Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

4th year presentations > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What is angina?

A

Chest pain on exertion caused by myocardial ischaemia from coronary heart disease, usually atherothrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the difference between stable and unstable angina?

A

Stable angina is induced by effort and relieved by rest/GTN spray
Unstable angina is an acute coronary syndrome with pain at rest/not relieved by GTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List aetiology/risk factors for angina

A 
Atherosclerosis
Males
Smoking, excess alcohol
Poor diet, obesity
Arteritis
Low exercise
Hypertension
Diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List clinical features of angina

A 
Central chest tightness on exertion
Pain may radiate to jaw/arm
Dyspnoea
Nausea
Sweating
Syncope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What investigations would you order for angina?

A

ECG may be normal
Exercise ECG, 24h ECG
CT catheter angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Outline medical treatment for angina

A

GTN spray when required
Secondary prevention (aspirin, statin, ACEi)
B-blockers unless contraindicated
Ivabradine/nicorandil if others not tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Outline surgical treatment for angina

A

Coronary revascularisation (PCI, CABG) using balloon stent or graft bypass from internal mammary artery and greater saphenous vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the acute coronary syndromes (ACS)?

A

Unstable angina
NSTEMI
STEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the pathophysiology of ACS?

A

Atherothrombotic plaque rupture leads to thrombosis and complete occlusion of coronary artery, causing ischaemia and potential necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List risk factors/aetiology for ACS

A 
Males
Family history
Smoking, excess alcohol
Hypertension
Diabetes
High cholesterol
Obesity
Sedentary lifestyle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List clinical features of ACS

A 
New onset severe crushing chest pain, radiating to arm and/or jaw
Nausea, vomiting
Not relieve by rest or GTN
Breathlessness
Syncope
Confusion
Pallor, sweating
Palpitations, tachycardia
SENSE OF IMPENDING DOOM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What investigations would you do for ACS?

A

Bloods: cardiac enzymes (CK, troponin), electrolytes, glucose, lipids
ECG
CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the criteria for STEMI on ECG?

A

ST elevation of 1mm or more in 2 adjacent limb leads
or
ST elevation of 2mm or more in 2 contiguous chest leads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List ischaemic changes on ECG

A 
T wave inversion
Q waves
Tall T waves
ST depression
ST elevation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When do levels of troponin and CK peak in ACS?

A

Troponin: 3-12 h
CK: 24 h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Outline medical treatment for acute MI

A

Aspirin 300 mg
GTN sublingual
IV morphine
O2 if hypoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Outline definitive treatment for acute NSTEMI

A

B-blocker IV
LMW heparin
IV nitrate
Angiography if high risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Outline definitive treatment for acute STEMI

A

PCI within 120 mins

Otherwise thrombolysis with streptokinase + aspirin, then reassess after 90 mins for need for PCI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the different stages of hypertension? (stage 1, stage 2 etc.)

A

Stage 1: 140-159/90-99
Stage 2: 160-179/100-109
Stage 3: 180/110 or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

List risk factors/aetiology for hypertension

A

Renal disease (GN, polyarteritis, renal artery stenosis)
Endocrine disease (Cushing’s, Conn’s, phaeochromocytoma)
Pregnancy
Drugs
Alcohol excess
High salt intake
Essential hypertension (idiopathic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List clinical features of hypertension

A 
Asymptomatic
Headache
Palpitations
Breathlessness
Advanced disease: blurred vision, palpable kidney, RF delay
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What investigations would you do for hypertension?

A 
ECG, echo
Bloods: electrolytes, endocrine markers
Funduscopy
Urinalysis
Home/ambulatory BP monitoring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is hypertensive retinopathy graded?

A

I: tortuous arteries, narrowing/sclerosis
II: AV nipping, marked sclerosis
III: haemorrhages, cotton wool spots, hard exudates
IV: III + papilloedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Outline medical management of hypertension

A 
If under 55yo, start with ACEi
If over 55yo or black, start with Ca ch blocker
If uncontrolled on these,
ACEi + Ca ch blocker
then
add thiazide diuretic
then
add alpha/beta blocker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the BP target for diabetic patients with hypertension?
Less than 130/80
26
What is an arrhythmia?
Disturbance in the cardiac rhythm generated by abnormal conduction
27
List risk factors/aetiology for arrhythmias
``` Heart conditions Congenital heart disease Smoking, alcohol High caffeine intake Pneumonia Thyrotoxicosis Metabolic imbalance Drugs (amiodarone, B agonists, digoxin, levodopa, illicit drugs) ```
28
List clinical features of arrhythmias
``` Palpitations Abnormal pulse Chest pain Syncope Dizziness Dyspnoea Altered consciousness ```
29
What investigations would you order for arrhythmias?
ECG, 24 h ECG, event recording Electrophysiology FBC, U+E, glucose, Ca, Mg, thyroid function Echocardiogram
30
Which drug can be used to treat bradycardia?
Atropine
31
Outline treatment of supraventricular tachycardias
Vagal maneuvres (breath-hold, Valsalva, ice, carotid massage) IV adenosine/verapamil DC shock
32
List class I anti-arrhythmic drugs and whether they are rhythm or rate controlling
Na channel blockers (rhythm control) Lignocaine Disopyramide Flecanaide
33
List class II anti-arrhythmic drugs and whether they are rhythm or rate controlling
B blockers (rate control) Atenolol Propranolol
34
List class III anti-arrhythmic drugs and whether they are rhythm or rate controlling
K channel blockers (rhythm control) Amiodarone Sotalol
35
List class IV anti-arrhythmic drugs and whether they are rhythm or rate controlling
Ca ch blockers (rate control) Verapamil Diltiazem
36
List the main narrow-complex tachycardias
``` Sinus tachycardia Supra-ventricular tachycardia Atrial fibrillation/flutter Atrial tachycardia Junctional tachycardia (AVNRT, AVRT, BBB) ```
37
List the main broad-complex tachycardias
Ventricular tachycardia Torsades de Pointes SVT with aberrancy Ventricular fibrillation
38
Outline treatment of narrow-complex tachycardias (except AF)
SVT: vagal maneuvres, IV adenosine/verapamil, DC shock Junctional: ablation of accessory pathways, rhythm control
39
Outline treatment of ventricular tachycardia
Amiodarone/lignocaine + dextrose if stable Correct K with calcium chloride DC shock if pulseless or unstable
40
Outline treatment of ventricular fibrillation
DC shock Mg chloride Implantable defibrillator
41
Outline treatment of torsades de Pointes
Mg sulfate IV | Overdrive pacing
42
List aetiology/risk factors for AF
``` Heart failure Ischaemia, MI Hypertension Mitral valve disease Pneumonia Hyperthyroidism Caffeine, alcohol Hypokalaemia Cardiomyopathy Pericarditis Sick sinus syndrome ```
43
Outline treatment of acute AF
O2 + emergency cardioversion/amiodarone if unstable Anticoagulation with LMW heparin Rate control: diltiazem/verapamol/metoprolol/digoxin AV node ablation or pacing
44
What is the aim for INR with warfarin on AF?
2-3
45
Describe 1' heart block
Prolonged PR interval (greater than 0.22s)
46
Describe 2' type 1 heart block
Progressive prolonging of PR interval with dropped QRS complex
47
Describe 2' type 2 heart block
Normal PR interval with some dropped QRS complexes
48
Describe 3' heart block
Dissociation of P-wave and QRS complexes
49
What would an ECG show in right bundle branch block?
M-wave in V1, W-wave in V6
50
What would an ECG show in left bundle branch block?
W-wave in V1, M-wave in V6
51
List risk factors/aetiology for heart blockWhat is
``` Normal variants Athletes Sick sinus syndrome Ischaemic heart disease Drugs (digoxin, B blockers) Congenital heart disease Calcified valves Trauma Surgery ```
52
Outline treatment of heart block
IV atropine | Pacing
53
How does the body try to compensate for low cardiac output in heart failure?
Retains fluid which increases preload and causes further stress on the heart, causing congestive heart failure
54
What is "systolic" heart failure? Give causes
Ventricles unable to contract normally, causing reduced cardiac output (ejection fraction less than 40%) Causes: IHD, MI, cardiomyopathy
55
What is "diastolic" heart failure? Give causes
Ventricles unable to relax normally, causing increased preload (ejection fraction greater than 50%) Causes: constrictive pericarditis, restrictive CM, tamponade, hypertension
56
List causes of right heart failure
Left ventricular failure Pulmonary stenosis Lung disease, cor pulmonale
57
List causes of left heart failure
Valve disease Arrhythmia Hypertension Congenital defects
58
List clinical features of right heart failure
``` Raised JVP Peripheral oedema Epistaxis Organomegaly Ascites Nausea Anorexia ```
59
List clinical features of left heart failure
``` Dyspnoea Fatigue, poor exercise tolerance Pulmonary oedema Orthopnoea PND Pink frothy sputum Cold peropheries ```
60
What are major symptoms/signs of heart failure according to Framingham criteria?
``` PND Crepitations S3 Cardiomegaly Raised JVP Pulmonary oedema Weight loss ```
61
What are minor symptoms/signs of heart failure according to Framingham criteria?
``` Ankle oedema Dyspnoea Tachycardia Nocturnal cough Pleural effusion ```
62
What would you see on an XR in heart failure?
``` Alveolar shadowing (bat's wings) Kerley B lines Cardiomegaly Dilated upper vessels Effusion ```
63
Outline treatment of acute heart failure
``` Sit up High flow O2 IV diamorphine IV furosemide GTN/nitrate ```
64
Outline medical treatment of heart failure
Diuretics (furosemide, spironolactone) ACEi if LV dysfunction Digoxin if LV impairment B-blocker reduces mortality long-term
65
What is a cardiac murmur?
Sound made due to turbulent blood flow against diseased/damaged heart valves
66
Systolic murmurs are in time with the carotid pulse. True/False?
True
67
List aetiology of mitral stenosis
Rheumatic fever Congenital anomaly Prosthesis Carcinoid tumour
68
List notable clinical features of mitral stenosis
``` Mid-diastolic "rumbling" with loud opening snap Tapping apex Malar flush Low-volume pulse Atrial fibrillation ```
69
List aetiology of mitral regurgitation
``` Rheumatic fever LV dilation Calcification Endocarditis Connective tissues disease Chordae rupture ```
70
List notable clinical features of mitral regurgitation
Pansystolic with radiation to axillar RV heave Atrial fibrillation Ankle swelling
71
List aetiology of mitral valve prolapse
``` WPW Atrial septal defect Patent ductus Cardiomyopath Connective tissue disease ```
72
List notable clinical features of mitral valve prolapse
Mid-systolic click +/- late systolic murmur | Autonomic dysfunction
73
Outline general treatment of mitral valve disease
Control AF, anticoagulation Balloon valvoplasty in stenosis Valve replacement B blocker may help symptoms
74
List aetiology of atrial stenosis
Calcification Congenital bicuspid valve Kidney disease Hypertrophic cardiomyopathy
75
List notable clinical features of aortic stenosis
Ejection systolic with radiation to carotids Slow-rising pulse Heaving apex Exertional dyspnoea
76
List aetiology of aortic regurgitation
Connective tissue disease Rheumatic fever Endocarditis Vasculitis
77
List notable clinical features of aortic regurgitation
``` Early-diastolic Displaced apex Collapsing pulse Corrigan's sign (carotid pulsation) De Musset sign (head nod with beat) ```
78
Outline general treatment for aortic valve disease
``` Valve replacement (valvotomy, TAVI) ACEi, diuretics ```
79
List aetiology of tricuspid regurgitation
``` RV dilation Pulmonary hypertension Rheumatic fever Endocarditis IV drug use Carcinoid tumour Ebstein's anomaly ```
80
List notable clinical features of tricuspid regurgitation
``` Pansystolic RV heave Hugely raised JVP Pulsatile hepatomegaly Hepatic pain on exertion Ascites ```
81
List aetiology of pulmonary stenosis
Congenital Turner's, Noonan's, Falot's Rheumatic fever Carcinoid tumour
82
List notable clinical features of pulmonary stenosis
Ejection systolic with radiation to left shoulder Split S2 Dyspnoa Ascites
83
If someone presents with a fever and new cardiac murmur, what's the diagnosis until proven otherwise?
Infective endocarditis
84
List non-bacterial aetiology/risk factors for endocarditis
``` IVDU Diabetes Valve disease Congenital heart conditions Low dental hygiene, dental procedures ```
85
List bacterial aetiology for endocarditis
Strep viridans Staph aureus, Enterococci, Staph epidermidis (prosthesis) Rare: Haemophilus, Actinobacillus, Cardiobacter, Eikenella, Kingella (HACEK)
86
List clinical features of endocarditis
``` Signs of sepsis - fever, rigors, night sweats, malaise, weight loss New murmur Breathless Fatigue Clubbing Roth spots (retinal haemorrhage) Splinter haemorrhages Janeway lesions (painless palmar nodes) Osler nodes (painful pulps on fingers/toes) ```
87
What investigations would you do for endocarditis?
``` 3 sets of blood cultures at peak of fever PRIOR to antibiotics Bloods Urinalysis CXR ECG Echocardiograph ```
88
Outline Duke's major criteria for endocarditis
``` +ve blood culture Endocardium involvement (+ve echo, new valve regurg) ```
89
Outline Duke's minor criteria for endocarditis
``` Risk factor present Fever above 38'C Immune/vascular signs +ve blood culture +ve echocardiograph ```
90
What is required from Duke's criteria to diagnose endocarditis?
2 majors 1 major + 3 minors 5 minors
91
What empirical therapy is used for endocarditis?
Benzylpenicillin + gentamicin | +/- flucloxacillin
92
What antibiotics would you give for Staph endocarditis?
Flucloxacillin Gentamicin Vancomycin if MRSA +/- rifampicin
93
What antibiotics would you give for Strep endocarditis?
Benzylpenicillin | Gentamicin
94
What antibiotics would you give for Enterococcus endocarditis?
Amoxicillin | Gentamicin
95
What antibiotics would you give for atypical endocarditis?
Doxycycline Cotrimoxazole Fluconazole/amphoterecin
96
List aetiology/risk factors for myocarditis
Viral infection (Coxsackie, CMV, adenovirus, HIV) Drugs (cyclophosphamide, penicillin, chloramphenicol, phenyotin, radiation) Idiopathic
97
List clinical features of myocarditis
``` Fatigue Dyspnoea Palpitations Chest pain Fever Tachycardia Soft S1, S4 gallop rhythm ```
98
What investigations would you do for myocarditis?
ECG (STE/STD, T inversion, arrhythmia, AV block) Tropnonin I or T confirms diagnosis CK
99
Outline treatment of myocarditis
Supportive, rest, treat cause Avoid sports ACEi/B-blocker/spironolactone where heart failure
100
List aetiology/risk factors for pericarditis
Viruses (EBV, Coxsackie, flu, mumps, varicella, HIV) Bacteria (pneumonia, rheumatic fever, TB) Post-MI (Dressler's syndrome) Drugs Inflammatory/chronic disease
101
List clinical features of pericarditis
Chest pain, worse on inspiration/lying flat, relieved sitting forward Friction rub Evidence of effusion/tamponade
102
What investigations would you order for pericarditis?
``` ECG shows widespread saddle-shaped STE CXR Echo Cardiac enzymes (troponin may be raised) Blood cultures/serology ```
103
Outline treatment of pericarditis
Rest, analgesia Treat cause Steroid or immunosuppression
104
What are cardiomyopathies?
Diseases that affect the mechanical/electrical function of the heart
105
What is hypertrophic cardiomyopathy?
LV outflow obstruction from asymmetrical septal hypetrophy
106
What is the genetic abnormality in hypertrophic cardiomyopathy?
Autosomal dominant mutation in sarcomeric genes, resulting in reduced myosin and troponin
107
List clinical features of hypertrophic cardiomyopathy
``` Asymptomatic or sudden death Syncope Chest pain Dyspnoea Jerky pulse Double apex pulsation Systolic thrill, ejection murmur ```
108
What investigations would you order for hypertrophic cardiomyopathy?
ECG shows LVH, inferolateral Q waves May be in AF/WPW Echo shoes asymmetrical septal hypertrophy, midsystolic aortic valve closure
109
Outline treatment of hypertrophic cardiomyopathy
B-blocker/verapamil for symptoms Amiodarone control arrhythmia Septal myomectomy if severe Implantable defib
110
What is dilated cardiomyopathy?
Dilated ventricles with systolic dysfunction but preserved wall thickness Essentially a flabby heart
111
What genetic abnormality causes dilated cardiomyopathy?
Mutation in cytoskeletal/myocyte genes causing contractile insufficiency
112
What risk factors is dilated cardiomyopathy associated with?
``` Alcohol Hypertension Haemochromatosis Viral infections Autoimmunity ```
113
List clinical features of dilated cardiomyopathy
``` Fatigue Dyspnoea Po oedema RV failure, emboli Raised JVP Arrhythmia, tachycardia Hypotension Displaced apex Jaundice, ascites, hepatomegaly ```
114
What investigations would you do for dilated cardiomyopathy?
CXR shows cardiomegaly, po oedema ECG Echo shows dilated chambers, low ejection fraction
115
Outline treatment of dilated cardiomyopathy
Manage heart failure (digoxin, furosemide, ACEi) Pacing Heart transplant
116
What is restrictive cardiomyopathy?
Reduced volume of both ventricles with atrial enlargement and impaired filling
117
What conditions are associated with restrictive cardiomyopathy?
Amyloidosis Haemochromatosis Sarcoidosis Scleroderma
118
List clinical features of restrictive cardiomyopathy
Similar to pericarditis RHF signs Hepatomegaly, ascites
119
What investigations would you do for restrictive cardiomyopathy?
CXR shoes po venous congestion ECG low-voltage QRS Echo shows impaired filling Cardiac catheterisation
120
What is arrhythmogenic right ventricular cardiomyopathy (ARVC)?
Fibro-fatty replacement of myocytes, causing RV dilation
121
What is the genetic abnormality that causes ARVC?
Mutation in desmosomal genes affecting the ryanodine receptor
122
What is atrial myxoma?
Rare benign cardiac tumour, usually found in right atrium
123
List clinical features of atrial myxoma
May mimic endocarditis Mitral stenosis Tumour plop on auscultation
124
What is the difference between ostium secundum and primum atrial septal defect?
Secundum: high in septum, presents in adulthood Primum: opposite endocardial cushions, presents early
125
List clinical features of atrial septal defect
``` Cyanosis Po hypertension Arrhythmia Haemoptysis Chest pain Raised JVP Wide split S2 heart sound Ejection systolic murmur Migraines ```
126
What investigations would you do for atrial septal defect?
Echo shows left-right shunt ECG shows RBBB with LAD and prolonged PR interval CXR shows small aortic knuckle, po plethora
127
Outline treatment of atrial septal defect
Usually closes before age of 10 | Transcatheter closure
128
What is the most common congenital cardiac anomaly?
Ventricular septal defect
129
List clinical features of ventricular septal defect
Severe heart failure Loud murmur, thrill Harsh pansystolic murmur at left sternal edge
130
What investigations would you do for ventricular septal defect?
Echo shows left-right shunt Eisenmenger complex (right-left shunt) ECG shows LAD and LVH or PVH CXR shows normal or cardiomegaly
131
Outline treatment of ventricular septal defect
May close spontaneously Endovascular or medical closure Treat heart failure
132
What is patent ductus arteriosus?
Persistent communication between po. artery and desc. aorta
133
List clinical features of patent ductus arteriosus
Bounding pulse | Machine-gun murmur
134
What is coarctation of aorta?
Narrowing of desc. aorta just distal to insertion of ductus arteriosus
135
List risk factors/aetiology of coarctation of aorta
``` Boys Bicuspid aortic valve Ventricular septal defect Mitral valve disease CTD's ```
136
List clinical features of coarctation of aorta
Headaches Nosebleeds Radio-femoral delay Scapular bruit
137
What would a CXR of coarctation of aorta show?
Rib-notching
138
Outline treatment of coarctation of aorta
Surgery | Balloon dilation +/- stent
139
What makes up tetralogy of Fallot?
Ventricular septal defect Pulmonary stenosis RV hypertrophy Overriding aorta
140
List clinical features of tetralogy of Fallot
``` Cyanosis (right-left shunt) Restless, agitated Toddler squat to increase peripheral resistance Difficulty feeding Failure to thrive Clubbing Exertional dyspnoea Palpitations RV failure Syncope ```
141
What investigations would you do for tetralogy of Fallot?
CXR boot-shaped heart | Echo assesses degree of stenosis
142
Outline treatment of tetralogy of Fallot
``` Oxygen Positioning Morphine if irritated Long-term B-blocker Endocarditis prophylaxis Surgery to close VSD, correct po stenosis ```
143
What is intermittent claudication?
Chronic lower limb ischaemia relieved by rest
144
List aetiology/risk factors for intermitted claudication
Smoking Diabetes High cholesterol Hypertension
145
List clinical features of intermittent claudication
``` Exertional/cramping pain usually in calves relieved by rest Ulceration Dry skin Hair loss Diminished/absent pulses Cold legs Atrophy Cap refill less than 2s ```
146
What investigations would you do for intermittent claudication?
``` Bloods ECG Catheterisation Duplex US scan ABPI of 0.4-0.9 ```
147
Outline treatment of intermittent claudication
Lifestyle improvement (smoking, exercise, weight) Antiplatelets (aspirin) Surgery (angioplasty +/- stent, bypass graft) Amputation
148
Acute limb ischaemia is a surgical emergency. True/False?
True | Requires revascularisation within 4-6 hours
149
List aetiology/risk factors for acute limb ischaemia
Thrombosis in situ Emboli Graft, angioplasty occlusion Trauma
150
List clinical features of acute limb ischaemia
``` Pale Pulseless Painful Paralysis Paraesthesiae Perishing cold ```
151
Outline treatment of acute limb ischaemia
``` Urgent arteriography Surgical embolectomy Local thrombolysis (tPA) Anticoagulate (heparin) Angioplasty ```
152
What are varicose veins?
Incompetent valves prevent blood progressing from deep to superficial veins, causing long tortuous dilated veins
153
List aetiology/risk factors for varicose veins
``` Obstruction DVT Ovarian tumour Valve disease AV malformation Prolonged standing Pregnancy OCP use ```
154
List clinical features of varicose veins
``` Pain Crampy legs Tingling Ugly legs Oedema Varicose eczema Ulcers Haemosiderin staining Atrophie blanche Lipidodermatosclerosis Phlebitis ```
155
What investigations would you do for varicose veins?
Doppler USS Trendelenberg test Buerger test
156
Outline treatment for varicose veins
``` Treat cause, education Elevation, stock, lose weight Injection sclerotherapy Laser coagulation Endovenous ablation ```
157
List aetiology/risk factors for DVT
``` Post-surgery Immobility Increasing age Pregnancy Oestrogen therapy Trauma Malignancy Thrombophilia Previous DVT ```
158
List clinical features of DVT
``` Calf warmth Tenderness Swelling Erythema Mild fever Pitting oedema PE-like features ```
159
What investigations would you do for DVT?
Bloods: d-dimers, thrombophilia tests Compression Doppler USS PTP score Well's score
160
Outline treatment of DVT
``` Stop OCP Mobilisation TED stockings Anticoagulate (LMWH, warfarin) IVC filters if active bleeding ```
161
What is an aneurysm?
Greater than 50% dilation of an artery's original diameter involving all layers of the vessel
162
What are the common sites for an aneurysm?
Aorta Iliac artery Femoral artery Popliteal artery
163
List aetiology/risk factors abdominal aortic aneurysm
``` Defect in collagen-elastase regulation Atherosclerosis Trauma Infection CTD's Vasculitis Genetics ```
164
List clinical features of abdominal aortic aneurysm
``` May be asymptomatic until rupture Intermittent/continuous abdo pain radiating to back Collapse Hypotension Expansile abdo mass Discoloured peripheries Tachycardia Pallor ```
165
What investigations would you do for abdominal aortic aneurysm?
Regular USS monitoring for men over 65
166
Outline treatment of abdominal aortic aneurysm
Less than 5.5 cm - monitoring Reserve surgery unless expanding more than 1cm a year Lifestyle advice, exercise tests Surgery (EVAR, open)
167
Outline acute treatment of rupture of abdominal aortic aneurysm?
Blood amylase, ECG, crossmatch blood Catheterise Large IV access, give O Rh blood Prompt surgery and antibiotic
168
What is aortic dissection?
Splitting of aortic tunica media | Either type A (involving ascending aorta) and type B (not involving ascending aorta)
169
List clinical features of aortic dissection
Sudden tearing chest pain radiating to back Hemiplegia Radio-radio delay Hypotension
170
What investigations would you do for aortic dissection?
``` Crossmatch blood ECG CXR CT/MRI Trans-oesophageal echo ```
171
Outline treatment of aortic dissection
Hypotensives (keep systolic 100-110) (labetolol) | Urgent surgery

4th year presentations (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions