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MRCP 1 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Antiplatelet mechanisms

A
  • Thromboxane A2i - Aspirin
  • Antithrombin III activator - Heparins
  • Coronary vasodilator - Nitrates
  • Glycoprotein IIb/IIIa receptor antagonist - Abciximab, Tirofiban
  • P2Y12 i - Clopidigrel, Ticagrelor
  • Reversible direct thrombin i - Bivalirudin
  • Increases effect of adenosine and non specific phosphodiesterase i - Dipyridamole
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2
Q

HOCM

A
  • Beta myosin heavy chain
  • Diastolic dysfunction
  • Myofibrillar hypertrophy with disorganized fashion myocytes and fibrosis on biopsy
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3
Q

HOCM clinical features

A
  • Syncope
  • Sudden death
  • Jerky pulse
  • Large a waves
  • ESM due to LVOT obstruction
  • PSM due to MR
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4
Q

HOCM echo findings

A
  • MR
  • SAM of anterior mitral valve leaflet
  • asymmetric hypertrophy
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5
Q

Variable intensity S1

A

Complete heart block
(also has cannon waves in JVP)

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6
Q

Associations for Coarctation of Aorta

A
  • Bicuspid aortic valve
  • Turner’s syndrome
  • Neurofibromatosis (NF1)
  • Berry aneurysms

Buy Two New Berries for aorta

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7
Q

ECG in hypokalemia

A

U waves, ST depression, T-wave inversion

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8
Q

Nicorandil

A

Potassium channel activator

Adverse effects
1. Headache
2. Flushing
3. GI ulceration anywhere including anal ulcers

Contraindicated in LV failure

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9
Q

S3

A

Diastolic rapid filling of ventricles
Normal in <30 years of age
- LV failure like dilated cardiomyopathy
- Constrictive pericarditis (pericardial knock)
- MR

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10
Q

S4

A

Atrial contraction against stiff ventricles
- AS
- HOCM with double apical impulse
- HTN

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11
Q

Collapsing Pulse

A
  • AR
  • PDA
  • Hyperkinetic states
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12
Q

Slow rising pulse

A

AS

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13
Q

Pulsus alternans

A

Severe LV failure

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14
Q

Pulsus paradoxus

A
  • Severe asthma
  • Cardiac tamponade
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15
Q

Pulsus bisferiens

A

Mixed aortic valve disease

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16
Q

Jerky pulse

A

HOCM

17
Q

Syndrome X

A

Angina like chest pain on exertion
- ST depression on stress ecg
- Normal Coronary angio

18
Q

Ebstein’s anomaly

A

Low insertion of tricuspid valve leading to large RA and small RV
- cyanosis
- hepatomegaly
- TR
- RBBB with WPW

19
Q

Important Cardiac genes

A
  • SCN5A - Brugada
  • MYBPC3 & MYH7 - HCM
  • CAV3 - Hereditary long QT syndrome
  • TTR - Transthyretin amyloidosis
20
Q

Adenosine interactions

A
  • Dipyridamole - enhances action
  • Aminophylline - reduces effect
21
Q

WPW associations

A

HOCM
MVP
Ebstein’s anomaly
Thyrotoxicosis
Secundum ASD

22
Q

Indications for stopping ETT

A
  • ST elevation >2 mm
  • ST depression >3 mm
  • SBP > 230 mm Hg
  • SBP falling more than 20 mm Hg
  • HR falling more than 20% of starting HR
23
Q

Causes of ST depression

A
  • Syndrome X
  • Ischaemia
  • Abnormal QRS
  • Digoxin
  • Hypokalemia

Remember SIADH

24
Q

Management of severe MS

A

Percutaneous mitral commisurotomy (PMC)
If fails, then valve replacement

25
Q

Difference between cardiac tamponade and constrictive pericarditis

A

Absent y descent on JVP for Tamponade

26
Q

Nicorandil important side effect

A

Ulcerations anywhere in the GI tract

27
Q

JVP Canon waves

A

Regular Canon waves:
- VT with 1:1 ventricular-atrial conduction
- AVNRT

Irregular Canon waves: Complete heart block

28
Q

Cardiac resynchronisation therapy (biventricular pacing) candidates

A
  • ECG: LBBB
  • TTE: LVeF<35%
29
Q

Prinzmetal Angina Management

A

Dihydropyridine CCB (Amlo or felodipine)

30
Q

Persistent ST elevation post MI and no CP

A

LV aneurysm

31
Q

Associations of MVP

A

M - Marfan
V - (V) Wolff Parkinson White $
P - Pseudoxanthoma elasticum
P - PDA
R - tuRneR’s syndrome
O - Osteogenesis imperfecta
L - Long QT syndrome
A - ASD
P - PCKD
S - Severe cardiomyopathy
E - Ehler Danlos

32
Q

Causes of DCM

A

THIAMIN
T - Thiamine deficiency
H - HTN
I - IHD
A - Alcohol and cocaine
M - Myocarditis
I - Infiltrative (hemochromatosis and Sarcoidosis)
N - no cause (idiopathic)

33
Q

Associations of WpW

A

HoT As ME

Ho - HOCM
T - Thyrotoxicosis
As - ASD Secundum
M - MVP
E - Ebstein’s anomaly

34
Q

Drugs with serious contraindications

A

Verapamil in VT
Nitrates in RV MI
ACEi, Nitrates and Inotropes in HOCM

MRCP 1 (3 decks)

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