Cardiology Flashcards
What is Bisferiens Pulse a sign off (double pulse on palpation of the artery)
Mixed aortic valve disease
Most common cause of infective endocarditis:
1) < 2 months post valve surgery
2) No cardiac surgery or over 2 months post cardiac surgery
1) Staphylococcus epidermis
2) Staphylococcus Aureus
Optimal time to take a statin?
Last thing in the evening
Patients with pulmonary arterial hypertension, who have a positive response to vasodilator testing should be treated with?
Calcium channel blockers (e.g. Nifedipine)
Medical definition of eisenmengers syndrome?
The reversal of a left to right shunt
In the management of stable angina, all patients should receive what combination of medication?
Aspirin + Statin
What is the first line medication for management of stable angina symptoms?
BB or CCB
What additional heart sound will be heard in:
1) DCM
2) HOCM
1) 3 (3 letters)
2) 4 (4 letters)
First line antihypertensive for pregnancy induced hypertension?
Labetalol
First cardiac enzyme marker to rise in acute MI?
Myoglobin
Cardiac enzyme which is useful to look for re-infarction within 3 days of acute ischaemic event?
CK-MB
Murmur: early diastolic murmur
Aortic Regurgitation
Murmur: loud systolic ejection murmur
Aortic Stenosis
Murmur: mid-systolic click usually accompanied by a late systolic murmur. It is more common in people with connective tissue disorders, such as Marfan syndrome.
Mitral Valve prolapse
Murmur: low-pitched, rumbling, mid-diastolic murmur heard loudest over the apex. The most common cause of mitral stenosis is rheumatic fever
Mitral Stenosis
What two conditions are Pulsus Paradoxus associated with?
1) Severe Asthma
2) Cardiac Temponade
What 3 conditions is a collapsing pulse associated with?
Aortic Regurgitation
Patent ductus arteriosus
Hyperkinetic states
Pulses alternans is associated with what condition?
LVF
“Jerky Pulse” is associated with what condition?
Hypertrophic obstructive cardiomyopathy
Pulmonary artery hypertension patients with negative response to vasodilator testing should be treated with?
Prostacyclin Analogues
Endothelin Receptor antagonists
Phosphodiesterase inhibitors
What is the reversal agent for bleeding when on Dabigatran?
Idarucizumab
Mechanism of action of thiazide diuretics which can result in hypokalaemia?
Increased delivery of sodium to the distal part of the convoluted tubule
Mechanism of furosemide?
Inhibits the Na-K-Cl cotransporter in the thick ascending limb of the loop of henle
What is the main ECG abnormality that you would see in Hyper Ca2+?
Shortening of the QTC interval
Inherited long QT syndrome, sensorineural deafness, due to an abnormal potassium channel
Lervell and Lange-Nielsen syndrome
S2 Hear sound (closure of the aortic valve followed by closure of pulmonary valve)
1) Loud
2) Revere Split
3) Widely Split
4) Fixed in the middle
1) Hypertension
2) LBBB, Severe Aortic Stenosis
3) RBBB, Deep Inspiration
4) Atrial septal defect
Patients with poor dental hygiene are at risk of developing infective endocarditis from what source of bacteria?
Viridans Streptococci (e.g. Streptococcus sanguinis)
A newborn is suffering from a continuous machine like murmur which subsequently is diagnosed as a PDA. What medications can promote closure of a PDA?
Ibuprofen OR Indomethacin
In Cyanotic heart disorders such as transposition of great vessels, what can keep the PDA open?
Prostaglandins
What is the most common cause of death (arrythmia) in patients following a myocardial infarction?
Ventricular Fibrillation
What ECG feature would be suggestive of a ventricular tachycardia rather than a supreventricular tachycardia with aberrant conduction?
Atrioventricular dissociation
Patient with congestive cardiac failure, oedematous despite furosemide. Key physiological changes:
-Aldosterone levels
-What activates renin angiotensin aldosterone system?
-Elevated
-Reduced renal pressure identified by the Juxtaglomerular apparatus
JVP Wave Forms:
A wave
C wave
V wave
X Descent
Y Descent
A wave = Atrial contraction
C Wave: Closure of tricuspid valve
V wave = Giant in tricuspid regurgitation
X Descent = Fall in atria pressure during ventricular systole
Y Descent = Opening of tricuspid valve
What receptors do Clonidine act on?
a-2 adrenoreceptors
MOA of Hydralazine?
-Contraindications
Elevates levels of cyclic GMP leading to relation of smooth muscle to a greater extent in the arterioles than the veins
-SLE/IHD
Congenital heart disease. Most common cyanotic causes:
-Birth
-Overall
-Transposition of great arteries
-Tetralogy of fallot
Congenital Heart Disease. Most common acyanotic cause
Ventricular Septal defect
Ventricular Septal Defect:
-Cyanotic or Acyanotic
-Murmur
-Acyanotic
-Pan Systolic
Tetralogy of Fallot
-Cyanotic or Acyanotic
-4 features
-Cyanotic
-VSD + Right ventricular hypertrophy + RVOT obstruction due to pulmonary stenosis and Overriding aorta
Patent Ductus Arteriosus
-Acyanotic or cyanotic
-Where is abnormal connection
-Risk factors
-Features
-Management to close the connection
-Acyanotic
-Pulmonary trunk and descending aorta
-Premature babies, high altitude, rubella infection in the first trimester
-Left subclavivcular thrill + continuous machinery murmur
-Indomethacin
Atrial Septal Defects
-Two types
- Feautres
-Ostium Secundum and Ostium Primum
-Ejection systolic murmur, fixed splitting of S2
In atherosclerotic cardiovascular disease, foam cells play a key role, from what cell lineage are they derived?
Monocytes
