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MRCP > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Hyperkalaemia ECG changes

A

Tall T waves
Prolonged PR interval
Flattened/absent P waves

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2
Q

Severe hyperkalaemia ECG changes

A

Wide QRS
Sine wave pattern
Ventricular tachycardia/ventricular fibrillation/asystole

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3
Q

Loud S2

A

Pulmonary hypertension (loud P2)
Systemic hypertension

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4
Q

Soft S2

A

Aortic stenosis

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5
Q

Widely split S2

A

Deep inspiration
RBBB
Pulmonary stenosis

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6
Q

Fixed in the middle S2

A

Atrial septal defect

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7
Q

Reverse split S2

A

LBBB
Severe aortic stenosis

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8
Q

ASD

Type of murmur
Loudest when

A

Ejection systolic murmur
Louder on inspiration

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9
Q

Mitral regurgitation

Type of murmur
Loudest when

A

Pansystolic
Louder on expiration

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10
Q

Loud S1 causes

A

Hyperdynamic states
Tachycardic states
Left-to-right shunts
Short PR interval

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11
Q

Soft S1 causes

A

Hypo-dynamic states
Mitral regurgitation
Poor ventricular function
Long PR interval

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12
Q

Split S1 causes

A

RBBB
LBBB
VT
Inspiration
Ebstein’s anomaly (congenital tricuspid regurgitation)

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13
Q

Variable intensity S1 (causes)

A

Complete heart block
Atrial fibrillation

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14
Q

Cannon a waves (causes)

A

Atrial contraction against closed tricuspid
Complete heart block

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15
Q

Tricyclic overdose (ECG changes)

A

Sinus tachycardia
Widening of QRS
Prolongation of QT interval

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16
Q

Syncope
Previous MI
HR 80
Displaced apex beat
No chest pain
ST elevation and Q waves on ECG

A

Ventricular tachycardia

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17
Q

Left ventricular aneurysm (ECG changes)

A

Persistent ST elevation and Q waves

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18
Q

Restoring sinus rhythm in a young patient with acute onset AF

A

Flecainide

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19
Q

Causes of upper zone fibrosis

A

Coal workers pneumoconiosis
Histiocytosis
Ankylosing sponylitis
Radiation
TB
Sarcoidosis

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20
Q

Causes of lower zone fibrosis

A

Most connective tissUe disorders (RA…)
Astbestosis
Idiopathic
Drugs (methotrexate)

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21
Q

Constrictive pericarditis signs

A

Earliest: hepatomegaly
- pericardial knock
- ascites

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22
Q

Giant a waves (and v waves)

A

Tricuspid regurgiation

23
Q

Collapsing pulse

A

Aortic regurgitation
Arterio-venous fistula
Patent ductus arteriosus

24
Q

Slow rising pulse

A

Aortic stenosis

25
Q

Bisferiens pulse

A

double shudder due to mixed aortic valve disease

26
Q

Jerky pulse

A

HOCM

27
Q

Alternans pulse

A

Severe LVF

28
Q

Pulsus paradoxus

A

Excessive reduction in pulse with inspiration (drop in BP)
Tamponade
Ventricular compression
Constrictive pericarditis
Severe asthma

29
Q

Septal MI

ST elevation
Blood vessel

A

V1-V2
Left anterior descending

30
Q

Anterior MI

ST elevation
Blood vessel

A

V3-V4
Left anterior descending

31
Q

Lateral MI

ST elevation
Blood vessel

A

V5-V6
Left anterior descending

32
Q

Left anterior descending localisation

A

Septal MI
Anterior MI
Lateral MI

33
Q

Inferior MI

ST elevation
ST depression
Blood vessel

A

II, III, aVF
aVL (reciprocal STD)
Right coronary artery (RCA)

34
Q

Posterior MI

ST elevation
ST depression
Blood vessel

A

V7-V9
V1-V3
left circumflex and RCA

35
Q

B-type natriuretic peptide

Origin…

A

Cardiac ventricles

36
Q

Complete heart block secondary to an inferior myocardial infarction

Management

A

Manage conservatively

37
Q

Vessel supplying AV node

A

Right coronary (90% of patients)

38
Q

Long QT causes

Electrolytes:
Drugs:
Others:

A

Electrolytes: hypokalaemia, hypocalcaemia
Drugs: tricyclic antidepressants, antihistamines, erythromycin, clarithromycin, amiodarone, haloperidol
Congenital long QT
MI
Cerebrovascular incident (SAH)
hypothermia

39
Q

HOCM treatment
ABCDE

A

Amiodarone
Beta blocker or verapamil for symptoms
Cardioverter defibrillator
Dual chamber pacemaker
Endocarditis prophylaxis

40
Q

Brugada

Features
ECG findings

A

Palpitations, syncope, sudden death
ST elevation V1 to V3

41
Q

Valvular issue in pulmonary hypertension

A

Functional tricuspid regurg (pansystolic murmur)

42
Q

Post-MI signs of LVF

Which treatment to add?

A

Aldosterone antagonist -> e.g. epleronone

43
Q

SVT + asthma = ?treatment

A

Verapamil

44
Q

Angiodysplasia of gut linked to which valvular disorder?

A

Aortic stenosis

45
Q

Management of cocaine-related MI

A

IV benzodiazepines

46
Q

AV block (heart block) affected by which MI territory?

A

Inferior MI

47
Q

Hypercalcaemia ECG changes

A

Shortening of QT interval
J waves (in severe hypocalcaemia)

48
Q

Which area has fastest conduction velocity in heart?

A

Purkinje fibres

49
Q

Digoxin toxicity ECG changes

A

Prolonged PR interval
Short QT interval
ST depression
Inverted T waves

50
Q

Anti-anginal treatment

A
  1. Statin and aspirin
  2. Beta-blocker or calcium channel blocker (verapamil or diltiazem)
  3. Titrate monotherapy to max dose
  4. Add the other from 2nd line
  5. If thinking of adding ivabradine or nicorandil - assess for PCI first
51
Q

S3 (ventricular gallop rhythm)

A

LVF
Normal in children/young adults

52
Q

Troponin I binds to…

A

actin

53
Q

Factors causing high pulse pressure (high SBP)

A

Reduced aortic compliance
High stroke volume

MRCP (19 decks)

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