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MRCP Part 2 > Cardio > Flashcards

Cardio Flashcards

1
Q

‘global speckled’ pattern on ECHO

A

Cardiac amyloidosis

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2
Q

Psuedoinfarction pattern on ECG appears as

A

Low-voltage complexes with poor R wave progression

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3
Q

Pseudoinfarction pattern on ECG associated with

A

Cardiac amyloidosis

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4
Q

Normal PR interval

A

120 - 200 ms

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5
Q

Anteroseptal - ECG changes

A

V1 - V4

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6
Q

Inferior - ECG changes

A

II, III, aVF

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7
Q

Anterolateral - ECG changes

A

V4-V6, I, aVL

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8
Q

Lateral - ECG changes

A

I, aVL +/- V5-V6

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9
Q

Posterior - ECG changes

A

Tall R waves V1-V2

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10
Q

Coronary artery affected: Anteroseptal changes

A

Left anterior descending

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11
Q

Coronary artery affected: Inferior changes

A

Right coronary

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12
Q

Coronary artery affected: Anterolateral changes

A

Left anterior descending,
or,
Left circumflex

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13
Q

Coronary artery affected: Lateral changes

A

Left circumflex

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14
Q

Coronary artery affected: Posterior changes

A

Usually left circumflex, also right coronary

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15
Q

Long QT1

A

Adrenergic surge due to physical activity

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16
Q

Long QT2

A

Adrenergic surge due to intense emotion

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17
Q

Long QT3

A

Death during sleep

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18
Q

Kussmaul’s sign looks like

A

JVP rises during inspiration

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19
Q

Kussmails sign associated with

A

Constrictive pericarditis

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20
Q

Definition of pulmonary arterial hypertension

A

Resting mean pulmonary artery pressure is >= 25 mmHg

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21
Q

Wellen’s syndrome - appearance on ECG

A

Deeply inverted/biphasic T waves in V2 - V3

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22
Q

Wellen’s syndrome - suggests

A

Critical LAD stenosis

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23
Q

Aortic stenosis - Criteria for aortic valve surgery

A

Symptomatic

Valvular gradient > 40 mmHg and features of LV systolic dysfunction

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24
Q

Dabigatran MOA

A

Inhibits thrombin

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25
Q

Dabigatran reversal agent

A

Idarucizumab

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26
Q

Blood pressure target - patient with hypertension without other comorbidity

A

< 140/90 mmHg

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27
Q

Blood pressure target - patient with diabetes and end organ damage

A

< 130/80 mmHg

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28
Q

Normal QRS duration

A

< 120 ms

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29
Q

INR > 8.0 with No bleeding

A

Oral Vitamin K 1-5 mg

Repeat dose vitamin K if INR still too high after 24hr

Restart warfarin when INR < 5

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30
Q

ECG findings associated with ostium primum

A

RBBB + LAD, prolonged PR

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31
Q

ECG findings associated with ostium secundum

A

RBBB + RAD

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32
Q

Heart failure - 1st-line management for all patients

A

ACEi + beta-blocker

start one, then add other

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33
Q

Heart failure - 2nd-line

A 
Aldosterone antagonist 
(spironolactine/eplerenone)
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34
Q

Heart failure - 3rd-line options

A

Ivabradine

Sacubitril-valsartan

Digoxin

Hydralazine with nitrate

Cardiac resynchroniziiton therpy

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35
Q

Heart failure management – criteria for ivabridine

A

Sinus rhythm >75 bpm +

LVEF <35%

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36
Q

Heart failure management - criteria for sacubitril-valsartan

A

LVEF <35%

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37
Q

Heart failure management - indication for digoxin

A

Coexistant AF

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38
Q

Heart failure management - indication for hydralazine with nitrate

A

Afro-Caribbean patient

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39
Q

Heart failure management - indication for cardiac resynchronization therapy

A

Widened QRS complex >130ms

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40
Q

Infective endocarditis- empiric treatment for prosthetic valve

A

Vancomycin + rifampicin + low-dose gentamicin

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41
Q

Infective endocarditis- empiric treatment for native valve

A

Amoxicillin + consider low-dose gentamicin

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42
Q

Infective endocarditis- empiric treatment for native valve (Penicillin allergy)

A

Vancomycin + low-dose gentamicin

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43
Q

Mitral regurgitatiion with new AF - management?

A

Refer for mitral valve replacement

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44
Q

Features of cholesterol embolism

A
  • Eosinophilia
  • Purpura
  • Renal failure
  • Livedo reticularis
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45
Q

Causes of LBBB

A
  • IHD
  • HTN
  • Aortic stenosis
  • Cardiomyopathy
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46
Q

Epsilon wave looks like

A

Small positive deflection at end of QRS complex

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47
Q

Infective endocarditis - treatment for prosthetic valve, caused by staphylococci

A

Flucloxacillin + rifampicin + low-dose gentamicin

48
Q

Prolonged QTc in men

A

> 440ms

49
Q

Infective endocarditis - treatment for native valve, caused by staphylococci (PEN ALLERGIC)

A

Vancomycin + rifampicin

50
Q

Acceptable increase in creatinine when starting AECi

A

Up to 30% increase

51
Q

Infective endocarditis - treatment for prosthetic valve, caused by MRSA

A

Vancomycin + rifampicin + low-dose gentamicin

52
Q

Secundum atrial septal defects occur where

A

Middle of atrial septum

53
Q

Infective endocarditis - treatment if caused by fully-sensitive streptococci eg viridans (PEN ALLERGIC)

A

Vancomycin + low-dose gentamicin

54
Q

Infective endocarditis - treatment if caused by less-sensitive streptococci (PEN ALLERGIC)

A

Vancomycin + low-dose gentamicin

55
Q

Infective endocarditis - treatment if caused by less-sensitive streptococci

A

Benzylpenicillin + low-dose gentamicin

56
Q

Causes of LBBB

A
  • IHD
  • HTN
  • Aortic stenosis
  • Cardiomyopathy
57
Q

Culture-negative causes of infective endocarditis

A 
Coxiella burnetii
Bartonella
Brucella
HACEK
Prior antibiotics
58
Q

Which pre-excitation disorder shows ECG with a short PR interval, and normal QRS complex

A

Lown-Ganong-Levine syndrome

59
Q

ECG findings in Wolff-Parkinson-White syndrome

A

Short PR interval, wide QRS complex with slurred upstroke (delta wave)

60
Q

PMH contraindications to adenosine use in SVT

A

Asthma

Taking dipyridamole

61
Q

ECG findings in dextrocardia

A

Inverted P wave in lead I
RAD
Loss of R wave progression

62
Q

Patient with WPW in AF - which medication for cardioversion

A

Flecainide

63
Q

Unifying diagnosis: Constrictive pericarditis + nephrotic syndrome + mononeuritis multiplex

A

Amyloidosis

64
Q

Digoxin contraindication

A

Cardiac amyloidosis (digoxin binds to amyloid > toxicity)

65
Q

1st line management of acute idiopathic/viral pericarditis

A

NSAID + colchicine

66
Q

HACEK agents

A 
Haemophilus
Actinobacillus
Cardiobacterium
Eikenella
Kingella
67
Q

Culture-negative causes of infective endocarditis

A 
Coxiella burnetii
Bartonella
Brucella
HACEK
Prior antibiotics
68
Q

Which pre-excitation disorder shows ECG with a short PR interval, and normal QRS complex

A

Lown-Ganong-Levine syndrome

69
Q

Contraindication to adenosine use in SVT

A

Asthma

70
Q

ECG findings in dextrocardia

A

Inverted P wave in lead I
RAD
Loss of R wave progression

71
Q

Patient with WPW in AF - which medication for cardioversion

A

Flecainide

72
Q

Unifying diagnosis: Constrictive pericarditis + nephrotic syndrome + mononeuritis multiplex

A

Amyloidosis

73
Q

Digoxin contraindication

A

Cardiac amyloidosis (digoxin binds to amyloid > toxicity)

74
Q

1st line management of acute idiopathic/viral pericarditis

A

NSAID + colchicine

75
Q

ECG findings in dextrocardia

A

Small complexes in chest leads vs the limb leads

Inverted complexes in I and aVL

76
Q

ECG findings in Second-degree AV block type 1 (Mobitz I, Wenckebach)

A

Progressive prolongation of PR interval until a dropped beat occurs

77
Q

ECG findings in Second-degree AV block type 2 (Mobitz II)

A

P waves are often not followed by a QRS complex.

Where a QRS complex does follow, the PR interval is NORMAL

78
Q

CHA2DS2-VASc

A

CCF - 1

HTN - 1

Age:
=>75 - 2
65-74 - 1

DM - 1

Stroke/TIA - 2

IHD/PAD - 1

Female - 1

79
Q

Hypertension - 4th line medical management
(already taking A + C + D)
- K < 4.5 mmol/l

A

Add low-dose spironolactone

80
Q

Hypertension - 4th line medical management
(already taking A + C + D)
- K > 4.5 mmol/l

A

Add alpha-blocker (doxazosin) or beta-blocker (nebivolol, carvedilol)

81
Q

Beta-blockers in systemic sclerosis

A

May worsen Raynauds

82
Q

Hypertension - 3rd line management, already taking ACEi + CCB

A

Thiazide-like diuretic (Indapamide)

83
Q

Hypertension - 1st line management <55 years old and not AFC

A

ACEi/ARB

84
Q

Hypertension - 1st line management any age, with T2DM, not AFC

A

ACEi/ARB

85
Q

Hypertension - 1st line management >55 years old not T2DM

A

Calcium channel blocker (amlodipine)

86
Q

Hypertension - 1st line management any age, AFC, not T2DM

A

Calcium channel blocker (amlodipine)

87
Q

Hypertension - 2nd line management - already taking ACEi/ARB

A

Add:
CCB (amlodipine)
or
TLD (indapamide)

88
Q

Hypertension - 2nd line management - already taking CCB

A

Add:
ACEi or ARB (ARB if AFC)
or
TLD (indapamide)

89
Q

Hypertension - 3rd line management, already taking ACEi + TLD

A

Add CCB

90
Q

Patient with AF, already on dual anti-platelet

A

Still needs formal anticoagulation (Warfarin/DOAC)

91
Q

Which anti-coagulant for AF, in patient with CKD?

A

Rivaroxaban

Reduced dose if GFR 15-50

92
Q

Dabigatran in renal impairment

A

Not safe, high risk of bleeding

93
Q

Cardiac monitor shows ‘short runs of polymorphic VT’

A

Torsades de pointes

94
Q

Management of Torsades de pointes

A

IV Magnesium sulphate

95
Q

Causes of long QT (therefore increase risk of Torsades de pointes)

A 
Amiodarone, sotalol
Erythromycin/clarithromycin
Low Ca, K, Mg
TCA/antipsychotics
Chloroquine
Fluconazole
96
Q

Management of monomorphic VT - no adverse signs

A

Amiodarone/
Lidocaine/
Procainamide

97
Q

Management of monomorphic VT - with adverse signs

A

DC cardioversion

98
Q

ECG findings in Brugada syndrome

A

Coved ST elevation in >1 of V1-V3 followed by negative T wave

99
Q

Diagnostic tool for Brugada

A

Fleicanide challenge

100
Q

Management of Brugada syndrome

A

ICD

101
Q

Long-term management of WPW

A

Radiofrequency ablation

102
Q

Medical management of SVT in WPW

A

Sotalol, adenosine, fleicanide, amiodarone

103
Q

CI to use of sotalol/adenosine in for SVT in WPW

A

Possible underlying AF

104
Q

Which type of atrial septal defect is most common

A

Ostium secundum defect

105
Q

ST elevation without reciprocal depression, shortly after myocardial infarction, suggests

A

Left ventricle aneurysm

106
Q

Feature that suggests vascular claudication (over neurogenic claudication)

A

No relief from leaning forward/sitting down.

Only relieved with rest

107
Q

ABPI > 1.2

A

Calcified stiff arteries

May be PAD or normal in old age

108
Q

ABPI 1.0 - 1.2

A

Normal

109
Q

ABPI 0.9 - 1.0

A

Acceptable

110
Q

ABPI < 0.9

A

Likely PAD

111
Q

ABPI < 0.5

A

Severe PAD - urgent referral

112
Q

ABPI required for compression bandaging

A

> = 0.8

113
Q

ECG features of trifascicular block

A

RBB + LAD/RAD + prolonged PR

114
Q

Management of sick sinus syndrome with bradarrhythmia

A

Pacemaker (AAIR)

115
Q

Inherited long QT and sensorineural hearing loss seen in

A

Jervell & Lange-Nielson syndrome

116
Q

Congenital syndrome with long QT (no hearing loss)

A

Romano-Ward syndrome

MRCP Part 2 (15 decks)

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