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Cardiology Flashcards

1
Q

What is pericarditis

A

Inflammation of pericardial sac lasting >4-6 weeks

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2
Q

causes of pericarditis

A

Coxackie B virus
Uraemia
TB
Post MI
SLE
R.A
Lung cancer

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3
Q

Clinical features of pericarditis

A

CP - Worse on lying flat
fever

Pericardial friction rub

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4
Q

Investigation findings of Percarditis

A

Widespread Saddle shaped ST elevation
PR depression

Raised troponin

ECHO - All patients

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5
Q

Management of pericarditis

A

Excercise restriction

NSAIDs and colchicine

2nd line - steroids

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6
Q

What is constrictive pericarditis and how does it present

A

scarring and loss of elasticity of the pericardial sac

fluid overload sx
Poor exercise tolerance / exertional dyspnoea
Raised JVO

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7
Q

Signs of cardiac tamponade

A

Becks triad
- Hypotension
- Quiet heart sounds
- Raised JVP

Pulsus parodoxus

ECG - Electrical alternas

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8
Q

Late complication of myocarditis

A

HF
Arrhythmia
Dilated cardiomyopathy

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9
Q

Causes of chronic venous insufficiency

A

age
mobility
obesity
prolonged standing
post DVT

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10
Q

What is haemosiderin staining

A

red brown discolouration due to Hb leaking into skin

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11
Q

describe venous eczema

A

dry
itchy
scaly
red
cracked skin

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12
Q

what is lipodermatosclerosis

A

hardening and tightening of the skin and tissue beneath the skin

Inverted champage bottle

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13
Q

What is atrophie blanche

A

smooth patches of porcelin white scar tissue on the skin - surrounded by hyperpigmentation

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14
Q

Management of chronic venous insufficeincy

A
  • monitor skin health
  • avoid skin damage
  • weight loss
  • keep active
  • elevate legs when resting
  • compression stockings

emollients
steroids to treat eczema flares

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15
Q

Name the different types of shock

A

Septic
Haemorrhagic
Cardiogneic
Neurogenic
Anaphylactic

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16
Q

Describe alterations in p wave

A

Bifid - p mitrale - LAH

Peaked - P pulmonale - RAH

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17
Q

Length of PR interval

A

0.12 - 0.2s

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18
Q

What does short PR interval indicate

A

faster AV conduction - WPW

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19
Q

What does a longer PR interval indicate

A

Prolonged AV conduction

Heart block
Hypokalaemia

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20
Q

Length of QRS interval

A

< 0.2s

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21
Q

causes of short QT interval

A

Hypocalcaemia

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22
Q

causes of prolonged QT interval

A

Hypokalaemia
hypocalcaemia
hypothermia
amiodarone
erythromycin
antipsychotics

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23
Q

Describe the pathway for arterial thrombosis

A

Endothelial dysfunction
endothelial proliferation
fatty infiltration
Foam cells - macrophages
Fibrous capsule - atheroma
rupture of atheroma

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24
Q

causes of raised troponin

A

MI
PE
Sepsis
Myocarditis
CKD
Arrhythmia

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25
What is IHD
Narrowing of blood vessels due to atherosclerosis causing heart disease
26
Give 5 modifiable and non modifiable risk factors
Male Age FHx Race DM HTN Hyperlipidaemia Smoking Alcohol
27
Define: Stable angina Unstable angina and give 2 other forms of angina
Chest pain brought on by exertion and releived by rest or GTN Unpredictable chest pain occuring at rest Decubitus - lying down Premenztral - vasospasm
28
Stable angina investigations
Full cardiac hx BP HR ECG Bloods - FBC / U+E / TFT/HbA1c / LFT / Lipid profile 1st line - CT coronary angiogram 2nd line - Stress ECHO 3rd line - Coronary angiogram
29
Name 4 precipitants of stable angina
emotion cold weather heavy meals stress
30
Outline the management of stable angina
C - Smoking cessation - increased exercise - healthy diet M - AAA ACEi Aspirin Atrovastatin
31
Name 3 adverse effects of nitrates
tolerance headache syncope
32
What leads if bradycardia after MI
2,3 and AvF RCA - Supplies AV node
33
Who is considered for PCI with coronary angioplasty / CABG in stable angina
Their symptoms are not satisfactorily controlled on optimal medical treatment AND There is complex 3 vessel disease or There is significant left main stem stenosis
34
Contraindications to thrombolysis
aortic dissection stroke in last 3m GI bleed HTN
35
What is the GRACE score
6m risk of death or repeat MI after NSTEMI
36
Outline the management of an NSTEMI
Low risk --> 3% Ticagrelor High risk >3% Coronary angiogram in 96 hours --> PCI Ticagrelor UH
37
Secondary prevention of ACS -
BAADS Beta blocker ACE-i Aspirin Clopidogrel Atorvastatin
38
Complications of ACS
Cardiac arrest Rupture of papillary muscles - MR Oedema Arrhythmia Pericarditis dresslers syndrome LV aneurysm - ST elevation and LVF LV free wall rupture - acute LVF secondary to cardiac tamponade
39
Outline the stages of PVD Intermittent claudication Critical limb ischemia Acute limb-threatening ischaemia
ID - Cramping pain in calf on walking - relieved by rest Critical - rest pain for > 2 weeks - worse at night - non healing ulcers - gangrene acute limb - 6P's
40
Management of Intermitent claudication
excercise statin + clopidogrel angioplasty + stent endarterectomy
41
management of critical limb
vascular surgery referral analgesia angioplasty + stent
42
Investigations for PVD
Check foot pulses Beurgers test Duplex USS ABPI
43
RF for aortic aneurysm
Male HTN Older age Smoking FHx Marfans / EDS
44
Screening for AAA
USS at 65 - >3cm --> non urgent referral --> regualr repeat USS >5.5cm --> Urgent referral
45
Presentation of ruptured AAA
Abdominal pain radiating to back LOC Collapse Expanisle mass Haemodynamically unstable
46
3 causes of aortic stenosis
degenerative calcification Bicuspid aortic valve HOCM - subvalvular Post rheumatic heart disease
47
signs of aortic stenosis
slow rising pulse narrow pulse pressure ESM Soft S2 LVH - heaves thrill
48
Investigations for Aortic stenosis
ECG - LVH CXR - Cardiomegaly ECHO
49
Criteria for valve replacement in aortic stenosis
symptomatic LVEF <50% Asx but valvular gradient >40mmHg
50
Causes of mitral regurgitation
idiopathic weakening with age IHD IE RHD EDS Marfans Post MI
51
Sx of mitral reguritation
AF LHF sx - SOB / Fatigue
52
what is indicative of MR in the acute setting
acute pulmonary oedema and hypotension post MI
53
Signs of MR
Pansystolic murmur loudest at apex radiates to axilla louder on expiration louder on rolling to left Soft S1
54
ECG findings of MR
P mitrale - left atrial enlargement RVH R axis deviation
55
causes of aortic regurgitation
rheumatic fever bicuspid aortic valve aortic dissection infective endoacriditis
56
symptoms of aortic regurgitation
dyspnoea orthopnea PND
57
signs of AR
Collpasing pulse early diastolic murmur Quincke's sign De musset's sign displaced apex beat
58
sx of MS
Exertional dyspnoea Decreased excercise toelrance haemoptysis Palpitations - AF Chest pain
59
Investigations for HF
Bloods - Pro BNP - FBC - U+E - Sodium levels and Meds - TFT - LFT - Glucose and lipid profile ECG CXR ECHO
60
Outline the steps required following a pro-BNP result
>2000 refer for ECHO in 2 weeks 400 - 2000 ECHO in 6 weeks
61
Outline the management of HF
C Smoking cessation Yearly flu and pneumococcal vaccine HF nurse M ACEi + BB Spirinolactone - NYHA 3/4 Options: - Digoxin - AF - Ivabradine - EF <35% - Hydralazine + nitrate - Black
62
Features of haemochromatosis
low mood ED / Amenorrhoea bronze skin Hypothyroid Arthritis cardiomyopathy hypogonadotrophic hypogonadism
63
secondary causes of hypertension
renal artery stenosis conns syndrome phaenchromocytoma hyperthyroidism OSA Steroids OCP Cuhsings syndrome
64
Investigations for end-organ damage in HTN
Urine:Albumin Dipstick - haematuria Fundoscopy ECG - LVH Bloods - FBC / HbA1c / U+E / Lipid profile
65
signs of end organ damage
Papilloedema seizure encephalopathy AKI CP HF signs

Finals revision (17 decks)

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