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Cardiology > Cardio Questions > Flashcards

Cardio Questions Flashcards

1
Q

Define mediastinum

A

Central compartment in thoracic cavity between pulmonary cavities

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2
Q

What covers the mediastinum?

A

Mediastinal pleura - covers all thoracic viscear bar lungs

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3
Q

How is volume and pressure change permitted in the mediastinum?

A

CT is loose and parietal pleura of lungs flexible

CT stiffens with age - structures less mobile

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4
Q

Parts of the mediastinum

A

Superior

Inferior - Anterior, Middle, Inferior

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5
Q

Limits of the superior mediastinum

A

Superior aperture to the transverse thoracic plane - T4/5

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6
Q

Limits of inferior mediastinum

A

Transverse thoracic plane to the diaphragm

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7
Q

Anterior inferior mediastinum

A

Body of sternum, transverse thoracic plane and pericardium. Continues with superior mediastinum superiorly

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8
Q

Contents of anterior inferior mediastinum

A

Sternopericardial ligaments

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9
Q

What is found in the anterior inferior mediastinum in children?

A

Thymus

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10
Q

Middle inferior mediastinum

A

Pericardium, Heart, ASC aorta, pulmonary trunk, SVC, arch of azygos, main bronchi

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11
Q

Borders of the heart

A

Right, Left, Superior, Inferior

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12
Q

Anterior/sternocostal surface is formed by which part of the heart?

A

Right ventricle

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13
Q

Posterior or base is formed by which part of the heart?

A

Left Atrium

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14
Q

Inferior surface of the heart

A

Left ventricle, partly right

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15
Q

To what structure is the inferior border of the heart related?

A

Central tendon of the diaphragm

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16
Q

What spinal level is the heart anterior to?

A

T5-T8

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17
Q

As the heart is related to the diaphragm, what happens to its position when standing upright?

A

Vertical position

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18
Q

What type of blood is carried by the aorta?

A

Oxygenated

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19
Q

Parts of the aorta

A

Ascending
Arch
Descending - thoracic and abdominal

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20
Q

Wheter does the abdominal aorta bifurcate and into which vessels?

A

L4- right and left common iliac

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21
Q

At what level do the common iliac vessels bifurcate?

A

L5

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22
Q

Name the branches of the ascending aorta

A

Left coronary artery

Right coronary artery

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23
Q

Branches of the left coronary artery

A

Anterior interventricular

Circumflex

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24
Q

Branches of the right coronary artery

A

Posterior interventricular

Right marginal

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25
Q

Position of the right marginal artery

A

Sinks into right ventricle

26
Q

Where do both coronary arteries originate>

A

Aortic sinus

27
Q

Describe the anastamosis of the coronary arteries

A

Anterior interventricular and posterior interventricular

Circumflex and right coronary artery as it continues

28
Q

Branches of the aortic arch

A

Braciocephalic
Left subclavian
Left common carotid

29
Q

Describe the veins of the heart

A

Great - within anterior ventricular groove
Middle - posterior ventricular groove
Small - next to right marginal

30
Q

Where do the veins of the heart drain?

A

Into the coronary sinus to the right atrium

31
Q

Branches of the descending thoracic aorta

A

Oesophageal arteries
Bronchial arteries
Pericardial arteries
Posterior intercostal arteries

32
Q

Terminal branches of abdominal aorta

A

Common iliac L4
External iliac - L5
Internal iliac

33
Q

Where do the common iliac arteries lie?

A

Iliac fossa

34
Q

What artery does the external iliac become?

A

Femoral

35
Q

What does the internal iliac artery supply>

A

Pelvic viscera

36
Q

Which organs are supplied by branches of the abdominal aorta?

A 
Diaphragm
Adrenals
Kidneys
Gut tube
Gonads
37
Q

What electrolyte abnormality is consitent with prolonged QT interval>

A

Hypokalaemia

38
Q

What does a long QT interval indicate?

A

Delayed repolarization of ventricles

39
Q

What are the possbile consequences of long QT syndrome>

A

Ventricular tachycardia
/ Torsades de pointes
Collapse/Sudden death

40
Q

What is a normal corrected QT interval?

A

less than 430 ms in males and 450 ms in females.

41
Q

What is the physiological cause of a long QT interval>

A

defects in the alpha subunit of the slow delayed rectifier potassium channel

42
Q

Name some causes of LQTS

A

Congenital - Jervell-Lange-Nielsen syndrome, Romano Ward Syndrome

Drugs - amiodarone, 
sotalol
class 1a antiarrhythmic drugs
tricyclic antidepressants
selective serotonin reuptake inhibitors (especially citalopram)
methadonechloroquine
terfenadine**
erythromycin
haloperidol
ondanestron
Electrolyte -  hypocalcaemia, hypokalaemia, hypomagnesaemia
acute myocardial infarction
myocarditis
hypothermia
subarachnoid haemorrhage
43
Q

What is the difference between Jervell Lange Nielsen Syndrome and Romano Ward syndrome?

A

Both congenital and associated with LQTS
Jervell has deafness included due to abnormal postassium channel
No deafness in Romano Ward

44
Q

Features of LQTS

A

may be picked up on routine ECG or following family screening
Long QT1 - usually associated with exertional syncope, often swimming
Long QT2 - often associated with syncope occurring following emotional stress, exercise or auditory stimuli
Long QT3 - events often occur at night or at rest
sudden cardiac death

45
Q

Management of LQTS

A

Avoid drugs exacerbating long QT interval
Reduce strenuous exercise
Beta blockers - * sotalol may exacerbate
Implantable cardioverter defib in high risk case

46
Q

What is the gold standard investigation for Pulmonary embolism?

A

CTPA

47
Q

What must be arranged if CTPA unavailable and patient has suspected PE?

A

Administer interim therapeutic anticoagulation - DOAC - apixabon, rivaroxaban

48
Q

What ECG changes are seen in patient with PE?

A

S1Q3T3
Right bundle branck block and right axis deviation
Sinusd tachycardia

49
Q

CXR findings in PE

A

Typically normal

May find wedge shaped opacification

50
Q

Which drugs can cause torsades de pointes?

A

Macrolides eg clarithromycin

51
Q

Characteristics of torsades de pointes on ECG

A

rapid, irregular QRS complexes, which appear to be ‘twisting’ around the baseline

52
Q

What is torsades de pointes?

A

a form of polymorphic ventricular tachycardia associated with a long QT interval. It may deteriorate into ventricular fibrillation and hence lead to sudden death.

53
Q

Management of torsades de pointes

A

IV Magnesium sulfate

54
Q

Features of acute pericarditis

A

Chest pain - may be pleuritic
Pericardial rub
Tachypnoea
Tachycardia

55
Q

Cause of acute pericarditis

A 
Uraemia
viral infections (Coxsackie)
tuberculosis
uraemia (causes 'fibrinous' pericarditis)
trauma
post-myocardial infarction, Dressler's syndrome
connective tissue disease
hypothyroidism
malignancy
56
Q

Changes on ECG in acute pericarditis

A

Saddle shape ST elevation

PR depression

57
Q

What additional investigation should patient with acute pericarditis have with ECG?

A

Transthoracic echocardiogram

58
Q

Management of acute pericarditis

A

Treat underlying cause

NSAIDs and colchicine

59
Q

ECG signs of hyperkalaemia

A

Small or absent P waves, tall tented T waves and broad bizarre QRS complexes
Long PR interval
Sine wave

60
Q

Symptoms of hypokalaemia

A

fatigue, muscle weakness, myalgia, muscle cramps, constipation, hyporeflexia and rarely paralysis.

61
Q

ECG signs of hypokalaemia

A 
U waves
small or absent T waves (occasionally inversion)
prolong PR interval
ST depression
long QT

Cardiology (7 decks)

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