Cardiology Flashcards

1
Q

Heart failure and AF

A

Digoxin as 2nd line

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2
Q

AF rate control

A

Beta blockers, Calcium blockers and 3rd line Digoxin 2nd line if HF

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3
Q

Unstable NSTEMI

A

Coronary angiography

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4
Q

Stable NSTEMI

A

GRACE

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5
Q

Malignant hypertension

A

severe hypertension + Bilateral retinal hemorrhage and exudates

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6
Q

STEMI management

A

aspirin, Clopidogrel; unfractioned heparin - PCI patients

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7
Q

Two types of ASD

A

Ostium primium and secundum

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8
Q

Ejection systolic murmur, Fixed splitting S2

A

ASD

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9
Q

RBBB and LBBB

A

William Marrow V1 and V6

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10
Q

1st line for HF

A

Beta blocker and ACE inhibitor

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11
Q

Second line for HF

A

Aldosterone antagonist

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12
Q

Patient symptomatic on ACE and ARBs

A

Sucubitril-Valsartan

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13
Q

HF + AF preferred drug

A

Digoxin

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14
Q

AF unstable patient >HR and

A

DC cardioversion

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15
Q

Ventricular tachycardia broad complex management

A

Loading dose of amiodarone

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16
Q

management of bradycardia

A

Atropine 500mcg upto 3 mg- 1st line
Transcutaneous pacing
Isoprenaline or adrenaline titration to response

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17
Q

Management of Torsades (polymorphic VT)

A

IV MGSO4

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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

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19
Q

Young man, AF, 0 CHADVAS score next step??

A

Transthoracic Echo - valve disease

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20
Q

Painful bones, renal stones, abdominal groans, and psychic moans.

A

Hypercalcemia

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21
Q

Diarrhoea, vomiting, impaired thirst, weight loss, oliguria and hypovolemia

A

Hypernatremia

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22
Q

Mental state changes, altered personality, lethargy, confusion, hyper reflexes and seizures due to electrolyte imbalance

A

Hyponatremia

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23
Q

K <= 4.5 and Hypertensive - 3rd line

A

Spironolactone

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24
Q

K >4.5 and 3rd line antihypertensive

A

Beta blocker or alpha blocker

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25
Q

u waves on ECG associated with

A

Hypokalemia

Can be caused by thiazides like diuretics

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26
Q

Tall T waves are seen in what electrolyte

A

Hyperkalemia

can be due to ACE-inhibitors

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27
Q

Apical ballooning of chest, Raised troponin and ST elevation

A

Takotsubo Cardiomyopathy

Trigger is stress

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28
Q

Weak or absent pulse, variation in BP, chest pain (like MI)

A

Aortic Dissection

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29
Q

Splinter Hemorrhages

A

Infective endocarditis

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30
Q

Slow rising pulse

A

Aortic stenosis

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31
Q

Pan-systolic murmur of the left heart

A

Mitral Regurgitation

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32
Q

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

A

Posterior wall MI

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33
Q

Transfer PCI time

A

120 minutes

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34
Q

AF cardioversion drugs

A

Amiodarone (preferred if SHD)

Flecainide

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35
Q

Same day referral for hypertension

A

> 180/120; papilloedema; new onset confusion; heart failure or kidney failure

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36
Q

1st line investigation for Suspected CAD, angina

A

Contrast enhanced CT coronary angiogram

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37
Q

Pulsus paradoxus

A

> 10 mmHg fall in Bp during inspiration

Severe asthma and cardiac tamponade

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38
Q

Slow rising pulse

A

Aortic stenosis

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39
Q

Collapsing pulse

A

Aortic regurgitation; PDA

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40
Q

Bisferiens pulse

A

TWO systolic peaks; Mixed aortic valve

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41
Q

Jerky pulse

A

HOCM

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42
Q

Rupture of papillary muscle leads to

A

Early to mid systolic murmur that radiates to axilla

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43
Q

fever, post-MI, anemia, Raised ESR, and pleural effusions

A

Dressler’s syndrome ; 2-6 weeks post MI

44
Q

HF + signs of Cardiac tamponade including muffled heart sounds, raised JVP and pulses paradoxus

A

Left ventricular free wall rupture

45
Q

Persistent ST elevation post MI

A

LV aneurysm

46
Q

Posterior wall MI on ECG

A

Tall R waves in V1-V2

47
Q

Vessel that causes leg weakness in stroke

A

Anterior vessels

48
Q

Vessels that cause face and arm weakness in stroke

A

Middle cerebral arteries

49
Q

Contralateral homonymous hemianopia with macula sparing and visual agnosia in stroke

A

Posterior cerebral artery

50
Q

Ipsilateral CN3 palsy + Contralateral weakness of upper and lower extremes

A

Weber’s Syndrome

PCA branches that supply the midbrain

51
Q

Ipsilateral facial paralysis and deafness + Facial temp loss
Contralateral: limb pain and temp loss; ataxia and nystagmus

A

Anterior inferior cerebellar syndrome

52
Q

Posterior inferior cerebellar artery (lateral medullary syndrome)

A

Ipsilateral: facial pain and temp loss
Contralateral: limb and torso pain + temp loss, ataxia and nystagmus

53
Q

Amaurosis fugax

A

Retinal or ophthalmic artery

54
Q

Locked in syndrome

A

Basilar artery

55
Q

Isolated hemiparesis, hemisensory loss or hemparesis with limb ataxia; Hypertension associated and affects basal ganglia, thalamus and internal capsule

A

Lacunar stroke

56
Q

Narrow complex tachycardia, stable patient, 1st line management

A

Vagal manoeuvres eg. valsalva or carotid sinus massage

2nd line: adenosine or Verapamil

57
Q

General transfusion threshold vs ACS threshold

A

70 g/L

80 g/L

58
Q

Kussmauls Sign

A

Sign of Constrictive pericarditis and is the JVP that does not fall with inspiration.

59
Q

Ankylosis Spondylitis is associated with which Heart defect

A

Aortic regurgitation

60
Q

1st heart imaging in Endocarditis

A

Transthoracic Echocardiogram

61
Q

Ejection systolic murmur louder on inspiration

A

Pulmonary stenosis

62
Q

Describe murmur of mitral stenosis

A

Mid-late diastolic murmur heard on expiration

63
Q

MVP murmur

A

Mid systolic murmur heard best on expiration

64
Q

Tricuspid stenosis murmur

A

Mid-late diastolic murmur heard loudest in inspiration

65
Q

Aortic stenosis murmur

A

Ejection systolic best heard in expiration

66
Q

RILE (just a pneumonic)

A

Right inspiration

Left expiration

67
Q

Types of ejection systolic murmurs

A
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
Q

Describe all Holosystolic murmurs

A

Mitral regurgitation and tricuspid regurgitation

VSD

69
Q

Describe all late systolic murmurs

A

MVP and coarctation of aorta

70
Q

Early diastolic murmur

A
Aortic regurgitation (blowing and high pitched ) 
Graham steel Murmur: Pulmonary regurgitation
71
Q

Mid-late diastolic murmurs

A

Mitral stenosis and Austin flint (AR) both are rumbling

72
Q

Inferior wall MI

A

RCA - 2,3 and avF

73
Q

Anteroseptal MI

A

V1 to V4- LAD

74
Q

Anterolateral

A

V4 to V6; 1 and aVL: LAD or LCx

75
Q

Lateral 1, aVL and v5-6

A

Left circumflex

76
Q

Posterior wall MI

A

Tall R waves in V1 to V2

77
Q

Treatment of Torsades de pointes

A

IV magnesium sulphate

78
Q

Posterior circulation symptoms such as dizziness, vertigo during exertion of an arm.

A

Subclavian steal syndrome

management: percutaneous transluminal angioplasty or a stent

79
Q

Acute pericarditis management

A

NSAID and colchicine

80
Q

Electrical Alternans is a sign of

A

Cardiac tamponade

81
Q

ECG of Eisenmenger’s Syndrome shows

A

RVH

82
Q

Most common cause of Endocarditis

A

S. Aureus

83
Q

Most common cause of Endocarditis in IVDUs

A

S. Aureus

84
Q

Microbe linked with poor dental hygiene or following dental procedure in endocarditis

A

S. Viridans

85
Q

Most common microbe linked to colon cancer in endocarditis

A

S. BOVIS

86
Q

Microbe in endocarditis linked to Q fever and farm animals

A

Coxiella burnetti

87
Q

Prosthetic valve surgery and Endocarditis

A

S. epidermis

88
Q

Dissented JVP; Muffled heart sounds and Hypotension

A

Beck’s triad of Cardiac tamponade

89
Q

NSTEMI anti platelet choice

A
Aspirin 
Plus Ticagrelor (if not high risk for bleeding) 
Plus Clopidogrel (if high risk)
90
Q

Deeply inverted or biphasic waves in V2-V3 in a person with history of angina

A

Wellen’s syndrome; Critical stenosis of the lAD

91
Q

Acute HF is associated with S3 or S4

A

S3

92
Q

Most common valve that is affected in endocarditis

A

Right sided valve; Tricuspid valve

93
Q

J waves on ECG

A

Hypothermia

94
Q

Blood test to determine reincarnation between 3-4 days following infarction

A

CKMB

95
Q

K >4.5 mmol/L and 4th line antihypertensive

A

Alpha blocker or beta blocker

96
Q

Infective endocarditis causing HF- management

A

Emergency valve replacement

97
Q

VSDs increase the risk of what heart condition

A

Endocarditis

98
Q

SE Bendroflumethazide

A

Hypercalcemia
Hypokalemia
Hyponatremia

99
Q

Management of SVTs

A

Vagal manoeuvres + carotid sinus massage
IV adenosine -6mg + 12 mg+ 12 mg CI? Give verapamil
Electrical cardioversion

100
Q

Dilated cardiomyopathy is associated with

A

Heart failure

101
Q

What Drug is CI in HOCM

A

ACE-inhibitors

102
Q

One off Hyperkalemia on blood test for Ramipril

A

Repeat the test for U/E

103
Q

Cocaine induced ACS is caused by

A

Coronary artery spasm

104
Q

SVC syndrome cause

A

Lung cancer

105
Q

What is 1st line in sinus bradycardia

A

Atropine