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Finals > Cardio And Resp > Flashcards

Cardio And Resp Flashcards

1
Q

Treatment for chronic bronchitis exacerbation?

A

Amoxicillin OR Tetracycline OR
Clarithromycin

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2
Q

Treatment for community acquired pneumonia?

A

Amoxicillin
If penicillin allergic: doxy or clarithromycin

Add flucloxacillin if staph ylococci suspected e.g. in influenza

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3
Q

Treatment for pneumonia with cause suspected to be aytypical?

A

Clarithromycin

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4
Q

Treatment for hospital acquired pneumonia?

A

Within 5 days of admission- co-amoxiclav or cefurotaxime

> 5days- piperacillin c tazobactam
OR
Broad spectrum cephalosporin (e.g. ceftazidime)
OR
Quinolone e.g. ciprofloxacin

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5
Q

What classes an asthma attack as severe?

A

One of following
- can’t complete sentences
- peak expiratory flow rate 33-50%
- RR >25
- Pulse >110

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6
Q

What classes an asthma attack as life threatening?

A

One of following
- peaks expiratory flow <33%
- O2 sats <92%
- silent chest
- cyanosis or feeble resp effort
- bradycardia
- dysarrythmia
- hypotension
- exhaustion, confusion or coma

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7
Q

Patient with a fever, dry cough and severe sob has severe Crohn’s. What is it likely to be and how what medication would you treat it with?

A

Pneumocystitis jiroveci pneumonia

Patient may be in long term steroids so immunosuppressed. Rare fungal cause

Co-trimoxazole
- a combo of trimethoprim and sulfamethoxazole

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8
Q

Which regions of an ECG are the lateral leads?

A

I, aVL, V5, V6

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9
Q

What regions on an ECG represent the anterior aspect of the heart?
What’s artery supplies it?

A

V1-V4

Supplied by the left anterior descending (LAD) artery

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10
Q

What regions on an ECG represent the inferior aspect of the heart?
What’s artery supplies it?

A

II, III, aVF
Right coronary artery

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11
Q

Changes to ECGs post STEMI?

A

Immediate
- hyperacute T waves
- then… ST elevation or new LBBB
Over next few days
- pathological Q waves
- T wave inversion

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12
Q

Complications post MI?

A

Cardiac arrest
Arrhythmias
Heart failure
DVT/PE
Pericarditis

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13
Q

Causes of acute pulmonary oedema?

A

Post MI
Valvular disease
Arrhythmias e.g. complete heart block

Non- cardiac
- fluid overload due to renal failure or overloaded
- post head injury
- ARDS

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14
Q

What region of an ECG is represented by I, II and aVF?
What artery supplies this area?

A

Inferior leads

Right coronary artery

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15
Q

Management of Tousades des pointes

A

Can spontaneously resolve or develop onto VT
Correct cause e.g electrolyte abnormality or medications
Magnesium infusion, even if Mg normal
Defibrillation if VT occurs

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16
Q

Symptoms of left ventricular failure

A

Dyspnoea
Reduced exercise tolerance
Fatigue
Paroxysmal nocturnal dyspnoea
Orthopnoea- worse lying flat
Wheeze
Cough- worse at night
Pink frothy sputum

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17
Q

CXR signs for heart failure

A

Cardiomegaly
Pleural effusions
Kerley B lines
Alveolar/interstitial oedema in bat wing distribution
Upper lobe diversion
Fluid in lung fissures

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18
Q

Furosemide MOA?

A

Competitively inhibits Na-K-2Cl cotransporter
in the thick ascending loop of Henle
reducing osmotic gradient for water reabsorption

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19
Q

Hypertensive retinopathy signs?

A

Silver/copper wiring
A-V nipping
Flame hemorrhages
Cotton wool spots
Papilloedema

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20
Q

ACEi side effects?

A

Dry cough
Hypotension- particularly first dose
Renal impairment
Hyperkalaemia
Angioedma/ urticaria

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21
Q

Hypertension complications?

A

Heart failure
Stroke
Aneurysmal disease
IHD
CKD- hypertensive nephropathy
Hypertensive retinopathy
Peripheral vasculopathy

22
Q

Hypercholesterolaemia signs?

A

Xanthelasma- yellowing growths around eyes
Tendon xanthoma
Corneal arcus
Other xanthomatas e.g. palmar, eruptive, tuberous

23
Q

Gout immediate and long term tx?

A

Immediate
- NSAIDS
- Colcichine
Long term (only)
- Allopurinol

24
Q

Causes of AF?

A

Pneumonia
Heart failure
Post MI
PE
Hyperthyroidism
Alcohol excess
Endocarditis

25
Q

Most common microorganism causing infective endocarditis?

A

Viridens streptococci

26
Q

Eye manifestation of infective endocarditis?

A

Roth spot

Which are boat shaped retinal hemorrhages with a pale center

27
Q

Criteria for diagnosing infective endocarditis?

A

Duke criteria

28
Q

What causes an early diastolic murmur? And other signs of this cause?

A

Aortic regurgitation

Collapsing pulse
Wide pulse pressure
Displaced apex beat

29
Q

Signs and symptoms of infective endocarditis?

A

Fever and new murmur- high suspicion

Symptoms
- fever
- rigors
- night sweats
- dyspnoea
- general malaise

Signs
- Hands: clubbing, splinter haemorages, Oslers nodes, Janeway lesions
- Eyes/fundi- Roth spots
- Urine dip- microscopic haematuria

30
Q

IVDU endocarditis most common cause?

A

Staph aureus, more likely introduced from skin and venous system

31
Q

ECG regions and their supplying artery?

A

Anterior aspect
LAD
V1-V4

Inferior aspect
RCA
II, III, aVF

Lateral aspect
Circumflex
I, V5, V6

32
Q

ECG changes in I, V5 and V6. Region and artery supply?

A

Lateral aspect + aVL
Supplied by circumflex artery

33
Q

ECG changes in II, III and aVF. Region and artery supply?

A

Inferior aspect
RCA

34
Q

Difference between the second degree heart blocks Mobitz I (Wenkebank) and Mobitz II?

A

Mobitz I- PR interval progressivly lengthens until P wave dropped
Mobitz II- PR interval constant but P wave is often not followed by a QRS complex

35
Q

What is first degree heart block?

A

Prolonged PR interval >0.2 seconds
Can be normal in athletes

36
Q

Signs of right sided heart failure?

A

Raised JVP
Ankle oedema
Hepatomegaly

37
Q

What is the CURB-65 score used for?

A

Stratifying risk for community acquired pneumonia assessing severity and guides whether tx should be as an in or outpatient

38
Q

What are the scoring factors in the CURB-65

A

Confusion
Urea >7 mmol/l
Resp rate >30
BP sys <90 or dias <60
>65 yo

39
Q

What do the points scored in the CURB-65 indicate for treatment?
And there prediction of mortality?

A

0-1: low risk- less than 3% mortality–> outpatient care
2: intermediate risk- 15% risk –> inpatient care
3-5: high risk- >15% risk –> inpatient/consider ITU

0-1:

40
Q

Most common causes of CAP?

A

Haem.influenzae
Strep.pneumoniae
Mycoplasma.pneumoniae

Atypical
Staph.aureus
Legionella.pneumophila

41
Q

What resp problem can cause Cushing’s syndrome?

A

Small cell lung cancers
Can release ACTH causing cortisol release, leading to cushings syndrome

42
Q

COPD medical first line?

A

SABA OR SAMA
SABA e.g. salbutamol
SAMA e.g. salmeterol

43
Q

2nd line COPD drug treatment?

A

If asthmatic features, likely steroid responsive- add LABA and ICS regularly

If no asthmatic features- LABA and LAMA regularly

44
Q

Example of a LABA

A

Salmeterol
Formoterol

45
Q

LAMA examples?

A

Long acting muscarinic antagonists
Tiotropium
Glycopyrronium

46
Q

Features of cor pulmonale?

A

Peripheral oedema
Raised jugular venous pressure
Systolic parasternal heave
Loud o2

47
Q

Management of cor pulmonale?

A

Loop diuretic for oedema e.g. furosemide
?long term O2 therapy

48
Q

How do you differentiate between transudatuve and exudative pleural effusions?

A

Exudative- protein level >30g/L
Transudative- protein level <30g/L

49
Q

Causes of transudative pleural effusions?

A

Cardiac failure
Cirrhosis
Renal failure

50
Q

Causes of exudative pleural effusions?

A

Have high protein content
Commonly caused by
Infection
Inflammation
Malignancy

Finals (13 decks)

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