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Year 6 Cross Section > Cardiology > Flashcards

Cardiology Flashcards

1
Q

5 causes of raised JVP

A

R sided heart disease
Tricuspid regurg
Complete Heart Block
CCF
Pericardial effusion
SVC Obstruction

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2
Q

Irregularly irregular pulse

A

ventricular ectopics
atrial flutter
sinus arrythmias

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3
Q

Austin Flint murmur

A

rumbling diastolic murmurs
severe AR
5th ICS MCL

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4
Q

mitral stenosis murmur

A

mid diastolic murmur

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5
Q

mitral regurg murmur

A

pan systolic murmur

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6
Q

cardioversion and anti-coagulation

A

3 weeks before
4 weeks after
or lifelong if CHADsVASc score

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7
Q

aspects of CHA2DSVASc score

A

CHF
HTN
Age > 75
DM
Stroke
Vascular disease
age 65-74
female

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8
Q

pulsus paradoxus

A

> 10mmHg fall in SBP during inspiration
varying strength of pulse with inspiration and expiration
causes: severe asthma, cardiac tamponade

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9
Q

pulsus alternans

A

regular alternation of force of arterial pulse
seen in severe LVF

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10
Q

Beurger’s disease

A

Raynaud’s syndrome
Intermittent Claudication
Finger ulceration

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11
Q

what is sacubitril with valsartan and indication

A

Entresto
improves LVF in patients already on other HF therapy

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12
Q

RBBB on ECG

A

complexes wide (>1.5 little squares) and upgoing in V1

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13
Q

LBBB on ECG

A

complexes wide (>1.5 little squares) and downgoing in V1

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14
Q

STEMI tx

A

activate primary PCI call
Aspirin 300mg and Ticagrelor (DAPT)
Morphine and Metoclopramide
Heparin
if delay in primary PCI = thrombolysis

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15
Q

what is normal/abnormal EF?

A

EF < 40-45% = abnormal
EF > 50% = normal

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16
Q

what post op care from MI is needed?

A

cardiac rehab
F/U in infarct clinic
smoking cessation

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17
Q

what are the 4 pillars to treating LV dysfunction?

A

beta blocker
ACEi
Eplerone
SCGLT-2 (start first)

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18
Q

what can you add if no improvement?

A

Sacubitril/Valsartan

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19
Q

what is CRT and how does it work?

A

special pacemaker
1 lead = R ventricle
1 lead = coronary sinus (paces L ventricle)
L and R ventricle out of sync in HF
CRT helps synchronize heart

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20
Q

what does patient need to have for CRT to work?

A

LBBB

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21
Q

NSTEMI treatment

A
  • aspirin and clopi
  • LMWH/Fondaparinux
  • Morphine + Metaclopramide
  • anti-anginal meds (GTN, beta blocker, Ca channel blockers)
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22
Q

after medical treatment for NSTEMI, what to consider?

A
  • need for revascularization?
  • find out LV function early on from echo
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23
Q

what do you need to hold 48 hours before and after angio?

A

LMWH

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24
Q

T wave inversion + chest pain?

A

ischaemia but not occlusionwhat

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24
Q

T wave inversion + chest pain?

A

ischaemia but not occlusion

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25
Q

what are the anti-anginal meds and MOA?

A

CCB: inc coronary blood flow, dec SVR
Beta blocker
Ivabradine: dec HR, sits on SAN, prolongs action potential

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26
Q

stable angina treatment

A

anti-platelet and statin
statin improves long term mortality
no benefit of PCI

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27
Q

how does nicorandil work?

A

anti-anginal
relaxes VSMC = inc blood flow = dec angina
no mortality benefit

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28
Q

diastolic HF pathology

A

stiff ventricles = poor filling = unable to relax
can result in AF

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29
Q

causes of AF

A

IHD
Sepsis
Electrolytes
Valvular disease
Endocrine causes

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30
Q

most common signs in IE

A

splenomegaly
microscopic haematuria

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31
Q

extras to add in cardio exam

A

BP
fundoscopy
peripheral pulses

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32
Q

AS heart sounds

A

soft S2 +/- S4
blood filling a non-compliant ventricles

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33
Q

AS symptoms

A

syncope, angina, dyspnoea

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34
Q

management of AS

A

MDT
1. RF modification = statin, anti-platelet
2. manage HTN, angina
3. Replace/valvuloplasty

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35
Q

AR symptoms

A

soft S2+/-S3
Blood filling against compliant ventricles

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36
Q

management of AR

A

reduce afterload
valve replacement (same for AS)

37
Q

HF symptoms

A

ACEi + BB
+ spironolactone
+ SGLT2 inhibitors

38
Q

Angina management

A
  1. GTN + BB or CCB
  2. GTN + BB + CCB
    • Long acting nitrate, Ivabradine
39
Q

Hypertension investigations

A

ABPM or home BP monitoring

40
Q

Stage 1 HTN

A

clinic BP >140/90 mmHg AND AB BP >135/85

41
Q

when do you treat stage 1?

A

if <80 yo and end organ damage/CVD/renal disease/diabetes, Q-risk >10%

42
Q

what is stage 2 HTN?

A

clinic BP >160/100mmHg AND >150/95
TREAT

43
Q

most common form of ECG change in pericarditis

A

PR depression

44
Q

cardiac causes of clubbing

A

atrial myxoma
cyanotic HD
IE

45
Q

respiratory causes of clubbing

A

malignancy
ILD
empyema
CF
Bronchiectasis

46
Q

abdominal causes of clubbing

A

malignancy
coeliac
IBD
cirrhosis

47
Q

HS in mitral stenosis

A

loud S1

48
Q

HS in mitral regurg

A

soft S1 +/- loud S2 (if pulmonary HTN)

49
Q

cause of arrhythmogenic right ventricular dysplasia

A

R ventricular myocardium replaced by fatty/fibrous tissue

50
Q

ECG changes in right ventricular dysplasia

A

V1-V3 T wave inversion
epsilon wave

51
Q

drug causes of long QT

A

macrolides
SSRIs
TCAs
Haloperidol

52
Q

cause of pulsus alternans

A

LVF

53
Q

cause of bisferiens pulse

A

HOCM

54
Q

Unipolar/bipolar
lead
indication

A

Lead: RA
Indication: SA node pathology

55
Q

Dual chamber
lead
indication

A

Lead: RA, RV
allows synchronisation

56
Q

Dual site atrial pacing
lead
indication

A

Leads: 2 x RA (SA node, coronary sinus), RV
indication: paroxysmal AF

57
Q

Biventricular pacemakers
leads
indication

A

leads: RA, RV LV
indication: HF

58
Q

what does an ICD treat?

A

treats tachyarrthmia

59
Q

Axis:
I and II +ve

A

normal axis

60
Q

Axis:
I +ve
II -ve (leaving)

A

Left axis deviation

61
Q

Axis:
I -ve
II +ve (reaching)

A

Right axis deviation

62
Q

RVH on ECG

A

dominant R wave in V1
deep S wave in V6

63
Q

LVH on ECG

A

R wave in V6 >25mm
R wave in V5/V6 + S wave in V1 >35mm

64
Q

which leads do you normally see T wave invertion?

A

aVR and V1

65
Q

What are U waves?

A

occur after T waves
seen in hypokalaemia

66
Q

what are J waves/Osborne waves?

A

between QRS and ST segment

67
Q

causes of J waves?

A

hypothermia
SAH
hyperCa

68
Q

RBBB on ECG

A

wide QRS
RSR pattern in V1

69
Q

LBBB on ECG

A

wide QRS
notched top of QRS

70
Q

ACS non-modifiable risk factors

A

age
male
FH

71
Q

how much ST elevation is needed?

A

> 1mm in limb leads
2mm in chest leads

72
Q

what drug should patients receive if they are not receiving any reperfusion therapy?

A

fondaprinaux

73
Q

how long to take clopidogrel following STEMI?

A

1 yeat
continue aspirin indefinitely

74
Q

what long term therapy in ACS?

A

ACEi
BB
Cardiac rehab
Statin
DAPT

75
Q

angina secondary prevention

A

aspirin
ACEi
Statins
Anti-HTN
+ anti-anginals

76
Q

causes of systolic HF

A

IHD/MI
dilated cardiomyopathy
HTN

77
Q

causes of diastolic HF

A

pericardial effusion/tamponade
restrictive cardiomyopathy

78
Q

Criteria for chronic HF

A

Framingham Criteria

79
Q

which medications cause a decrease mortality in HF

A

ACEi
BB
Spirolactone

80
Q

HTN classifications

A
  1. clinic BP >140/90
  2. clinic BP >160/100
  3. Severe >180/110
  4. Malignany >180/110 + papilloedema +/- retinal haemorrhages
81
Q

BP targets

A

<80 yrs: <140/90 (<130/80 in DM)
>80 yrs: <150/90

82
Q

which murmurs are in end expiration?

A

MS
AR
AS

83
Q

what drug to avoid in AS?

A

nitrates

84
Q

important treatments in all heart murmurs

A

optimise RFs
monitor: regular FU with echo

85
Q

murmur in mitral valve prolapse

A

mid systolic click
+/- late systolic murmur

86
Q

Criteria for infective endocarditis

A

Duke’s

87
Q

what is Kussmaul’s sign? What is it seen in?

A

inc JVP with inspiration
- constrive pericarditis

88
Q

signs of tamponade

A

Beck’s triad
Pulsus paradoxus
Kussmaul’s sign

89
Q

pro of mechanical valve but…

A

mechanical valves last longer but need anticoagulants

Year 6 Cross Section (23 decks)

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