Cardiology Flashcards

1
Q

LQT1

A

KVLQT1

Phase 3 K channels (Kr)

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2
Q

LQT2

A

HERG gene

Under active K channel (Ks)

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3
Q

LQT3

A

SCN5A

Overactive Na channel on depolarisation (NaL)

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4
Q

Drug with best mortality benefit HFrEF

A

Beta Blockers
Carvedilol (CAPERNICUS for severe HF)
Metoprolol
Bisoprolol

MRA > ACEi > ARB

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5
Q

Benefit of ACE for HF

A

Mortality 3.8%
Decreased readmission for heart failure
no difference compared to ARB

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6
Q

Digoxin in HF

A

Reduce HF hospitalisation for those intolerant to B Blockers or persistent symptoms on B Blockers

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7
Q

Emperor Preserve Trial

A

Empagliflozin vs placebo

21% RR for CV death and HHF

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8
Q

E/e’ consistent with HFpEF

A

> 13

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9
Q

Impaired longitudinal strain cut off

A

Abnormal if >-16

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10
Q

Indication for CMRI

A

LV Hypertrophy

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11
Q

LA volume index consistent with HFpEF

A

> 34

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12
Q

Clinically significant MS

A

Valve area <1cm
Mean gradient >10mmhg
PASP >30mmHg

If symptomatic, recommended for perc MV repair or surgery

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13
Q

PCSK9 Inhibitors

A

Alirocumab

Evolocumab

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14
Q

COURAGE trial

A

In stable angina (2000)
Optimal medical therapy vs PCI
Nil reduction in death or MI

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15
Q

ISCHAEMIA trial

A

No reduced risk of Mortality or MI in invasive vs conservative strategy

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16
Q

SYNTAX study

A

Cardiac surgery superior to PC in triple vessel or left main disease
> MACE at 1 year

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17
Q

STITCHES trial

A

At 10 years, mortality benefit of CABG for ischaemic CM

Should be considered in young patients without angina

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18
Q

Non dihydropyridine CCB

A

Diltiazem

Verapamil

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19
Q

The immediate success rate of cardio version

A

90%
Falls with duration of AF
risk of early recurrence

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20
Q

Drugs that increase likelihood of successful cardio version

A

Sotalol
Ibutilide
Dofetilide

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21
Q

Irreversible P2Y12 platelet receptor

A

Clopidogrel

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22
Q

Reversibly binds to P2Y-12 receptor

A

Ticagrelor

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23
Q

Poor METS

Good METS

A

<4

>10

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24
Q

MACE

A
total death
MI
stroke
hospitalization because of HF
revascularization (PCI, ACBG)
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25
Q

Main benefit of DES over BMS

A

Less restenosis

26
Q

Triple therapy post stent

A

1/52 for triple therapy
12/12 clop + DOAC
At 1 year aspirin + DOAC

27
Q

regular broad complex tachy

A

pre-excited atrial tachycardia
svt with abberency
VT
electrolytes

28
Q

VT features

A

A-V dissociation
fusion/capture beats
Concordance within the precordial leads

29
Q

Trigger for brugada

A

Fever

30
Q

Antiarrhythmic for brugada

A

Quinidine

31
Q

Genetic abnormality leading to Arrythmogenic RV cardiomyopathy

A

Defect in genes encoding desmosomal proteins

32
Q

Giant TWI precordial leads

A

apical HOCM

33
Q

prolonged PR in Aortic IE

A

Aortic root abscess

Need surgery

34
Q

Cause of haemorrhagic pericardial effusion

A

TB
Neoplasm
Uraemic effusion

35
Q

Cardiac syndrome X

A

Microvascular disease that leads to typical angina
Normal coronaries
Positive stress test (ischaemic changes)

36
Q

Most common aetiology of viral myocarditis

A

Coxsackie virus

37
Q

Most common heart defet in Down’s syndrome

A

Atrio-ventricular cushion defect

  1. Common AV valve
  2. Ostium primum ASD
  3. Posterior septal ventricular defect
38
Q

Ratio that indicates ASD closure is required

A

Pulmonary:systemic flow ratio >2:1

39
Q

Duration of antibiotic prophylaxis for RHD

A

ARF nil cardiac involvement - 5 years or 21
Mild RHD - 10 years or 21
Mod RHD - 10 years or 35
Severe RHD - 10 years or 40

40
Q

Signs of severe AS

A
  1. Loud (grade 4) murmur
  2. Mid or late peaking murmur
  3. Diminished or absent S2
  4. Split s2 (AV closes after PV)
  5. Disappearance of ejection click
  6. Parvus et tardus carotid pulse
  7. S3/S4
41
Q

S4

A

Diastolic sound before S1
Atrial gallop
Blood ejecting into a stiff ventricule (diastolic HF)

42
Q

S3

A

Ventricular gallop
After S2
Blood entering a floppy ventricle
Systolic HF

43
Q

Signs of AR

A
Early diastolic /holodiastolic if severe
Displaced apex with apical thrust
Corrigans= water hammer pulse
De mussets = head bobbing
Landolfis sign = pulsing pupils 
Becker’s = retinal artery pulsing
Austin Flint 
Taubes = pistol shot over femoral 
Quinces 
Hills = LL systolic > UL by 20mmhg
44
Q

Type 3 MI

A

Typical MI with death before troponins

45
Q

Type 4a MI

A

Associated with PCI

46
Q

Type 5 MI

A

Associated with CABGS

47
Q

Type 4b MI

A

In stent thrombosis

48
Q

ASD ECG

A

First degree heart block
Rbbb
Notching of r wave in inferior leads

49
Q

Congenital cause of cyanosis heart diseas

A
Truancy’s arteriosis
Tricuspid atresia
TOF
TAPVR 
Transposition of great vessels

Non cyanotic - asd vsd PDA (until eisenmonger syndrome with shunt reversal)

50
Q

Neprilysin hydrolysis action

A

glucagon, enkephalins, substance P, neurotensin, oxytocin, and bradykinin.

51
Q

Diagnosis of HFpEF on exercise RHC

A

pulmonary capillary wedge pressure (PCWP) ≥15 mmHg at rest or ≥25 mmHg during exercise is diagnostic for HFpEF.

52
Q

Echo findings of HFpEF

A

Doppler echocardiographic E/e’ >15
Pulmonary artery systolic pressure >35 mmHg
Left atrial volume index (LAVI) >34 mL/m2

53
Q

Treatment of ventricular septal rupture

A

Surgery

54
Q

Window for thrombolysis

A

12 hours

55
Q

High risk cardiac abnormalities requiring antibiotic prophylacis

A

– Prosthetic cardiac valves or prosthetic material
– Previous infective endocarditis
– Unrepaired cyanotic congenital defects
– Rheumatic Heart Disease patients
– Heart Transplant patients

56
Q

Alzheimer’s medication with bradycardic effect

A

Donezapil (anticholinesterase with muscarinic effects)

57
Q

Prostate medication leading to drop in BP

A

Tamusolin
A1- antagonist
Preferential selectivity of a1A in the prostate over a1B in blood vessels

58
Q

Lipoprotein Lipase Deficiency cholesterol pattern

A

No LDL

High VLDL therefore high total cholesterol

59
Q

Adenosine deaminase (>50 U/L) in the pericardial fluid

A

TB pericaditis

60
Q

Ostium secumdum vs ostium primum ASD

A

2nd-
Nil MR
No LAD