Cardio

Question 1

Causes chest pain

Answer 1

Cardiac:

• angina
• MI
• pericarditis
• aortic dissection

Question 2

Non cardiac causes chest pain

Answer 2

Resp:

• pleurisy
• PE
• pneumothorax

GI:

• GORD
• oesophagitis

MSK:
- strain/trauma/costochondritis

Question 3

Arterial pulse signs

• Plateau
• Small volume
• Bisferiens
• Anacrotic
• Pulsus alternans
• Pulsus paradoxus

Answer 3

• Plateau - AS
• Small volume - AS, shock
• Bisferiens - AS, AR
• Anacrotic - AS
• Pulsus alternans - LVF
• Pulsus paradoxus - Pericardial effusion, constrictive pericarditis, severe asthma

Question 4

Causes of ↑JVP

Answer 4

• RVF
• Pulmonary HTN
• Pulmonary stenosis
• Tricuspid stenosis
• SVC obstruction

Question 5

Causes of AF

Answer 5

• IHD
• HTN
• Mitral stenosis
• Idiopathic
• cardiomyopathy
• hyperthyroidism

Question 6

Causes of cor pulmonale

Answer 6

• COPD
• idiopathic
• massive PE
• OSA
• 1º pulmonary HTN

Question 7

Causes right HF

Answer 7

• 2º to left HF
• MI
• PS, TS, TR
• 1º pulmonary HTN
• 2º pulmonary HTN (COPD)

Question 8

Causes left HF

Answer 8

• IHD
• HTN
• MI
• AS, AR, MR

Question 9

Causes of bradycardia

Answer 9

• athletes
• β-blockers
• hypothyroidism
• heart block
• hypothermia

Question 10

Causes of tachycardia

Answer 10

• pain
• fever
• anxiety
• thyrotoxicosis
• β2-agonist
• hypovolaemia
• arrhythmia

Question 11

Causes of ↑D-Dimer

Answer 11

• DVT
• MI
• recent surgery
• liver disease
• renal disease
• malignancy

Question 12

Causes generalised (bilateral) peripheral oedema

Answer 12

Fluid overload:
- HF, renal failure, iatrogenic

Hypoproteinaemia:

• malnutrition
• malabsorption
• chronic liver disease
• nephrotic syndrome

Drugs:
- CCB

Question 13

Causes localised (unilateral) peripheral oedema

Answer 13

Obstruction - pelvic tumour, DVT

Infection - cellulitis

Postural - prolonged standing

Ruptured baker’s cyst

Question 14

Causes pericarditis

Answer 14

Infarction - MI

Iatrogenic - cardiac surgery

Inflammation - SLE, Rheumatoid disease

Infection: coxsackie, bacterial

Question 15

Causes central cyanosis

Answer 15

Resp:

• acute severe asthma
• COPD
• pulmonary oedema
• PE

Cardiac: R→L shunt

Blood: methaemoglobulinaemia, polycythaemia

Question 16

Causes of peripheral cyanosis

Answer 16

as central +

• Vasoconstriction: cold, reynaud’s, β-blockers
• Poor circulation: HF
• Blockage: arterial obstruction

Question 17

Features of aortic stenosis

Answer 17

• harsh crescendo-decrescendo systolic murmur
• loudest in aortic area
• radiates carotids
• sustained, heaving, minimally displaced apex beat
• slow rising pulse

Question 18

Features of mitral regurgitation

Answer 18

• pansystolic murmur
• radiates to axilla
• displaced, thrusting apex beat
• soft S1

Question 19

Features of aortic regurgitation

Answer 19

• early diastolic murmur
• at LSE with inspiration
• displaced, thrusting apex beat
• collapsing pulse
• wide pulse pressure
• postal shot noise over femoral

Question 20

Features of mitral stenosis

Answer 20

• mid diastolic murmur
• tapping apex beat
• loud S1

Question 21

Causes of right axis deviation

Answer 21

RVH: cor pulmonale, pulmonary stenosis

Left posterior fascicular block: cardiomyopathy, diffuse infarction/ischaemia

Left lateral infarction

Question 22

Causes of left axis deviation

Answer 22

Left anterior fascicular block: LAD ischaemia/infarction, cardiomyopathy

R-sided infarction
LVH

Question 23

ECG changes in hyperkalaemia

Answer 23

• tall tented T waves
• widened QRS
• absent P waves
• sine wave

Question 24

ECG changes in hypokalaemia

Answer 24

• flattened T waves

Question 25

ECG changes in MI

Answer 25

<5min: hyperacute T waves

<20min: