Cardiology

Question 1

Angina

Answer 1

Can be stable, variant or unstable

Question 2

Acute Coronary Syndrome

Answer 2

MI or unstable angina

Question 3

MI

Answer 3

Neutrophils and macrophages go to infarcted area

Question 4

Hypertension

Answer 4

Primary= ANS or RAS dysfunction
Secondary= CKD, Conn’s, Cushing’s, phaechromocytoma
Risk calculated by Framingham score

Question 5

Conn’s Syndrome

Answer 5

High aldosterone

Sodium and water retention

Question 6

RAS System

Answer 6

Renin cleaves angiotensinogen to angiotensin I (changed to II in lungs)
Angiotensin stimulates aldosterone

Question 7

Left Heart Failure

Answer 7

Causes= high BP, vascular disease, MIs
Symps= irritability, stupor, coma, dyspnoea, orthopnoea, PND, cyanosis, sputum

Question 8

Right Heart Failure

Answer 8

Causes= LHF, cor pulmonale (high lung BP)
Symps= hepatomegaly, splenomegaly, ascites, effusions, oedema, fatigue

Question 9

Mitral Stenosis

Answer 9

Rheumatic heart disease

Causes= group A strep, inflam, pericarditis, vegetations, calcifications, fused valves

Question 10

Aortic Stenosis

Answer 10

Causes= LV hypertrophy, ischaemia, hypertension, CHF, angina

Question 11

Aortic Regurgitation

Answer 11

Causes= rheumatic, infections, aortic dilations

Question 12

Mitral Prolapse

Answer 12

Flappy valve
Causes= infection, calcification, degeneration
Symps= click, chest pain, dyspnoea
Comps= endocarditis, insufficiency, arrhythmias, death

Question 13

Left to Right shunts

Answer 13

No cyanosis

Pulmonary hypertension

Question 14

Atrial Septal Defect

Answer 14

LtoR
Primary= next to AV valves
Secondary= defective fossa ovale
Sinus venosus= next to sup vena cavae

Question 15

Ventricular Septal Defect

Answer 15

LtoR
Mostly membranous septum
If muscular, have many holes

Question 16

Patent Ductus Arteriosus

Answer 16

Shunts either way if pressure equalises
Harsh murmur
Needs closing

Question 17

AV Septal Defect

Answer 17

LtoR
Defective valves
Partial or complete
Associated with Down’s

Question 18

Right to Left Shunts

Answer 18

Get cyanosis

Question 19

Truncus Arteriosus

Answer 19

RtoL
Aorta+pulmonary artery continuous
Associated with VSD

Question 20

Tetralogy of Fallot

Answer 20

RtoL
VSD
Pulmonary Stenosis
Overriding Aorta
RV Hypertrophy

Question 21

Transposition of Great Arteries

Answer 21

RtoL
Aorta goes to lungs, PA goes to body
Need shunt, ASD, VSD or PDA to survive

Question 22

Total Anomalous Pulmonary Venous Connection

Answer 22

RtoL
Pulmonary vein goes into wrong place
Often as small left atrium
Need PFO or VSD to survive

Question 23

Coarctation of the Aorta

Answer 23

Bad if proximal to PDA

50% have bicuspid aortic valve

Question 24

Pulmonary Stenosis/Atresia

Answer 24

Hypoplastic right ventricle with ASD

Question 25

Infective Endocarditis

Answer 25

``` Acute= necrotising, ulcerative, cured with surgery Sub-acute= deformed valves, cured with abx RFs= abnormalities, rheumatism, fake valves Bacteria= strep viridans from mouth, s aureus, coag -ve staph Comps= glomerulonephritis ```

Question 26

Non-Infective Endocarditis

Answer 26

Causes= SLE, hypercoaguable state, trauma, catheter

Question 27

Rheumatic Fever (endocarditis)

Answer 27

Causes= group A strep, pharyngitis, inflam Aschoff bodies= transmural lesions Get mitral stenosis Comps= mural thrombi, RV hypertrophy

Question 28

Pericarditis Causes

Answer 28

Infections (coxsackie) SLE Post MI

Question 29

Acute Pericarditis

Answer 29

Serou, supparative, haemorrhagic (cancer, infections, surgery) or caseous (TB or fungal)

Question 30

Chronic Pericarditis

Answer 30

Adhesive or constrictive

Question 31

Dressler's Syndrome

Answer 31

``` Post MI (AI response to Ags) Get pericardial effusion ```

Question 32

Dilated Cardiomyopathy

Answer 32

Causes= genetics, alcohol, chemo, SLE, DM | Can die from LVF, arrhythmias or emboli

Question 33

Hypertrophic Cardiomyopathy

Answer 33

``` Myocytes lose arrangement Genetic Low SV Systolic ejection murmur Treatment= beta blockers, surgery ```

Question 34

Restrictive Cardiomyopathy

Answer 34

Decreased ventricular competence | Causes= unknown, fibrosis, sarcoidosis, cancer

Question 35

Arrhythmogenic Right Ventricular

Answer 35

Genetic Affects desmosomes RV dilation and thin myocardium

Question 36

Myocarditis

Answer 36

Causes= coxsackie, Chagas, echoviruses, HIV, post viral, rheumatic fever, SLE, sarcoidosis

Question 37

Vasculitis

Answer 37

Causes= giant cell arthritis Get chronic granulomatous infection Thick intima Need corticosteroids

Question 38

Aneurysms

Answer 38

Micro syphilitic= intracerebral capillaries Mycotic= weak wall due to infection False= blood fills around vessel