Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MHU > Cardiology > Flashcards

Cardiology Flashcards

0
Q

What are the signs of AS severity?

A
  • Slow-rising carotid pulse
  • Narrow pulse pressure
  • Length of murmur (early systolic)
  • Soft, split then absent A2
  • Displaced apex beat
  • HF: pulmonary oedema, raised JVP, ankle oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

How do you grade a heart murmur?

A
  1. Audible by experienced physician
  2. Easily audible in one area
  3. Audible throughout praecordium
  4. Palpable thrill
  5. Audible with stethoscope just off chest
  6. Audible without stethoscope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the ejection fraction in systolic heart failure?

A

<40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the basis of pharmacological treatment in chronic systolic heart failure?

A

ACEI + Beta Blocker (diuretic given to achieve euvolaemia if fluid overload, aldosterone antagonist given if symptoms persist)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the pharmacological approach to the management of acute heart failure?

A
  • Supplemental O2 Diuretics (loop +/- thiazide)
  • Vasodilators (nitroglycerin)
  • Inotropes (if low output)
  • Vasopressor therapy (if low output)
  • Mechanical support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the basis of management in chronic diastolic heart failure?

A

Relief of pulmonary/systemic congestion

Address uderlying causes (e.g. hypertension, CAD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the features of dextrocardia on ECG?

A
  • Right axis deviation
  • Positive QRS in aVR
  • Negative QRS in I
  • Absent R wave progression in chest leads
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the normal PR interval?

A

Less than 5 small squares (or one large square)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the normal QRS width?

A

Less than 3 small squares

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is atropine and when is it given?

A

Anticholinergic - competitive antagonist of muscarinic receptors, increases HR in bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is isoprenaline and when is it given?

A
  • Beta-1 agonist with positive chronotropic, dromotropic and inotropic effects
  • Given in bradycardia with haemodynamic compromise and heart block
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define the following:

(a) Inotrope
(b) Chronotrope
(c) Dromotrope

A

(a) Regarding cardiac contractility
(b) Regarding heart rate
(c) Regarding cardiac conduction (esp. through AV node)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the mechanism of action for digoxin and when is it given?

A
  • Increases vagal tone (slow HR, reduce AV nodal conduction)
  • Has positive inotropic effect

Given in AF, atrial flutter and as an adjunct in heart failure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What the mechanism of a action of amiodarone and when is it given?

A
  • Decreases SA node and junctional automaticity
  • Slows AV node and bypass tract conduction

Given as pharmacological cardioversion for refractory tachyarrhythmias (VT, AF, SVT).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the mechanism of action of adenosine and when is it given?

A
  • Depresses sinus node activity
  • Slows conduction through AV node
  • Causes vasodilation

Given as bolus in acute SVT for pharmacological cardioversion (has rapid onset and short duration of action)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the mechanism of action of lignocaine and when is it given?

A
  • Reduces the automaticity of myocardial tissue,

Given as pharmacological cardioversion in ventricular arrhythmias.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the features of mitral stenosis on examination of the praecordium?

A
  • Low-pitched, mid-diastolic crescendo-decrescendo murmur best heard in left lateral position over apex with bell of stethoscope
  • Opening snap (after S2)
  • Accentuated first heart sound (stiff valve)
  • Loud P2 (pulmonary hypertension)
  • Basal lung crackles (pulmonary oedema)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the third heart sound?

A

Low-pitched, mid-diastolic gallop (after S2), best heart with bell (sloshing-in)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does a third heart sound indicate?

A

Rapid ventricular filling

  • Physiological: young people, pregnancy, thyrotoxicosis
  • Pathological: LV failure (dilated), mitral incompetence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the fourth heart sound?

A
  • Late diastolic gallop (before S1)
  • Higher pitched than S3 (a-stiff-wall)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does a fourth heart sound indicate?

A

Poorly compliant (stiff) ventricle against atrial contraction, caused by:

  • Age
  • Acute MR
  • Hypertension
  • IHD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the most common site of spontaneous rupture of an atherosclerotic aortic aneurysm?

A

Abdominal aorta below the level of the renal arteries

23
Q

What are the adverse effects of amiodarone?

A
  • Interstitial Lung Disease
  • Hypothyroidism
  • Hyperthyroidism
  • Corneal Deposits
  • Abnormal LFTs
  • Grey-blue skin discolouration
  • Epididymitis
  • Peripheral Neuropathies

**NOT renal toxicity**

24
Q

What is the difference between dihydropyridine and non-dihydropyridine calcium channel blockers?

A

Dihydropyridine (end in -pine):

  • bBlock L-type calcium channels on smooth muscle of peripheral vasculature
  • Used to treat hypertension

Non-dihydropyridine (verapamil, diltiazem):

  • Reduce cardiac contractility, HR and conduction
  • Have less of an effect on peripheral vasodilation
25
Q

What medications should all patients receive long-term after myocardial infarction?

A
  • Low dose aspirin + clopidogrel
  • ACEI
  • Statin
  • Beta-blocker
26
Q

Which medications improve mortality in heart failure?

A
  • Beta-2 antagonists
  • ACEIs
  • ARBs
  • Statins
  • Spironolactone / eplenerone
27
Q

What is the first line pharmacological treatment for systolic heart failure?

A
  • ACEI
  • Beta Blocker
  • Loop diuretic (if fluid overloaded)
  • Spironolactone (if symptoms persist)
28
Q

What are the indications for commencing statin therapy?

A
  • Clinical evidence of vascular disease (CAD, stroke, PVD)
  • Diabetes with microalbuminuria
  • Diabetes in patients >60 or Indigenous Australians
  • Extremely strong family history
  • Total cholesterol >7.5 or triglycerides >4 (PBS) in asymptomatic patients with no comorbidities or family history
29
Q

What is the approach to the management of a stable patient with sinus tachycardia?

A

Consider no treatment Try vagal manouvres Beta-blocker or calcium blocker if necessary

30
Q

What may a prolonged QT interval progress to?

A

Torsades de Pointes

31
Q

What is considered to be the safest cardioversion drug in heart failure?

A

Amiodarone

32
Q

What are the vagal manouvres?

A
  • Carotid sinus pressure
  • Swallowing ice cold water
  • Valsalva manouevre
33
Q

What is the management approach to AV nodal re-entry tachycardia?

A
  • Vagal manouevres
  • IV adenosine or verapamil if manouvres ineffective
  • Consider ablation in long-term management
34
Q

What medications can be used to treat bradyarrhythmias resulting in acute haemodynamic compromise?

A

Atropine or isoprenaline

35
Q

What is the treatment for persistent bradycardias?

A

Pacemaker insertion

36
Q

What are the praecordial findings in ASD?

A
  • Systolic murmur at upper LSB
  • Mid-diastolic murmur at lower LSB
  • Split S2
  • RV heave
37
Q

What is the murmur of a patent ductus arteriosus?

A

Continuous machine-like murmur in subclavian region

38
Q

What is the murmur of a VSD?

A
  • Harsh holosystolic murmur heard at LSB
  • Diastolic murmur at apex
39
Q

How do you determine left and right BBB?

A

Wide QRS with normal P waves Look at V1:

  • Mostly positive = RBBB
  • Mostly negative = LBBB
40
Q

Which cardiac medications can cause heart block?

A
  • Digoxin
  • Beta blockers
  • Calcium channel blockers
41
Q

What medical condition is associated with multifocal atrial tachycardia?

A

COPD

42
Q

What is the treatment for ventricular tacychardia?

A

If the patient is not hypotensive, give amiodarone or lignocaine.

If hypotensive/pulseless, give defibrillation.

43
Q

Which medications are contraindicated in WPW syndrome?

A

A - Adenosine

B - Beta-blockers

C - Calcium-channel blockers

D - Digoxin

44
Q

What is a delta wave and in which arrhythmia does it occur?

A

Slurred upstroke of QRS, occurring in WPW syndrome

45
Q

What is Beck’s triad and when does it occur?

A
  1. Hypotension
  2. Distal heart sounds
  3. Raised JVP

Occurs in cardiac tamponade.

46
Q

What features on ECG indicate a technical dextrocardia?

A
  • Negative P waves in lead I
  • Positive P waves in aVR
47
Q

What are the Soklov-Lyon criteria for LVH?

A

Combined S wave depth in V1 + tallest R wave height in V5-6 must be 35mm or greater

48
Q

Which diagnoses should be considered with the following T-wave changes on ECG?

(a) Peaked T waves
(b) Flattened T waves

A

(a) Hyperkalaemia
(b) Myocardial ischaemia, hypokalaemia

49
Q

What are Stokes-Adams attacks?

A

Loss of consciousness caused by rapid tachycardia at the onset of heart block or transient asystole

50
Q

Which viruses are typically involved in pericarditis?

A

Coxsackie B Viruses

51
Q

What is Dressler’s Syndrome?

A

Pericarditis occurring secondary to myocardial infarction (autoimmune, inflammatory reaction)

52
Q

Give 3 causes of ST elevation.

A
  1. Myocardial infarction
  2. Early repolarisation variant
  3. Pericarditis
53
Q

What is the diagnosis?

A

Hyperkalaemia (sine wave)

MHU (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions