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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
Management of cardiac tamponade
urgent pericardiocentesis
26
How do vasopressors work?
vasoconstriction - act on V1 receptors increase SVR increase MAP
27
What are the different types of aortic dissection? (Stanford classification)
Type A : Ascending aorta Type B : descending aorta
28
How to manage aortic dissections?
Type A : IV labetalol + Surgery Type B : IV labetalol
29
Patient on ACEi + signs of CKD + K>=6. What do you do?
swap ACE
30
Description of Torsades de Pointes on an ECG
polymorphic ventricular tachycardia prolonged QT intervals
31
How to manage torsades de pointes?
IV magnesium sulphate
32
What drugs cause prolonged QT interval?
Anti-arrhytmics anti - B iotics --> macrolides and fluoroquinolones anti - psyChotics & Cholorquine anti -Depressants & thiazide- diruetics --> TCAs anti -Emetics anti-Fungals
33
What CCB can you use alongside beta blockers?
longer- acting dihydropyridine ( eg amlodipine)
34
What CCB is contraindicated with beta blockers? What does it cause?
Verapamil complete heart block
35
What is the difference in auscultation between Type A and type b aortic dissection?
Type A - reduced heart sounds Type B normal heart sounds
36
What is the minimum mm ST elevation can be in chest leads for it to be ACS?
2mm closer to the heart
37
What is the minimum mm of ST elevation for ACS to be diagnosed?
1mm +
38
What else counts as a STEMI without having ST elevation?
LBBB Posterior STEMI
39
How to diagnose a posterior STEMI on ECG?
dominant r-waves in V1-V3 anterior ST depression
40
What anti-emetic do you give when giving morphine?
metoclopramide
41
What do U - waves in an ECG show?
HypoK
42
What is narrow pulse pressure associated with?
Aortic Stenosis
43
What is collapsing pulse associated with?
Aortic regurg
44
What type of murmur is ejection systolic which is louder on expiration?
Aortic Stenosis
45
What type of murmur is ejection systolic which is louder on inspiration?
Pulmonary stenosis
46
What sided heart murmurs are heard louder on expiration?
left- sided
47
What sided heart murmurs are heard louder on inspiration?
right-sided
48
What are some complications of MIs?
Cardiac arrest Dresslers syndrome Left ventricular aneurysm left ventricle free wall rupture CHF Ventricle septal defect Acute mitral regurg
49
What antidepressant leads to Torsades de pointes and QT elongation?
Citalopram
50
What is normal QRS width?
70-100ms
51
What is a major risk factor associated with rewarming?
Disruptive shock this is due to vasodilation --> hypopefusion
52
How to manage a patient who has had AF for over 48 hours?
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
What murmur is associated with VSDs?
Pansystolic murmur
54
What % increase in creatine is acceptable when starting ACEi?
30%
55
What are Q waves associated with?
previous MI
56
What are J waves associated with?
Hypothermia
57
What are delta waves associated with?
Wolfs Parkinson White Syndrome
58
What is the most common cause of infective endocarditis?
staph aureus
59
What is Takayasu Arteritis?
Vasculitis of large vessels
59
What vessel is usually affected in Takayasu Arteritis?
occlusion of aorta
59
What are some features of Takayasu Arteritis?
-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
Management of Takayasu Arteritis
steroids
60
In what groups is it more common for chest pain not to be a symptom in an MI?
elderly diabetic female
61
What ECG abnormality can subarachnoid haemorrhage cause?
Torsades de pointes
62
Management of symptomatic aortic stenosis in low risk patients
surgical valve replacement
63
Management of symptomatic aortic stenosis in high risk patients
transcatheter valve replacement
64
What medication should you add if angina is not managed by Beta Blocker?
longer-acting dihydropyridine calcium channel blocker Amlodipine
65
What class of drugs do statins interact with?
macrolides
66
Difference between tricuspid regurg and mitral regurg
tricuspid regurg is louder on inspiration
67
What scoring system looks at a patients with AF and their bleeding risk if anticoagulation is started?
ORBIT
68
What medications are used for cardioversion of AF?
amiodarone flecainide
69
What should tearing chest pain + Aortic regurg + ST elevation in inferior leads suggest?
asending aorta dissection
70
What part of the QRS complex is cardioversion synchronised to?
r wave
71
What does an ASD sound like on examination?
ejection systolic murmur splitting S2
72
How can ASD present in older people?
stroke symptoms can have a thrombus move from right to left side and cause stroke
73
What is multiple system atrophy?
Parkinsonism + autonomic features ( ED, postural hypotension)
74
What causes bisferiens pulse?
mixed aortic valve disease
75
How is bisferiens pulse desribed?
double pulse during systole
76
What to give a patient who is still SOB following treatment for acute heart failure?
consider CPAP
77
Side effects of ACEi
- cough - hyperkalaemia angiodema

Year 6 (19 decks)

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