Cardiology Flashcards
1
Q
Heart failure and AF
A
Digoxin as 2nd line
2
Q
AF rate control
A
Beta blockers, Calcium blockers and 3rd line Digoxin 2nd line if HF
3
Q
Unstable NSTEMI
A
Coronary angiography
4
Q
Stable NSTEMI
A
GRACE
5
Q
Malignant hypertension
A
severe hypertension + Bilateral retinal hemorrhage and exudates
6
Q
STEMI management
A
aspirin, Clopidogrel; unfractioned heparin - PCI patients
7
Q
Two types of ASD
A
Ostium primium and secundum
8
Q
Ejection systolic murmur, Fixed splitting S2
A
ASD
9
Q
RBBB and LBBB
A
William Marrow V1 and V6
10
Q
1st line for HF
A
Beta blocker and ACE inhibitor
11
Q
Second line for HF
A
Aldosterone antagonist
12
Q
Patient symptomatic on ACE and ARBs
A
Sucubitril-Valsartan
13
Q
HF + AF preferred drug
A
Digoxin
14
Q
AF unstable patient >HR and
A
DC cardioversion
15
Q
Ventricular tachycardia broad complex management
A
Loading dose of amiodarone
16
Q
management of bradycardia
A
Atropine 500mcg upto 3 mg- 1st line
Transcutaneous pacing
Isoprenaline or adrenaline titration to response
17
Q
Management of Torsades (polymorphic VT)
A
IV MGSO4
18
Q
Angina management
A
Beta blocker or calcium blocker as 1st line
Calcium blocker - verapamil or diltiazem
With beta blocker - Nifedipine
3rd line: Long acting nitrate, Ivabradine and nicorandil
19
Q
Young man, AF, 0 CHADVAS score next step??
A
Transthoracic Echo - valve disease
20
Q
Painful bones, renal stones, abdominal groans, and psychic moans.
A
Hypercalcemia
21
Q
Diarrhoea, vomiting, impaired thirst, weight loss, oliguria and hypovolemia
A
Hypernatremia
22
Q
Mental state changes, altered personality, lethargy, confusion, hyper reflexes and seizures due to electrolyte imbalance
A
Hyponatremia
23
Q
K <= 4.5 and Hypertensive - 3rd line
A
Spironolactone
24
Q
K >4.5 and 3rd line antihypertensive
A
Beta blocker or alpha blocker
25
u waves on ECG associated with
Hypokalemia
| Can be caused by thiazides like diuretics
26
Tall T waves are seen in what electrolyte
Hyperkalemia
| can be due to ACE-inhibitors
27
Apical ballooning of chest, Raised troponin and ST elevation
Takotsubo Cardiomyopathy
| Trigger is stress
28
Weak or absent pulse, variation in BP, chest pain (like MI)
Aortic Dissection
29
Splinter Hemorrhages
Infective endocarditis
30
Slow rising pulse
Aortic stenosis
31
Pan-systolic murmur of the left heart
Mitral Regurgitation
32
ST depression in lead V1-V3, Tall R waves in V1-V3, inverted T wave in lead aVR and all other leads are normal + Chest pain
Posterior wall MI
33
Transfer PCI time
120 minutes
34
AF cardioversion drugs
Amiodarone (preferred if SHD)
| Flecainide
35
Same day referral for hypertension
>180/120; papilloedema; new onset confusion; heart failure or kidney failure
36
1st line investigation for Suspected CAD, angina
Contrast enhanced CT coronary angiogram
37
Pulsus paradoxus
>10 mmHg fall in Bp during inspiration
| Severe asthma and cardiac tamponade
38
Slow rising pulse
Aortic stenosis
39
Collapsing pulse
Aortic regurgitation; PDA
40
Bisferiens pulse
TWO systolic peaks; Mixed aortic valve
41
Jerky pulse
HOCM
42
Rupture of papillary muscle leads to
Early to mid systolic murmur that radiates to axilla
43
fever, post-MI, anemia, Raised ESR, and pleural effusions
Dressler’s syndrome ; 2-6 weeks post MI
44
HF + signs of Cardiac tamponade including muffled heart sounds, raised JVP and pulses paradoxus
Left ventricular free wall rupture
45
Persistent ST elevation post MI
LV aneurysm
46
Posterior wall MI on ECG
Tall R waves in V1-V2
47
Vessel that causes leg weakness in stroke
Anterior vessels
48
Vessels that cause face and arm weakness in stroke
Middle cerebral arteries
49
Contralateral homonymous hemianopia with macula sparing and visual agnosia in stroke
Posterior cerebral artery
50
Ipsilateral CN3 palsy + Contralateral weakness of upper and lower extremes
Weber’s Syndrome
| PCA branches that supply the midbrain
51
Ipsilateral facial paralysis and deafness + Facial temp loss
Contralateral: limb pain and temp loss; ataxia and nystagmus
Anterior inferior cerebellar syndrome
52
Posterior inferior cerebellar artery (lateral medullary syndrome)
Ipsilateral: facial pain and temp loss
Contralateral: limb and torso pain + temp loss, ataxia and nystagmus
53
Amaurosis fugax
Retinal or ophthalmic artery
54
Locked in syndrome
Basilar artery
55
Isolated hemiparesis, hemisensory loss or hemparesis with limb ataxia; Hypertension associated and affects basal ganglia, thalamus and internal capsule
Lacunar stroke
56
Narrow complex tachycardia, stable patient, 1st line management
Vagal manoeuvres eg. valsalva or carotid sinus massage
| 2nd line: adenosine or Verapamil
57
General transfusion threshold vs ACS threshold
70 g/L
| 80 g/L
58
Kussmauls Sign
Sign of Constrictive pericarditis and is the JVP that does not fall with inspiration.
59
Ankylosis Spondylitis is associated with which Heart defect
Aortic regurgitation
60
1st heart imaging in Endocarditis
Transthoracic Echocardiogram
61
Ejection systolic murmur louder on inspiration
Pulmonary stenosis
62
Describe murmur of mitral stenosis
Mid-late diastolic murmur heard on expiration
63
MVP murmur
Mid systolic murmur heard best on expiration
64
Tricuspid stenosis murmur
Mid-late diastolic murmur heard loudest in inspiration
65
Aortic stenosis murmur
Ejection systolic best heard in expiration
66
RILE (just a pneumonic)
Right inspiration
| Left expiration
67
Types of ejection systolic murmurs
```
Aortic stenosis (best heard on expiration)
HOCM (best heard on expiration)
```
```
Pulmonary stenosis (best heard on inspiration)
ASD (best heard on inspiration)
```
TOF is also a E/S murmur
68
Describe all Holosystolic murmurs
Mitral regurgitation and tricuspid regurgitation
| VSD
69
Describe all late systolic murmurs
MVP and coarctation of aorta
70
Early diastolic murmur
```
Aortic regurgitation (blowing and high pitched )
Graham steel Murmur: Pulmonary regurgitation
```
71
Mid-late diastolic murmurs
Mitral stenosis and Austin flint (AR) both are rumbling
72
Inferior wall MI
RCA - 2,3 and avF
73
Anteroseptal MI
V1 to V4- LAD
74
Anterolateral
V4 to V6; 1 and aVL: LAD or LCx
75
Lateral 1, aVL and v5-6
Left circumflex
76
Posterior wall MI
Tall R waves in V1 to V2
77
Treatment of Torsades de pointes
IV magnesium sulphate
78
Posterior circulation symptoms such as dizziness, vertigo during exertion of an arm.
Subclavian steal syndrome
| management: percutaneous transluminal angioplasty or a stent
79
Acute pericarditis management
NSAID and colchicine
80
Electrical Alternans is a sign of
Cardiac tamponade
81
ECG of Eisenmenger’s Syndrome shows
RVH
82
Most common cause of Endocarditis
S. Aureus
83
Most common cause of Endocarditis in IVDUs
S. Aureus
84
Microbe linked with poor dental hygiene or following dental procedure in endocarditis
S. Viridans
85
Most common microbe linked to colon cancer in endocarditis
S. BOVIS
86
Microbe in endocarditis linked to Q fever and farm animals
Coxiella burnetti
87
Prosthetic valve surgery and Endocarditis
S. epidermis
88
Dissented JVP; Muffled heart sounds and Hypotension
Beck’s triad of Cardiac tamponade
89
NSTEMI anti platelet choice
```
Aspirin
Plus Ticagrelor (if not high risk for bleeding)
Plus Clopidogrel (if high risk)
```
90
Deeply inverted or biphasic waves in V2-V3 in a person with history of angina
Wellen’s syndrome; Critical stenosis of the lAD
91
Acute HF is associated with S3 or S4
S3
92
Most common valve that is affected in endocarditis
Right sided valve; Tricuspid valve
93
J waves on ECG
Hypothermia
94
Blood test to determine reincarnation between 3-4 days following infarction
CKMB
95
K >4.5 mmol/L and 4th line antihypertensive
Alpha blocker or beta blocker
96
Infective endocarditis causing HF- management
Emergency valve replacement
97
VSDs increase the risk of what heart condition
Endocarditis
98
SE Bendroflumethazide
Hypercalcemia
Hypokalemia
Hyponatremia
99
Management of SVTs
Vagal manoeuvres + carotid sinus massage
IV adenosine -6mg + 12 mg+ 12 mg CI? Give verapamil
Electrical cardioversion
100
Dilated cardiomyopathy is associated with
Heart failure
101
What Drug is CI in HOCM
ACE-inhibitors
102
One off Hyperkalemia on blood test for Ramipril
Repeat the test for U/E
103
Cocaine induced ACS is caused by
Coronary artery spasm
104
SVC syndrome cause
Lung cancer
105
What is 1st line in sinus bradycardia
Atropine
