Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCP Part 1 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What ECG changes are seen in Brugada syndrome? (2)

A

1) Convex ST elevation >2mm in V1-V3, followed by a negative T wave

2) Partial RBBB

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

What medications will worsen the ECG changes seen in Brugada syndrome? (2)

A

1) Flecainide

2) Ajmaline

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

What percentage of patients with infective endocarditis have previously normal heart valves?

A

50%

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

What is the most commonly affected valve in infective endocarditis?

A

Mitral valve

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

What is the most commonly affected valve in infective endocarditis, in IVDU populations?

A

Tricuspid valve

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

What is the most common cause of infective endocarditis in the developed world?

A

Staph. aureus

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

What is the most common cause of infective endocarditis in the developing world?

A

Strep. viridans

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

In what cohort of patients is Strep. viridian most commonly isolated? (3)

A

1) Patients in the developing world

2) Patients with poor oral hygiene

3) Patients having recently undergone dental surgery

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

What bacteria in infective endocarditis is commonly associated with indwelling lines, or post-valvular surgery?

A

Coagulase-negative Staphylococci, including Staph. epidermis

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

What bacteria in infective endocarditis is commonly associated with colorectal malignancy?

A

Strep. bovis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some non-infective causes of endocarditis? (2)

A

1) SLE (Libra-Sacks Endocarditis)

2) Malignancy (Marantic endocarditis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the indications for surgery in patients with infective endocarditis? (5)

A

1) Severe valvular incompetence
2) Aortic abscess
3) Treatment-resistant infections
4) Cardiac failure
5) Recurrent emboli post-ABx treatment

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

What changes on an ECG would be consistent with an aortic root abscess?

A

PR prolongation

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

What scoring system is used to diagnose infective endocarditis?

A

Modified Duke’s criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When can a positive diagnosis of infective endocarditis be made?

A

Modified Duke’s:

  • Pathological criteria positive, OR
  • 2 major criteria, OR
  • 1 major and 3 minor criteria, OR
  • 5 minor criteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What cardiac complication is associated with Long QT Syndrome?

A

1) VT
2) Torsades de pointes

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

What drugs are implicated in the development of Long QT Syndrome? (10)

Think acronym

A

ASTHMATiC

Amiodarone
Sotalol/SSRIs
Haloperidol
Methadone/Metoclopramide/Macrolides
Antiarrhythmics class 1a
TCAs
Chloroquine

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

What genetic defects are seen that lead to Long QT Syndrome?

A

Defect in alpha-subunit of slow-delayed rectifier potassium channel

19
Q

What genetic conditions are associated with Long QT Syndrome?

A

1) Jervelle-Lange-Mielsen (deaf)

2) Romero-Ward (non-deaf)

20
Q

What electrolyte abnormalities are associated with Long QT Syndrome?

A

1) Hypocalcaemia
2) Hypokalaemia
3) Hypomagnesaemia

21
Q

What types of Long QT Syndrome can manifest?

A

LQT 1 - Exertional syncope

LQT 2 - Emotional syncope

LQT 3 - Rest/nocturnal events

22
Q

What drug should be avoided in the treatment of Long QT Syndrome?

A

Sotalol (may worsen QT duration)

23
Q

What is the INR target for a patient with a mechanical aortic valve?

A

3.0

24
Q

What is the INR target for a patient with a mechanical mitral valve?

A

3.5

25
Q

What is the underlying cause of ventricular tachycardia?

A

1 or more ventricular ectopic foci

26
Q

What are the two types of ventricular tachycardia?

A

1) Monomorphic (1 ectopic focus)
2) Polymorphic (>1 ectopic foci)

27
Q

Torsades de Pointes is a subtype of what cardiac condition?

A

Ventricular tachycardia

28
Q

What is the most common underlying cause for monomorphic ventricular tachycardia?

A

Myocardial infarction

29
Q

What is the first-line treatment for a patient with monomorphic ventricular tachycardia, with no signs of severe symptoms?

A

Amiodarone 300mg IV over 10-60 minutes

30
Q

What is the treatment for polymorphic ventricular tachycardia, with no signs of severe symptoms?

A

Magnesium 2g IV over 10 minutes

31
Q

If drug therapy fails to resolve ventricular tachycardia, what are the next best management steps?

A

1) Electrophysiological studies (EPS)
2) ICD insertion (almost certain in those with LVSD)

32
Q

What does NICE recommend for initial management of Angina Pectoris?

A

1) Aspirin/Statin as secondary prevention (provided not contraindicated)

2) Either a beta-blocker (e.g. Atenolol), or rate-limiting CCB in monotherapy (e.g. Verapamil/Diltiazem)

33
Q

If prescribing both a beta-blocker and CCB for Angina Pectoris, what type of CCB should be used?

A

A longer-acting dihydropyridine CCB (Amlodipine, M/R Nifedipine)

34
Q

What drug should not be co-prescribed in patients taking a beta-blocker?

A

Verapamil (increased risk of complete heart block)

35
Q

If dual-therapy with beta-blockers and CCB are ineffective for treating Angina Pectoris, what drugs can be considered? (4)

A

1) Modified release Nitrates, OR
2) Ivabradine, OR
3) Nicorandil, OR
4) Ranolazine

36
Q

Why do patients experience tolerance when taking nitrates?

A

Depletion of intracellular sulfhydryl groups, which are needed to convert nitrates into NO, which then induces vasodilation

37
Q

In what conditions would you expect to see pulsus paradoxus? (2)

A

1) Severe asthma

2) Cardiac tamponade

38
Q

What is the clinical characteristics of pulsus paradoxus?

A

> 10mmHg fall in BP during inspiration, leading to a faint/absent pulse on inspiration

39
Q

In what condition would you expect to find a slow-rising pulse?

A

Aortic stenosis

40
Q

In what condition would you expect to find a collapsing pulse? (6)

A

1) Patent ductus arteriosis
2) Anaemia
3) Thyrotoxicosis
4) Pyrexia
5) Exercise
6) Pregnancy

41
Q

What is the characteristic finding of pulsus alternans?

A

A regular alternation in the force of the arterial pulse

42
Q

In what conditions would you expect to find pulsus alternates?

A

Severe LVF

43
Q

What is the characteristic finding of Bisferiens pulse?

A

2 distinct systolic peaks of a pulse

44
Q

In what condition would you expect to find Bisferiens pulse?

A

Mixed aortic valve disease

MRCP Part 1 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions