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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
Description of AVNRT
140-220bpm | P-waves barely visible
26
Management of AVNRT
Vagal manœuvres | Cardioversion with verapamil or adenosine
27
Description of AVRT
140-220bpm retrograde P waves during tachycardia Delta wave and short PR interval in sinus rhythm
28
Management of AVRT
Vagal manœuvres | Adenosine or Verapamil for cardioversion
29
Name 3 broad complex tachycardias
VT Torsade de pointes SVT with aberrant conduction
30
Features and management of VT
Rate >120bpm Lignocaine Amiodarone DC cardioversion
31
Features and management of torsade de pointes
Variable QRS axis Prolonged QT Magnesium sulphate infusion
32
Features and management of SVT with aberrant conduction
Treat as if VT if in any doubt | I.E. Avoid verapamil in case of haemorrhaging collapse and sudden death
33
Symptoms of MI
``` Rapid onset severe central chest pain Radiation to neck and arms Sweaty Nausea Faint Dizzy ```
34
Risk factors for MI
``` Smoking HT IHD/stroke Alcohol High cholesterol DM PVD Family Hx ```
35
6 drugs to improve prognosis in MI
``` Beta blockers Aspirin Statin ACEI Clopidogrel Thrombocytes with streptokinase or tPA ```
36
2 drugs that exacerbate symptoms of heart failure
Beta blockers | Calcium channel blockers
37
CXR findings in HF
``` Alveolar shadowing/oedema/fluid in horizontal fissure B-lines Cardiomegaly Diversion in upper lobes Effusions ```
38
Management of HF
Diuretics ACEI Digoxin Nitrates Other vasodilators eg hydralazine/prazosin
39
Symptoms of AF
Fast, irregular palpitations Dyspnoea Limb weakness (TIA)
40
Conditions that can cause AF
``` Thyrotoxicosis IHD Cardiomyopathy Mitral stenosis Alcoholism, smoking ```
41
Management of AF
Address risk factors Digoxin, amiodarone, solatolol Aspirin 300mg OD/warfarin if does not consume alcohol +/- DC cardioversion
42
Siide effects of amiodarone
Grey skin and photosensitivity Pulmonary fiibrosis Thyroid dysfunction Hepatitis
43
Symptoms of IE
``` Exertional dyspnoea Malaise Fever Flu-like illness/cough Ankle oedema Pansystolic murmur in mitral area ```
44
Murmur in IE
Pansystolic murmur in mitral area
45
3 Eponymous signs of IE
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
2 essential investigations in IE
``` Blood cultures (x3) Echo ```
47
Complications of IE
Septic emboli (LHS) causing renal failure Meningitis/meningio-encephalitis Pulmonary emboli (RHS) Mycotic aneurysm
48
Common organisms causing IE
Strep viridans/bovis Staph aureus/epidermidis Pseudomonas HACEK group (uncommon) (Gram -ve fastidious) Haemophilus, Actinobacillus, Actinomyces, Cardiobacterium,Eikenella, Kingella
49
Symptoms of HOCM
Exertional dyspnoea CP Exertional collapse FHx
50
Inheritance of HOCM
Autosomal dominant
51
Causes of cardiomyopathy
IHD HT Alcohol Sarcoid
52
Ix of HOCM
CXR ECG Echo with doppler Exercise test with BP monitoring
53
Tx of HOCM
``` Amiodarone Beta-blockers Ca Channel blockers Surgery Family screening ```
54
Causes of cyanotic heart disease
Fallot's tetralogy Transposition of great vessels Eisenmenger's syndrome (R-L shunt across VSD)
55
Components of Fallot's Tetralogy
Over riding aorta VSD RVH Pulmonary stenosis
56
Treatment options for Fallot's tetralogy
Surgery: 1. Palliative with shunt formation 2. Complete repair 6 months later If advanced disease, palliate with diuretics and oxygen
57
Symptoms of cyanotic heart disease
``` Exertional dyspnoea Clubbing Cyanosis at rest Parasternal heave Ejection systolic murmur loudest in pulmonary area ```
58
Management of acute LVF
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
Symptoms of AS
Exertional CP Exertional dyspnoea Syncope
60
Common causes of AS
Old age calcification Rheumatic valve disease Congenital bicuspid valve
61
Ix for AS
CXR ECG Echo Cardiac catheter studies
62
Signs of AS
Slow-rising pulse Narrow pulse pressure Apex heave Ejection systolic murmur radiating to carotids
63
AS management
Replace the valve
64
7 classes of anti-hypertensive medication
``` 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
4 endocrine disorders that can present with HT
DM Conn's syndrome Cushing's syndrome Phaechromocytoma
66
3 renal causes of HT
RA stenosis Polycystic kidney disease Renal malignancy

Medicine (15 decks)

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