cardiology Flashcards
Jerky pulse, mid systolic murmur - what is the dx?
HOCM
Common complication of MR?
Atrial flutter or fibrillation
Prophylaxis for SVT in pregnancy?
Metoprolol
HOCM: defective mutation is beta or alpha myosin?
β-myosin heavy chain
Strep or staph - which is better prognosis in IE?
Streptococcal infection
Pansystolic murmur worse on inspiration, associated with WPW syndrome?
Ebstein’s anomaly
What parameter is essential to monitor when giving Mg?
RR
a wave, cannon a, c wave, v wave, x descent, y descent interpretation?
a wave - atrial contraction
cannon a - atrial contraction against closed tricuspid valve
c wave - closure of tricuspid valve
v wave - passiVe filling of blood in atrium against closed tricuspid valve
x descent - fall in atrial pressure during ventricular systole
y descent - opening of tricuspid valve
Mechanism of hypokalemia?
Increased delivery of sodium to the distal part of the distal convoluted tubule
Drug class of dabigatran and bivalirudin?
Direct thrombin inhibitor
Mechanism of furosemide?
Inhibits the Na-K-Cl cotransporter in the thick ASCENDING LIMB of the loop of Henle
Mechanism of indapamide?
Inhibiting the sodium-chloride symporter (NCC) in the DCT
Eplerenone
Blocking aldosterone-mediated sodium reabsorption and potassium secretion at the level of COLLECTING DUCTS
Palpitations, pre-syncope and ECG findings of T wave inversion and epsilon waves in V1-V3?
Arrhythmogenic right ventricular cardiomyopathy (ARVD)
Which drugs can be used to promote duct closure in PDA?
Ibuprofen/indomethacin
Most important test to confirm PH?
Cardiac catheterisation
Common causes of endocarditis?
Staph aureus, staph epidermis (if <2 months post valve surgery)
What enhances and reduces effect of adenosine?
E - dipyridamole R - aminophylline
ST depression on exercise stress testing despite normal coronary arteries?
Cardiac syndrome X
Swan-Ganz catheter measures pressure in which heart chamber?
Left atrium
CHB following an MI - which artery?
Right coronary artery
TiMe
Tricuspid regurg - louder on inspiration
Mitral regurg - louder on expiration
Treatment for PAD?
1 - smoking cessation and exercise 2 - 80mg atorva, clopidogrel 3 - surgical/endovascular revasc 4 - naftidrofuryl (5HT2 antag)
Drainage of coronary sinus?
RA
Right ventricle fibro fatty infiltrate?
Arrhythmogenic right ventricular cardiomyopathy
ASD murmur?
Ejection systolic - louder on inspiration
Is murmur in AR high pitched or low pitched? MS murmur?
High pitched and MS is low pitched
Anjali Had Lovely Salmon Sandwiches
Causes of restrictive cardiomyopathy?
Amyloidosis, haemochromatosis, Loffler’s syndrome, sarcoidosis, scleroderma
Amiodarone mechanism of action?
Blocks potassium channels
Treatment for severe MS? Commissurotomy or valve replacement?
Percutaneous mitral commissurotomy
After successful cardioversion how long should anticoag continue for? 1 week or 4 weeks?
4 weeks
Definiton of Eisenmenger’s Syndrome? Reversal of left to right shunt or right to left shunt?
Reversal of left to right shunt
When to give four-factor prothrombin complex concentrate in context of warfarin therapy?
Emergency surgery
When to give 5 mg vitamin K IV in context of warfarin therapy?
6-8 hours till surgery
What guides surgery for AS? Symptoms or aortic valve gradient?
Symptoms
What is downsloping ST depression associated with?
Cardiac syndrome x
Convex ST elevation in V1-V3 with a partial right bundle branch block pattern?
Brugada
Harsh systolic murmur that increases on Valsalva manoeuvre, LVH?
HOCM
T wave inversions in the right precordial leads and epsilon waves?
Arrhythmogenic right ventricular cardiomyopathy (arvc)
Bicuspid aortic valve association?
Coarctation of aorta
Drug to avoid in HOCM?
Ramipril
Mechanism of hypokalaemia due to thiazides?
Increased delivery of sodium to the distal part of the distal convoluted tubule
Presentation of rheum fever? Organism in rheumatic fever?
Pyrexia, arthralgia - Strep pyogenes
Mechanism of action of bivalirudin in acute coronary syndrome?
Reversible direct thrombin inhibitor
Long QT syndrome usually due to?
Loss-of-function/blockage of K+ channels
Atrial myxoma commonest site?
Left atrium
If high-risk of failure of cardioversion (previous failure), offer electrical cardioversion after at least 4 weeks treatment with which drug?
Amiodarone
ECG shows irregular broad complex monomorphic tachycardia with a stable axis?
Amiodarone
Fonda mechanism of action?
Activates antithrombin III
Left parasternal heave in which heart pathology?
Tricuspid regurg
Familial hypertriglyceridaemia association? Familial hypercholesterolaemia association?
Tri - eruptive xanthoma
Chlo - tendon xanthoma
COPD and different P wave morphologies?
Verapamil
Can PDA cause hypertension?
No
