Cardio Flashcards
What is the diagnosis?
21 yr old high jumper with acute onset SOB + R pleuritic chest pain. O/e: increased resonance + reduced R expansion
Pneumothorax
What is the diagnosis?
23yr old female with localised L chest pain
Exacerbated by coughing + painful on light pressure to area
Relieved by aspirin
Unremarkable ECG
Costochondritis
N.B. idiopathic costocondritis = Tietze’s syndrome
Identify the cause of the following findings:
Pulsus paradoxus, JVP rises on inspiration, muffled heart sounds
Cardiac tamponade/constrictive pericarditis
N.B. This is Beck’s triad:
- Signs of falling BP
- Rising JVP on insp.
- Muffled heart sounds
What is the cause of the following findings:
Bounding pulse in SOB patient
Mitral stenosis
Bounding pulse = acute CO2 retention
Identify the murmur:
Pansystolic heard best at lower L sterna, edge during insp in a pt with pulsatile hepatomegaly
Tricuspid regurgitation
N.B. common to get infective endocarditis of tricuspid valve in IVDU
Identify he murmur:
Displaced, volume overloaded apex. Soft S1, pansystolic murmur at apex radiating to axilla
Mitral regurgitation
N.B. Causes of mitral regurgitation = rheumatic fever, valve prolapse, connective tissue disorders
Identify the murmur:
Left parasternal heave and harsh pansystolic murmur at lower L sternal edge also audible at apex
VSD
Identify cause for JVP observed:
Giant systolic V waves
Tricuspid regurgitation
Identify cause for JVP observed:
Large a waves and slow y descent in JVP. Patient has ascites.
Tricuspid stenosis
N.B. Most common cause is rheumatic fever
Identify the cause of the JVP observed:
Cannon a waves
Complete heart block / ventricular tachycardia
Identify the cause of the JVP observed:
JVP that rises on inspiration
Constrictive pericarditis
N.B. This is Kussmaul’s sign
Identify the cause of the ECG abnormality:
Prolonged PR, depressed ST, flattened T waves, prominent U waves
Hypokalaemia
Could be due to loop/thiazides diuretics
What is the cause of the ECG abnormality:
Sinus rhythm, bifid p waves best seen in II, V3 and V4
Mitral stenosis
N.B. Bifid p waves = p mitrale
Identify the cause of the ECG abnormality:
55yr old with HTN shows tall tented T waves
Hyperkalaemia
N.B. maybe due to HTN Tx e.g. K+ sparing diuretics or ACEis
What is the cause of the ECG abnormality:
85yr old with pneumonia complains of palpitations. ECG shows absent p waves.
AF
What is the cause of the ECG abnormality:
45yr old M With sarcoidosis shows M pattern in V5 and inverted T waves in I, avL and V5-6
LBBB
WiLLiaM
What is the cause of he ECG abnormality:
8yr old F, normal P waves and QRS complexes but T wave inversion in V1.
Normal ECG
Inverted T waves in V1-3 normal in children
What is the diagnosis?
30yr old F with HTN has hypokalaemia and mild met acidosis
Conn’s Syndrome (= unilateral adrenocortical adenoma)
N.B. primary hyperaldosteronism = HTN + hypoK+ + met acidosis
What is the diagnosis?
26yr old anxious F with episodes of chest pain and palpitations precipitated by stress and smoking.
24h urine shows elevated catecholamimes.
Phaeochromocytoma (=catecholamime secreting tumour)
N.B. Non specific presenting symptoms inc. anxiety, palpitations, tachycardia + blanching
What is the diagnosis?
45yr old F with weight gain, muscle weakness, and hrsuitism.
O/e: HTN + pedal oedema
Cushing’s syndrome
What is the diagnosis?
40yr old M with severe headache. O/e has papilloedema and fundal haemorrhages. BP is 220/145.
Malignant HTN (=severe HTN associated with acute end organ failure)
What is the diagnosis?
75yr old with HTN who is heavy smoker with widespread PAD
Renal artery stenosis
N.B. Renal disease is most common cause of 2nd HTN (1. Glomerulonephritis, 2. RAS)
What is the Tx?
65yr old F being treated with large doses of loop diuretics requires add on therapy for oedema refractory to Tx.
Metolazone (=thiazide)
What is the Tx?
69yr old F with asthma being Tx with loop diuretic, ACEi and long acting nitrate is prescribed a drug to reduce long term mortality
Spironalactone
