Cardio

Question 1

When would you hear a pansystolic murmur that radiates to the axilla?

Answer 1

Patient with mitral valve regurgitation

Question 2

Give 3 pathogen causes of infective endocarditis?

Answer 2

S. Aureus, S. epidermis, Strep Viridans (dental)

Question 3

Give 3 risk factors for infective endocarditis?

Answer 3

Aortic or mitral valve disease, IVDU, prosthetic valves, immunosuppression, dental caries, recent infection

Question 4

Give 3 symptoms of infective endocarditis?

Answer 4

Fever, Malaise, Night sweats, Chest Pain, SOB, Osler nodes, Roth spots (blood vessels in eyes), janeway lesions (red fingers)

Question 5

What criteria is used to diagnose infective endocarditis?

Answer 5

Duke’s Criteria

Question 6

Give 3 causes of atrial fibrillation?

Answer 6

Hyperthyroidism, Caffeine/Alcohol, Heart Failure, Hypertension, Mitral valve disease

Question 7

Give 3 symptoms of atrial fibrillation?

Answer 7

Palpitations, chest pain, shortness of breath, dizziness, fainting

Question 8

Suggest 2 medications to control heart rate in AF?

Answer 8

Beta Blocker (atenolol), Calcium Channel Blocker (Veramapil)

Question 9

Suggest 2 a method to control heart rhythm in AF?

Answer 9

Electrial cardioversion or medical cardioversion is amiodarone

Question 10

Suggest 2 causes of heart block?

Answer 10

Cardiomyopathy, Coronary artery disease

Question 11

What murmur would you hear in a patient with mitral valve stenosis?

Answer 11

Mid-diastolic murmur

Question 12

Give 3 symptoms of aortic stenosis?

Answer 12

Syncope, Angina, Dyspnoea, Dizziness

Question 13

Give 3 signs on examination in a patient with aortic stenosis?

Answer 13

Slow rising pulse
Ejection systolic murmur
Murmur radiates to carotid

Question 14

What are the 3 main causes of left sided heart failure?

Answer 14

Ischaemic heart disease, Cardiomyopathy, Hypertension, Aortic/Mitral Valve disease

Question 15

Give 3 symptoms of left sided heart failure?

Answer 15

SOB on exertion, PND, fatigue, pink sputum, wheeze, weight loss

Question 16

Give 3 symptoms of right sided heart failure?

Answer 16

Peripheral oedema, ascites, nausea, anorexia, GI upset

Question 17

What findings would you see on an X-Ray for a patient with heart failure?

Answer 17

Cardiomegaly, Pleural effusion, alveolar oedema, dilated upper lobe vessels and Kerley B lines (interstitial oedema)

Question 18

What specific marker would you look for in blood in a patient with heart failure?

Answer 18

BNP

Question 19

Give 2 management options for a patient with heart failure?

Answer 19

ACE-Inhibitor, Beta Blocker

Question 20

If a patient is intolerant to ACE-Inhibitor what medication would you offer?

Answer 20

Angiotensin Receptor Blocker (Losartan)

Question 21

If a patient is >55 and not afro-caribbean what would your first line anti-hypertensive medication be?

Answer 21

ACE inhibitor

Question 22

What is second line medication for hypertension?

Answer 22

ACE inhibitor and Calcium Channel blocker

Question 23

Give 3 symptoms of Angina?

Answer 23

Heavy tight chest pain, radiate to jaw, relieved by rest and GTN

Question 24

What is the difference between stable and unstable angina?

Answer 24

Unstable angina occurs at rest

Question 25

What is the difference between unstable angina and NSTEMI?

Answer 25

Unstable angina has no biochemical markers eg troponin

Question 26

What is the difference between NSTEMI and STEMI?

Answer 26

NSTEMI has no ST elevation

Question 27

Give 4 stages of initial management after a STEMI?

Answer 27

MONA (Morphine, Oxygen, Nitrates, Aspirin)

Question 28

What are the ECG changes of an MI?

Answer 28

ST elevation, T-wave inversion

Question 29

Give 3 non-modifiable risk factors for acute coronary syndrome?

Answer 29

Age, gender, family history

Question 30

Give 3 modifiable risk factors for acute coronary syndrome?

Answer 30

Smoking, hypertension, hyperlipidaemia, obesity

Question 31

Give 3 symptoms of an MI?

Answer 31

Chest pain lasting >20mins, nausea, sweating, dyspnoea, palpitations radiates to arms

Question 32

Give 3 causes of pericarditis?

Answer 32

Viral (adenovirus), Post MI (Dresslers), Bacterial (TB, pneumonia), autoimmune (SLE)

Question 33

Give 3 clinical features of pericarditis?

Answer 33

Sharp central chest pain, worse on inspiration, or lying flat and relieved by sitting forward, fever, recent infection, palpitation/tacycardia

Question 34

What are the 6 P's of peripheral vascular disease?

Answer 34

Pain, pallor, perishing cold, pulseless, paralysis, parasthesia

Question 35

Give 2 clinical features of critical limb ischaemia?

Answer 35

Nocturnal pain, ulcers