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Year 6 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What coronary artery is linked to changes in V1-V4?

A

Left anterior descending

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2
Q

What coronary artery is linked to changes in II,III and aVF?

A

Right Coronary

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3
Q

What coronary artery is linked to changes in V1-V6, I, aVL?

A

Proximal left anterior descending

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4
Q

What coronary artery is linked to changes in I, aVL +/- V5-6?

A

Left circumflex

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5
Q

What is the management of chronic heart failure?

A

1) ACEi and BB
2) Aldosterone antagonist ( Spironolactone) + SGLT-2 inhibitor

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6
Q

What does LBBB look like on an ECG?

A

W in V1 and M in V6

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7
Q

What are some causes of LBBB?

A

MI
Hypertension
Aortic Stenosis
cardiomyopathy

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8
Q

What is first line medication for PE?

A

DOAC ( e.g. apixaban) when first suspected, then continued if confirmed

Unprovoked - 6m
Provoked - 3m

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9
Q

What is the first line management of Acute Pericarditis?

A

Ibuprofen + Colchicine

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10
Q

When should a patient be admitted for acute pericarditis?

A

temp >38
elevated troponin

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11
Q

What are some causes of acute pericarditis?

A
  • viral infection ( Coxsackie)
  • TB
  • Uraemia
  • Post MI early –> fibrinous pericarditis
  • Post MI late –> Dressler’s Syndrome
  • Radiotherapy
  • connective tissue
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12
Q

If patient cannot tolerate ACEi what do you switch their medication to?

A

ARB ( e.g Candesartan)

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13
Q

What is Brugada syndrome?

A

Inherited Cardiovascular disease
Autosomal dominant inheritance
Mutation that codes Myocardium Sodium Ion Channel protein

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14
Q

What hypertension management drug should you avoid using when patient has gout?

A

thiazide-like diuretics

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15
Q

What is the first line mediation used in bradycardia?

A

Atropine ( 5oomcg IV)

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16
Q

What anti-coaculant to use with someone with a mechanical valve?

A

Warfarin

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17
Q

What rhythms are shockable?

A

VT/VF

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18
Q

What rhythms are not shockable?

A

Asystole / Pulseless electrical activity

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19
Q

How does shocking the patient differ when they are being monitored?

A

do 3 quick shots

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20
Q

What DOAC is preferred in someone with a mechanical valve?

A

Warfarin

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21
Q

First line rate control in AF

A

Beta blocker

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22
Q

Posterior on MI

A

Tall R waves in V1-V2

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23
Q

How to notice Cardiac tamponade on an ECG?

A

Electrical alterans
QRS complexes different heights
due to swinging of heart

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24
Q

Presentation of Cardiac Tamponade

A

Becks triad : Low BP, Elevated JVP , muffled heart sounds
dyspnoea, tachycardia
pulsus paradoxus
absent Y wave ( Y wave describes ventricular filling, fluid build up means the heart unable to relax and fill)

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25
Q

Management of cardiac tamponade

A

urgent pericardiocentesis

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26
Q

How do vasopressors work?

A

vasoconstriction - act on V1 receptors
increase SVR
increase MAP

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27
Q

What are the different types of aortic dissection? (Stanford classification)

A

Type A : Ascending aorta
Type B : descending aorta

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28
Q

How to manage aortic dissections?

A

Type A : IV labetalol + Surgery
Type B : IV labetalol

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29
Q

Patient on ACEi + signs of CKD + K>=6.
What do you do?

A

swap ACE

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30
Q

Description of Torsades de Pointes on an ECG

A

polymorphic ventricular tachycardia
prolonged QT intervals

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31
Q

How to manage torsades de pointes?

A

IV magnesium sulphate

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32
Q

What drugs cause prolonged QT interval?

A

Anti-arrhytmics
anti - B iotics –> macrolides and fluoroquinolones
anti - psyChotics & Cholorquine
anti -Depressants & thiazide- diruetics –> TCAs
anti -Emetics
anti-Fungals

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33
Q

What CCB can you use alongside beta blockers?

A

longer- acting dihydropyridine ( eg amlodipine)

34
Q

What CCB is contraindicated with beta blockers?
What does it cause?

A

Verapamil
complete heart block

35
Q

What is the difference in auscultation between Type A and type b aortic dissection?

A

Type A - reduced heart sounds
Type B normal heart sounds

36
Q

What is the minimum mm ST elevation can be in chest leads for it to be ACS?

A

2mm
closer to the heart

37
Q

What is the minimum mm of ST elevation for ACS to be diagnosed?

38
Q

What else counts as a STEMI without having ST elevation?

A

LBBB
Posterior STEMI

39
Q

How to diagnose a posterior STEMI on ECG?

A

dominant r-waves in V1-V3
anterior ST depression

40
Q

What anti-emetic do you give when giving morphine?

A

metoclopramide

41
Q

What do U - waves in an ECG show?

42
Q

What is narrow pulse pressure associated with?

A

Aortic Stenosis

43
Q

What is collapsing pulse associated with?

A

Aortic regurg

44
Q

What type of murmur is ejection systolic which is louder on expiration?

A

Aortic Stenosis

45
Q

What type of murmur is ejection systolic which is louder on inspiration?

A

Pulmonary stenosis

46
Q

What sided heart murmurs are heard louder on expiration?

A

left- sided

47
Q

What sided heart murmurs are heard louder on inspiration?

A

right-sided

48
Q

What are some complications of MIs?

A

Cardiac arrest
Dresslers syndrome
Left ventricular aneurysm
left ventricle free wall rupture
CHF
Ventricle septal defect
Acute mitral regurg

49
Q

What antidepressant leads to Torsades de pointes and QT elongation?

A

Citalopram

50
Q

What is normal QRS width?

51
Q

What is a major risk factor associated with rewarming?

A

Disruptive shock

this is due to vasodilation –> hypopefusion

52
Q

How to manage a patient who has had AF for over 48 hours?

A

anti-coagulation needs to be given for atleast 3 weeks prior to cardioversion

Can perform a TOE to see if there is a thrombus, if not can heparin + cardiovert

53
Q

What murmur is associated with VSDs?

A

Pansystolic murmur

54
Q

What % increase in creatine is acceptable when starting ACEi?

55
Q

What are Q waves associated with?

A

previous MI

56
Q

What are J waves associated with?

A

Hypothermia

57
Q

What are delta waves associated with?

A

Wolfs Parkinson White Syndrome

58
Q

What is the most common cause of infective endocarditis?

A

staph aureus

59
Q

What is Takayasu Arteritis?

A

Vasculitis of large vessels

59
Q

What vessel is usually affected in Takayasu Arteritis?

A

occlusion of aorta

59
Q

What are some features of Takayasu Arteritis?

A

-systemic features of a vasculitis e.g. malaise, headache
-unequal blood pressure in the upper limbs
-carotid bruit and tenderness
-absent or weak peripheral pulses
-upper and lower limb claudication on exertion
-aortic regurgitation (around 20%)

59
Q

Management of Takayasu Arteritis

60
Q

In what groups is it more common for chest pain not to be a symptom in an MI?

A

elderly
diabetic
female

61
Q

What ECG abnormality can subarachnoid haemorrhage cause?

A

Torsades de pointes

62
Q

Management of symptomatic aortic stenosis in low risk patients

A

surgical valve replacement

63
Q

Management of symptomatic aortic stenosis in high risk patients

A

transcatheter valve replacement

64
Q

What medication should you add if angina is not managed by Beta Blocker?

A

longer-acting dihydropyridine calcium channel blocker
Amlodipine

65
Q

What class of drugs do statins interact with?

A

macrolides

66
Q

Difference between tricuspid regurg and mitral regurg

A

tricuspid regurg is louder on inspiration

67
Q

What scoring system looks at a patients with AF and their bleeding risk if anticoagulation is started?

68
Q

What medications are used for cardioversion of AF?

A

amiodarone
flecainide

69
Q

What should tearing chest pain + Aortic regurg + ST elevation in inferior leads suggest?

A

asending aorta dissection

70
Q

What part of the QRS complex is cardioversion synchronised to?

71
Q

What does an ASD sound like on examination?

A

ejection systolic murmur
splitting S2

72
Q

How can ASD present in older people?

A

stroke symptoms
can have a thrombus move from right to left side and cause stroke

73
Q

What is multiple system atrophy?

A

Parkinsonism + autonomic features ( ED, postural hypotension)

74
Q

What causes bisferiens pulse?

A

mixed aortic valve disease

75
Q

How is bisferiens pulse desribed?

A

double pulse during systole

76
Q

What to give a patient who is still SOB following treatment for acute heart failure?

A

consider CPAP

77
Q

Side effects of ACEi

A
  • cough
  • hyperkalaemia
    angiodema

Year 6 (19 decks)

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