic valves)

Do 3 blood cultures for IE
DUKEs Criteria
Pneumonia (mycoplasma?), step, straps, TB, rheumatic fever

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5
Q

Pericarditis O/E

A

Pericardial rub
Soft S1
S4 gallop

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6
Q

Complications of pericarditis

A

Cardiac tamponade

Pericardial effusion

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7
Q

Complications of MI

A

DARTH VADER

  • death
  • arrhythmias
  • rupture (mitral regurg due to papillary muscle rupture)
  • tamponade
  • HF
  • valve disease
  • anureysm (ventricular)
  • Dressler’s
  • embolism
  • reinfarction
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8
Q

Acute ACS management

A

MONA BASH

Morphine, oxygen, nitrates, antiplatelets

B blockers, ACEi, statins, (LMWH)

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9
Q

Immediate unstable angina/NSTEMI management

A

Aspirin and antithrombin eg fondaprinux

If undergoing angi within next 24hrs give LMWH instead

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10
Q

High risk NSTEMI/ unstable angina management via GRACE

A
  • glycoprotein inhibitors (IIb/IIIa)

- PCI

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11
Q

Functional cardiac imaging examples

A

12 lead ECG
Exercise ECG
Cardiac catheterisation
ECHO

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12
Q

Structural cardiac imaging examples

A

Echo
CXR
CT or coronary angiogram

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13
Q

Left ventricular failure can cause

A 
Cardiomegaly 
Displaced apex beat
S3
RV HEAVE
murmurs - aortic valve

Nb right ventricular failures cause mitral murmurs

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14
Q

Gold standard investigation for HF

A

BNP and TTE Echo Doppler

Nb BNP is sensitive but not specific, on its own cannot diagnose HF. If negative can rule out HF

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15
Q

Management of PE if haemodynamically unstable

A

Thrombolysis or embolectomy

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16
Q

Immediate unstable angina/NSTEMI management

A

Aspirin and antithrombin eg fondaprinux

If undergoing angi within next 24hrs give LMWH instead

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17
Q

High risk NSTEMI/ unstable angina management via GRACE

A
  • glycoprotein inhibitors (IIb/IIIa)

- PCI

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18
Q

Functional cardiac imaging examples

A

12 lead ECG
Exercise ECG
Cardiac catheterisation
ECHO

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19
Q

Structural cardiac imaging examples

A

Echo
CXR
CT or coronary angiogram

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20
Q

Left ventricular failure can cause

A 
Cardiomegaly 
Displaced apex beat
S3
RV HEAVE
murmurs - aortic valve

Nb right ventricular failures cause mitral murmurs

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21
Q

Gold standard investigation for HF

A

BNP and TTE Echo Doppler

Nb BNP is sensitive but not specific, on its own cannot diagnose HF. If negative can rule out HF

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22
Q

Heart failure on CXR

A 
Alveolar odema (bat wings) 
Kerly B lines
Cardiomegaly
Dilated prominent upper love vessels 
Pleural effusion
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23
Q

Hypertension management

A

After ACD

Consider further diuretic, alpha blocker or b blocked

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24
Q

BP control goals

  • stage 1 and 2
  • diabetic
  • > 80
A
  • 140/90
  • 130/80
  • 150/90
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25
Q

Hypertension medication side effects

ACE inhibitors

A

Cough, increased K, renal failure, Angio odema

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26
Q

Hypertension medication side effects

ARB

A

Vertigo, urticarial, puritis

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27
Q

Hypertension medication side effects

CCB

A

Ankle oedema
Flushes
Headache
Gum hyperplasia

28
Q

Hypertension medication side effects

Thiazides

A 
Decreased potassium (ECG changes, arrhythmias)
Decreased Na (confusion)
29
Q

Hypertension medication side effects

Spirolocatone

A

Increased potassium, gynaecomastia

30
Q

Hypertension medication side effects

B blocker

A

Bronchospasm, heart failure, lethargy

31
Q

Gold standard for pericarditis

A

Echo

NB do cxr is tamponade suspected

32
Q

Early diastolic murmur

A

Regurgitation murmurs

Aortic and pulmonary

33
Q

Late diastolic murmurs

A

Stenosis

Mitral and tricuspid

34
Q

Aortic stenosis

A 
Worsening SOB
PND
Collapse
Leg swelling 
Narrow pulse pressure and heaving apex beat
35
Q

Graham steel

A

Pulmonary regurgitation

Early diastolic murmur

36
Q

Austin Flint

A

Aortic incompetence - AR

AR gives wide pulse pressure

37
Q

Mitral stenosis is associated with..

A 
AF
Opening snap 
Loud S1
Red cheeks 
Rheumatic fever
38
Q

Becks Triad

A
  1. low arterial blood pressure,
  2. distended neck veins, and
  3. distant, muffled heart sounds.

CARDIAC TAMPONADE

39
Q

Hyperkalaemia ECG signs

A

tented t waves
broad QRS
flattened p waves
(path deep Q waves)

–> lead to sine wave pattern and VF

40
Q

Imaging to show infarcted myocardium

A

Nuclear studies of myocardium

single photon emission CT

41
Q

Causes of AF

A

Causes of atrial fibrillation can be remembered using ‘Dehydrated PIRATES’:

 Dehydration
Pulmonary disease, e.g. pulmonary embolism
 Ischaemia (hypertension, ischaemic heart disease, heart failure)
Rheumatic heart disease
Anaemia, atrial myxoma
Thyrotoxicosis
Ethanol abuse
 Sepsis
42
Q

Kussmaul’s sign

A

Kussmaul’s sign is a raised jugular venous pressure (JVP) upon inspiration
that falls in expiration and is seen in constrictive pericarditis.

43
Q

Investigations for chest pain

A
  1. ECG
  2. Troponin
    +ve= coronary angio
    -ve= ETT
  3. Echo
44
Q

Non cardio and resp causes of chest pain

A

Musc: costochondritis, Tietz’s
Gastro: GORD, oesophageal spasm, esophagitis, gastritis

45
Q

STEMI/NSTEMI (amir sam management)

A

STEMI; aspirin, clopidogrel, PCI

NSTEMI: aspirin, clopidogrel and fonduparinx (anti thrombin)

46
Q

Outflow obstruction (right and left)

A

Left: AS, HOCUM
Right: PE

47
Q

The t in an ecg should finish before the middle of the R-R interval in what?

A

Long QT syndrome:

  1. Congenital: mutations in K channels
  2. Aquired: low K or Mg, drugs
48
Q

Carvallo’s sign is a clinical sign found in patients with tricuspid regurgitation.

A

The pansystolic murmur found in this condition becomes louder during inspiration; this sign enables it to be distinguished from mitral regurgitation.

49
Q

Mummurs that increase on inspiration:

A

PS, PR

TR

50
Q

Pansystolic mumurs

A
  1. MR
  2. TR
  3. VSD
51
Q

DDx of increased JVP

A
  1. RHF
  2. TR (giant v waves)
  3. Constrictive pericarditis
52
Q

Cannon A waves

A

complete heart block
VEB
VT

53
Q

elevated and fixed JVP

A

SVC obstruction

54
Q

Causes of RHF

A
  • secondary to LHF

- pulmonary HTN (PE, COPD)

55
Q

TR causes

A
  • valve leaflets

- right ventricle dilation

56
Q

Causes of sinus tachycardia

A
  • sepsis
  • hypovolaemia
  • endocrine (thyrotoxicosis and phaeo)
57
Q

Causes of SVT

A

re entery circuit

58
Q

AF causes

A

Throtoxicosis, Alcohol
Heart: muscle, valve, pericardium
Lungs: pneumonia, PE, cancer

59
Q

VT causes

A

ischemia, electrolyte abnormality, long QT

60
Q

short pr

delta wave

A

AVRT

61
Q

When is adenosine contra indicated?

A

asthmatics

62
Q

LVH differentials

A

AS or pulmponary HTN

63
Q

mid systolic click

A

mitral valve prolapse

64
Q

split S2

A

atrial septal defect

65
Q

s1

A

mitral; valve

66
Q

s2

A

aortic valve

67
Q

medication which can increase your potassium levels in HF

which lower your potassium

A

SPIROLACTONE

Thiazide diuretics, fusemide

Resp (13 decks)

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