Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

finals > Cardiology > Flashcards

Cardiology Flashcards

1
Q

ST elevation in leads 1, Avl, V5 and V6 - which artery affected

A

right coronary artery (inferior territory MI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ST elevation in leads V1 - V4 - which artery affected

A

anterior MI - left anterior descending artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ST elevation in leads 2, 3 and AVF - which artery affected

A

lateral MI - left circumflex artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

findings in hypertensive retinopathy on fundoscopy

A
  1. papilloedema
  2. cotton wool spots
  3. flame haemorrhages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

eye findings in infective endocarditis

A

roth spots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

2 x signs of hypercholesterolaemia on examination

A

xanthelasma

corneal arcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

findings on chest x ray in pulmonary oedema (heart failure)

A 
alveolar oedema (batwing distribution)
Kerley B lines
cardiomegaly
Diversion (upper lobe diversion)
pleural effusions
fluid in fissures

^ABCDEF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

which classification system is used for heart failure

A

new york heart association

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

name 3 cardiac enzymes that can indicate ischaemia / muscle damage

A
  1. troponin
  2. lactate dehydrogenase
  3. creatinine kinase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what criteria is used for a diagnosis of infective endocarditis

A

Duke criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

name the components of duke criteria (infective endocarditis)

A

major criteria:
positive blood cultures (2 x samples)
evidence of cardiac involvement: ECG changes / new valvular regurg, new murmur, worsening of pre existing murmur

minor:
predisposing heart condition
IVDU
fever
vascular phenomena eg arterial emboli, janeway lesions, conjunctival haemorrhage
immune phenomena: oslers nodes, glomerulonephritis, roth spots
microbiological evidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how do you manage acute pulmonary oedema

A
  1. oxygen
  2. nitrates (in the case of heart failure)
  3. IV furosemide or bumetanide (loop)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the most common complication of an MI

A

ventricular fibrillation (most common cause of death) and ventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

which type of arrythmia is common following an inferior MI

A

AV block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is dresslers syndrome

A

a complication that occurs around 2-3 weeks post-MI usually due to an autoimmune reaction when the myocardium is recovering
CP: fever, pleuritic chest pain + raised ESR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

management of dresslers syndrome

A

NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

common complication following a transmural MI

A

pericarditis
occurs in 48 hours of MI
CP: pleuritic chest pain, pericardial rub on ausciltation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

symptoms of left ventricular aneurysm post mi

A 
extreme tiredness
increasing SOB
if clot forms can cause a stroke
palpitations / new arrhythmia 
oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how should you manage pts with a left ventricular aneurysm post MI

A

anticoagulate bc at increased risk of a clot firing off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how long after an MI does a left ventricular free wall rupture occur

A

1-2 weeks after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how does a left ventricular free wall rupture present

A

1-2 weeks post MI, acute heart failure secondary to a cardiac tamponade:
raised JVP, SOB, cough, frothy white / pink sputum, peripheral oedema, chest pain
syncope
pulsus paroxodus
diminished heart sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is pulsus paradoxus

A

an abnormally large decrease in stroke volume, systolic BP and pulse wave amplitude during inspiration

drop has to be over 10mmhg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

management of cardiac tamponade

A

urgent pericardiocentesis + thoracotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

acute heart failure 1 week post MI with a pan systolic murmur

A

ventricular septal defect caused by MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

acute heart failure with sharp chest pain and collapse 2 weeks post MI with pulsus paradoxus and diminished heart sounds

A

ventricular free wall rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

signs on examination in aortic regurg

A
  1. early diastolic murmur heart at left sternal edge 3rd intercostal
  2. collapsing pulse
    3.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

slow rising pulse

A

aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

presentation of infective endocarditis

A 
high persistent fever
generally unwell - myalgia, arthraliga, malaise
palpitations - new murmur
SOB
headache
anorexia
night sweats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

findings on examination of a pt with infective endocarditis

A 
janeway lesions (palms)
roth spots (eyes)
osler nodes
splinter haemorrhages (nails)
petechiae / purpura
splenomegaly
new or changing murmur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what diagnostic criteria is used for infective endocarditis

A

modified duke criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

2 major criteria in duke criteria for IE

A

evidence of endocardial involvement on echo or auscultates a new valve regurg or new/changing murmur

2x positive blood cultures showing a typical organism eg strep viridans or persistent bacteraemia from a less specific organism eg staph aureus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

4 minor criteria in duke criteria for IE

A

predisposing heart condition
IVDU
persistent fever over 38 degrees
vascular phenomenon: splinter haemorrhages, janeway lesions, purpura/petechiae

immunological phenomenon: osler nodes, roth spots, glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

most common causative organism for infective endocarditis

A

staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

causative organisms for infective endocarditis

A

staph aureus
strep viridans
staph epididermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

most common organism for infective endocarditis after valve surgery

A

staph epididermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

most common organism for infective endocarditis in IVDU

A

staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

name 5 risk factors for infective endocarditis

A 
IVDU
recent prosthetic heart valvue surgery
prev IE infection
poor dental hygeine
SLE (can cause non-infective endocarditis)
congenital heart defects eg PDA
rheumatic valve disease
recent piercings / tattoo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is the strongest risk factor for infective endocarditis

A

previous episode of IE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

name 3 complications of infective endocarditis

A

aortic abscess
heart failure
death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

which organism that causes infective endocarditis carries the worst prognosis

A

staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

management of infective endocarditis initially (before cultures back)

A

amoxicillin +low dose gent if normal valve
vancomycin if pen allerg
Vancomycin + low dose gent + rifampicin if prosthetic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

management of infective endocarditis with prosthetic valve + staph infection

A

flucloxacillin + rifampicin + low dose gent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

management of infective endocarditis with normal valve and staph infection

A

Flucloxacillin + low dose gent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

management of infective endocarditis with normal valve and strep infection

A

Benzylpenicillin and low dose gent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

management of infective endocarditis with prosthetic valve and strep infection

A

Rifampicin, Benzylpenicillin and low dose gent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what antibiotic do you use in infective endocarditis for pen allergic patients

A

Vancomycin + low dose gentamicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what antibiotic do you add in patients with a prosthetic heart valve for infective endocarditis

A

Rifampicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what investigations would you order in a patient with suspected infective endocarditis

A
  1. 2 x blood cultures taken 12 hours apart
  2. sepsis 6
  3. echo
  4. ECG
    5 - FBC U+E LFT CRP ESR
  5. complement levels - used for prognosis
  6. autoimmune antibodies if thinking sle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what is the most common type of cardiomyopathy

A

dilated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

name the cardiomyopathies that are primarily systolic dysfunction

A

dilated = weakens and thins the muscles = cant contract properly bc weak = systolic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

name the cardiomyopathies that are primarily diastolic dysfunction

A

hypertrophic = muscle too big = makes the area inside the ventricles smaller = cant fill properly = diastolic problem

restrictive = a hard and stiff ventricle = doesnt move to open up to fill properly = increased ventricular pressure all the time due to it being stiff so gets backflow of blood = diastolic problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

which chambers become dilated in dilated cardiomyopathy

A

all 4 chambers become dilated, but left ventricle dialted more than the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

name 4 causes of a dilated cardiomyopathy

A 
alcohol
coxsackie B virus
HTN
cocaine
duchenne muscular dystrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what is cor pulmonale

A

right sided heart failure caused by an increase in pulmonary vessel pressures (pulmonary hypertension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

name 4 causes of cor pulmonale

A

COPD
interstitial lung disease
cystic fibrosis
PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

how does cor pulmonale present

A

often asymptomatic to begin with
then right side heart failure symptoms: raised JVP, peripheral oedema, hepatomegaly, heart murmur, cyanosis, syncope, SOBOE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

symptoms of right heart failure

A 
peripheral oedema
ascites
raised JVP
hepatomegaly
sacral oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

symptoms of left heart failure

A 
pulmonary oedema (pink frothy sputum)
nocturnal paroxysmal dyspnoea
orthopnoea
nocturnal cough
weight loss
cool peripheries
SOB 
fatigue
poor exercise tolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

name 2 causes of high output heart failure

A

anaemia

thyrotoxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what 4 investigations would you do to diagnose heart failure and why

A
  1. BNP
  2. echo - to look at EF and look for a cause
  3. ECG - to look for hypertrophies or ischaemic changes
  4. bloods = U+E for any meds going to start, FBC for anaemia that may be making heart failure worse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what is pre load

A

the pressure needed to over come to pump blood into ventricles - so stretching of cardiac myocytes on filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

what is afterload

A

the pressure left in the ventricle needed to overcome to pump blood out on systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

how do you work out cardiac output

A

HR x stroke volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what is ejection fraction

A

amount of blood pumped out of the heart with each contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what is stroke volume

A

amount of blood pumped out of the left ventricle in one contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what is end diastolic volume

A

amount of blood in the ventricles at the end of diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what is end systolic volume

A

amount of blood left in the ventricles at the end of systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

how does left ventricular hypertrophy show up on ECG

A

left axis deviation

T wave inversion in leads 1, avl and v5 and v6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

how does right ventricular hypertrophy look on ECG

A

right axis deviation
very tall R waves in v1-v3
T wave inversion in leads v1-v3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Management of chronic heart failure (essential drugs)

A

Ace - i
beta blocker
Aldosterone antagonist! spironolactone / epelerone
Loop diuretic - furosemide

ABAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

which type of anti hypertensive should be avoided in patients with valvular heart disease unless indicated by a specialist

A

ace inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

what are the 3 typical anginal symptoms

A

heavy chest pain
on exertion
relieved by rest or GTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

when would you use the word atypical angina

A

when less than 3 of the typical symptoms arent met (so for example might be heavy chest pain thats not relieved by rest or GTN)

74
Q

what 3 tests would you consider to investigate angina

A
  1. ECG
  2. CT coronary angiography
  3. exercise ECG
  4. bloods such as FBC to look for things that might be exacerbating symptoms
75
Q

management of stable angina

A
  1. GTN for symptom relief
  2. prevention with beta blocker and aspirin
  3. if not controlled with betablocker can add a calcium channel blocker eg mod release nifedipine
  4. if doesn’t tolerate beta blocker can switch to CCB such as verapamil or dilitazem as a monotherapy only as these types of CCB’s cant be used alongside beta blockers due to the risk of complete heart block
76
Q

initial management of ACS

A
  1. GTN
  2. 300mg aspirin
  3. IV morphine if in pain
77
Q

what is the criteria for Primary PCI in ACS

A
  • must be within 12 hours of symptom onset

- and must be able to be done within 120 minutes of the time when fibrinolysis could have been done

78
Q

what drugs are used for fibrinolysis in ACS

A

alteplase

streptokinase (old)

79
Q

which antiplatelet should be given if the patient is going for PCI

80
Q

which antiplatelet should be given if patient is being treated for ACS with fibrinolysis

A

ticagrelor

81
Q

which antiplatelet should be given if patient is having ACS but is already on an anticoag or has an increased bleeding risk

A

clopidogrel

82
Q

NSTEMI treatment

A

if low GRACE score then conservative with batman
if high risk then PCI within 4 days of admission

BATMAN
beta blockers
aspirin
ticagrelor
morphine
anticoag (fondaparinoux)
nitrates (GTN)
83
Q

TTO drugs post - MI

A

6 x A’s
Aspirin
another antiplatelet (ticagrelor, prasugrel or clopidogrel)
atenolol (or other b blocker)
antihypertensive
atorvastatin
aldosterone antagonist in pts with signs of heart failure (eplerenone)

84
Q

what is dresslers syndrome

A

a complication of MI that occurs 2-3 weeks post MI.

causes a pericarditis

85
Q

what type of scar will a pt have if they have had a valve replacement

A

midline sternotomy or right sided mini sternotomy

86
Q

name 3 complications of a valve replacement

A

infective endocarditis
thrombotic emboli
haemolysis (from churning through the valve) = anaemia

87
Q

what is the INR target for patients post mechanical valve insertion

88
Q

what is a TAVI

A

transcatheter aortic valve insertion

89
Q

what is TAVI used for

A

severe aortic stenosis in patients who are too high risk for open heart surgery

90
Q

how does a mitral valve prolapse present

A

usually has a weird genetic disorder
atypical chest pain
new palpitations
mid systolic click on examination

91
Q

symptoms of dresslers syndrome

A 
low grade fever
pericardial rub
chest pain (pleuritic)
2-3 weeks post - mi
can present as a pericardial tamponade
92
Q

management of dresslers syndrome

A

NSAIDS
steroids
pericardiocentesis if pericardial effusion

93
Q

name 3 renal causes of secondary hypertension

A

adult polycystic kidney disease
glomerulonephritis
renal artery stenosis

94
Q

name 3 endocrine causes of secondary hypertension

A 
conns syndrome (primary hyperaldosteronism)
phaeochromocytoma
cushings
congenital adrenal hyperplasia
acromegaly
95
Q

name the 2 criteria for diagnosing hypertension

A
  1. systolic over 140 persistently on clinic readings

2. average 24 hr bp >135

96
Q

investigating the cause of hypertension

A
  1. U+E
  2. lipids
  3. hba1c
97
Q

how do you diagnose hypertension

A

24 hour BP monitor

98
Q

what drug would you use to control HTN in a pregnant or breastfeeding woman

99
Q

what 1st line drug would you use to control hypertension in a diabetic patient

A

ace inhibitor / arb

100
Q

what 1st line drug would you use to treat hypertension in an under 55 year old otherwise healthy pt

A

ace inhibitor / arb

101
Q

which drug would you use 1st line to treat hypertension in a person of black ethnicity

A

calcium channel blocker

102
Q

what drug would you use first line to control hypertension in a patient over the age of 55

A

calcium channel blocker

103
Q

what drug would you add next in a patient already on an ace inhibitor

A

calcium channel blocker

104
Q

what drug would you add next in a patient already on a CCB

A

ARB if black

ace inhibitor otherwise

105
Q

what drug would you add next in a patient already on and ace inhibitor and CCB

A

thiazide like diuretic eg indapamide

106
Q

what drug would you add next in a patient already on an ace inhibitor, CCB and indapamide with a potassium <4.5

A

low dose spironolactone

107
Q

which two antihypertensives should you never combine

A

ARB and ace inhibitor

108
Q

what drug would you add next in a patient already on an ace inhibitor, CCB and indapamide with a potassium >4.5

A

either an alpha blocker eg doxazocin

or beta blocker eg bisoprolol

109
Q

what is resistant hypertension

A

when HTN is failed to be controlled by 3 + drugs

110
Q

what investigations would you order to rule out ACS

A
  1. ECG
  2. cardiac enzymes - troponin, CK, LDH
  3. pci angiography
  4. look for cause eg TFT, U+E, FBC, glucose, lipids
  5. echo post procedures
111
Q

which 3 cardiac enzymes can indicate ischaemia

A

troponin
LDH
Creatinine kinase

112
Q

STEMI on ECG

A

ST elevation

or new LBBB

113
Q

name 3 causes of aortic stenosis

A

calcification with age
rheumatic heart disease
bicuspid valve

114
Q

what is the most common cause of aortic stenosis

A

calcification with age

115
Q

presentation of symptomatic aortic stenosis

A 
SOBOE
syncope on exertion
ejection systolic murmur
CCF
anginal pain
116
Q

signs of aortic stenosis on examination

A 
ejection systolic murmur heart loudest over aortic area (left 3rd intercostal, sternal border), radiates to carotids
heaving apex beat
slow rising pulse
narrow pulse pressure
aortic thrill
117
Q

murmur heard in aortic stenosis

A

ejection systolic

118
Q

what investigations would you do to diagnose aortic stenosis

A
  1. ecg
  2. echo - diagnostic
  3. cxr
119
Q

management of aortic stenosis

A

valve replacement

TAVI if not fit enough for open surgery

120
Q

what is demussets sign and what is it seen in

A

head bobbing along with pulse in aortic regurg

121
Q

what is quinckes sign and what is it seen in

A

pulsating capillaries in nail bed - aortic regurg

122
Q

management of aortic regurg

A

optimise BP
monitor with echo ev 6-12 months
definitive - valve replacement
tx underlying cause eg if caused by dissection

123
Q

indications for surgery in aortic stenosis

A

aortic dilation
severe symptomatic regurg
enlarging LV
deteriorating LV function

124
Q

what murmur is heard in mitral regurg

A

pan systolic

125
Q

name 4 causes of mitral regurg

A 
infective endocarditis
rheumatic heart disease
annular calcification in the elderly
dilated left ventricle eg cardiomyopathy
ruptured chordinae tendinae
126
Q

symptoms of mitral regurg

A

SOB, palpitations, fatigue
heart failure
pansystolic murmur
can cause atrial fibrillation !!

127
Q

investigations in mitral regurg

A

ECG - look for AF , LV dilatation / hypertrophy
echo - diagnostic / can look at LV function
cardiac catheterisation to confirm

128
Q

management of mitral regurg

A
  1. rate control if AF
  2. anti coag
  3. valve repair / replacement surgery
  4. diuretics for heart failure symptoms
129
Q

name the most common cause of mitral stenosis

A

rheumatic heart disease

130
Q

presentation of mitral stenosis

A

symptoms are due to pulmonary hypertension caused by the stiff mitral valve = blood backs up into pulmonary vein..
SOB
haemoptysis
hoarse voice if pulm vessel enlargement
dysphagia if pulm vessel enlargement
mallar flush
mid diastolic rumbling murmur with loud S1
can cause AF due to strain on left atrium

131
Q

signs of mitral regurg on examination

A

pansystolic murmur heard loudest over mitral area and radiates to axilla

132
Q

what murmur is heard in mitral stenosis

A

mis diastolic rumbling murmur

133
Q

describe 1st degree heart block

A

progressive PR prolongation but doesnt drop a QRS

134
Q

describe 2nd degree heart block

A

2 types
mobitz 1 and mobitz 2
mobits 1 is where PR gets progressively longer until it drops a QRS
mobitz 2 is where a QRS will drop every couple of beats so will get a set number of P’s and then a dropped QRS in ratio

135
Q

describe 3rd degree heart block

A

complete heart block so no atrial signals transferred to ventricles so P waves and QRS’s totally independent of eachother

136
Q

management of bradycardia

A
  1. IV access, o2 if required, BP monitoring
  2. check for cause so electrolyte levels, digoxin levels
  3. if patient has adverse signs eg unstable or shock or ischemia then give IV atropine
  4. if patient has no adverse signs and low risk of asystole then just observe
  5. if patient still bradycardic can give atropine every 3-5 mins whilst anaesthetist on the way, can use adrenaline and also transcutaneous pacing
137
Q

what drugs can be used to increase heart rate in brady cardic patients

A

atropine

adrenaline

138
Q

name causes of heart block

A 
fibrosis
electrolyte disturbance
drug interactions
post-MI (usually inferior MI)
aortic valve disease
hypothermia
139
Q

how do you manage torsades des pointes

A

IV magnesium sulphate

140
Q

name 4 causes of long QT syndrome

A 
inherited
hypokalaemia
low magnesium
antipsychotics 
amiodarone
macrolide antibiotics
141
Q

name 3 drugs that prolong the QT

A

antipsychotics
macrolides
amiodarone

142
Q

management of complete heart block

A

implantable pacemaker

143
Q

management of long QT syndrome

A

if inherited then implantable defib

beta blockers

144
Q

what are the two shockable rhythm’s

145
Q

two non shockable rhythms

A

PEA

asystole

146
Q

SVT management

A
  1. continuous ECG, o2, IV access
  2. vagalmanouvers
  3. adenosine if SVT
  4. can give another 2 x bolus if doesn’t work
  5. if sinus rhythm not achieved check for atrial flutter (can be un masked by adenosine) and seek expert help
  6. if atrial flutter seen after adenosine start beta blocker
147
Q

management of fast AF

A
  1. continuous ECG, O2, IV access
  2. if patient unstable cardiovert +/- amiodarone
  3. if patient stable then do rate control with bisoprolol or dilitazem
  4. if started less than 48 hours ago then you can opt for rhythm control with flecanide or amiodarone but if unsure when started would need to anticoagulate for at least 3 weeks before doing rhythm control
148
Q

how does WPW show up on an ECG

A
  1. delta wave (sloped up on QRS)
  2. short PR interval
  3. wide QRS
149
Q

what is the pathway called in wolf parkinson white

A

bundle of kent

150
Q

how do you manage wold parkinson white

A

radiofrequency abalation

151
Q

what medications are contraindicated in WPW

A

rate and rhythm control because they increase the risk of developing a chaotic pattern AF, polymorphic wide QRS tahcycardias

152
Q

what score is used to determine the need for anticoagulation in chronic AF

A

CHA2DS2VASC

153
Q

what are the components of CHA2DS2VASC

A 
congestive cardiac failure
hypertension
age 64-75 / over 75
diabetes
stroke / tia
vascular disease
sex female
154
Q

when is flecanide contraindicated for rhythm control

A

structural heart disease

155
Q

what drugs can be used for rhythm control in fast AF that started less than 48 hours ago

A

dc cardioversion
flecanide
amiodarone

(always give heparin before)

156
Q

management of fast AF that started more than 48 hours ago

A

rate control with bisoprolol

157
Q

when can you use digoxin for rate control in chronic AF

A

if a beta blocker, rate limiting calcium channel blocker have both failed

158
Q

last option for controlling chronic AF that has failed to be controlled by beta blocker, CCB and digoxin

A

amiodarone

159
Q

symptoms of AF

A 
palpitations
SOB 
syncope
dizziness
chest pain
160
Q

name 4 causes of irregularly irregular rhythm

A
  1. AF
  2. atrial flutter with heart block
  3. multifocal atrial tachycardia (common in COPD)
  4. sinus arrhythmia
161
Q

name 5 causes of a regularly irregular rhythm

A 
sinus tachy
focal atrial tachy
atrial flutter
AV nodal re-entry tachy (SVT)
junctional tachy
162
Q

what is focal atrial tachycardia

A

where some random atrial cells decide to act as a pacemaker and emit impulses

163
Q

what is atrial flutter

A

where electrical impulses circle around the atria and flutters at a rate of >330 per min
AV node still manages to pass on some of these impulses and the ventricular rate will always be in multiples of 300 eg 150, 75

164
Q

name 5 causes of pericarditis

A 
viral - coxsackie B
TB
malignancy
hypothyroid
uraemia
post-MI
dresslers syndrome
connective tissue disease
165
Q

most common viral organism causes pericarditis

A

coxsackie B

166
Q

presentation of pericarditis

A 
pleuritic chest pain
SOB
low grade fever
palpitaitons
tachycardia
tachypnoea
167
Q

describe pleuritic chest pain

A

sharp chest pain
worse on deep inspiration
relieved by sitting forward

168
Q

what investigations would you do in suspected pericarditis

A
  1. ECG
  2. transthoracic echo - look for effusion etc
  3. exclude differentials eg MI cardiac enzymes, U+E
  4. look for cause - TFT’s, sputum culture, CXR,
169
Q

ecg findings in pericarditis

A

global saddle shaped ST elevation

170
Q

how do you treat pericarditis

A

NSAIDS to be tapered down over a couple of weeks to reduce recurrence rate
colchicine for 3 months

171
Q

presentation of cardiac tamponade

A 
becks triad - raised jvp, low BP and muffled heart sounds
pulsus paradoxus
tachy
SOB
absent Y in JVP
172
Q

what is becks triad in cardiac tamponade

A

low bp
raised JVP
muffled heart sounds

173
Q

management of cardiac tamponade

A

urgent pericardiocentesis

174
Q

what is constrictive pericarditis

A

where pericardium becomes stiff from inflammation causing it to compress the heart = diastolic heart failure

175
Q

symptoms of constrictive pericarditis

A

right heart failure - raised JVP, peripheral oedema, hepatomegaly
SOB
kaussmall sign

176
Q

what is kaussmall sign

A

paradoxical increase in JVP with inspiration - seen in constrictive pericarditis

177
Q

what investigations would you do to diagnose constrictive pericarditis

A
  1. ECG
  2. ECHO
  3. CXR - shows pericardial calcification
178
Q

how would you manage constrictive pericarditis

A

more a chronic problem so not immediately life threatening so can do pericardectomy at some point to prevent diastolic heart failure

179
Q

what would you expect the PT and APTT to be like in a patient on warfarin

A

PT be prolonged because warfarin acts on extrinsic pathway

180
Q

what would you expect the PT and APTT to be like in a patient on warfarin

A

PT be prolonged because warfarin acts on extrinsic pathway (play tennis outside)

finals (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions