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Medicine > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Origin of Troponin I

A

Cardiac specific regulatory sub-unit of contractile apparatus of striated muscle

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2
Q

Significance of Troponin reading

A

Trop released by damage to striated myocytes, indicating irreversible infarction or necrosis
Maximal 12h post cardiac event

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3
Q

Modes of coronary revascularisation

A

CABG

Percutaneous coronary angioplasty +/- stent

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4
Q

ACS

A

Acute reduction or cessation in coronary blood flow

  • NSTEMI
  • STEMI
  • Unstable angina
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5
Q

Symptoms associated with ACS

A

Sweating
Palpitations
Pallor
Dyspnoea

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6
Q

GP IIb/IIIa inhibitor examples

A

Tirofiban
Abciximab
Eptifbatide

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7
Q

4 classes of drugs contraindicated in 3rd degree heart block

A

ß-Blockers: propanolol
Non-dihydropyradine Ca channel blockers: Verapamil, diltiazem
Anti-arrhythmics: Amiodarone, Flecainide

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8
Q

4 treatment options in 3rd degree heart block (no haemodynamic compromise)

A

Conservative: monitor in CCU
Atropine 600ug IV
External pacing (sedation)
Temporary ventricular pacing (risk infection)

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9
Q

Symptoms of acute paricarditis

A

Sharp, central CP
Pleuritic CP, relieved on sitting upright
Intermittent fever/lethargy
Systolic rub

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10
Q

Causes of acute viral pericarditis

A 
Coxsackie
Echovirus
Mumps
Rubella
Influenza
Hepatitis B
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11
Q

ECG changes in pericarditis

A

Widespread ST elevation
Saddle shaped ST segment
T wave flattening/inversion later
Resolves in time

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12
Q

Non infectious causes of pericarditis

A 
Acute MI
Dressler's syndrome (post MI)
Post-cardiotomy syndrome
Haemopericardium
Renal failure
Autoimmune disease/vasculitis
Neoplasia
Mediastinal irritation
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13
Q

Management of acute idiopathic pericarditis

A

Analgesia, usually NSAID

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14
Q

Dressler’s syndrome

A

Acute febrile illness 2-4 weeks post MI

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15
Q

Cause of bacterial pericarditis

A

Mycobacterium TB

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16
Q

5 causes of narrow complex tachycardia

A 
Atrial flutter with 2:1 block
Atrial tachycardia
AVNRT
AVRT
Sinus tachycardia
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17
Q

Causes of regular tachycardia

A 
Caffeine
Alcohol
Stress
ß-agonists
Exercise
HT
Thyrotoxicosis
PE
Sepsis
Hypovolaemia
Anaemia
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18
Q

Management of atrial flutter

A

Give adenosine to reveal flutter waves in narrow complex tachycardia/vagal manouvre
Amiodarone IV to terminate flutter waves
If amiodarone fails, DC cardioversion (anticoagulant if long-term arrhythmia)

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19
Q

Description of sinus tachycardia

A

Rate rarely >150bpm unless exercising

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20
Q

Management of sinus tachycardia

A

Treat underlying cause e.g. anaemia, exercise, caffeine, sepsis

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21
Q

Description of atrial flutter

A

300bpm

Conduction block common, resulting in 150 bpm ventricular rate

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22
Q

Management of Atrial Flutter

A

Adenosine or vagal manouvres to reveal flutter waves if uncertain re:Dx
Amiodarone for cardioversion

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23
Q

Description of atrial tachycardia

A

120-150bpm due to hyper-excitable tissue/extrasystoles
Occurs in digoxin toxicity
P waves visible and roughly normal

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24
Q

Management of atrial tachycardia

A

Amiodarone or verapamil for cardioversion

If digoxin toxicity: correct hypokalaemia, give ß-blockers +/- digoxin specific antibody fragments

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25
Q

Description of AVNRT

A

140-220bpm

P-waves barely visible

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26
Q

Management of AVNRT

A

Vagal manœuvres

Cardioversion with verapamil or adenosine

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27
Q

Description of AVRT

A

140-220bpm
retrograde P waves during tachycardia
Delta wave and short PR interval in sinus rhythm

28
Q

Management of AVRT

A

Vagal manœuvres

Adenosine or Verapamil for cardioversion

29
Q

Name 3 broad complex tachycardias

A

VT
Torsade de pointes
SVT with aberrant conduction

30
Q

Features and management of VT

A

Rate >120bpm

Lignocaine
Amiodarone
DC cardioversion

31
Q

Features and management of torsade de pointes

A

Variable QRS axis
Prolonged QT

Magnesium sulphate infusion

32
Q

Features and management of SVT with aberrant conduction

A

Treat as if VT if in any doubt

I.E. Avoid verapamil in case of haemorrhaging collapse and sudden death

33
Q

Symptoms of MI

A 
Rapid onset severe central chest pain
Radiation to neck and arms
Sweaty
Nausea
Faint
Dizzy
34
Q

Risk factors for MI

A 
Smoking
HT
IHD/stroke
Alcohol
High cholesterol
DM
PVD
Family Hx
35
Q

6 drugs to improve prognosis in MI

A 
Beta blockers
Aspirin
Statin
ACEI
Clopidogrel
Thrombocytes with streptokinase or tPA
36
Q

2 drugs that exacerbate symptoms of heart failure

A

Beta blockers

Calcium channel blockers

37
Q

CXR findings in HF

A 
Alveolar shadowing/oedema/fluid in horizontal fissure
B-lines
Cardiomegaly
Diversion in upper lobes
Effusions
38
Q

Management of HF

A

Diuretics
ACEI

Digoxin
Nitrates
Other vasodilators eg hydralazine/prazosin

39
Q

Symptoms of AF

A

Fast, irregular palpitations
Dyspnoea
Limb weakness (TIA)

40
Q

Conditions that can cause AF

A 
Thyrotoxicosis
IHD
Cardiomyopathy
Mitral stenosis
Alcoholism, smoking
41
Q

Management of AF

A

Address risk factors
Digoxin, amiodarone, solatolol
Aspirin 300mg OD/warfarin if does not consume alcohol
+/- DC cardioversion

42
Q

Siide effects of amiodarone

A

Grey skin and photosensitivity
Pulmonary fiibrosis
Thyroid dysfunction
Hepatitis

43
Q

Symptoms of IE

A 
Exertional dyspnoea
Malaise
Fever
Flu-like illness/cough
Ankle oedema
Pansystolic murmur in mitral area
44
Q

Murmur in IE

A

Pansystolic murmur in mitral area

45
Q

3 Eponymous signs of IE

A

Janeway lesions: macular, non-tender lesions on palms and soles
Osler’s nodes: painful red lesions on finger pulps
Roth spots: retinal haemorrhage with pale exudative centre

46
Q

2 essential investigations in IE

A 
Blood cultures (x3)
Echo
47
Q

Complications of IE

A

Septic emboli (LHS) causing renal failure
Meningitis/meningio-encephalitis
Pulmonary emboli (RHS)
Mycotic aneurysm

48
Q

Common organisms causing IE

A

Strep viridans/bovis
Staph aureus/epidermidis
Pseudomonas
HACEK group (uncommon) (Gram -ve fastidious) Haemophilus, Actinobacillus, Actinomyces, Cardiobacterium,Eikenella, Kingella

49
Q

Symptoms of HOCM

A

Exertional dyspnoea
CP
Exertional collapse
FHx

50
Q

Inheritance of HOCM

A

Autosomal dominant

51
Q

Causes of cardiomyopathy

A

IHD
HT
Alcohol
Sarcoid

52
Q

Ix of HOCM

A

CXR
ECG
Echo with doppler
Exercise test with BP monitoring

53
Q

Tx of HOCM

A 
Amiodarone
Beta-blockers
Ca Channel blockers
Surgery
Family screening
54
Q

Causes of cyanotic heart disease

A

Fallot’s tetralogy
Transposition of great vessels
Eisenmenger’s syndrome (R-L shunt across VSD)

55
Q

Components of Fallot’s Tetralogy

A

Over riding aorta
VSD
RVH
Pulmonary stenosis

56
Q

Treatment options for Fallot’s tetralogy

A

Surgery:

  1. Palliative with shunt formation
  2. Complete repair 6 months later

If advanced disease, palliate with diuretics and oxygen

57
Q

Symptoms of cyanotic heart disease

A 
Exertional dyspnoea
Clubbing
Cyanosis at rest
Parasternal heave
Ejection systolic murmur loudest in pulmonary area
58
Q

Management of acute LVF

A

Sit upright
Oxygen
IV furosemide
Diamorphine and anti-emetic
IV nitrates and catheterisation if severe
Monitor obs in case of requirement for inotropic support

59
Q

Symptoms of AS

A

Exertional CP
Exertional dyspnoea
Syncope

60
Q

Common causes of AS

A

Old age calcification
Rheumatic valve disease
Congenital bicuspid valve

61
Q

Ix for AS

A

CXR
ECG
Echo
Cardiac catheter studies

62
Q

Signs of AS

A

Slow-rising pulse
Narrow pulse pressure
Apex heave
Ejection systolic murmur radiating to carotids

63
Q

AS management

A

Replace the valve

64
Q

7 classes of anti-hypertensive medication

A 
Beta-blocker: atenolol
Ca channel blocker: Diltiazem, verapamil, nifedipine, amloipine
Nitrates: BTN
ACEI: Ramipril, lisinopril
Diuretic: Bendroflumethiazide
Alpha blockers: Doxazocin
ATII antagonists: valsartan, candesartan
65
Q

4 endocrine disorders that can present with HT

A

DM
Conn’s syndrome
Cushing’s syndrome
Phaechromocytoma

66
Q

3 renal causes of HT

A

RA stenosis
Polycystic kidney disease
Renal malignancy

Medicine (15 decks)

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