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MRCP > Cardio > Flashcards

Cardio Flashcards

1
Q

ECG findings PE (3)

A

Large S wave in lead I, a large Q wave in lead III and an inverted T wave in lead III - ‘S1Q3T3’
Right axis deviation/RBBB
Sinus tachycardia

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2
Q

Sacubitril (neprilysin inhibitor) MoA in heart failure

A

Inhibits degradation of BNP and ANP - thus promotes natriuresis and vasodilation

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3
Q

Stage 1 HTN

A

Clinic BP >140/90 and subsequent ABPM/HBPM >135/85

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4
Q

Stage 2 HTN

A

Clinic BP >160/100 and subsequent ABPM/HBPM >150/95

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5
Q

Stage 3 HTN

A

Clinic systolic >180 or diastolic >110

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6
Q

Indications for treating Stage 1 HTN

A 
Target organ damage 
Established CVD
Renal disease 
DM
10-year cardiac risk 10% or greater
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7
Q

Resistant HTN defintion

A

clinic BP >= 140/90 mmHg after step 3 treatment with optimal or best tolerated doses as resistant hypertension

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8
Q

Infective Endocarditis poor prognostic features (4)

A

Staph aureus
Low complements
Prosthetic valve (esp if soon after placement)
Culture negative

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9
Q

Mortality per IE organism - staph, bowel, strep

A

30%, 15%, 5%

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10
Q

Initial blind Rx for IE - native valve

A

Amoxicillin +/- gent low dose

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11
Q

Initial blind Rx for IE - native valve - pen allergic/MRSA/Severe sepsis

A

Vancomycin + low dose gent

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12
Q

Initial blind Rx for IE - prosthetic valve

A

Vanc + rifampicin + low dose gent

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13
Q

Native valve endocarditis caused by staphylococci

A

Flucloxacillin

Vanc + rifamp if pen allergic

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14
Q

Prosthetic valve endocarditis caused by staphylococci

A

Flucloxacillin + rifampicin + low-dose gentamicin

Pen allergic - vancomycin + rifampicin + low-dose gentamicin

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15
Q

Endocarditis caused by fully-sensitive streptococci (e.g. viridans)

A

Benzylpenicillin

Pen allergic - vanc + low dose gent

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16
Q

Endocarditis caused by less sensitive streptococci

A

Benpen + low dose gent

Pen allergic - Vanc + low dose gent

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17
Q

IE indications for Sx (5)

A

Severe valvular incompetence
Aortic abscess (often indicated by a lengthening PR interval)
Infections resistant to antibiotics/fungal infections
Cardiac failure refractory to standard medical treatment
Recurrent emboli after antibiotic therapy

18
Q

Indications for a temporary pacemaker (3)

A

Symptomatic/haemodynamically unstable bradycardia, not responding to atropine
Post-ANTERIOR MI - type 2 or complete heart block
Trifascicular block prior to surgery

19
Q

Poor prognostic factors in HOCM (5)

A 
Syncope
Family Hx of sudden death
Young age at Px
Non-sustained ventricular tachycardia on 24 or 48h Holter monitoring
Abnormal BP changes on exercise
20
Q

Features suggesting VT rather than SVT with aberrant conduction (7)

A 
AV dissociation
Fusion or capture beats 
Positive QRS concordance in chest leads
Marked left axis deviation
Hx of IHD
Lack of response to adenosine or carotid sinus massage
QRS > 160ms
21
Q

Cholesterol Embolisation characterisitics (4)

A

Eosinophilia
Purpura
Renal failure (common site of emboli)
Livedo reticularis

22
Q

Aspirin antiplatelet effect MoA

A

Inhibits thromboxane A2 production

23
Q

CLopidogrel MoA

A

Inhibits ADP binding to its plt receptor

24
Q

Enoxaparin MoA

A

Activates anti-thrombin III, in turn potentiates the inhibition of coagulation factors Xa

25
Q

Fondparinux MoA

A

Activates antithrombin III, in turn potentiates the inhibition of coagulation factors Xa§

26
Q

Bivalirudin MoA

A

Reversible direct thrombin inhibitor

27
Q

Abciximab, eptifibatide, tirofiban MoA

A

Glycoprotein IIb/IIIa receptor antagonists

28
Q

Pulsus paradoxus - description, conditions

A

> 10mmHg fall in systolic BP during inspiration -> faint or absent pulse in inspiration
Severe asthma or cardiac tamponade

29
Q

Slow rising/plateau condition

A

Aortic stenosis

30
Q

Collapsing pulse

A

AR
Patent ductus arteriosus
Hyperkinetic - anaemia, thyrotoxicosis, fever, exercise/pregnancy

31
Q

Pulsus alternans conditions

A

Regular allternation of the force of the arterial pulse

Severe LVF

32
Q

Bisferiens pulse description, conditions

A

Double pulse - two systolic peaks

Mixed aortic valve disease

33
Q

CHA2DS2-VaSc

A 
Congestive heart failure
HTN
Age >75 (2), 65-74 (1)
Diabetes
Prior stroke/TIA (2)
Vascular disease - inc IHD/PVD
Sex (female)
34
Q

HASBLED

A

HTN - uncontrolled (systolic >160)
Abnormal renal function (dialysis, Cr >200)
Abnormal Liver function - Cirrhosis, bili>x2 normal, AST/ALT/ALP x3 normal
Stroke
Bleeding Hx
Labile INRs - <60% of time in therapeutic range
Elderly >65
Drugs predisposing to bleeding (NSAIDs, antiplatelets) or alcohol use >8 drinks per week

35
Q

ST elevation V1-4

A

Anteroseptal MI

LAD (proximal V1-2, distal V3-34)

36
Q

ST elevation leads II, III, AvF

A

Inferior MI

Right coronary

37
Q

ST elevation leads V4-6, I, aVL

A

Anterolateral

LAD or left circumflex

38
Q

ST elevation I, aVL +/- V5-6

A

Lateral

Left circumflex

39
Q

Tall R waves V1-2

A

Posterior MI

Usually left circumflex, also R coronary

40
Q

LVEF calculation

A

Stroke volume/ end diastolic volume

41
Q

Stroke volume calculation

A

end diastolic volume - end systolic volume

MRCP (17 decks)

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