cardiology Flashcards
investigation for infective endocarditis
3 blood cultures taken from different parts of the body atleast 1 hour apart and a transoesophageal echocardiogram
diagnosis for infective endocarditis
dukes critera: either 2 major criteria, 1 major and three minor or 5 minor
What is in duke major criteria
positive blood culture tests, strong suggestive abnormality on echo
what is in duke minor criteria
fever more than 38, positive blood culture, but not for correct organism, cardiac/valvular abnormality, vasculitic phenomenon, embolic phenomenon, suggestive echo
When does aortic stenosis in someone with a biscupid valve present
by 30 years
what is the difference between stenosis and regurgitation
stenosis: valve cannot open properly and impedes forward flow and regurgitation: cannot close properly causing reverse flow
In which group is mitral valve prolapse most common
mainly women
most common cause of mitral valve regurg
what happens to the valves during mitral valve prolapse
dense collagen and elastin matrix is replaced by myxoedematous glucoaminoglycans
What is acute heart failure always a complication of
MI, either ischaemia, papillary muscle rupture or developing an arrythmia
what is the most important risk factor for developing AAA
atherosclerosis
characterising malignant/accelerated hypertension
marked raised diastolic pressure over 130mm-140Hg in younger adults where their arteries are not protected by atherosclerosis, fibrinoid necrosis nests are formed within arteries and there are complications of acute renal failure, blindness and microangiopathic haemolytic anaemia and DIC are complications
investigation for all patients with suspected pericarditis
transthoracic echo
what is the first and second line for supraventricular tachycardia
valslava manouevre and then adenosine
side effect of adenosine
flushing
Where does furosemide act
ascending loop of henle
when should people with a NSTEMI need a coronary angiography
grace score more than 3% do a coronary angiography within 72 hours
common cause of infective endocarditis in iv drug users
staph auerus- highly pathogenic
what to do for severe pneumonia (CAP)
coamoxiclav
What pneumonia causative agents does the urine antigen test for
legionella and strep pneumoniae
how are TSH and T4 and T3 affected by severe pneumoniae
normal TSH and low T4/T3
give examples of inspiratory and expiratory wheeze
inspiratory: croup, epiglottitis, anaphylaxis and expiratory: COPD and asthma
where would you see curshmann’s spirals
asthma
ejection systolic murmurs
aortic stenosis, pulmonary stenosis
pansystolic murmur
mitral regurgitation, tricuspid regurgitation and ventricular septal defect
mid systolic murmur
mitral valve prolapse
early diastolic
aortic regurgitation
mid diastolic
tricuspid stenosis and bicuspid stenosis
which hypertensive medication should we avoid in someone with gout
thiazide like diuretic: bendroflumethiazide
hypotension, tachycardia and muffled heart sounds and raised JVP
cardiac tamponade
example of a shockable rhythm
monomorphic ventricular tachycardia without a pulse
short and long term treatment for complete heart block
transcutaneous pacing is temporary to wait for a pacemaker
what is long QT syndrome and bazots formula
long QT syndrome: is 470ms in men and 440ms in women when there is coprescription of a macrolide and antiepileptic medication
what can cause hypoxic ischaemic strokes
. Precipitous drops in blood pressure can cause “watershed” area ischaemic strokes.
difference between mobitz i and ii
i is progressively increase PR until P wave drops and ii is constant PR with occasional non conducted p waves and first degoree is when they get progressively longer but no effect on P waves
dizziness and yellowing of vision describes the toxicity of which drug
digoxin and can be caused by hypokalaemia
feature of pericarditis on an ecg
saddle shaped st elevation
which medication is contraindicated in aortic stenosis
nitrates like GTN
when do you offer cardiac resynchronisation therapy
in an ejection fraction less than 35%
reduced ejection fraction with continual heart failure symptoms: treatments
ARB/ACEi, mineralocorticoid receptor and beta blocker
st elevation in someone with no obstructtive coronary heart disease and looks like an octopus pot
takotsubo cardiomyopathy
angina with beta blocker is insufficieent what can be used in combination
long acting dihydrapyridine calcium channel blocker
angina but asthmatic first line medication
rate limitng ccb: dilitazem
which of the following is not associated with aortic stenosis: soft S2, ejection click murmur, narrow pulse pressure and S4 heart sound and quinickes sign
quinickes sign and s4 heart sound
u waves
hypokalaemia
turners syndrome aortic valve
bicuspid aortic valve
ECG changes in v1 to v4- part of the heart and artery affected
anteroseptal and left anterior descending
ECG changes in I II avF- part of the heart and artery affected
inferior and right coronary artery
ECG changes in I, avL, V5-6 part of the heart and artery affected
lateral, left circumflex
ECG changes in I avL, v1-v6 part of the heart and artery affected
anterolateral, proximal left anterior descending
ECG changes in v1-3 part of the heart and artery affected
posterior, left circumflex and right coronary
beck’s triad for cardiac tamponade
hypotension, muffled heart sounds and sitended neck veins
what can an aortic abscess lead to
complete heart block as it is close to the AVN node
does aortic regurgitation lead to HFNEF, HFrEF
HFrEF
pansystolic murmur radiating to the axilla
mitral regurgitation
quinickes sign
nail bed pulsation due to aortic regurg: early diastolic
which medication can lead to redcued hypoglycaemic awareness
beta blockers
first line treatment for otitis externa
topical antibiotics
