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MSRA 2 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What ABPI would you expect in arterial disease?

A

<0.8

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2
Q

Define first degree heart block

A

PR interval >0.2s

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3
Q

What is the difference between Mobitz type 1 and type 2 heart block?

A

T1 - progressive prolongation of PR interval

T2 - Intermittent failure of conduction of atrial impulse without progressive prolongation of PR interval

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4
Q

What is a Baker’s cyst?

A

Popliteal cyst is the result of accumulation of joint synovial fluid outside the knee joint - in the interval between the semimembranosus and the medial gastrocnemius.

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5
Q

What is a normal PR?

A

0.12-0.2s or 3-5 small squares

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6
Q

How do we determine right axis deviation?

A

The QRS complex is negative in lead I

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7
Q

How do we determine L axis deviation?

A

The QRS complex is negative in II and aVF

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8
Q

When do we give oxygen in MI?

A

If sats <94% or if pulmonary oedema

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9
Q

When can you return to sexual intercourse after an MI?

A

1/12

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10
Q

When can you return to work after an MI?

A

2/12

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11
Q

What are the non-shockable rhythms?

A

PEA and asystole

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12
Q

How does aortic dissection in the aortic arch and the descending aorta differ in presentation?

A

Aortic arch = pain in the neck or jaw

Descending aorta = pain in the intrascapular area

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13
Q

What is the first-line anti-anginal medication?

A

BB or CCB to reduce the sx of stable angina

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14
Q

What is stage 1 htn?

A

Clinic BP reading of 140/90 to 159/99
ABPM 135/85 to 149/94

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15
Q

What is stage 2 htn?

A

Clinic BP reading of >=160/100 to 180/120
ABPM average over 150/95

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16
Q

What is stage 3 htn?

A

Clinic BP of >= 180/120

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17
Q

What is a provoked DVT?

A

Associated with a transient risk factor such as significant immobility, surgery, trauma, pregnancy or puerperium. Unprovoked have no identifiable risk factor or one which cannot easily be removed e.g. active ca or thrombophilia

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18
Q

What is pulsus paradoxus?

A

An exaggeration of the normal inspiratory decrease of systemic BP (>12mmHg or 9%)

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19
Q

Where do you see pulsus paradoxus?

A

Constrictive pericarditis
Severe obstructive pulmonary disease
Restrictive cardiomyopathy
PE
Rapid and laboured breathing
Right ventricular infarction with shock

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20
Q

How does pericarditis present?

A

To do

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21
Q

What is Beck’s triad?

A

Increased JVP, hypotension and muffled heart sounds = cardiac tamponade

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22
Q

How do we treat ? cardiac tamponade

A

Pericardiocentesis when clinically unstable

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23
Q

When do we use dipyramidole?

A

Indicated for secondary prevention of stroke (not associated with AF) and TIAs (either alone or with aspirin). Can also be used as an adjunct to oral anticoagulation for prophylaxis of VTE associated w/ prosthetic heart valves

24
Q

What is the most common cause of rhabdomyolysis?

A

Fall w/ long lie

25
Q

What are the ECG changes in hyperkalaemia?

A

Prolonged PR
Broad, bizarre QRS complexes
Peaked T waves

26
Q

What is pulsus paradoxus?

A

An exaggeration (>12mmHg or 9%) of the normal inspiratory decrease in systolic blood pressure. Seen in cardiac tamponade

27
Q

What is Kussmaul sign?

A

Paradoxical increase in venous distension and pressure during inspiration. Seen in cardiac tamponade

28
Q

What is Ewart sign or Pins sign

A

Seen in pts with large pleural effusions & is described as an area of dullness, with bronchial breath sounds and bronchophony below the angle of the left scapula. Seen in tamponade

29
Q

How do we treat cardiac tamponade?

A

Pericardiocentesis

30
Q

How do we manage those on warfarin with AF?

A

Considering switching patients from warfarin to a DOAC at the next review

31
Q

What is seen on ECG in hypercalcaemia?

A

Reduced QT interval

32
Q

What is seen on ECG in hypocalcaemia

A

Prolonged QT interval

33
Q

What is the most common cause of pericarditis?

A

Viral infection

34
Q

What is lone AF?

A

AF in younger adults (<60y.o.) with no clinical history or echocardiographic evidence of cardiovascular disease/pulmonary conditions

35
Q

What is paroxysmal AF?

A

Episodes lasting longer than 30s but less than 7/7 that are self-terminating and recurrent

36
Q

How do we manage acute HF?

A

Sit pt upright and give 100% O2 unless CO2 retainer
Furosemide IV
Consider small amounts opioids if pain
GTN IV BP permitting
Consider CPAP if poor response

37
Q

What do we administer directly after thrombolysis of MI?

A

Heparin

38
Q

What are femoral pseudoaneurysms?

A

Haematomas that result from a leaking hole in an artery - complication of cardiac catheterisation
Present with pulsatile mass, femoral bruit and compromised distal pulses

39
Q

How does AAA present?

A

Constant and gnawing epigastric pain
Pain radiating to lower back and both groins
Palpable pulsatile mass just left of the midline of the umbilicus

40
Q

What is Tietze’s syndrome?

A

Like costochondritis but with swelling of the costal cartilages

41
Q

How does the pain in pericarditis change on movement?

A

Worsens on lying down, improves on sitting forward

42
Q

What do you see on ECG in PE?

A

Sinus tachy
Right axis deviation
RBBB
Rarely S1QIIITIII

43
Q

How does digoxin toxicity impact eyesight?

A

Objects may appear green or yellow

44
Q

How does digoxin toxicity present on ECG?

A

Reverse tick sign - ST depression and inverted T waves in V5-6

45
Q

How may hypokalaemia present?

A

Muscle weakness and cramps

46
Q

What is the most common cause of IE?

A

S aureus

47
Q

What ECG change do you see in hypothermia?

A

J waves

48
Q

When do we offer ABPM?

A

If clinic BP between 140/90 and 180/120

49
Q

When does Dressler’s syndrome usually present?

A

1-6wks post MI
Pericarditis

50
Q

How do we manage htn in an under 40y.o. with no evidence of disease?

A

Refer to investigate secondary cause of htn

51
Q

What is Vincent’s angina?

A

Vincent’s angina is a bacterial infection that causes inflammation of the tonsils and pharynx, and is also known as trench mouth

52
Q

How does oesophageal spasm present?

A

Painful contractions in the esophagus that can feel like sudden chest pain. These contractions can also cause difficulty swallowing or regurgitation.

53
Q

When do we favour warfarin over apixaban?

A

If eGFR <30ml/min, significant liver dysfunction or weight greater than 120kg

54
Q

What is streptokinase?

A

Thrombolytic agent derived from streptococcal bacteria

55
Q
A

MSRA 2 (2 decks)

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