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MRCP Part 1 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

First and second line management of stable angina?

A
  1. Bisoprolol/Verapamil
  2. Bisoprolol + nifedipine
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2
Q

Nicorandil: 1. Mechanism of action, 2. Major associate adverse reaction?

A
  1. Potassium channel activator
  2. GI ulceration
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3
Q

Nicorandil: 1. Mechanism of action, 2. Major associate adverse reaction?

A
  1. Potassium channel activator
  2. GI ulceration
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4
Q
  1. What is printzmetal angina?
  2. notes on medical Rx?
A
  1. coronary artery spasm causing chest pain at rest
  2. BB CI, use dihydropyridines
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5
Q

persistent ST depression and LVF post-MI is indicative of what?

A

LV aneurysm

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6
Q

Two post-MI complications more common in inferior MIs?

A

complete heart block (no pacing needed), acute MV regurgitaiton

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7
Q

3 groups of drugs that should be avoided in HF?

A
  1. -ve inotropes e.g. verapamil
  2. drugs causing fluid retention e.g. steroids
  3. class 1 antiarrhymics e.g. flecanides
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8
Q

acute medical Rx of SVT, should valsalva manoeuvre is unsuccessful

A

IV bolus of adenosine, 6/12/18mg (to increase if unsuccessful)

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9
Q

How should amiodarone be commenced and why

A

At a loading dose due to long half-life

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10
Q

6 main adverse reactions of amiodarone?

A
  1. thyroid dysfunction
  2. lung fibrosis
  3. liver fibrosis
  4. prolonged QT
  5. peripheral neuropathy
  6. photosensitivity
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11
Q

What is type 2 amiodarone-induced thyrotoxicosis and how should it be treated?

A

a destructive thyroiditis that requires cessation + steroids

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12
Q

5 features of digoxin toxicity?

A
  1. bradycardia/AV block
  2. yellow tinged vision
  3. confusion
  4. GI upsets
  5. gynaecosmatia
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13
Q

3 ECG features of digoxin toxicity?

A
  1. down sloping ST depression (reverse tick)
  2. short QT
  3. T wave inversion
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14
Q

1st-3rd line Rx for life-threatening bradycardia?

A
  1. atropine 500mcg up to 3mg
  2. isoprenaline/adrenaline infusion
  3. transcutaneous pacing
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15
Q

cannon a wave in seen in…?

A

AV dissociation e.g. VT, CHB, junctional rhythm

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16
Q

What specific organisms matches with the following descriptions regarding infective endocarditis?
1. Most common overall
2. Most common within 2m of prosthetic valve replacement surgery
3. Poor dental hygiene
4. Negative blood culture
5. Associated with colorectal cancer

A
  1. S. Aureus
  2. S. Epidermis (Coagulase -ve)
  3. Viridans Streptococcus
  4. Coxiella burnetii, Bartonella, Brucella, HACEK group
  5. Strep bovis esp gallolyticus
17
Q

Abx regime for the following scenarios of IE?
1. Empirical
2. Prosthetic valve associated
3. Prosthetic and pen allergic
4. Staphylococcal
5. Streptococcal
6. Enterococcal/HACEK

A
  1. Amoxicillin +/- gentamicin
  2. Flucloxacillin + gentamicin + rifampicin
  3. Vancomycin + gentamicin + rifampicin
  4. Flucloxacillin
  5. Benzylpenicillin
  6. Amoxicillin + gentamicin
18
Q

HOCM mutation and inheritance pattern?

A

β-myosin heavy chain protein or myosin-binding protein C, autosomal dominant

19
Q

6 Poor prognostic factors/risk factors for sudden cardiac death in HOCM and their relevance for ICD?

A
  1. FH of sudden cardiac death
  2. Non sustained VT on 24/48h ECG
  3. Septal wall thickness
  4. Resting LVOT gradient > 30mmHg
  5. Fall in SBP during exercise by > 25mmHg
  6. Hx of syncope

> 2 indicate ICD

20
Q

Summary of management for HOCM?

A

A - Amiodarone
B - Beta-blocker/verapamil
C - ICD
D - dual chamber pacemaker
E - endocarditis prophylaxis

21
Q

Drugs to avoid in HOCM?

A
  1. ACE-I/ARB
  2. Nitrates
  3. Dihydropyridines
  4. +ve inotropes
22
Q

Arrhythmogenic right ventricular cardiomyopathy mutation and inheritance pattern?

A

Desmosome, autosomal dominant

23
Q

What is the hallmark pathological feature of AVRC?

A

RV myocardium replaced by fibromyalgia-fatty tissue

24
Q

Key ECG changes in ARVC?

A
  1. T wave inversion in V1-3
  2. Epsilon wave
  3. PVC/VT of LBBB morphology
25
Q

ECG changes in Brugada syndrome?

A

convex (down-sloping) ST elevation in V1-3 with T wave inversion

26
Q

Brugada syndrome mutation and inheritance pattern?

A

SCN5A gene for myocardium sodium channel, autosomal dominant

27
Q

What drug can be given to help diagnose Brugada syndrome?

A

Flecanide to accentuate ECG changes

28
Q

Key pathological feature of Ebstein’s anomaly?

A

cogenital low insertion of tricuspid valve

29
Q

Common congenital heart defect associated with Ebstein’s anomaly

A

Patent foramen ovale, atrial septal defect

30
Q

Key clinical and JVP features in Ebstein’s anomaly?

A

Tricuspid regurgitation, large a wave

31
Q

3 Key ECG changes in WPW?

A
  1. delta waves (slurred initiation of QRS)
  2. short PR interval
  3. prolonged QRS

MRCP Part 1 (6 decks)

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