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MSRA > Cardio > Flashcards

Cardio Flashcards

1
Q

Management of AAA

A

> 5.5cm: offer elective repair

5.5cm has 10% annual risk of rupture, risk increases as gets larger

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2
Q

Atrial myxoma presentation

A

Symptoms are due to local mechanical effects + constitutional:
- Eg. Dyspnoea, palpitations, syncope, heart failure, fever, w/l, arthralgia
80% on left
75% females
NB. Familial myxoma may be associated with CARNEY syndrome (myxoma in breast, skin, thyroid, neural tissue, endo dysfunction, pigmented naevi)

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3
Q

Dukes Criteria for IE

A

2 major / 1 major + 2 minor / 5 minor

Major:

  • micro evidence on 2 separate BCs of typical organism
  • positive echo

Minor

  • Predisposition eg. Valve abnormality
  • Vascular phenomena
  • Elevated CRP
  • Immunological phenomena
  • BCs not fitting major criteria
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4
Q

Amiodarone SEs

A

3 Hs, 3Ps, cornea and skin

Hypo/hyperthyroidism
Hepatotoxic
Hypotension - NOT hypertension
Photosensitivity
Peripheral neuropathy
Pulmonary fibrosis
Grey skin
Corneal microdeposits
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5
Q

Px of VSD as a complication of MI

A

Tends to be post anterior MI
Pansystolic murmer at LSE (unlike MR)
Signs of heart failure

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6
Q

Contraindications for Exercise ECG

A 
UA
HF/Pulmonary oedema
Recent MI (last 7 days)
AS
Electrolyte imbalance
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7
Q

Pharm options for thrombolysis for STEMI

A

Streptokinase vs Reteplase? Reteplase~better outcomes and fewer deaths

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8
Q

Features and management of Digoxin toxicity

A

GI: anorexia, N+V, diarrhoea
ECG: bradycardia, 1st degree HB, other arrhythmias (eg ST and TW changes)

Rx:
Check potassium (low K can potential toxicity)
Correct electrolyte abnormalities
Treat arrhythmias
DIGIBIND
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9
Q

Issues with Exercise tolerance test to diagnose stable angina?

A

High sensitivity but only moderate specificity
A normal test does not exclude CAD
I.E. Exercise ECG and MRCA NOT used to diagnose or exclude stable angina in people without known CAD

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10
Q

Diagnostic tests for Aortic Dissection

A 
TransOESOPHAGEAL Echocardiography (as the aorta is posterior to heart
(CTA and MRA can also be diagnostic)
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11
Q

Sick sinus syndrome presentation and pathology

A

Px: fatigue and pre/syncope
ECG: sinus brady

Path: idiopathic fibrosis of sinus node -> inappropriate atrial rate for normal requirements

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12
Q

Holiday heart syndrome

A

Px: palpitations, narrow complex tachycardia
Often results from binge drinking, dehydration, stress
Sx and arrythmia tends to resolve following rehydration, no follow up

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13
Q

Polymorphic VT vs TdP

A

Polymorphic VT = beat to beat variability in morphology

TdP = Polymorphic VT + Prolonged QT

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14
Q

Staging and Management of HTN

A

Stage 1: 140/90 clinic or 135/85 ABPM
Stage 2: 160/100 clinic or 150/95 ABPM
Stage 3/Severe: 180/100
Malignant: Stage 3 + papilloedema/retinal haemorrhages

Malignant Rx:

  • immediately treat
  • immediate specialist care
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15
Q

Causes and features of High Output Heart Failure

A

Causes: ~hyper dynamic circulation
- Anaemia, pregnancy, thyrotoxicosis, beriberi, Pagets

Px:

  • palpitations + heart failure Sx
  • venous hum over RIJ
  • wide pulse pressure
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16
Q

PDA presentation and management

A

DA should close after 48 hours

Px: loud, constant machinery murmur heard at 6 week newborn check
Rx: indomethacin

17
Q

Tricuspid stenosis features

A

Large “a” waves ~increased R to right atrial emptying

Right sided diastolic murmur, louder on inspiration (can be EDM)

18
Q

Graham Steel murmur?

A

High pitched early diastolic murmur over pulmonary area, louder in inspiration ie. pulmonary regurgitation
Often in context of pulmonary hypertension eg. Cor pulmonale, mitral stenosis
(S2 can be split)

19
Q

Peripartum cardiomyopathy presentation

A

HF developing in last month of pregnancy, or within 5 months of delivery
With no other cause of reduced EF found

20
Q

AAA and DVLA

A

> 6cm: notify DVLA and annual review

>6.5cm: notify DVLA and NO DRIVING

21
Q

Features of Tetralogy of Fallot

A

Clubbed infant, often cyanotic during feeding. Has a habit of squatting.

  • RVOT
  • RVH
  • VSD
  • Overriding aorta

(Squatting reduces RVOT)

22
Q

Definition of features of Coarctation of Aorta

A

Definition: narrowing of aorta at or distal to origin of Subclavian A ie. can compromise distal circulation

Features:

  • Cold feet, claudication, radiofemoral delay
  • Associated with Turner’s syndrome (5-10%)
23
Q

Management of aortic stenosis in child

A

First line: balloon angioplasty of AV

If fails, surgical AVR

24
Q

Rheumatic fever scoring criteria, eponymous name

A

Jones’ criteria

25
Q

Abdo pain, dyspnoea, ascites, pedal oedema

Muffled HS

A

Constrictive pericarditis

26
Q

Pulsus alternans sign of?

A

Failing LV function

27
Q

Post CABG acutely unwell, elevated JVP, displaced apex, quiet HS, ECG pulses alternans

MSRA (18 decks)

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