Cardio 6 Flashcards

1
Q

pulmonary stenosis murmur heard best where?

A

second left intercostal space

radiates to shoulder

ejection systolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Left ventricular free wall rupture
is associated with?

A

cardiac tamponade and acute HF due to

pericardium to rapidly fill with blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when investigating aortic dissection
after Xray what do you look at?

if patients are unstable?

A

CT angiography
transoesophageal echocardiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what type of antibiotic can cause torsades desn pointes?

A

macrolide
azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

unstable angina is at rest
T/F?

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Aortic Dissection
management
Ascending aorta?

A

IV labetolol to control BP
> theatre
> surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is broad complex QRS?

how many small squares?

A

> 0.12 milliseconds

3 small squares

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

common causes of broad complex?

A

Stable broad complex tachycardia
is VT unless proven otherwise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diagnosing bundle branch block
step 1
what would QRS show?

A

wide QRS > 3 small squares / >0.12 ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dx BBB
left
which leads to look at?

A

1) wide QRS
2) Lead V1 / V6/ lead 1

cominant negative QRS in v1
broad slurred R in V6 / lead 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

which antibiotic class reacts with statins?

what is the interaction?

A

macrolide such as erythromycin

increase risk of hepatotoxicity and rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

pedunculated heterogeneous mass on echocardiogram

A

atrial myxoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Atrial myxoma is a

A

benign tumour
left atrium (most likely)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

atrial myxoma presents with triad of?

A

mitral valve obstruction, systemic embolisation + constitutional symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

following a TIA if a patient has Afib how to manage?

A

anticoagulate immediately once imaging has ruled out haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

acyanotic congenital cardiac abnormality?

A

vetricular septal defect - pansystolic murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

congenital cardiac murmurs
patent ductus arteriosus

A

continuous machinery murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

congenital cardiac murmur

murmur which is more prominent at beginning of systole?

A

ejection systolic
atrial septal defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A murmur which is more prominent at the start of diastole

A

early diastolic

aortic and pulmonary regurg

20
Q

A murmur more prominent towards the end of systole

A

coarctation of the aorta / mitral valve prolapse

21
Q

coarctation of aorta?

A

aortic clicks
radio-femoral delay

22
Q

bisferiens pulse

A

mixed aortic valve disease

2 distinct systolic peaks

23
Q

statin monitoring

A

LFTs

baseline
3 months and
12 months

24
Q

Streptococcus sanguinis

group of viridans group of streptococci

A

a-hemolytic

commensal in mouth / dental disease

25
ALT can be raised in statin use on LFT but what is the limit?
upto 3 times the upper limit of normal
26
Management for complete heartblock?
pacemaker
27
for pts with IHD history with a new onset AF how should antithrombotic medication be given?
they would be on a antiplatelet but if stable say MI was 20 years ago
28
causes of AS >65 <65
degenerative calcification most common in older bicuspid aortic valve
29
pt high bleeding risk NSTEMI mx?
aspirin and clopidogrel
30
1st degree heart block post MI
inferior leads affected II, III, aVF
31
af and anticoagulation female, 64 and healthy?
do not offer anticoagulant <65 if no RF other than sex
32
symptomatic bradycardia is managed with?
IV atropine <60bpm
33
Potential risk of asystole bradycardic pt
complete heart block with broad complex QRS recent asystole Mobitz type II AV block ventricular pause > 3 seconds
34
Mitral regurgitation
pansystolic high pitched blowing
35
pericarditis cardinal features on ECG causes?
widespread ST elevation w PR depression infection: viral coxsackie, TB, inflammation : SLE/ RA malignancy
36
complications post MI pansystolic murmur acute HF
ventricular septal defect rupture of the interventricular septum echo needed to confirm corrective surgery required
37
complications post MI acute onset shortness of breath, bibasal crackles, raised jugular venous pressure, muffled heart sounds
left ventricular free wall rupture Urgent pericardiocentesis and thoracotomy
38
acute heart failure clinical signs
raised JVP wheeze bibasal crackles displaced apex beat S3
39
when should warfarin be stopped before surgery?
5 days INR <1.5
40
current chest pain and abnormal ECG at a GP? <12 hours chest pain
emergency admission to secondary care - ambulance w aspirin given
41
patients on warfarin having emergency surgery:
25-50 units/kg four-factor prothrombin complex if 5-6 hours to surgery give IV vitamin K
42
heart failure with fluid overload
severe anaemia from a big bleed can cause this inadequate perfusion of blood
43
hypothermia VF?
rewarmed to 30 degrees then shock
44
Moderate-severe aortic stenosis is a contraindication to ACE-i why?
vasodilator effect of an ACE inhibitor might lead to a reduction in the coronary perfusion pressure cardiac ischaemia
45