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Pass Med finals pack > cardio deck 1 > Flashcards

cardio deck 1 Flashcards

1
Q

most common ECG change in PE is

A

sinus tachycardia

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2
Q

78 y/o female, sudden onset, severe shortness of breath. CTPA likely to show

A

pulmonary embolism

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3
Q

what murmur is heard in aortic stenosis and when is it loudest

A

ejection systolic murmur

louder in expiration

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4
Q

what murmur is heard in mitral stenosis

A

mid-late diastolic murmur

louder in expiration

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5
Q

murmur heard in pulmonary stenosis and when is it loudest?

A

ejection systolic

louder on inspiration

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6
Q

murmur louder on expiration

A

aortic stenosis

hypertrophic obstructive cardiomyopathy

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7
Q

murmur louder on inspiration

A

pulmonary stenosis

atrial septal defect

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8
Q

is tricuspid regurgitation louder on inspiration or on expiration?

A
  • holosystolic (high-pitched, blowing)
  • louder on inspiration
  • during inspiration, venous bf to RA & RV increase
  • increases stroke volume of RV during systole
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9
Q

late systolic murmur heard it

A

mitral valve prolapse

coarctation of aorta

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10
Q

describe typical presentation of Dressler’s syndrome

A
  • tends to occur 2-6 weeks post MI
  • thought to be autoimmune reaction against antigenic proteins formed as myocardium recovers
  • characterised by combo of fever, pleuritic pain, pericardial effusion and raised ESR.
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11
Q

management of Dressler’s syndrome

A

NSAIDS

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12
Q

when may protamine sulphate be used?

A
  • as a reversal agent in patients bleeding on

- heparin, enoxaparin or dalteparin

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13
Q

what is dabigatran ?

A
  • oral anticoagulant

- works as direct thrombin inhibitor

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14
Q

action of statins

A
  • inhibit action of HMG-CoA reductase

- rate limiting enzyme in hepatic cholesterol synthesis

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15
Q

Wolff-Parkinson White syndrome

A
  • caused by congenital accessory conducting pathway between atria and ventricles
  • leads to atrioventricular re-entry tachycardia (AVRT)
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16
Q

common ECG change in wolff-parkinson white syndrome?

A
  • short PR interval

- wide QRS complexes with slurred upstroke ‘delta wave’

17
Q

75 y/o female.

PC: fatigue, dysponea, anklee swelling

PMH: HT, OA, gout, T2DM

Ex: cheeks erythematous, irregular pulse, raised JVP, peripheral oedema to knees bilaterally

1st heart sound loud, added low, rumbling diastolic murmur

diagnosis, likely cause ?

A

mitral stenosis!

rhemautic fever most common cause of mitral stenosis

18
Q

libman-sacks endocarditis

A
  • non-bacterial endocarditis seen in association with SLE
19
Q

potential biochemical side effect of ACE inhibitor

A

hyperkalaemia

20
Q

78 y/o female

  • worsening SOB over past 4 months
  • LHS pain
  • lightheadedness on exertion

OE
- ejection systolic murmur radiating to carotids

what findings may you also find one examination?

A

classic aortic stenosis

  • Syncope
  • Angina
  • Dyspnoea on exertion

narrow pulse pressure

slow rising pulse

thrill over cardiac apex

21
Q

what does Corrigan’s sign refer to?

A
  • rapid upstroke and collapse of carotid artery pulse

- seen in aortic regurgitation

22
Q

describe the three main points associated with an aortic stenosis murmur?

A
  • Ejection sytolic murmur
  • classically radiates to carotids
  • decreased during the valsalva manoeuver
23
Q

management for patient over 55 years of age with

  • stage 2 hypertension
  • QRisk > 10%
A
  • calcium channel blocker (amlodipine)
  • atorvastatin
  • lifestyle advice as first line
24
Q

if patient is still experiencing angina symptoms despite being on a beta blocker which has been titrated to maximum dose, what is the next step?

A

add on calcium channel blocker such as nifedipine.

25
Q

why is verapamil not prescribed alongside a beta blocker?

A

due to risk of complete heart block

26
Q

in a patient who is already taking a calcium channel blocker and has poorly controlled hypertension. what additional treatment can be added?

A
  • ACE inhibitor
  • angiotensin receptor blocker
  • thiazide like diuretic
27
Q

what is an important side effect to note of thiazide like diuretics such as indapamide?

A
  • sexual dysfunction

- patients should be made aware

28
Q

thiazides can worsen glucose tolerance

A

thiazides can worsen glucose tolerance

29
Q

what is a recognised side effect of loop diuretics such as furosemide?

A
  • ototoxicity
  • hypotension
  • hyponatraemia
  • hypokalaemia
  • hypomagnesaemia
  • hypochloraemic alkalosis
  • renal impairment
  • hyperglycaemia
  • gout
30
Q

21 y/o student

  • 1 month hx of episodic, retrosternal chest pain
  • each episode lasts 30 mins
  • accompanied by dizziness and SOB
  • exacerbated by lying down

OE
- 12 lead ECG , ST elevation in all leads

potential diagnosis?

A

acute pericarditis

  • chest pain (often relieved by sitting forwards)
  • non-productive cough, dyspnoea, and flu like symptoms
  • pericardial rub
  • tachypnoea
  • tachycardia
31
Q

first line investigation for suspected pulmonary embolism

A

CTPA

32
Q

does tricuspid regurgitation get louder during inspiration or expiration?

A

gets louder during inspiration

33
Q

what drug is important to avoid in patient with long QT syndrome?

A
  • erythromycin
34
Q

which coronary artery supplies the inferior aspect of the left ventricle?

A
  • right coronary arteries
35
Q

what valvular pathology would cause a murmur that radiates to the carotids?

A
  • aortic stenosis
36
Q

What blood test is most important in a patient who is starting an ACE inhibitor?

A
  • U&Es

- check renal function

37
Q

what investigation will be most helpful in diagnosing chronic heart failure?

A

b-type natriuretic peptide

- released from heart ventricles in response to muscle strethc

38
Q

which artery supplies the left atrium?

A
  • circumflex artery
39
Q

acute NSTEMI treatment

A

BATMAN

B- beta blockers 
A- aspirin (330mg)
T- ticagrelor (180mg stat)
M- morphine titrated to control pain 
A- anticoagulant LMWH (enoxaparin)
N- nitrates

Pass Med finals pack (40 decks)

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