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MRCP Part 1 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Most Specific ECG Finding in Acute Pericarditis

A

PR Depression

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2
Q

2 main complications of PCI

A
  1. Restenosis (5-20%)
  2. Stent Thrombosis (1-2%)
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3
Q

Restenosis presenting complaint

A

Recurrence of Angina

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4
Q

Stent Thrombosis presenting complaint

A

Acute MI

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5
Q

What are Drug-eluting stents

A

Stent coated with paclitaxel or rapamycin which inhibit local tissue growth

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6
Q

Complications of Drug-eluting stents

A

Reduces restenosis rates, but stent thrombosis rates are increased

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7
Q

NICE Guidelines for Amiodarone

A

To be given 4 weeks prior to Electrical cardioversion if high risk of failure

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8
Q

AF onset less than 48 hours anticoagulation rule

A

patient should be heparinised

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9
Q

Cardioversion for AF onset less than 48 hours

A
  1. Electrical
  2. Pharmacological
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10
Q

AF onset more than 48 hours anticoagulation rule

A

3 week anticoagulation prior to cardioversion

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11
Q

Rheumatic Heart Disease Histological Finding

A

Aschoff Bodies

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12
Q

Most Common Complication Post MI

A

Ventricular fibrillation

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13
Q

Catecholaminergic Polymorphic Ventricular Tachycardia cause

A

Defect in the ryanodine receptor (RYR2)

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14
Q

Catecholaminergic Polymorphic Ventricular Tachycardia feature

A

Symptoms generally develop before the age of 20 years

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15
Q

Management of Catecholaminergic Polymorphic Ventricular Tachycardia

A
  1. Beta-blockers
  2. Implantable cardioverter-defibrillator (ICD)
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16
Q

Jervell and Lange-Nielsen syndrome C/F

A
  1. congenital long QT syndromes
  2. sensorineural deafness
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17
Q

Poor Prognosis in Infective Endocarditis

A
  1. Staphylococcus Infection
  2. Prosthetic Valve
  3. Culture Negative Endocarditis
  4. Low complement levels
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18
Q

Better Prognosis in Infective Endocarditis

A
  1. Streptococcal Infection
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19
Q

DEAR mnemonic for Adenosine

A
  1. Dipyridamole Enhances effect
  2. Aminophylline Reduces effect
  3. Lignocaine also Enhance
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20
Q

Causative organism for Infective endocarditis in Ca Colon

A

Streptococcus Gallolyticus

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21
Q

Causative organism for Culture Negative Infective endocarditis

A

Coxiella Burnetti

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22
Q

Most commonly affected valve in Infective endocarditis

A

Mitral Valve

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23
Q

Takayasu Arteritis C/F

A
  1. Absent Pulse
  2. Unequal Blood Pressure
  3. Intermittent Claudication
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24
Q

Drug of Choice for Prinzmetal Angina

A

Calcium Channel Blocker - Felodipine

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25
Q

Indications for stopping Exercise Tolerance Test

A
  1. > 3mm ST depression
  2. > 2mm ST elevation
  3. SBP >230
  4. SBP falling > 20
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26
Q

Arrhythmogenic right ventricular cardiomyopathy (ARVC) ECG Changes

A
  1. T Wave inversion in V1-V3
  2. Epsilon Wave
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27
Q

Naxos disease Triad

A
  1. ARVC
  2. Wolly Hair
  3. Palmoplantar keratoderma
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28
Q

ALS plan for witnessed cardiac arrest

A

3 shocks followed by Amiodarone

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29
Q

ALS plan for unwitnessed cardiac arrest

A

30:2 Compressions

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30
Q

Indications for Urgent DC Cardioversion in Tachycardia

A
  1. Shock
  2. Syncope
  3. Heart Failure
  4. MI
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31
Q

Hypertension Step 1 DOC for patients < 55-years-old or with diabetes mellitus

A

Angiotensin receptor blocker (ACE-i or ARB)

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32
Q

Hypertension Step 1 DOC for patients >= 55-years-old or of black African origin:

A

Calcium channel
blocker

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33
Q

Hypertension Step 2 treatment

A

if already taking an ACE-i or ARB add a Calcium channel blocker or a thiazide-like Diuretic

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34
Q

Hypertension Step 4 treatment

A

if potassium < 4.5 mmol/l add low-dose spironolactone
if potassium > 4.5 mmol/l add an alpha- or beta-blocker

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35
Q

Cardiac syndrome X definition

A

Patients have a normal ECG at rest and normal coronary arteries but develop ST depression on exercise stress testing.

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36
Q

Epsilon Wave

A

Terminal Notch in QRS Complex

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37
Q

Delta Wave

A

slurred upstroke in the QRS complex

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38
Q

Delta Wave Seen in

A

WPW Syndrome

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39
Q

Most common cause of Infective Endocarditis in prosthetic valve

A

Staphylococcus Epidermidis (if post surgery <2 months)

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40
Q

Most common cause of Infective Endocarditis in prosthetic valve in post surgery >2 months

A

Staphylococcus Aureus

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41
Q

Infective Endocarditis Blind Therapy for Native Valve

A

Amoxicillin + Low Dose Gentamycin

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42
Q

Infective Endocarditis Blind Therapy for Prosthetic Valve

A

Vancomycin + Rifampicin + Gentamycin

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43
Q

Glycemic Control Post MI in CCU

A

Stop OHA + Insulin Infusion

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44
Q

Management of Stable Torsades De Pointes

A

IV Magnesium

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45
Q

First Line Investigation for Pulmonary Embolism

A

CT Pulmonary Angiography

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46
Q

Golden Standard Investigation for Pulmonary Embolism

A

Pulmonary Angiography

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47
Q

Disadvantage of D-dimer for Pulmonary Embolism

A

High Sensitivity but Low Specificity

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48
Q

Investigation of Choice for Pulmonary Embolism in case of Renal Impairment

A

V/Q Scan

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49
Q

Giant ‘a’ Wave JVP seen in

A
  1. Tricuspid Stenosis
  2. Pulmonary Stenosis
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50
Q

Giant ‘v’ Wave JVP Seen in

A

Tricuspid Regurgitation

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51
Q

Canon ‘a’ wave JVP seen in

A
  1. Complete Heart Block
  2. Nodal Rhythm
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52
Q

First Line Angina Prophylaxis

A

Beta Blockers - Bisoprolol

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53
Q

Contraindication for Beta blocker use in Angina

A

Use of Calcium Channel Blocker use (Verapamil)

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54
Q

Angina in a patient with Verapamil Use DOC

A

Nicorandil

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55
Q

Conditions associated with Aortic Dissection

A
  1. Pregnancy
  2. Trauma
  3. Marfans Syndrome
  4. Turners Syndrome
  5. Noonans Syndrome
  6. Syphillis
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56
Q

Blood Finding in Cholesterol Emboli

A

Eosinophilia

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57
Q

Causes of Elevation of BNP

A
  1. Heart Failure
  2. Chronic Kidney Disease
  3. Sepsis
  4. COPD
  5. Cirrhosis
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58
Q

First Line Management of Hypertension in patient with Chronic Heart Failure

A

ACE Inhibitors -> Beta Blockers

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59
Q

Drug commonly prescribed to increase HDL Levels

A

Nicotinic Acid

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60
Q

Cause of Fixed Splitting of S2

A

Atrial Septal Defect

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61
Q

Cause of Wide Split S2

A

RBBB with Heart Failure

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62
Q

Cause of Loud S2

A

Hypertension

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63
Q

Cause of Soft S2

A

Aortic Stenosis

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64
Q

Aortic Stenosis marker of severity

A

Absent or Quiet S2

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65
Q

Target INR of Venous Thromboembolism

66
Q

Target INR of Recurrent Venous Thromboembolism

67
Q

Target INR of Atrial Fibrillation

68
Q

Nicorandil MOA

A

Potassium Channel Activator

69
Q

Aortic Stenosis Marker of Severity

70
Q

JVP Regular Cannon ‘a’ waves

A

Atrio Ventricular Nodal Re entry Tachycardia (AVNRT)

71
Q

Investigation of choice for Pulmonary Artery Hypertension

A

Acute Vasodialator Testing

72
Q

Endothelin Receptor Antagonist

A

Bosentan
Ambrisentan

73
Q

Dentistry Procedure in Warfarinized patients

A

Check INR 72 hours before procedure and proceed if INR <4.0

74
Q

HOCM Drugs to Avoid

A

NIA
Nitrates
Inotropes
ACE Inhibitors

75
Q

HOCM Management

A

ABCDE
Amiodarone
Beta Blocker
Cardioverter Defibrillator
Dual Chamber Pacemaker
Endocarditis Prophylaxis

76
Q

Ostium Secundum defect Features

A

ECG: RBBB with Right Axis Deviation

77
Q

Ostium Primum defect Features

A

ECG: RBBB with Left Axis Deviation

78
Q

Tri-Phalageal Thumb + Ostium Secundum

A

Holt–Oram syndrome

79
Q

Clopidogrel Common Drug Interaction

A

Omeprazole (PPI)

80
Q

Changes to Blood Pressure during Exercise

A

SBP Increases
DBP decreases

81
Q

Malignant Hypertension Management

A

Oral Therapy: Atenolol
IV Therapy: Sodium Nitroprusside

82
Q

ST depression seen in

A

Digoxin Use

83
Q

Anterior Wall MI ECG Changes

A

ST elevation in V1 to V4

84
Q

Lateral Wall MI ECG Changes

A

ST elevation inV5,V6 and avL

85
Q

Inferior Wall MI ECG Changes

A

ST elevation in II, III, avF

86
Q

ECG findings in Inferior MI with RV infarction

A

ST elevation in II, III, avF, V1

87
Q

Posterior MI ECG Changes

A

ST depression in V1 and V2

88
Q

Lateral Wall MI Artery

A

Left Circumflex artery

89
Q

Cardiac Catheterization for Hyperthyroidism patient

A

Thyroid Radionucleotide Isotope Scan is done to identify between Graves Disease and Toxic Multinodular Goiter

90
Q

Anti Hypertensives Safe in Pregnancy

A
  1. Labetalol
  2. Alpha Methyl Dopa
  3. Nifedipine
91
Q

Diagnosis of Lumbar Pain following Pacemaker Insertion few weeks back

A

Infective Discitis

92
Q

Acute Pulmonary Edema Initial Drug Therapy

A

IV Glyceryl Trinitrate

93
Q

Antibiotics with QT prolongation

A

Macrolides and Quinolones

94
Q

Relation of Alcohol and HDL Cholestrol

A

Alcohol Increases HDL Cholesterol

95
Q

Definition of Long QT syndrome

A

QTc >450 mSec

96
Q

Long QT Syndrome defective Ion Channel

A

Potassium Channel Alpha Sub-unit(LQT1, LQT2)

97
Q

Most common congenital Long QT Syndrome

A

Potassium Channel Alpha Sub-unit (LQT1)

98
Q

LQT1 mutation

A

Slow Delayed Rectifier Potassium Channel

99
Q

LQT2 mutation

A

Rapid Delayed Rectifier Potassium Channel

100
Q

Murmur worsening on Valsalva or Standing and Improves on Squatting

A

HOCM Murmur

101
Q

Murmur Worsening on Squatting

A
  1. Aortic Stenosis
  2. VSD
102
Q

Paradoxical Embolus with Normal Cardiovascular Examination Findings

A

Patent Foramen Ovale

103
Q

DOC for WPW + Broad Complex Irregular Tachycardia

A

Procainamide

104
Q

Common ECG finding in Congenital Myotonic Dystrophy

A

PR Prolongation

105
Q

DOC for Reducing ventricular rate in AF

106
Q

Heart Condition which is an absolute contraindication to pregnancy

A

Primary Pulmonary Hypertension

107
Q

Tricuspid Stenosis + Pulmonary Embolus + Benign tumor of breast

A

Right Atrial Myxoma

108
Q

MI with 1 hour history of Chest Pain

A

Percutaneous Coronary Intervention

109
Q

MI with less than 12 hour history of Chest Pain

A

IV Thrombolysis followed by PCI

110
Q

Features of Complete heart block

A
  1. Irregular Canon ‘a’ waves
  2. High Volume Pulse
  3. Systolic Murmur
111
Q

Most common valve injured in Precordial Stab

A

Pulmonary Valve

112
Q

HOCM Most common cause

A

Sarcomere Protein Gene Mutation

113
Q

Investigation of choice for HOCM

A

Transthoracic Echo

114
Q

Pulsus Alternans seen in

A

Acute Left Ventricular Heart Failure

115
Q

Electrical Alternans seen in

A

Pericardial Effusion

116
Q

Indications for Urgent Surgery in Infective Endocarditis

A
  1. Increasing PR interval
  2. Heart Failure
  3. Septal Perforation
117
Q

Hypertensive Emergency with End Organ Damage Blood Pressure Decrease Protocol

A

Decrease in MAP by 15-25%

118
Q

X-ray shows Calcification around heart borders + Low Voltage QRS

A

Constrictive Pericarditis

119
Q

Management of Small Pulmonary Embolism

A

Rivaroxaban 15 mg for 21 days Followed by maintenance dose

120
Q

Management of Large Pulmonary Embolism

A
  1. Thrombolytic Therapy
  2. Mechanical Intervention
121
Q

NSTEMI Management

A

2 Antiplatelet + Heparin + Beta Blocker

122
Q

Conditions where ductus arteriosus is kept open

A

Any Cyanotic Heart Disease
1. Tricuspid Atresia
2. TOF
3. TAPVC
4. TGA

123
Q

Biventricular Hypertrophy + Murmur

124
Q

First Cardiac Enzyme to Increase after Myocardial Necrosis

A

Glycogen Phosphorylase BB

125
Q

Precordial Pulsations + Wheezing + Flushing + Loose Stools

A

Carcinoid Heart Disease

126
Q

Indication for Thrombolysis post fluid bolus in PE

A

SBP of 80 mmHg

127
Q

Medication NOT Associated with Torsades De Pointes

128
Q

Which Cholesterol is associated with CAD

A

LDL- Cholesterol

129
Q

Initial Shock Joules for Monophasic

130
Q

Initial Shock Joules for Biphasic

131
Q

AF long term Anticoagulation DOC

A

Rivaroxaban

132
Q

Anti Hypertensive of Choice in patients with Lithium

A

CCB - Amlodipine (ACE/ARB are C/I)

133
Q

Heart Condition in which BNP is not elevated

A

Unstable Angina

134
Q

Chemotherapy drug associated with Dilated Cardiomegaly

A

Doxorubicin

135
Q

Cardiac Enzyme to be elevated after DC Cardioversion

A

Creatinine Kinase

136
Q

Features in ECG for Diagnosing VT

A
  1. RS duration of >100 ms
  2. Ventriculoatrial Dissociation in any of 12 leads
  3. Absence of RS Complexes
137
Q

Poor Prognosis in HOCM

A

Septal wall thickness >3 CM

138
Q

Drug Contraindicated in WPW

A

Verapamil (increases conduction via accessory system)

139
Q

ECG Hypothermia Characteristic

140
Q

Antiarrythmic with Highest Risk of Torsades de pointes

141
Q

Antihypertensive contraindicated in myasthenia gravis

A

Beta Blockers

142
Q

DVT Management in pregnancy

A

LMW Heparin throught pregnancy

143
Q

Drug Causing Allergic Myocarditis

A

Co-Trimoxazole

144
Q

Unilateral Swelling of eyelid + Travel to South America

A

Trypanosomiasis (Chagas Disease)

145
Q

Main Indication of Inserting Pacemaker

A

Mobitz Type II block

146
Q

Heart Failure + AF Drug of Choice

147
Q

Multifocal Atrial Tachycardia in Pulmonary Artery Hypertension DOC

148
Q

Time of Highest Risk of DVT in Pregnancy

A

First 6 weeks after delivery

149
Q

Atrial fibrillation persist despite Multiple Drugs

A

Radiofrequency pulmonary vein isolation with ablation

150
Q

Ankylosing Spondylitis associated heart murmur

A

Aortic Regurgitation murmur

151
Q

CVS complication of Co-trimoxazole

A

Allergic Myocarditis

152
Q

Second Trimester Diastolic BP Change

A

A 10mmMHg Drop in Diastolic due to reduction in PVR

153
Q

Most important cell that drives atherosclerotic plaques

A

Macrophages

154
Q

Reason for reduction of digoxin dose in older patients

A

Decreased renal clearance

155
Q

ECG Shows complete heart block what is clinical feature

A

Variable S1

156
Q

Tolerance to Nitric Oxide is due to

A

Reactive Oxygen Species

157
Q

MR Carotid Angiography shows String of bead appearance

A

Fibromuscular Dysplasia

158
Q

MR Carotid Angiography shows String of bead appearance

A

Fibromuscular Dysplasia

159
Q

Most significant side effect of celecoxib

A

Can worsen heart failure

160
Q

The fastest conduction velocities in the heart

A

Purkinje Fibers

161
Q

Which molecule does troponin T bind to?

A

Tropomyosin

162
Q

Which molecule does troponin I bind to?

MRCP Part 1 (17 decks)

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