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Barts Final Year > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What common drugs should be avoided in HF?

A

CCBs

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2
Q

Systolic above what requires immediate treatment?
- Bonus point for diastolic

A

180
- 120

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3
Q

What can statins not be given with?

A

Macrolides (Azithromycin, clarithromycin, and erythromycin)

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4
Q

What is electrical alterans?
What condition is it associated with?

A

Alternating QRS amplitude on ECG
- Associated with pericardial effusion -> cardiac tamponade

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5
Q

How many layers does the pericardium have?

A

3
- Visceral
- Serous
- Fibrous

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6
Q

What is caridiac tamponade?
Name and describe the triad associated with the condition

A

Accumulation of pericardial fluid under pressure
- Becks triad: Hypotension, Raised JVP, Muffled heart sounds

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7
Q

What is pulsus paradoxus?

A

Abnormally large drop in BP during inspiration
- Tamponade (also: asthma, copd, CHF, tension pneumothorax)

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8
Q

How may you differnetiate LV aneurysm and LV free wall rupture?

A
  • Free wall rupture is worse and usually occurs 1-2 weeks after, aneurysm slightly earlier
  • Both have HF, rupture more acute
  • Rupture has cardiac tamponade -> pulsus paradoxus, raised JVP, diminished HS
  • Ruture needs urgent pericardiocentesis and thoracotomy
  • Aneurysm not painful wall rupture is
  • Aneurysm requires anticoagulation
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9
Q

Describe the features of Ventricular septal defect post-MI

A
  • Usually 1st week post MI, 1-2% of patients
  • Acute HF
  • Pansystolic murmur
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10
Q

How is a Ventricular septal defect post-MI diagnosed and treated?

A

Echo (signs similar to MR)
- Surgery

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11
Q

Describe the features of Mitral regurgitation post-MI

A

Acute hypotension and pulmonary oedema may occur
- Early-to-mid systolic murmur

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12
Q

When should you advise to take statins?

A

Last thing in the evening

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13
Q

Warfarin rules

A
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14
Q

What is the first thing to look for in bundle branch block?

A

Increased QRS (>0.12, 3 small squares)

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15
Q

HS, 3rd 4th, all valvular

A
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16
Q

What electrolyte abnormalities cause Long QT?

A
  • Hypocalcaemia
  • Hypokalaemia
  • Hypomagnesaemia
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17
Q

What clinic and ambulatory BP are considered stage 2 hypertension?

A
  • Clinic BP 160/100
  • Ambulatory: 150/95
18
Q

At what dose is adenosine given initially?

19
Q

At what dose is atropine given initially?

A

500 micrograms

20
Q

When would ticagrelor be given solely for an MI?

A

NSTEMI (GRACE <=3%)

21
Q

What drugs are given alongside and after fibrinolysis?

A
  • Antithrombin at same time
  • Following give Ticagrelor
22
Q

What drugs are given with PCI?

A
  • Give prasugrel and unfractionated heparin
  • If STEMI bailout: GpIIb/IIIa may be given (like abciximab)
23
Q

If PCI is done through femoral instead of radial what drug is used instead of Unfractionated heparin?

A

Bivalirudin (direct thrombin inhibitor)

24
Q

What kind of drugs are diltiazem and verapamil?

A

Non-dihydropyridine CCBs

25
Q

Left sided valves are louder on expiration or inspiration?

A

Expiration

26
Q

Right sided valves are louder on expiration or inspiration?

A

Inspiration

27
Q

Late systolic murmurs examples:

A
  • Mitral valve prolapse
  • Coarctation of the aorta
28
Q

Describe the features of aortic and pulmonary regurgitation murmur

A
  • Early diastolic
  • Blowing
  • High pitched
29
Q

Describe the features of mitral stenosis murmur

A
  • Mid-late diastolic
  • Rumbling
  • Opening snap
30
Q

Describe the features of mitral regurgitation murmur

A
  • Pan-systolic
  • Soft S1 (valve not strong), split S2 (more sounds from valve)
31
Q

What is an Austin-Flint murmur?

A

Severe AR
- mid-late diastolic and rumbling (similar to MS)

32
Q

What is S4 due to?

A

Issue with atria
- Diastolic HF - LVH, HOCM, aortic stenosis
- Restrictive cardiomyopathy, post-MI fibrosis

33
Q

When is S4 heard?

A

Just before S1

34
Q

When is S3 heard?

A

Just after S2

35
Q

What is S3 due to?

A

Blood flowing into a complaint ventricle
- Can be normal in youngsters, athletes
- Severe Mitral regurgitation, tricuspid regurgitation
- HF, cardiomyopathy

36
Q

How long is one small square on ECG?

37
Q

How long is one big sqaure on ECG?

38
Q

What are the 2 ways of calculating HR on ECG?

A

300 divided by big squares

R waves x 6

39
Q

Brain and body clot - TIA, stroke, and PAD treatment of choice longterm

A

Clopidogrel

40
Q

MI long-term treatment

A

Aspirin (lifelong)
- Ticagrelor (or prasugrel if treated with PCI but can give either)

41
Q

Aortic stenosis features

A
  • Narrow pulse pressure
  • slow rising pulse
  • delayed Ejection systolic murmur
  • soft/absent S2
  • S4
  • thrill
  • LVF if severe

Barts Final Year (13 decks)

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