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YEAR 3 CORRECTIONS > Cardiology > Flashcards

Cardiology Flashcards

1
Q

If the anterolateral leads are showing ischaemic changes on ECG, what artery is occluded?

A

Left anterior descending artery

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2
Q

If the infero/posterolateral leads are showing ischaemic changes on ECG, what artery is occluded?

A

Left circumflex artery

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3
Q

If a haemodynamically unstable patient with signs of heart failure is also in atrial fibrillation, how are you going to manage the patient?

A

Treat the atrial fibrillation by giving oxygen and rate control using bisoprolol.

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4
Q

What can a patient with atrial fibrillation also present with? (hint:not palpitations)

A

Signs of congestive heart failure and chest pain

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5
Q

A patient faints after micturition or stress, what do they have and how do you manage them? When would you follow them up?

A

Vasovagal syncope
Reassure and discharge. No need to follow up unless a postural drop > 20 SBP or >10 DBP.

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6
Q

What is the most appropriate management for a patient with a BP of >180/120

A

investigate for target organ damage

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7
Q

A patient with a BP >180/120 was found to have an increased albumin: creatine ratio. What is the most appropriate management>?

A

Start anti-hypertensive management immediately.

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8
Q

A patient with a BP >180/120 was found to have retinal haemorrhages, chest pain, AKI, HF. What is the most appropriate management>?

A

Malignant hypertension so refer to secondary care on the same day.

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9
Q

A patient with a BP >180/120 was found to have no target organ damage. What is the most appropriate management>?

A

Repeat clinic reading within 7 days or ABPM and review within 7 days. If BP >180/110, start anti-hypertensives.

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10
Q

A patient has fever, joint pain, a murmur and blood+ protein on a urine dipstick. What does this suggest?

A

Infective endocarditis

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11
Q

List 4 signs of rheumatic fever and what is the first line treatment.

A
  1. strep pyogenes throat
  2. erythema marginatum
  3. polyarthritis
  4. evidence of vasculitis e.g. regurgitation murmur
    -> give oral penicillin
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12
Q

What medication is contraindicated in heart failure and why?

A

Rate limiting CCB e.g. verapamil as it can worsen heart failure and make them more breathless.

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13
Q

A patient with a mechanical heart valve on warfarin is about to have surgery. What should they do about their warfarin?

A

A mechanical heart valve increases risk of thrombosis so stop warfarin 2 days before surgery and give heparin instead.

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14
Q

What is seen on fundoscopy in stage 3 hypertensive retinopathy?

A

Flame haemorrhages
Cotton wool spots

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15
Q

What is the stepwise treatment for familial hypercholesterolaemia?

A
  1. atorvastatin
  2. fenofibrate + ezetimibe
  3. PCSK9 inhibitor
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16
Q

What is the management for Mobitz 2 heart block?

A

Discontinue AV blockers and consider pacemaker/CRT/ ICD

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17
Q

What could cause a displaced apex beat to the axilla in a young person with chest pain?

A

Myocarditis leading to dilated cardiomyopathy

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18
Q

A patient with aortic stenosis has a valvular gradient >40. What is the management?

A

Young/ low risk-> surgical AVR
Old/ high risk-> transcatheter AVR
not fit for AVR-> balloon valvuplasty

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19
Q

What is the first thing to do in a patient with AF who is haemodynamically unstable ( low BP) with a low potassium?

A

give IV fluids

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20
Q

What about the murmur can show the severity of mitral stenosis?

A

length of murmur
opening snap after S2

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21
Q

What about the murmur can show severe aortic stenosis?

A

a soft or absent S2

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22
Q

Is furosemide or bendroflumethiazide more likely to cause palpitations?

A

Low potassium from furosemide compared to high calcium from bendroflumethiazide

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23
Q

A patient collpased after they raised their arm and they have a lump in their supraclavicular fossa. What do they have?

A

Subclavian steal syndrome

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24
Q

Is bilateral ankle oedema a minor or major criteria in the Framingham criteria for congestive cardiac failure?

A

Minor

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25
Q

What does syncope in a young person with a family history of heart disease and a jerky carotid on examination suggest?

A

HOCM

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26
Q

What pulse is found in severe LVF?

A

pulsus alternans

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27
Q

What pulse is found in aortic stenosis?

A

pulsus parvus et tardus (slow rising pulse)

28
Q

What pulse is found in HOCM/ mixed aortic valve disease?

A

pulsus bisfirens

29
Q

In a patient with ischaemic heart disease presenting less than 48 hours with AF, what rhythm control medication is given?

A

Amiodarone

30
Q

What kind of breathing can be seen in patients with heart failure during sleep?

A

Cheyne-Stokes breathing. Deep then shallow then apnoea.

31
Q

In a patient without ischaemic heart disease presenting less than 48 hours with AF, what rhythm control medication is given?

A

Flecainide

32
Q

Why is indomethacin contraindicated in heart failure?

A

NSAIDs can cause peripheral vasoconstriction

33
Q

What is given to asthmatics who are contraindicated to adenosine?

A

Verapamil

34
Q

What 3 electrolyte abnormalities causes long QT syndrome?

A
  1. low calcium
  2. low potassium
  3. low magnesium
35
Q

Is clubbing seen in infective endocarditis?

A

Yes

36
Q

What is Barlow syndrome and what murmur is heard?

A

Mitral valve prolapse
mid systolic click

37
Q

What kind of murmur can be heard in LVH?

A

crescendo systolic murmur
aortic stenosis causes LVH

38
Q

What is a complication of ventricular septal defect?

A

Endocarditis

39
Q

What can be used instead of fondaparunix in unstable angina?

A

LMWH

40
Q

What symptoms can digoxin toxicity cause?

A

nausea
anorexia
yellow rings around lights

41
Q

What early ECG changes can be seen in an MI?

A

hyperacute T waves

42
Q

A patient has a BP of >180/120 with hallucinations, what are they experiencing?

A

Hypertensive encephalopathy

43
Q

What congenital defect of the heart can lead to an ischaemic stroke?

A

patent foramen ovale

44
Q

What kind of drug is doxazosin?

A

alpha blocker

45
Q

Name four things in Marfans cardiovascular criteria

A

aortic dissection
aortic dilation
mitral valve prolapse
mitral valve calcification

46
Q

What murmur does an atrial myxoma cause?

A

A loud S3

47
Q

What is the BP target of a CKD patient?

A

120-130 mmHg

48
Q

A diabetic patient presents with nausea, sweating and epigastric pain. What are you concerned about?

A

Silent MI

49
Q

What does a summation gallop rhythm (S3 and S4) with tachycardia suggest?

A

Left Ventricular Failure

50
Q

What antithrombin is given after thrombolysis with alteplase for an MI?

A

IV heparin

51
Q

What is the treatment for beta blocker overdose causing bradycardia?

A

Atropine
glucagon

52
Q

What is given to treat life threatening benzodiazepine leading to cardiorespiratory arrest?

A

Flumazenil

53
Q

Briefly describe the NYHA classification for heart failure

A
  1. asymptomatic
  2. mild symptoms, slight limitation, asymptomatic at rest
  3. symptoms with day to day activities, significant restrictions, asymptomatic at rest
  4. severe limitation symptomatic at rest
54
Q

Why is a past medical history of angina important when considering ACS?

A

Can predispose to unstable angina

55
Q

What ECG changes suggest dextrocardia?

A

inverted p waves

56
Q

What does cerebral abscess count as in Duke criteria for embolic phenomenon?

A

Embolic phenomenon

57
Q

What valve defect for it to count as a major Duke criteria?

A

Regurgitation

58
Q

Name an ionotropic drug

A

Digoxin

59
Q

What is a cause of aortic stenosis in a young person?

A

Bicuspid heart valve

60
Q

What is a bifascicular block?

A

RBBB and LB hemiblock

61
Q

What Hb level do we transfuse blood in ACS?

A

Hb <80 (usually it is <70)

62
Q

What medication is useful to treat heart failure secondary to severe hypertension?

A

IV sodium nitroprusside (nitrates) or GTN

63
Q

What medication is contraindicated in severe aortic stenosis?

A

GTN

64
Q

HTN and peripheral oedema when eGFR <30 what diuretic can you give?

A

Furosemide > indapamide

65
Q

End stage heart failure to relieve dyspnoea. What analgesia can you give to help them?

A

IV morphine

YEAR 3 CORRECTIONS (16 decks)

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