Cardio mcq's Flashcards
left circumflex artery occlusion would show what on an ECG?
ST elevation in leads V5-V6
aortic stenosis will result in what failure first?
- left ventricular failure
- war of increased ventricular pressure
- as ventricles try to pump blood across narrowed valve
Left ventricular failure will result in?
- backlog of blood into lungs
- pulmonary oedema
- first sign could be bibasal crepitations
What is the first sign of pulmonary oedema before enough fluid accumulates to be visible on CXR?
- bibasal crepitations
- before pleural effusion can be seen on CXR
What are earlier signs of pulmonary oedema?
on CXR
Kerley B lines as fluid infiltrates the interstitium.
narrow pulse pressure is a sign off…
aortic stenosis
65 y/o female to A&E , shortness of breath, sharp pain in RHS of chest, painful on taking a deep breath. Patient also complains of mild pain in RHS leg.
most likely to be PULMONARY FUCKING EMBOLISM
- pleuritic chest pain
- cough
- haemoptysis
60 y/o male to A&E . 3 day history of increasing severe chest pain. sharp, tearing pain, starting in back of chest. radiating straight through back between shoulder blades.
looks in pain but no pallor, heart rate 95, respect rate 20, tempt okay. 155/95mmHg BP
AORTIC DISSECTION
ventricular tachycardia
- patient is pulseless
- cardioversion required
- cannon ‘a waves’
JVP atrial fibrillation
absent ‘a waves’ due to dysfunctional atrial systole.
mitral stenosis clinical signs
mid diastolic murmur
opening snap
49 y/o increasing shortness of breath on exertion. no chest pain or cough, no ankle swelling. crackles at both lung bases, decrescendo diastolic murmur at left sternal edge.
most likely diagnosis?
aortic regurgitation.
long Q-T syndrome
- inherited condition associated with delayed repolarisation of ventricles
- may lead to ventricular tachycardia
ventral septal defect commonly associated with what murmur?
pan-systolic murmur
Eisenmenger’s syndrome
- reversal of a LHS to RHS shunt in a congenital heart defect
- due to pulmonary hypertension
rib notching is a late feature of what…
- coarctation of the aorta
13 y/o recurrent attacks of collapse. episodes typicaly occur without warning or post sport.
on examination she has an ejection systolic murmur.
most likely cause
Hypertrophic obstructive cardiomyopathy
- more common cause of murmur and recurrent collapse than aortic stenosis
- myocardium becomes thickened, leading to cardiac muscle impairment and sudden death
- autosomal dominant
aortic dissection
- tear in intimal layer of aorta
- tearing chest pain
- radiates to between the scapulae
- hypertension great risk factor
55 y/o female, shortness of breath on exertion and orthopnoea.
ECHO shows dilation in all four chambers. no regional wall motion.
left ventricular ejection fraction is poor.
indicative of…
DILATED CARDIOMYOPATHY
- four chamber dilation
- systolic dysfunction
chronic alcohol use may cause this
Hypertrophic obstructive cardiomyopathy associated with what on ECG
- deep ST depression and T-wave inversions
62 y/o male chest pain, severe shortness of breath. orthopnoea paroxysmal noctural dyspnoea hepatomegaly smoker, COPD
indicative of what:
Right sided heart failure: COR PULMONALE
- raised JVP
- ankle oedema
- hepatomegaly
pulmonary hypertension associated with what sound
- loud second heart sound
continuous ‘machinery’ like murmur associated with …
- patent ductus arteriosus
aortic regurgitation causes an early
- early diastolic murmur
34 y/o to A&E, fever, chills and felling unwell.
examination reveals vesicular breath sounds.
s1, s2 sounds with murmur.
indicative of ….
infective endocarditis
42 y/o overweight man, two day history of anterior chest pain.
worse on deep inspiration and lying down.
Pericarditis
young male smoker with symptoms similar to limb ishcaemia
- cold peripheries
- RHS foot ulcer
- absent dorsalis pedis, posterior tibial, radial and ulnar pulses
THINK?
Buerger’s disease
12 y/o girl, from bulgaria, 2 weeks unwell. joint pain intermittently in knees, hips and ankles.
on examination there are some pink, ring shaped lesions on trunk.
occasional jerking movements of face and hands.
indicative of:
Rheumatic fever
- strep. pyogenes
- antigen presentation to T cells
- damage to smooth muscle of arteries
- Aschoff bodies (granulomatous nodules) found in rheumatic heart fever
