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FINALS: PASSMED/QUESMED > Cardiology > Flashcards

Cardiology Flashcards

1
Q

central, pleuritic chest pain and fever 4 weeks following a myocardial infarction suggests what?

A

Dresslers - Pericarditis following MI

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2
Q

traumatic accident with respiratory distress, hypotension, jugular venous distension, and absent lung sounds suggests what?

A

Tension pneumothorax

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3
Q

A third heart sound is considered in patients under what age?

A

<30 years old

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4
Q

What are the common causative organisms of infective endocarditis?

A

Most common/IVDU - Staph aureus
Those with poor dental hygiene/post dental proceudure - Strep viridans
Following prosthetic valve surgery - Staph epidermidis

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5
Q

Widened mediastinum on CXR with severe chest pain suggests what?

A

Aortic dissection

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6
Q

In ALS, if IV drugs cannot be given, how should they be given?

A

Intraosseous

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7
Q

What is the most specific ECG finding in acute pericarditis?

A

PR depression

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8
Q

Type A (ascending) vs Type B (descending) aortic dissection?

A

A - chest pain
B - upper back pain

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9
Q

tall R waves in leads V1-3 are a classic finding for what?

A

Posterior MI

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10
Q

What score should be used to assess the risk of bleeding when starting someone on anticoagulation in AF?

A

Orbit

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11
Q

What are reversible causes of cardiac arrest?

A

Hypoxia
Hypovolaemia
Hyperkalaemia, hypokalaemia, hypoglycaemia, hypocalcaemia, acidaemia and other metabolic disorders
Hypothermia
Thrombosis (coronary or pulmonary)
Tension pneumothorax
Tamponade – cardiac
Toxins

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12
Q

When should warfarin be stopped prior to surgery?

A

5 days before

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13
Q

What is the key diagnostic finding of aortic dissection on CT?

A

False lumen

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14
Q

What are C/I to thrombolysis?

A

active internal bleeding
recent haemorrhage, trauma or surgery (including dental extraction)
coagulation and bleeding disorders
intracranial neoplasm
stroke < 3 months
aortic dissection
recent head injury
severe hypertension

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15
Q

weak or absent carotid, brachial, or femoral pulse
variation in arm BP suggests what?

A

Aortic dissection

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16
Q

When can electrical cardioversion be considered for patients with AF?

A

If presenting within 48 hours

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17
Q

What medication should be stopped when patients are given a course of macrolides e.g. clarithromycin?

A

Statins

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18
Q

Thiazide-like diuretics should not be used in patients with what?

A

Gout

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19
Q

ST elevation and acute pulmonary oedema in a young patient with a recent flu-like illness suggests what?

A

Myocarditis

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20
Q

When should rhythm control be used for AF instead of rate control?

A

coexistent heart failure, first onset AF or an obvious reversible cause

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21
Q

Which medication can reduce hypoglycaemia awareness?

A

Beta blockers

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22
Q

Which medication can impair glucose tolerance?

A

Thiazides

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23
Q

Widespread ST elevation in V1-4 suggests what?

A

100% occlusion of the LAD

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24
Q

Erythromycin can cause which cardiac abnormality?

A

QT prolongation

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25
Q

What kind of bacteria is staph aureus?

A

Gram positive cocci

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26
Q

How should a patient with minor bleeding with INR > 8 be managed?

A

Stop warfarin and give IV Vitamin K with repeat dose of Vit K after 24 hours if INR still high

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27
Q

What drugs can cause hypokalaemia?

A

Loop diuretics e.g. furosemide

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28
Q

A new left bundle branch block should raise alarms for what?

A

ACS

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29
Q

What scoring system should be used to identify patients with a pulmonary embolism that can be managed as outpatients?

A

Pulmonary Embolism Severity Index (PESI)

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30
Q

How does fondaparinux work?

A

Activates antithrombin III

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31
Q

What is the management of AF if ChadsVasc is 0?

A

Echo to rule out valvular causes

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32
Q

What are ecg findings of hypokalaemia?

A

small or absent T waves (occasionally inversion)
prolong PR interval
ST depression
long QT
U waves

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33
Q

What is the second-line therapy in patients with HFrEF?

A

SGLT-2 inhibitors e.g Empagliflozin

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34
Q

inferior myocardial infarction and AR murmur suggests what?

A

Proximal aortic dissection

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35
Q

High dose statins should be commenced in stroke patients when?

A

48 hours after stroke

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36
Q

What criteria should be used for infective endocarditis?

A

Duke criteria

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37
Q

What criteria should be used for rheumatic fever?

A

Jones criteria

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38
Q

What drugs should be used for anticoagulation in those with mechanical heart valves?

A

Warfarin/LMWH

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39
Q

Complete heart block following an MI suggests the lesion is where?

A

Right coronary

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40
Q

Investigation of choice for aortic dissection?

A

CT Angio

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41
Q

Management of aortic dissection

A

Control BP with IV Labetalol and surgery

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42
Q

Most common ECG change of PE?

A

Sinus tachycardia

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43
Q

Management of pericarditis?

A

NSAIDs plus colchicine

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44
Q

PR Depression on ECG is indicative of what?

A

Pericarditis

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45
Q

Medical management of NSTEMI?

A

dual antiplatelet therapy, an ace inhibitor, a beta-blocker, and a statin

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46
Q

What is Beck’s triad?

A
  • Raised JVP
  • Muffled heart sounds
  • Falling BP
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47
Q

What is Beck’s triad a sign of?

A

Cardiac tamponade

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48
Q

Management of major bleed with someone on warfarin?

A

stop warfarin, give intravenous vitamin K 5mg, prothrombin complex concentrate

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49
Q

How should episodic palpitations be investigated?

A

Holter monitoring

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50
Q

notching of the inferior border of the ribs suggests what?

A

Aortic coarctation

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51
Q

Management of PE with low PESI score?

A

Can be managed as an outpatient with DOAC

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52
Q

Nitrates for MI are contraindicated when?

A

Patients with hypotension

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53
Q

What is the treatment for torsades de pointes?

A

IV Mag Sulph

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54
Q

What is a normal cardiac variant in athletes?

A

First degree heart block

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55
Q

Investigation of choice for someone with PE and renal impairment?

A

V/Q scan

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56
Q

What is normal in an athlete and does not require any intervention?

A

First degree heart block

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57
Q

If angina is not controlled by a beta blocker, what should be added?

A

Amlodipine

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58
Q

What should be used if atropine if not helping with bradycardia?

A
  • transcutaenous pacing
  • transvenous pacing
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59
Q

Sydenham’s chorea is a complication of what?

A

Rheumatic fever

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60
Q

Management of persistent myocardial ischaemia following fibrinolysis

A

PCI even if time elapsed

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61
Q

What on echo is used to determine the severity of aortic stenosis?

A

Trans-valvular pressure gradient

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62
Q

What is Buerger’s disease?

A
  • A small/medium vasculitis which is associated with smoking
  • Causes intermittent claudication, Raynaud’s and ischaemic ulcers
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63
Q

What is the mode of action of statins?

A

Decrease intrinsic cholesterol synthesis by inhibiting HMG-CoA reductase enzyme

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64
Q

How to manage a strong suspicion of PE whilst waiting for scan?

A

Start treatment dose anticoagulant

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65
Q

Electrical alternans is a sign of what?

A

Cardiac tamponade

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66
Q

J waves are associated with what?

A

Hypothermia

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67
Q

Hypertrophic obstructive cardiomyopathy is associated with what?

A

Wolf-Parkinson-White

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68
Q

Management of acute heart failure not responding to furosemide?

A

Consider CPAP

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69
Q

What is a complication of MI?

A

Pulmonary oedema

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70
Q

SVT Management?

A
  1. Valsalva
  2. IV Adenosine upto 3 doses
  3. Electrical cardioversion
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71
Q

Criteria for rate control vs anticoag/cardioversion?

A
  • Under 65
  • No Hx of IHD
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72
Q

Thrombus in aVL, which artery?

A

Left circumflex

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73
Q

What is Framingham risk score?

A

estimate the 10-year risk of heart attack

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74
Q

severe hypertension and bilateral retinal hemorrhages and exudates

A

Malignant HTN

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75
Q

Endocarditis - which valves are affected?

A

Mitral - most common
Aortic
Tricuspid - IVDU

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76
Q

A patient develops acute heart failure 5 days after a myocardial infarction. A new pan-systolic murmur is noted on examination

A

VSD

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77
Q

Treatment for cardiac tamponade?

A

Pericardial needle aspiration

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78
Q

What is Kussmaul sign?

A
  • JVP rises on inspiration
  • Sign of constrictive pericarditis
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79
Q

holosystolic murmur, high-pitched and ‘blowing’ in character

A

Mitral regurg

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80
Q

Tachycardia and tachypnoea with no signs

A

Think PE

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81
Q

Can warfarin be used when breast feeding?

A

Yes

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82
Q

What electrolyte abnormality do thiazide diuretics cause?

A
  • Hypokalaemia
  • Hyponatraemia
  • Hypercalcaemia
  • Gout
  • Impaired glucose tolerance
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83
Q

Management of irregular broad complex tachycardia

A

Seek cardiology input

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84
Q

What is Takayasu’s arteritis?

A
  • Systemic features of vasculitis
  • Unequal BP in upper limbs
  • Carotid tenderness
  • Absent/weak peripheral pulses
  • Associated with renal artery stenosis
  • MRA/CTA to treat with steroids
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85
Q

Low pitched diastolic murmur?

A

Mitral stenosis

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86
Q

Acute mitral valve regurg + pulmonary oedema

A

Think MI

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87
Q

What is the dose of adrenaline used in cardiac arrest?

A

1mg of IV adrenaline

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88
Q

Breathing problems with clear chest

A

PE

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89
Q

What is Brugada syndrome?

A
  • AD disorder which can cause sudden death
  • ECG shows ST elevation and T wave inversion (may become clearer after giving flecainide_
  • Tx is implantable cardioverter-defib
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90
Q

Most common place of inhaled foreign body?

A

Right inferior bronchus

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91
Q

Findings for aortic stenosis?

A

narrow pulse pressure
slow rising pulse
a thrill palpable over the cardiac apex
a fourth heart sound (S4) indicative of left ventricular hypertrophy
a soft/absent S2

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92
Q

Which medications can cause torsades de pointes?

A

Macrolides e.g. azithromycin

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93
Q

What condition are ACE inhibitors C/I with?

A

Renovascular disease

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94
Q

What causes the acute mitral regurg following MI?

A

Rupture of the papillary muscle/ischaemia

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95
Q

When can you commence spironolactone for HTN?

A

When already taking ACE, CCB and thiazide-like diuretic + K is below 4.5

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96
Q

When should adrenaline be given for shockable rhythms?

A

After 3 unsuccessful shocks

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97
Q

Pericarditis vs Myocarditis?

A

Myocarditis -> elevated troponin

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98
Q

Which markers can you test for STEMI?

A

Troponin, CK, AST, LDH

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99
Q

What ECG changes might be seen following STEMI?

A

T wave inversion, pathological Q waves

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100
Q

Driving rules post MI

A
  • No need to inform DVLA
  • Can drive after1 week if successful angioplasty
  • Can drive after 4 weeks if no angio/unsuccessful angio
101
Q

Complication of coronary angio

A

Bleeding, haemorrhage, infection, MI, stroke, damage to coronary vessels, death

102
Q

What triggers are there for angina?

A

Exertion, cold weather, emotions such as anger, vivid dreams

103
Q

How does aspirin work?

A

Inhibits COX which inhibit thromboxane which inhibits platelets aggregation

104
Q

Abnormally large drop in BP during inspiration?

A

Pulsus paradoxus -> Cardiac tamponade

105
Q

How should diabetes be managed following MI?

A

Use IV insulin infusion and stop the oral diabetes meds

106
Q

patients with a GRACE score > 3% should have what?

A

Coronary angio within 72 hours

107
Q

Management of persistent MI following fibrinolysis

A

PCI

108
Q

What is the treatment of broad complex tachycardias?

A
  • Amiodarone
109
Q

Single episode of paroxysmal AF?

A

ChadsVasc and consider DOAC

110
Q

Management of IE causing congestive cardiac failure

A

Emergency valve replacement

111
Q

What is the alternative to 3 weeks of anticoagulation for someone having cardioversion with AF?

A

Transoeseophageal echo to exclude left atrial appendage thrombus

112
Q

What are warfarin INR targets for mechanical valves?

A

Aortic - 3.0
Mitral - 3.5

113
Q

What is the NYHA heart failure classification?

A

Class 1 - no symptoms and no limitations
Class 2 - mild symptoms with slight limitation (some fatigue, dyspnoea)
Class 3 - moderate symptoms with marked reduction in activity (symptoms anytime except rest)
Class 4 - severe symptoms and symptoms of HF present even at rest

114
Q

When is AAA screening done?

A

Men aged 65

115
Q

How is AAA screening managed?

A

< 3 cm - normal
3 - 4.44cm - rescan every 12 months
4.45 - 5.4cm - rescan every 3 months
>5.5 - refer to vascular surgery within 2 weeks

Other referral criteria
- Rapidly growing (>1cm per year)

116
Q

What is the biggest indicator of a poor prognosis in someone with MI?

A

Cardiogenic shock

117
Q

What would an ABG for pulmonary embolism show?

A

Respiratory alkalosis -> hyperventilation

118
Q

When is staph epidermidis the most common organism causing endocarditis?

A

If <2 months post valve surgery

119
Q

Why is verapamil C/I in heart failure + VT?

A

It can slow down contractility of the heart even further

120
Q

What is the most common cause of death in patients post MI?

A

V Fib

121
Q

Haemoptysis can be a symptom of what?

A

Mitral stenosis

122
Q

mid-diastolic low-pitched rumbling murmur

A

mitral stenosis

123
Q

Management of BP > 180/120 in GP

A

If unstable/signs of papilloedema/retinal haemorrhages -> refer to specialist
If stable then arrange urgent investigations for organ damage eg. bloods, urine ACR, ECG

124
Q

What is the normal QRS value?

A

<0.12s / 3 small squares

125
Q

What are signs of left ventricular failure?

A

Dyspnoea, reduced exercise tolerance, fatigue, paroxysmal nocturnal dyspnoea, orthopnoea, wheeze, cough (worse at night), pink, frothy sputum

126
Q

What are signs of right ventricular failure?

A

Peripheral oedema, facial engorgement and abdominal distension

127
Q

What are causes of AF?

A

Pneumonia, MI, PE, Alcohol excess, HF, Endocarditis

128
Q

What are signs of aortic regurg?

A
  • Collapsing pulse
  • Early diastolic murmur
  • Wide pulse pressure
  • Displaced apex
  • Carotid pulsation: Corrigans sign
  • pulsation of nail bed: Quincke’s sign
129
Q

Absent arm pulses in a young woman?

A

Think Takayasu’s arteritis

130
Q

AF + mass in left atrium

A

Cardiac myxoma - bengin tumour of the heart

131
Q

Patients with aortic valve IE are at risk of what?

A

Developing aortic valve abscess (prolongation of PR can be first sign)

132
Q

What pulse can you get with heart failure?

A

Pulsus alternans - strong and weak beats due to varying systolic pressure

133
Q

When is rhythm control used in AF treatment over rate control?

A
  • Coexistent HF
  • First onset AF
  • Obvious reversible cause
  • Use amiodarone/flecainide
134
Q

What is the inheritance of HOCM?

A

AD

135
Q

What is the pathophysiology of HOCM?

A
  • Diastolic dysfunction as LVH causes decreases compliance and decreased CO
  • Biopsy shows myofibrillar hypertrophy with disarrayed myocytes
136
Q

ECG findings for hypercalcaemia?

A

Short QT

137
Q

What are the components for JONES criteria?

A

Joint involvement
<3 - Myocarditis
Nodules
Erythema marginatum
Sydnehams chorea

138
Q

Post MI patient develops pulmonary oedema and has pansystolic murmur?

A

Think acute mitral regurg

139
Q

What can cause orthostatic hypotension?

A
  • Excercise induced
  • After meals
  • After prolonged bed rest
  • Drugs such as CBB, Levodopa
140
Q

QT prolongation with no electrolyte abnormalities?

A

Think hereditary long QT syndrome -> caused by loss of function/blockage of K+ channels

141
Q

When should LFTs be checked with statins?

A

Baseline, 3 months and 12 months

142
Q

What murmur do you get with VSD?

A

Pansystolic murmur - entire systolic period

143
Q

Which drug when used alongside clopidogrel can make it less effective?

A

Omeprazole/Esomeprazole

144
Q

What dose of amiodarone is given in ALS?

A

Initially 300mg
After 5th shock, an additional 150mg can be given alongside 1mg of adrenaline

145
Q

What will type A aortic dissection cause?

A

Acute aortic regurg

146
Q

What is the treatment for rheumatic fever?

A

IM BenPen or Oral PenV with NSAIDs

147
Q

Patients taking isosorbide mononitrate should use what dosing regime?

A

Asymmetric dosing interval to prevent nitrate tolerance

148
Q

NSTEMI in an unstable patient?

A

Immediate coronary angio

149
Q

Which antihypertensive cause hyperkalaemia?

A

ACE

150
Q

What is tongue and facial swelling?

A

Angioedema -> ACE inhibitor

151
Q

What are examination signs of pericarditis?

A

-Pericardial rub
- Quiet heart sounds
- Raised JVP

152
Q

What are causes of pericarditis?

A
  • Infective
  • Malignancy
  • MI complication
  • SLE
  • RA
153
Q

3 main investigations for IE?

A
  • Blood cultures
  • Echo
  • ECG
154
Q

What are some triggers for worsening pulmonary oedema?

A
  • Arrhythmia
  • MI
  • Sepsis
155
Q

What is the most common cardiomyopathy?

A

Dilated

156
Q

management of mitral stenosis?

A

Asymptomatic - Monitor with regular echo
Symptomatic - Percutaneous mitral commissurotomy

157
Q

When fibrinolysis is done for ACS, when should ECG be repeated?

A

60-90 minutes

158
Q

What are the ChadsVasc categories?

A

Congestive HF
HTN
Age >75 (2), >65 (1)
Diabetes
Stroke/TIA/VTE
Vascular disease
Sex (Female)

159
Q

Where is access preferred for PCI?

A

Radial artery

160
Q

Which medications can worsen glucose tolerance?

A

Thiazides

161
Q

widespread pansystolic murmur, hypotension, pulmonary oedema post MI?

A

Acute mitral regurg

162
Q

Management of suspected HF in GP?

A

Measure BNP and refer for TTE if elevated

163
Q

What does a loud opening snap indicate?

A

The mitral valve leaflets are still mobile in mitral stenosis

164
Q

What can indicate the severity of the mitral stenosis?

A

Length of murmur increases

165
Q

What are components of orbit score?

A
  • Haemoglobin
  • Age
  • Bleeding history
  • Renal impairment
  • Treatment with anti platelets
166
Q

Nailed pulsation?

A

Quincke’s sign -> aortic regurgitation

167
Q

Rate control for AF?

A

Beta blocker
CCB
Digoxin

168
Q

Management of continued pain post PCI for MI?

A

Urgent CABG

169
Q

Reverse nike sign?

A

Digoxin

170
Q

Persistent ST elevation post MI?

A

Left ventricular aneurysm

171
Q

What are signs of aortic coarctation?

A
  • radio-femoral delay
  • mid systolic murmur
  • weak peripheral pulses in legs
  • Left ventricular heave
172
Q

Investigations to confirm aortic coarctation?

A
  • Echo
  • CT aorta
  • Cardiac catheterisation
173
Q

Management options for aortic coarctation?

A
  • Open surgery
  • Balloon angioplasty and stent insertion
  • Mild cases can be controlled with antihypertensives
174
Q

What carries the worst prognosis in symptomatic aortic stenosis?

A

Exertional syncope

175
Q

What medication should be avoided in someone with aortic stenosis?

A

Nitrates

176
Q

When should adenosine be avoided?

A

Asthmatics

177
Q

What is the definitive management of bradycardia?

A

Permanent pacemaker

178
Q

Which organisms often cause rheumatic fever?

A

Strep pyogenes

179
Q

Stroke + AF?

A

2 weeks of aspirin then warfarin/DOAC

180
Q

ADPKD is associated with what?

A

Mitral valve prolapse

181
Q

S3 vs S4 sounds

A

CCF - 3 letters - S3
HOCM - 4 letters - S4

182
Q

What does aortic dissection cause?

A

Weak/absent carotid, brachial or femoral pulses

183
Q

HF with rEF vs HF with pEF?

A

rEF - systolic dysfunction e.g. IHD, arrythmias
pER - diastolc dysfunction e.g. HOCM, cardiac tamponade

184
Q

What can be done for patients not responding to medications for HF?

A

Cardiac resynchronisation therapy if wide QRS

185
Q

Raised JVP, ankle oedema, hepatomegaly

A

Right sided HF

186
Q

What are causes of torsades de pointes?

A
  • Congenital
  • Macrolides
  • Subarachnoid haemorrhage
  • Hypothermia
  • Electrolyte disturbances
187
Q

What is torsades de pointes?

A

Polymorphic VT

188
Q

Heart failure management

A
  1. ACE + BB
  2. Spironolactone/Eplerenone

3rd lines
- Ivabradine if HR > 75 and reduced EF
- Hydralazine with nitrate for Afro-Caribbean patients
- Sacubitrtil-valsartan for patients with reduced EF after ACE/ARB wash out period
- Digoxin if sinus rhythm

189
Q

What vaccines should be given to HF patients?

A

Annual flu
One off PCV

190
Q

Sudden heart failure, raised JVP, pulsus parodoxus post MI?

A

Left ventricular free wall rupture

191
Q

What ABG picture will hyperaldosteronism cause?

A

Metabolic alkalosis with hypokalaemia

192
Q

What can cause high output heart failure?

A

Anaemia

193
Q

When is DC cardioversion done for arrhythmias?

A

Systolic < 90

194
Q

How to manage HTN when patient is on ACE/CCB/Thiazide and K+ > 4.5?

A

Add alpha/beta blocker

195
Q

AF with sudden onset abdo pain?

A

Think acute mesenteric ischaemia -> treat with immediate laparotomy

196
Q

Management of ruptured AAA?

A

Crossmatch 6 units of blood

197
Q

When is amiodarone preferred for pharmacological cardioversion?

A

Evidence of structural heart disease

198
Q

Chest pain + neurology?

A

Think aortic dissection

199
Q

new BP >= 180/120 mmHg + new-onset confusion, chest pain, signs of heart failure, or acute kidney injury

A

Refer for assessment

200
Q

CCB side effects

A

headache, flushing, ankle oedema

201
Q

Amlodipine can cause what?

A

Gingival hyperplasia

202
Q

What is the cut off for aortic valve surgery if no symptoms?

A

Valvular gradient > 40 with features of left systolic dysfunction

203
Q

pre-excitation syndrome that occurs due to the presence of an accessory electrical pathway between the atria and ventricles

A

Wolf-Parkinson-White

204
Q

Gallop rhythm is a sign of what?

A

Left sided heart failure

205
Q

Prosthetic vs mechanical valve?

A

Mechanical last longer so are given to younger patients

206
Q

What can be considered in CPR if a PE is supected?

A

Thrombolytic drugs such as alteplase

207
Q

How should 80+ year olds with raised BP be managed?

A

Lifestyle advice

208
Q

Nifedipine can cause what?

A

Peripheral vasodilation which can cause reflex tachycardia

209
Q

What is an alternative to amiodarone in arrest?

A

Lidocaine

210
Q

What drugs are an alternative to atropine?

A

Isoprenaline/adrenaline infusion

211
Q

How long should CPR be continued when thrombolytic drugs are being given?

A

60-90 minutes

212
Q

Tension pneumothorax can cause what?

A

Pulseless electrical activity

213
Q

Clinically unstable aortic dissection?

A

Transoesophageal echo

214
Q

What is the most common cause of aortic stenosis in young patients?

A

Congenitally bicuspid valve

215
Q

Hyperlipidaemia can cause what?

A

Pseudohyponatremia -> serum osmolality will be normal

216
Q

Premature supraventircular beats vs premature ventricular betas on ECG?

A

Supraventricular - narrowed QRS complexes
Ventricular - widened QRS complexes

217
Q

What is cardiac tamponade?

A

Accumulation of pericardial fluid causing increased pericardial pressure which compromises ventricular filling, resulting in a
reduced cardiac output.

218
Q

cardiomyopathy + diabetes + joint pain + hepatomegaly

A

Think haemochromatosis

219
Q

What antibiotic is recommended in COPD patients who continue to have exacerbations?

A

Azithromycin

220
Q

Chronic infection with Pseudomonas and Bulkholderia in CF

A

Increased risk of morbidity or mortality

221
Q

Pericarditis vs STEMI ECG?

A

STEMI will have ST elevation greater in lead III than lead II

222
Q

Aortic dissection can cause what?

A

Neuro deficits

223
Q

Persistent ST elevation with fatigue

A

Left ventricular aneurysm

224
Q

When do CK levels normalise after an MI?

A

48-72 hours -> good to check if suspecting a reinfarction

225
Q

When should sacubitril-valsartan be initiated?

A

Following an ACE/ARB wash out period

226
Q

What part of the QRS is electrical cardioversion synchronised to?

A

R wave

227
Q

Mitral regurg is associated with which conditions?

A
  • Marfans
  • Ehlers-Danlos
228
Q

DC cardioversion vs unsynchronised cardioversion?

A

DC- Tachyarrhythmias
Unsynchronised - Cardiac arrest (VT, VF)

229
Q

What is the management of atrial flutter?

A
  1. Beta blocker/CCB
  2. Consider cardioversion
  3. Catheter ablation
230
Q

Sudden increase in BP associated with ACS?

A

Treat with IV GTN

231
Q

Elderly patient with ECG with periods of sinus bradycardia + atrial tachycardia?

A

Sick sinus syndrome

232
Q

What is a normal PR interval?

A

0.12-0.20s
3-5 small squares

233
Q

Absent P waves + regular rhythm of QRS

A

SVT

234
Q

What stroke is most likely during cardiac catheterisation?

A

Embolic -> debris can be scraped from aortic wall

235
Q

Most common cause of left ventricular hypertrophy in a healthy person?

A

Hypertrophic cardiomyopathy

236
Q

Heart failure + wide QRS?

A

Consider resynchronisation pacemaker device

237
Q

2nd line investigation for endocarditis if echo is negative but high suspicion?

A

PET CT

238
Q

What is the PR interval?

A

Start of P wave to start of QRS complex

239
Q

Indications for DC cardioversion in tachyarrhythmias except shock?

A
  • Syncope
  • MI
  • Heart failure
240
Q

What are the 2 options for aortic valve replacement?

A

Surgical - low risk patients
Transcatheter - high risk patients

241
Q

When to do 1 shock vs 3 shocks in shockable rhythms?

A

3 shocks - if witness cardiac arrest
1 shock - if not witnessed

242
Q

What is a common cause of tricuspid regurg?

A

Pulmonary HTN e.g. COPD

243
Q

Investigation of choice for cardiac tamponade?

A

Echo

244
Q

When in CABG indicated?

A

More significant coronary artery disease e.g. triple vessel

245
Q

Abx for MRSA resistant endocarditis?

A

Prosthetic valve - Vancomycin, Rifampicin and Gentamicin
Normal valve - Vancomycin and Rifampicin

246
Q

Thiazides can precipitate what?

A

Digoxin toxicity

247
Q

De Musset sign is a sign of what?

A

Aortic regurgitation

248
Q
A

FINALS: PASSMED/QUESMED (22 decks)

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