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AMK > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Sx AAA

A

Epigastric pain to back which is constant or intermittent

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2
Q

Risk factor AAA

A

old men and marinas

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3
Q

when should you treat AAA

A

when >5.5cm - surgery

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4
Q

what is a MI

A

atherosclerotic plaque in coronary artery ruptures = occlusion of vessel

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5
Q

Sx ACS

A
  • Central/left sided chest pain
  • Pain to jaw or left arm
  • Sweating
  • N and V
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6
Q

treatment for ACS (not STEMI)

A
  • Morphine
  • Oxygen (if <94%)
  • Nitrates
  • Aspirin
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7
Q

Treatment for STEMI

A

MONA + clopidogrel + PCI

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8
Q

sx pericarditis

A
  • Chest pain better on sitting forwards
  • Cough + dyspnoea
  • Pericardial rub
  • Tachycardia
  • ECG: ‘saddle-shaped’ ST elevation and PR depressiom
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9
Q

causes of pericarditis

A

coxsackie, TB, trauma, Marfan’s

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10
Q

treatment pericarditis

A

treat underlying cause
NSAIDs and colchicine for relief

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11
Q

angina treatment

A

statin + GTN + aspirin
CCB and B blocker

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12
Q

Difference between AA rupture and aortic dissection pathophys

A

AAA is tunica media, dissection is intima and forms new lumen

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13
Q

sx aortic dissection

A
  • Severe/tearing chest pain
  • Back pain
  • Weak pulses
  • Aortic regurgitation
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14
Q

Ix aortic dissection

A

CXRL wide mediastinum, CT angiogram

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15
Q

tx aortic dissection

A

beta blockers

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16
Q

cause of sudden cardiac death

A

arrythmogenic right ventricular cardiomyopathy

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17
Q

final step in atherosclerosis formation

A

smooth muscle from media to intima

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18
Q

ti which wave is cardioversion synched?

A

R wave

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19
Q

what happens if pt does not respond to 3x shocks

A

adenosine 300mg

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20
Q

sx AF

A
  • Palpitations
  • Dyspnoea
  • Chest pain
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21
Q

treatment AF

A

B blockers for rate control

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22
Q

if at high risk of stroke what do you give in AF

A

DOAC - apixaban

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23
Q

treatment unstable AF

A

If unstable can cardiovert but if this fails after 3 times then give 300mg adenosi

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24
Q

ECG atrial flutter

A

sawtooth

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25
Q

most common primary cardiac tumour

A

Atrial myxoma

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26
Q

type 1 heart block

A

long PR >0.2 seconds

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27
Q

Type 2 mobitz 1 heart block

A

Progressively longer PR until drop QRS

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28
Q

Type 2 mobitz 2 heart block

A

PR constant with random drop of beat

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29
Q

type 3 heart block

A

no association between P and QRS

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30
Q

what do high levels of BNP indicate

A

heart failure

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31
Q

where and when is BNP produced?

A

LV in response to strain

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32
Q

functions of BNP

A

diuretic and vasodilator

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33
Q

what is Brugada syndrome

A

Common cause of cardiac death, issue with cardiac sodium Chanels

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34
Q

Treatment of brugada syndrome

A

cardioverter-defibrillator

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35
Q

what is cardiac tamponade

A

accumulation of pericardial fluid under pressure

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36
Q

sx cardiac tamponade

A
  • Muffled heart sounds
  • Increased JVP
  • Hypotension
  • Absent Y on JVP (TAMponade = TAMpaX)
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37
Q

Treatment tamponade

A

pericardiocentesis

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38
Q

coagulative necrosis

A

organs digested by macrophages

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39
Q

sx heart failure

A
  • Dyspnoea
  • Breathless on lying flat
  • Fatigue
  • Oedema
  • Raised JVP
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40
Q

most common cause of heart failure

A

ischaemic heart disease

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41
Q

treatment heart failure

A

ACEi and B-blocker followed by aldosterone antagonist

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42
Q

treatment acute heart failure

A

loop diuretics +/- oxygen +/- nitrates

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43
Q

how does digoxin work

A

acts sats sodium potassium ATPase pump to increase intracellular calcium = increased contractility

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44
Q

during which part of the cardiac cycle do coronary arteries fill

A

diastole

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45
Q

venous drainage of the heart

A

coronary sinus -> RA

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46
Q

blood supply to heart

A

right aortic sinus -> RCA -> posterior descending including SAN and AVN
left aortic sinus -> LCA -> LAD and LCX

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47
Q

common cause of axis deviation

A

Wolff-Parkinson- White

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48
Q

most common type of cardiomyopathy

A

dilated cardiomyopathy

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49
Q

causes of dilated cardiomyopathy

A

Coxsackie/HIV
Ischaemic heart disease
muscular dystrophy

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50
Q

pathophysiology dilated cardiomyopathy

A
  • Dilated heart = premature systolic dysfunction
  • All4 chambers dilated but L>R
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51
Q

signs of dilated cardiomyopathy

A

systolic murmur + s3 + balloon on CXR

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52
Q

what are xanthelasma

A

yellowish papules and plaques caused by localized accumulation of lipid deposits commonly seen on the eyelid - surgically excise

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53
Q

treatment for hypertension for <55 or T2DM

A

A
A+C or A+D
A+C+D

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54
Q

treatment for hypertension if >55 without T2DM or afro/caribbean

A

C
C+A or C+D
A+C+D

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55
Q

causes of orthostatic hypertension

A

A_BLOCKERS

56
Q

mx orthostatic hypertension

A

midodrine and fludrocortisone

57
Q

pyoderma gangrenous associations

A

AI disease

58
Q

which ulcers are assodictaed with diabetes

A

neuropathic - plantar surface of foot

59
Q

arterial ulcers features

A

anterior shin, heel and toes, painful, cold and no pulse - ‘punched out’ appearance

60
Q

venous ulcers features

A

due to hypertension, located above ankle, use compression banding for mx

61
Q

cardiac condition associated with Kawasaki

A

coronary artery aneurysm

62
Q

what is infective endocarditis

A

Caused by staph aureus normally - in acute presentation and intravenous drug users

Strep viridians is associated with dental health

63
Q

sx infective endocarditis

A

fever/murmur
splinter haemorrhages
haematuria
splenomegaly
laneway lesions
Osler’s nodes

64
Q

tx endocarditis

A

flucloxacillin

65
Q

difference between Janeway lesions and Osler’s nodes

A

Janeway lesions are painless

66
Q

what does JVP measure?

A

pressure in RA

67
Q

meaning of each JVP wave

A

A = RA contraction

X = relaxation of atria

C = RV contraction, tricuspid bulges into RA

X = RV contraction (atria expand)

V = RA filling

Y = opening of tricuspid

68
Q

No A waves

A

AF

69
Q

Large A waves

A

RV hypertrophy

70
Q

large V waves

A

tricuspid regurgitation

71
Q

why does the ductus arteriosus close after birth?

A

reduced PGE2 levels

72
Q

treatment for patent ductus arteriosus

A

ibuprofen = decreased prostaglandin synthesis

73
Q

what does DA connect

A

pulmonary artery to aorta

74
Q

normal flow of blood

A
  • Placenta
  • Body
  • Vena cava
  • RA
  • RV
  • Pulmonary artery
  • Lungs
  • Pulmonary vein
  • LA
  • LV
  • Aorta
75
Q

sx PDA

A
  • Machinery murmur
  • Large volume, collapsing pulse
  • Heaving apex beat
76
Q

which sided shunt is PDA

A

l to r

77
Q

patent foramen ovale

A

blood passes from RA to LA

78
Q

intermittent claudication

A

intermittent claudication: aching or burning in the leg muscles following walking
patients can typically walk for a predictable distance before the symptoms start
usually relieved within minutes of stopping
not present at rest

79
Q

statin treatment for CVD

A

atorvastatin 80mg

80
Q

treatment for peripheral arterial disease

A

statin + clopidogrel

81
Q

definition of pulmonary arterial hypertension

A

mean pulmonary artery pressure of >25

82
Q

sx pulmonary hypertension

A
  • Exertional dyspnoea
  • Syncope, chest pain
  • Peripheral oedema
  • Cyanosis
83
Q

tx pulmonary hypertension

A

vasodilators

84
Q

sx PE

A
  • Pleuritic chest pain
  • Dyspnoea
  • Haemoptysis
  • Tachycardia
85
Q

What is S1Q3T3

A

large S wave in lead 1, large Q wave in lead 3 and inverted T wave in lead 3
for PE

86
Q

Ix PE

A

CTPA - interim coagulant is DOAC

87
Q

Tx PE

A

DOAC >3m

88
Q

how to differentiate between COPD and heart failure

A

heart failure has orthopnoea

89
Q

causes of long QT

A

hypokalaemia
hypocalcaemia
amoidarone
TCA
macrolides

90
Q

cardiac side effect of Friedrich’s ataxia

A

hypertrophic obstructive cardiomyopathy

91
Q

where does the aorta rupture due to trauma

A

bifurcation (thoracic) aorta

92
Q

Torsades de pointes ECG

A

‘twisting’ around baseline and long QT

93
Q

management torsades de pointes (long QT)

A

magnesium sulphate

94
Q

how quickly do you want to do PCI

A

<120 mins

95
Q

treatment for AF if haemodynamically unstable

A

cardioversion

96
Q

what is transposition of great arteries

A

Aorta leaves RV and pulmonary trunk leaves LV

97
Q

sx transposition of great arteries

A

cyanosis
tachypnoea
loud S2
“egg-on-side’ CXR

98
Q

mx transposition of great arteries

A

prostaglandins to keep DA open -> surgery

99
Q

what are varicose veins

A

Superficiel veins that occur secondary to incompetent valves - most commonly in legs

100
Q

mx of varicose veins

A

ablation

101
Q

what is wolff-parkinson white syndrome

A

Accessory conducting pathway between atria and ventricles = atrioventricular re-entry tachycardia → can rapidly degenerate to VF

102
Q

ECG changes wolff-parkinson white

A
  • Short PR
  • Wide QRS with delta wave
  • Opposite side deviation to the accessory pathway formed
103
Q

what is a ventricular septal defect?

A

hole between ventricles, due to down’s/edward’s/patau’s

104
Q

Pathophys Eisenmenger’s complex

A

LHS is at higher pressure which causes L→R shunt

Over time, this causes pulmonary hypertension

Pulmonary hypertension can cause right side to be at higher pressure than left so causes R→L shunt (Eisenmenger’s complex, causes cyanosis and clubbing)

105
Q

Sx VSD

A
  • Failure to thrive
  • Hepatomegaly
  • Tachycardia
  • Pallor
  • Pan-systolic murmur
106
Q

four components of tetralogy of fallot

A
  • Ventricular septal defect
  • Right ventricular hypertrophy
  • Right ventricular outflow tract obstruction
  • Overriding aorta
107
Q

pathophys tetralogy of allot

A

narrow RV outflow means RV hypertrophies to overcome this stenosis. This pressure, in addition to VSD created a R->L shunt (cyanosis and clubbing). The aorta overrides and moves position to maximise outflow

108
Q

What is Dressler’s syndrome?

A

post-MI pericarditis from autoimmune reaction to antibodies

109
Q

sx Dressler’s syndrome

A

pleuritic chest pain, fever, pleuritic rub

110
Q

mx Dressler’s syndrome

A

aspirin and ibuprofen

111
Q

how to treat heart blocks/BBB

A

pacemaker - stop BB/CCb

112
Q

boot shaped heart

A

tetralogy of fallot

113
Q

batwings and Kelley B lines

A

heart failure

114
Q

left sided heart failure

A

LV failure due to ischaemia and fatigue leads to decreased CO, sx include pulmonary oedema and breathlessness, coarse crackles, raised JVP and S3

115
Q

right sided heart failure

A

Peripheral oedema, increased JVP, S3, weight gain and fatigue

116
Q

cor-pulmonale

A

RSHF secondary to respiratory cause like COPD

117
Q

congestive HF

A

L and R failure - breathlessness and peripheral oedema

118
Q

gold standard for dignosing angina

A

ct coronary angiogram

119
Q

hypertrophic obstructive cardiomyopathy

A

thicker walls of LV mean it is harder to pump blood out (heart failure)
Obstruction of LV outflow tract gives you crescendo-decrescendo murmur - similar to aortic stenosis - because blood struggles to get out
valsalva manoeuvre means reduced preload so ventricle not stretched as much so murmur louder

120
Q

what are the shockable rhythms?

A

VF and pulseless VT

121
Q

how often can you give adrenaline?

A

3-5 mins

122
Q

sawtooth appearance ECG

A

atrial flutter

123
Q

tx unstable atrial flutter

A

synchronised DC cardioversion

124
Q

tx stable atrial flutter

A

rate control - BB or CCB if asthma

125
Q

mx wolff parkinson white

A

catheter ablation of accesssory conduction pathway

126
Q

short PR, wide QRS, pre-excitation and delta wave

A

WPW syndrome

127
Q

how to differentiate VF and VT ecg

A

VT looks more regular, with same baseline

128
Q

tx VF

A

shock - unsynchronised cardioversion

129
Q

how to treat tornadoes du pointes

A

magnesium sulphate

130
Q

what bp for dc cardioversion?

A

diastolic <60

131
Q

tx pathway for regular, narrow QRS

A

Vagal maneouvres
IV adenosine 6mg
IV adenosine 12mg
IV adenosine 18mg
BB/verapamil
DC shock

132
Q

tx pathway for irregular, narrow QRS

A

BB/CCB if asthma
Digoxin/amiodarone
Anticoagulant

133
Q

tx pathway regular, broad QRS

A

VT: amiodarone
DC shock

134
Q

maximum dose atropine

A

3mg - 6x 500mcg dose

135
Q

treatment for bradycardia if life threatening sx - shock/syncope/MI etc

A

IV atropine 500mcg

136
Q

no PR elongation followed by drop

A

2:2

AMK (33 decks)

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