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Pastest/Synap > Cardio > Flashcards

Cardio Flashcards

1
Q

How is a paroxysmal SVT treated first and second line?

A

Carotid sinus massage then adenosine

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2
Q

When is primary pulmonary hypertension common?

A

Post-partum

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3
Q

In patients with what conditions is temporary pacing during PCI indicated?

A

Type II or complete heart block

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4
Q

What is a side effect of amiodarone?

A

Slate grey rash

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5
Q

What ECG changes are caused by digoxin-overdose?

A

Reversed-tick ST segment depression

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6
Q

rSR pattern in V1 indicates what?

A

RBBB

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7
Q

Name 3 causes of QT prolongation

A

Antibiotics
Hypokalaemia
Bradycardia

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8
Q

What heart murmur is associated with an opening snap?

A

Mitral stenosis

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9
Q

Name 4 causes of palpitations

A

Alcohol
Caffeine
Heavy metals
Cigarettes

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10
Q

Apart from AS, what murmur may cause an ejection systolic murmur?

A

Severe AR

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11
Q

VSDs can cause what heart murmur?

A

AR

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12
Q

What arrhythmia may be caused by hyperthyroidism?

A

AF

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13
Q

Occlusion of which coronary vessel cannot be treated safely with PCI?

A

Left main stem

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14
Q

Define pulsus paradoxus

A

A decrease of >10mmHg (systolic) upon inspiration

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15
Q

What are 3 characteristics of an ASD?

A
  • Fixed splitting of S2
  • Dilation of RA and RV
  • Ejection systolic murmur
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16
Q

In what condition are cannon a waves seen in JVP?

A

Complete heart block

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17
Q

Which heart murmur leads to an elevated JVP?

A

Tricuspid regurgitation

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18
Q

With which valve is a defect in the ostium priumum associated?

A

Mitral valve

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19
Q

Name a condition which can cause pulsus paradoxus

A

Cardiac tamponade

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20
Q

What is Takayasu’s arteritis?

A

Absent pulses

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21
Q

Head bobbing and visible capillary pulsations are associated with which murmur?

A

AR

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22
Q

Which kind of inheritance is HOCM?

A

Autosomal dominant

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23
Q

Does the valsalva manoeuvre increase/decrease preload/afterload?

A

Decreases preload

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24
Q

Pericarditis may cause which heart sound?

A

3rd

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25
Q

A LV aneurysm may present how on an ECG?

A

Persistent ST elevation

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26
Q

What is Tietze’s disease?

A

Inflammation around the costosternal junctions (painful to touch)

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27
Q

Coronary artery vasospasms are common in patients with a history of what medical condition?

A

Migraines

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28
Q

Having AF increases your risk of stroke by how much?

A

5x

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29
Q

What % of EDV is ejected during systole?

A

50-70%

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30
Q

Which is worse prognostically (post-MI) - high or low BP?

A

Low

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31
Q

Do inferior or anterior infarcts have a worse prognosis?

A

Anterior

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32
Q

When do large VSDs usually present?

A

Within the first month of life

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33
Q

In which lead may T wave inversion be normal?

A

V1

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34
Q

What is the maximum time for normal QRS duration?

A

120ms (3 small boxes)

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35
Q

Which is better post-MI for revascularisation - tPA or streptokinase?

A

tPA

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36
Q

When is streptokinase contraindicated (4 reasons)?

A

Peptic ulcer disease
Previous hypertensive stroke
History of hypersensitivity
Extensive cardiac massage

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37
Q

Which type of endocarditis is related to SLE?

A

Liebmann Sacks

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38
Q

In under 70s, what is the most common cause of AS?

A

Bicuspid aortic valve

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39
Q

What % of hypertension cases are secondary?

A

10%

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40
Q

What types of diseases most commonly cause secondary hypertension?

A

Renal diseases

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41
Q

Describe characteristics of Turner’s syndrome

A 
Coarctation
Aortic dissection
Congenital bicuspid aortic valve
Mitral valve prolapse
Non-development of secondary sexual characteristics
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42
Q

What causes fixed splitting of the second heart sound?

A

ASDs

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43
Q

Is streptokinase given in NSTEMI?

A

No - only in the presence of ECG changes

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44
Q

Which murmur are UC, ankylosing spondylitis and rheumatoid arthritis associated?

A

AR

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45
Q

What is De Mussett’s sign?

A

Bobbing of the head

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46
Q

What is Durosiez’s sign?

A

Bruit in the femoral artery

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47
Q

How is alcoholic dilative cardiomyopathy treated?

A 
Bed rest
Fluid restriction
Cautious diuresis
ACE inhibitors
Spironolactone
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48
Q

When is a wide pulse pressure seen?

A

When there is a low peripheral vascular resistance eg due to vasodilation

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49
Q

What does renal artery stenosis result in?

A

Inequal sized kidneys

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50
Q

What does Kartagener’s syndrome effect?

A

Cilia in respiratory and reproductive tracts

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51
Q

Cushing syndrome is associated with what physical appearance?

A

Moon face

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52
Q

Acute pericarditis may present how on an ECG?

A

ST elevation in leads I and II

53
Q

In which population is Brugada syndrome most common?

A

Asian males

54
Q

What ECG changes does Brugada syndrome involve?

A

RBBB and ST elevation

55
Q

What are the limits for stage 1 hypertension?

A

140/90mmHg
or
135/85mmHg (ABPM/HBPM)

56
Q

What are the limits for stage 2 hypertension?

A

160/100mmHg
or
155/95mmHg (ABPM/HBPM)

57
Q

What are the limits for severe hypertension?

A

> 180mmHg systolic
or
110mmHg diastolic

58
Q

What two drugs may be used prophylactically in AF?

A

Amiodarone or flecainide

59
Q

What is the most common cause of endocarditis in the developing world?

A

Strep viridans

60
Q

When is PCI indicated (ECG changes)?

A

> 2mm elevation in 2 or more consecutive anterior leads

61
Q

What type of genetic inheritance does catecholaminergic polymoprhic VT show?

A

Autosomal dominant

62
Q

How is Torsades de Pointes treated?

A

MgSO4

63
Q

What effect do beta-blockers have in heart failure?

A

Decrease mortality

64
Q

How does LVH present on an ECG?

A

R wave in aVL >12mm
or
S wave in V1 or V2 + R wave in V5 or V6 >35mm

65
Q

Which layer of the heart is most vulnerable to ischaemia?

A

Endocardium

66
Q

Which fraction of stroke volume is ejected in the first 1/3 of diastole?

A

2/3

67
Q

What does a bifid P wave indicate?

A

LA hypertrophy

68
Q

Which murmur is associated with LA hypertrophy?

A

Mitral stenosis

69
Q

What are the HACEK organisms associated with endocarditis?

A 
Haemophilus
Aggregatibacter
Cardiobacterium
Eikenella
Kingella
70
Q

What usually causes restrictive cardiomyopathy?

A

Substance deposition

71
Q

What is the mechanism of arrhythmogenic RV dysplasia?

A

It affects desmosomes, which causes cardiac muscle to be replaced by fat (which may lead to arrhythmias)

72
Q

What are four causes of dilated caridomyopathy?

A

Genetics
Alcohol
Chemotherapy
Pregnancy

73
Q

What are the normal durations of systole and disatole?

A 
Systole = 0.3s
Diastole = 0.5s
74
Q

What are the four aspects of the tetralogy of Fallot?

A

Over-riding aorta
Pulmonary stenosis
RV outflow obstruction and hypertrophy
VSD

75
Q

What medications should be continued post-MI?

A

Dual antiplatelet therapy (clopidogrel + aspirin)
ACE inhibitors
Beta blockers
Statins

76
Q

In what condition is IV adenosine contraindicated?

A

Asthma

77
Q

Which heart murmur is associated with S4?

A

Aortic stenosis

78
Q

Is Torsades de Pointes mono- or polymorphic?

A

Polymorphic

79
Q

What is Frank-Starling law?

A

The more the ventricles are filled, the greater the systolic contractions

80
Q

What effect will sympathetic stimulation have on the Frank-Starling curve?

A

Shift to the right

81
Q

Pulmonary conditions eg PE cause which type of axis deviation?

A

Right

82
Q

Which two ECG leads should be used to determine axis deviation?

A

I and aVF

83
Q

Tall QRS complexes in V4,5,6 indicate what?

A

LVH

84
Q

Which drug directly inhibits thrombin?

A

Dabigatran

85
Q

What are three catecholamines?

A

Adrenaline
Dobutamine
Noradrenaline

86
Q

What is first line management of SVT?

A

Valsalva manouevre or carotid massage

87
Q

What is second line management of SVT?

A

Adenosine and cardioversion

88
Q

What is the most common cause of endocarditis?

A

Staph aureus

89
Q

What is the most common anti-emetic given with diamorphine during a STEMI?

A

Metoclopramide

90
Q

Where is the ectopic focus usually located in AF?

A

The ostia of pulmonary veins

91
Q

When should CCBs not be used for rate control in AF?

A

When there is co-existing heart failure

92
Q

When should beta blockers not be used to treat AF?

A

Asthmatics

93
Q

Is electrical or pharmacological cardioversion superior?

A

Electrical

94
Q

After what period of time of AF should anti-coagulation be carried out for before cardioversion? How long should anti-coagulation be continued for?

A

AF for >48hours

Anti-coagulation for 3 weeks

95
Q

What is second line AF therapy?

A

2/3 from beta blockers, rate limiting CCBs and digoxin

96
Q

Which two drugs should never be used together to treat AF?

A

Verapamil and beta-blockers

97
Q

Which two murmurs are associated with low volume pulses?

A

AS and MS

98
Q

What is the resting potential of a myocardial cell?

A

-90mV

99
Q

Give an example of an a1 receptor antagonist

A

Adenosine

100
Q

Which drug can be used in VTs and SVTs?

A

Amiodarone

101
Q

How long is the action of adenosine?

A

8-10 seconds

102
Q

Which heart murmur is associated with S3?

A

MR

103
Q

Via which method of signalling does adenosine work?

A

GPCR

104
Q

Which two drug classes work on supraventricular arrhythmias in the atria?

A

IC and III

105
Q

How does amiodarone decrease heart rate?

A

Prolongs the action potential

106
Q

Which group is most likely to develop SVTs?

A

Young women

107
Q

Which pattern of inheritance does Brugada syndrome show?

A

Autosomal dominant

108
Q

Which 3 conditions does Brugada increase the risk of?

A

VT, VF and AF

109
Q

Which type of heart block isknown as Wenckbach phenomenon?

A

Mobitz Type I

110
Q

Which condition contraindicates the use of diamorphine in heart failure?

A

COPD

111
Q

What is the treatment for chronic heart failure?

A 
ACEi
Beta blocker
Diuretics
Digoxin
Spironolactone
112
Q

What is the treatment for DVT?

A

LMWH

Warfarin

113
Q

When is warfarin use contraindicated?

A

Pregnancy

114
Q

What is the treatment for limb ischaemia?

A 
ALPS:
Antiplatelets
Lifestyle change
PCI or vascular bypass
Statins
115
Q

What is the treatment for acute pulmonary oedema?

A

Furosemide

116
Q

What is the treatment for varicose veins?

A

Foam scleropathy
Endovenous ablation
Compression stockings

117
Q

What is the treatment for an ischaemic stroke?

A

Statins
Aspirin
Thrombolysis
Supportive

118
Q

What is the treatment for a haemorrhagic stroke?

A

Supportive

119
Q

How is phlegmasia dolens treated?

A

IVC filter through the femoral artery

120
Q

What is the purpose of treatment in phlegmasia dolens?

A

Prophylaxis for PE

121
Q

What is the treatment for cardiac tamponade?

A

Pericardiocentesis

122
Q

What is the treatment for co-arctation of the aorta?

A

Stent and balloon dilation

123
Q

What is the treatment for Tetralogy of Fallot?

A

Oxygen
Beta blockers
Endocarditis prophylaxis
Surgery

124
Q

What is the treatment for AAA?

A

Endovascular aneurysm repair

125
Q

What is the treatment for stable angina?

A 
ABC BAGS P
ACEi
Beta blockers
CCBs
Bypass
Aspirin
GTN
Statins
Potassium channel openers
126
Q

What is the treatment for unstable angina?

A

HAG
Heparin
Aspirin
GTN (IV)

127
Q

What is the treatment for coronary artery vasospasm?

A

CCBs

Isosorbide mononitrate

128
Q

What condition is the Bundle of Kent associated with?

A

WPW

129
Q

Which congenital defect will cause splitting of the second heart sound?

A

ASD

Pastest/Synap (6 decks)

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