Cardiology Flashcards
1
Q
Most Specific ECG Finding in Acute Pericarditis
A
PR Depression
2
Q
2 main complications of PCI
A
- Restenosis (5-20%)
- Stent Thrombosis (1-2%)
3
Q
Restenosis presenting complaint
A
Recurrence of Angina
4
Q
Stent Thrombosis presenting complaint
A
Acute MI
5
Q
What are Drug-eluting stents
A
Stent coated with paclitaxel or rapamycin which inhibit local tissue growth
6
Q
Complications of Drug-eluting stents
A
Reduces restenosis rates, but stent thrombosis rates are increased
7
Q
NICE Guidelines for Amiodarone
A
To be given 4 weeks prior to Electrical cardioversion if high risk of failure
8
Q
AF onset less than 48 hours anticoagulation rule
A
patient should be heparinised
9
Q
Cardioversion for AF onset less than 48 hours
A
- Electrical
- Pharmacological
10
Q
AF onset more than 48 hours anticoagulation rule
A
3 week anticoagulation prior to cardioversion
11
Q
Rheumatic Heart Disease Histological Finding
A
Aschoff Bodies
12
Q
Most Common Complication Post MI
A
Ventricular fibrillation
13
Q
Catecholaminergic Polymorphic Ventricular Tachycardia cause
A
Defect in the ryanodine receptor (RYR2)
14
Q
Catecholaminergic Polymorphic Ventricular Tachycardia feature
A
Symptoms generally develop before the age of 20 years
15
Q
Management of Catecholaminergic Polymorphic Ventricular Tachycardia
A
- Beta-blockers
- Implantable cardioverter-defibrillator (ICD)
16
Q
Jervell and Lange-Nielsen syndrome C/F
A
- congenital long QT syndromes
- sensorineural deafness
17
Q
Poor Prognosis in Infective Endocarditis
A
- Staphylococcus Infection
- Prosthetic Valve
- Culture Negative Endocarditis
- Low complement levels
18
Q
Better Prognosis in Infective Endocarditis
A
- Streptococcal Infection
19
Q
DEAR mnemonic for Adenosine
A
- Dipyridamole Enhances effect
- Aminophylline Reduces effect
- Lignocaine also Enhance
20
Q
Causative organism for Infective endocarditis in Ca Colon
A
Streptococcus Gallolyticus
21
Q
Causative organism for Culture Negative Infective endocarditis
A
Coxiella Burnetti
22
Q
Most commonly affected valve in Infective endocarditis
A
Mitral Valve
23
Q
Takayasu Arteritis C/F
A
- Absent Pulse
- Unequal Blood Pressure
- Intermittent Claudication
24
Q
Drug of Choice for Prinzmetal Angina
A
Calcium Channel Blocker - Felodipine
25
Indications for stopping Exercise Tolerance Test
1. > 3mm ST depression
2. > 2mm ST elevation
3. SBP >230
4. SBP falling > 20
26
Arrhythmogenic right ventricular cardiomyopathy (ARVC) ECG Changes
1. T Wave inversion in V1-V3
2. Epsilon Wave
27
Naxos disease Triad
1. ARVC
2. Wolly Hair
3. Palmoplantar keratoderma
28
ALS plan for witnessed cardiac arrest
3 shocks followed by Amiodarone
29
ALS plan for unwitnessed cardiac arrest
30:2 Compressions
30
Indications for Urgent DC Cardioversion in Tachycardia
1. Shock
2. Syncope
3. Heart Failure
4. MI
31
Hypertension Step 1 DOC for patients < 55-years-old or with diabetes mellitus
Angiotensin receptor blocker (ACE-i or ARB)
32
Hypertension Step 1 DOC for patients >= 55-years-old or of black African origin:
Calcium channel
blocker
33
Hypertension Step 2 treatment
if already taking an ACE-i or ARB add a Calcium channel blocker or a thiazide-like Diuretic
34
Hypertension Step 4 treatment
if potassium < 4.5 mmol/l add low-dose spironolactone
if potassium > 4.5 mmol/l add an alpha- or beta-blocker
35
Cardiac syndrome X definition
Patients have a normal ECG at rest and normal coronary arteries but develop ST depression on exercise stress testing.
36
Epsilon Wave
Terminal Notch in QRS Complex
37
Delta Wave
slurred upstroke in the QRS complex
38
Delta Wave Seen in
WPW Syndrome
39
Most common cause of Infective Endocarditis in prosthetic valve
Staphylococcus Epidermidis (if post surgery <2 months)
40
Most common cause of Infective Endocarditis in prosthetic valve in post surgery >2 months
Staphylococcus Aureus
41
Infective Endocarditis Blind Therapy for Native Valve
Amoxicillin + Low Dose Gentamycin
42
Infective Endocarditis Blind Therapy for Prosthetic Valve
Vancomycin + Rifampicin + Gentamycin
43
Glycemic Control Post MI in CCU
Stop OHA + Insulin Infusion
44
Management of Stable Torsades De Pointes
IV Magnesium
45
First Line Investigation for Pulmonary Embolism
CT Pulmonary Angiography
46
Golden Standard Investigation for Pulmonary Embolism
Pulmonary Angiography
47
Disadvantage of D-dimer for Pulmonary Embolism
High Sensitivity but Low Specificity
48
Investigation of Choice for Pulmonary Embolism in case of Renal Impairment
V/Q Scan
49
Giant 'a' Wave JVP seen in
1. Tricuspid Stenosis
2. Pulmonary Stenosis
50
Giant 'v' Wave JVP Seen in
Tricuspid Regurgitation
51
Canon 'a' wave JVP seen in
1. Complete Heart Block
2. Nodal Rhythm
52
First Line Angina Prophylaxis
Beta Blockers - Bisoprolol
53
Contraindication for Beta blocker use in Angina
Use of Calcium Channel Blocker use (Verapamil)
54
Angina in a patient with Verapamil Use DOC
Nicorandil
55
Conditions associated with Aortic Dissection
1. Pregnancy
2. Trauma
3. Marfans Syndrome
4. Turners Syndrome
5. Noonans Syndrome
6. Syphillis
56
Blood Finding in Cholesterol Emboli
Eosinophilia
57
Causes of Elevation of BNP
1. Heart Failure
2. Chronic Kidney Disease
3. Sepsis
4. COPD
5. Cirrhosis
58
First Line Management of Hypertension in patient with Chronic Heart Failure
ACE Inhibitors -> Beta Blockers
59
Drug commonly prescribed to increase HDL Levels
Nicotinic Acid
60
Cause of Fixed Splitting of S2
Atrial Septal Defect
61
Cause of Wide Split S2
RBBB with Heart Failure
62
Cause of Loud S2
Hypertension
63
Cause of Soft S2
Aortic Stenosis
64
Aortic Stenosis marker of severity
Absent or Quiet S2
65
Target INR of Venous Thromboembolism
INR = 2.5
66
Target INR of Recurrent Venous Thromboembolism
INR = 3.5
67
Target INR of Atrial Fibrillation
INR = 2.5
68
Nicorandil MOA
Potassium Channel Activator
69
Aortic Stenosis Marker of Severity
S4
70
JVP Regular Cannon 'a' waves
Atrio Ventricular Nodal Re entry Tachycardia (AVNRT)
71
Investigation of choice for Pulmonary Artery Hypertension
Acute Vasodialator Testing
72
Endothelin Receptor Antagonist
Bosentan
Ambrisentan
73
Dentistry Procedure in Warfarinized patients
Check INR 72 hours before procedure and proceed if INR <4.0
74
HOCM Drugs to Avoid
NIA
Nitrates
Inotropes
ACE Inhibitors
75
HOCM Management
ABCDE
Amiodarone
Beta Blocker
Cardioverter Defibrillator
Dual Chamber Pacemaker
Endocarditis Prophylaxis
76
Ostium Secundum defect Features
ECG: RBBB with Right Axis Deviation
77
Ostium Primum defect Features
ECG: RBBB with Left Axis Deviation
78
Tri-Phalageal Thumb + Ostium Secundum
Holt–Oram syndrome
79
Clopidogrel Common Drug Interaction
Omeprazole (PPI)
80
Changes to Blood Pressure during Exercise
SBP Increases
DBP decreases
81
Malignant Hypertension Management
Oral Therapy: Atenolol
IV Therapy: Sodium Nitroprusside
82
ST depression seen in
Digoxin Use
83
Anterior Wall MI ECG Changes
ST elevation in V1 to V4
84
Lateral Wall MI ECG Changes
ST elevation inV5,V6 and avL
85
Inferior Wall MI ECG Changes
ST elevation in II, III, avF
86
ECG findings in Inferior MI with RV infarction
ST elevation in II, III, avF, V1
87
Posterior MI ECG Changes
ST depression in V1 and V2
88
Lateral Wall MI Artery
Left Circumflex artery
89
Cardiac Catheterization for Hyperthyroidism patient
Thyroid Radionucleotide Isotope Scan is done to identify between Graves Disease and Toxic Multinodular Goiter
90
Anti Hypertensives Safe in Pregnancy
1. Labetalol
2. Alpha Methyl Dopa
3. Nifedipine
91
Diagnosis of Lumbar Pain following Pacemaker Insertion few weeks back
Infective Discitis
92
Acute Pulmonary Edema Initial Drug Therapy
IV Glyceryl Trinitrate
93
Antibiotics with QT prolongation
Macrolides and Quinolones
94
Relation of Alcohol and HDL Cholestrol
Alcohol Increases HDL Cholesterol
95
Definition of Long QT syndrome
QTc >450 mSec
96
Long QT Syndrome defective Ion Channel
Potassium Channel Alpha Sub-unit(LQT1, LQT2)
97
Most common congenital Long QT Syndrome
Potassium Channel Alpha Sub-unit (LQT1)
98
LQT1 mutation
Slow Delayed Rectifier Potassium Channel
99
LQT2 mutation
Rapid Delayed Rectifier Potassium Channel
100
Murmur worsening on Valsalva or Standing and Improves on Squatting
HOCM Murmur
101
Murmur Worsening on Squatting
1. Aortic Stenosis
2. VSD
102
Paradoxical Embolus with Normal Cardiovascular Examination Findings
Patent Foramen Ovale
103
DOC for WPW + Broad Complex Irregular Tachycardia
Procainamide
104
Common ECG finding in Congenital Myotonic Dystrophy
PR Prolongation
105
DOC for Reducing ventricular rate in AF
Digoxin
106
Heart Condition which is an absolute contraindication to pregnancy
Primary Pulmonary Hypertension
107
Tricuspid Stenosis + Pulmonary Embolus + Benign tumor of breast
Right Atrial Myxoma
108
MI with 1 hour history of Chest Pain
Percutaneous Coronary Intervention
109
MI with less than 12 hour history of Chest Pain
IV Thrombolysis followed by PCI
110
Features of Complete heart block
1. Irregular Canon 'a' waves
2. High Volume Pulse
3. Systolic Murmur
111
Most common valve injured in Precordial Stab
Pulmonary Valve
112
HOCM Most common cause
Sarcomere Protein Gene Mutation
113
Investigation of choice for HOCM
Transthoracic Echo
114
Pulsus Alternans seen in
Acute Left Ventricular Heart Failure
115
Electrical Alternans seen in
Pericardial Effusion
116
Indications for Urgent Surgery in Infective Endocarditis
1. Increasing PR interval
2. Heart Failure
3. Septal Perforation
117
Hypertensive Emergency with End Organ Damage Blood Pressure Decrease Protocol
Decrease in MAP by 15-25%
118
X-ray shows Calcification around heart borders + Low Voltage QRS
Constrictive Pericarditis
119
Management of Small Pulmonary Embolism
Rivaroxaban 15 mg for 21 days Followed by maintenance dose
120
Management of Large Pulmonary Embolism
1. Thrombolytic Therapy
2. Mechanical Intervention
121
NSTEMI Management
2 Antiplatelet + Heparin + Beta Blocker
122
Conditions where ductus arteriosus is kept open
Any Cyanotic Heart Disease
1. Tricuspid Atresia
2. TOF
3. TAPVC
4. TGA
123
Biventricular Hypertrophy + Murmur
VSD
124
First Cardiac Enzyme to Increase after Myocardial Necrosis
Glycogen Phosphorylase BB
125
Precordial Pulsations + Wheezing + Flushing + Loose Stools
Carcinoid Heart Disease
126
Indication for Thrombolysis post fluid bolus in PE
SBP of 80 mmHg
127
Medication NOT Associated with Torsades De Pointes
Verapamil
128
Which Cholesterol is associated with CAD
LDL- Cholesterol
129
Initial Shock Joules for Monophasic
360 J
130
Initial Shock Joules for Biphasic
150-200 J
131
AF long term Anticoagulation DOC
Rivaroxaban
132
Anti Hypertensive of Choice in patients with Lithium
CCB - Amlodipine (ACE/ARB are C/I)
133
Heart Condition in which BNP is not elevated
Unstable Angina
134
Chemotherapy drug associated with Dilated Cardiomegaly
Doxorubicin
135
Cardiac Enzyme to be elevated after DC Cardioversion
Creatinine Kinase
136
Features in ECG for Diagnosing VT
1. RS duration of >100 ms
2. Ventriculoatrial Dissociation in any of 12 leads
3. Absence of RS Complexes
137
Poor Prognosis in HOCM
Septal wall thickness >3 CM
138
Drug Contraindicated in WPW
Verapamil (increases conduction via accessory system)
139
ECG Hypothermia Characteristic
J wave
140
Antiarrythmic with Highest Risk of Torsades de pointes
Sotalol
141
Antihypertensive contraindicated in myasthenia gravis
Beta Blockers
142
DVT Management in pregnancy
LMW Heparin throught pregnancy
143
Drug Causing Allergic Myocarditis
Co-Trimoxazole
144
Unilateral Swelling of eyelid + Travel to South America
Trypanosomiasis (Chagas Disease)
145
Main Indication of Inserting Pacemaker
Mobitz Type II block
146
Heart Failure + AF Drug of Choice
Digoxin
147
Multifocal Atrial Tachycardia in Pulmonary Artery Hypertension DOC
Verapamil
148
Time of Highest Risk of DVT in Pregnancy
First 6 weeks after delivery
149
Atrial fibrillation persist despite Multiple Drugs
Radiofrequency pulmonary vein isolation with ablation
150
Ankylosing Spondylitis associated heart murmur
Aortic Regurgitation murmur
151
CVS complication of Co-trimoxazole
Allergic Myocarditis
152
Second Trimester Diastolic BP Change
A 10mmMHg Drop in Diastolic due to reduction in PVR
153
Most important cell that drives atherosclerotic plaques
Macrophages
154
Reason for reduction of digoxin dose in older patients
Decreased renal clearance
155
ECG Shows complete heart block what is clinical feature
Variable S1
156
Tolerance to Nitric Oxide is due to
Reactive Oxygen Species
157
MR Carotid Angiography shows String of bead appearance
Fibromuscular Dysplasia
158
MR Carotid Angiography shows String of bead appearance
Fibromuscular Dysplasia
159
Most significant side effect of celecoxib
Can worsen heart failure
160
The fastest conduction velocities in the heart
Purkinje Fibers
161
Which molecule does troponin T bind to?
Tropomyosin
162
Which molecule does troponin I bind to?
Actin
