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Finals revision > Cardiology > Flashcards

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
Q

What is IHD

A

Narrowing of blood vessels due to atherosclerosis causing heart disease

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26
Q

Give 5 modifiable and non modifiable risk factors

A

Male
Age
FHx
Race

DM
HTN
Hyperlipidaemia
Smoking
Alcohol

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27
Q

Define:
Stable angina
Unstable angina

and give 2 other forms of angina

A

Chest pain brought on by exertion and releived by rest or GTN

Unpredictable chest pain occuring at rest

Decubitus - lying down

Premenztral - vasospasm

28
Q

Stable angina investigations

A

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
Q

Name 4 precipitants of stable angina

A

emotion
cold weather
heavy meals
stress

30
Q

Outline the management of stable angina

A

C
- Smoking cessation
- increased exercise
- healthy diet

M
- AAA
ACEi
Aspirin
Atrovastatin

31
Q

Name 3 adverse effects of nitrates

A

tolerance
headache
syncope

32
Q

What leads if bradycardia after MI

A

2,3 and AvF

RCA - Supplies AV node

33
Q

Who is considered for PCI with coronary angioplasty / CABG in stable angina

A

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
Q

Contraindications to thrombolysis

A

aortic dissection
stroke in last 3m
GI bleed
HTN

35
Q

What is the GRACE score

A

6m risk of death or repeat MI after NSTEMI

36
Q

Outline the management of an NSTEMI

A

Low risk –> 3%
Ticagrelor

High risk >3%
Coronary angiogram in 96 hours –> PCI
Ticagrelor
UH

37
Q

Secondary prevention of ACS -

A

BAADS
Beta blocker
ACE-i
Aspirin
Clopidogrel
Atorvastatin

38
Q

Complications of ACS

A

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
Q

Outline the stages of PVD

Intermittent claudication
Critical limb ischemia
Acute limb-threatening ischaemia

A

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
Q

Management of Intermitent claudication

A

excercise
statin + clopidogrel
angioplasty + stent
endarterectomy

41
Q

management of critical limb

A

vascular surgery referral

analgesia
angioplasty + stent

42
Q

Investigations for PVD

A

Check foot pulses
Beurgers test
Duplex USS
ABPI

43
Q

RF for aortic aneurysm

A

Male
HTN
Older age
Smoking
FHx
Marfans / EDS

44
Q

Screening for AAA

A

USS at 65
- >3cm –> non urgent referral –> regualr repeat USS

> 5.5cm –> Urgent referral

45
Q

Presentation of ruptured AAA

A

Abdominal pain radiating to back
LOC
Collapse
Expanisle mass
Haemodynamically unstable

46
Q

3 causes of aortic stenosis

A

degenerative calcification
Bicuspid aortic valve
HOCM - subvalvular
Post rheumatic heart disease

47
Q

signs of aortic stenosis

A

slow rising pulse
narrow pulse pressure
ESM
Soft S2
LVH - heaves
thrill

48
Q

Investigations for Aortic stenosis

A

ECG - LVH
CXR - Cardiomegaly
ECHO

49
Q

Criteria for valve replacement in aortic stenosis

A

symptomatic
LVEF <50%
Asx but valvular gradient >40mmHg

50
Q

Causes of mitral regurgitation

A

idiopathic weakening with age
IHD
IE
RHD
EDS
Marfans
Post MI

51
Q

Sx of mitral reguritation

A

AF
LHF sx - SOB / Fatigue

52
Q

what is indicative of MR in the acute setting

A

acute pulmonary oedema and hypotension post MI

53
Q

Signs of MR

A

Pansystolic murmur
loudest at apex
radiates to axilla
louder on expiration
louder on rolling to left

Soft S1

54
Q

ECG findings of MR

A

P mitrale - left atrial enlargement
RVH
R axis deviation

55
Q

causes of aortic regurgitation

A

rheumatic fever
bicuspid aortic valve
aortic dissection
infective endoacriditis

56
Q

symptoms of aortic regurgitation

A

dyspnoea
orthopnea
PND

57
Q

signs of AR

A

Collpasing pulse
early diastolic murmur
Quincke’s sign
De musset’s sign
displaced apex beat

58
Q

sx of MS

A

Exertional dyspnoea
Decreased excercise toelrance
haemoptysis
Palpitations - AF
Chest pain

59
Q

Investigations for HF

A

Bloods
- Pro BNP
- FBC
- U+E - Sodium levels and Meds
- TFT
- LFT
- Glucose and lipid profile

ECG

CXR

ECHO

60
Q

Outline the steps required following a pro-BNP result

A

> 2000 refer for ECHO in 2 weeks

400 - 2000 ECHO in 6 weeks

61
Q

Outline the management of HF

A

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
Q

Features of haemochromatosis

A

low mood
ED / Amenorrhoea
bronze skin
Hypothyroid
Arthritis
cardiomyopathy
hypogonadotrophic hypogonadism

63
Q

secondary causes of hypertension

A

renal artery stenosis
conns syndrome
phaenchromocytoma
hyperthyroidism
OSA
Steroids
OCP
Cuhsings syndrome

64
Q

Investigations for end-organ damage in HTN

A

Urine:Albumin
Dipstick - haematuria
Fundoscopy
ECG - LVH
Bloods - FBC / HbA1c / U+E / Lipid profile

65
Q

signs of end organ damage

A

Papilloedema
seizure
encephalopathy
AKI
CP
HF signs

Finals revision (17 decks)

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