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Exam Revision > Cardiology > Flashcards

Cardiology Flashcards

1
Q

what does the P wave represent

A

atrial depolarisation

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2
Q

normal duration of P wave

A

0.08-0.1 seconds

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3
Q

what does the QRS complex represent

A

ventricular depolarisation

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4
Q

normal duration of QRS

A

<0.1 seconds

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5
Q

what does the T wave represent

A

ventricular re-polarisation

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6
Q

what does the PR interval represent

A

AV node delay

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7
Q

normal duration of PR interval

A

0.12-0.2 seconds

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8
Q

where do the ventricles contract

A

ST segment (systole)

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9
Q

where do the ventricles relax

A

TP segment (diastole)

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10
Q

which leads does an inferior MI affect

A

II, III, aVF

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11
Q

which artery is occluded in inferior MI

A

Right coronary artery

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12
Q

which leads does an anterior MI affect

A

V1-V4

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13
Q

which artery is occluded in an anterior MI

A

Left anterior descending

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14
Q

which leads does a lateral MI affect

A

I, aVL, V5-V6

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15
Q

which artery is occluded in a lateral MI

A

left circumflex

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16
Q

which leads are affected in an antero-lateral MI

antero-septal MI

A

anterolateral = I, aVL, V4-V6
(left circumflex)

anteroseptal = I, aVL, V1-V4
(LAD)

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17
Q

Types of MI

A

STEMI
- ST elevation + tall T waves

NSTEMI

  • ST depression
  • T wave inversion
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18
Q

what marker is raised in MI

A

troponin T

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19
Q

acute management of MI

A 
MONA + C
morphine 
oxygen 
nitrates (GTN sublingual) 
aspirin 300mg chewed 
clopidogrel 300mg oral gel
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20
Q

MI Tx if presenting in 90 mins

A

PCI

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21
Q

MI Tx if presenting >90 mins

A

Thrombolysis

- streptokinase + aspirin

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22
Q

what is dressers syndrome

A

2-6 weeks post MI

  • recurrent pericarditis (chest pain relieved by sitting forward)
  • fever
  • increased ESR
  • anaemia
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23
Q

what score is used to assess NSTEM

A

GRACE score

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24
Q

Tx of Angina

A

GTN + either:
Beta blocker or rate limiting calcium channel blocker (verapamil)

secondary prevention: aspirin/ACEi/statin

If uncontrolled, can add in

  • long acting nitrate – isosorbide mononitrate
  • HCN channel inhibitor – ivabradine
    • K+ activator – nicorandil
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25
Q

presentation of left heart failure

A

fatigue
exertional dyspnoea
orthopnoea
cough - pink frothy sputum

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26
Q

presentation of right heart failure

A

Increased JVP
Pitting oedema
Ascites
Hepatomegaly

27
Q

Tx heart failure

A

ACEI/ARB
Beta blocker
Loop diuretic

28
Q

what can be added in heart failure not improving with first line therapy

A

spironolactone

digoxin

29
Q

signs of cardiac tamponade

A

decreased BP
increased JVP
muffled heart sounds
pulsus paradoxus – pulses fade on inspiration

30
Q

diagnostic of tamponade

A

ECHO

31
Q

tx tamponade

A

urgent pericardiocentesis

32
Q

most common cause of myocarditis

A

coxackie

33
Q

symptoms of myocarditis

A 
flu like symptoms - fever, sore throat, myalgia 
SOB
fatigue 
palpitations 
chest pain
34
Q

what BP is defined as hypertensive

A

> 140/90 on 2 separate readings

35
Q

what is used if diagnosis of hypertension is unclear

A

24 hour ambulatory blood pressure

36
Q

what is recommended if BP is borderline high-normal (e.g. 130-139/85-90)

A

lifestyle modification

reassess yearly

37
Q

first line antihypertensive if younger than 55

A

ACEI or ARB

38
Q

first line antihypertensive if over 55

A

calcium channel blocker (amlodipine)

39
Q

second line hypertension

A

ACE + Calcium channel blocker

40
Q

3rd line hypertension

A

ACE + Ca blocker + thiazide diuretics

41
Q

tx resistant hypertension

A

ACE + ca blocker + thiazide + spironolactone

42
Q

malignant hypertension

A

diastolic BP > 120 + headache, visual disturbance, convulsions

tx- oral atenolol or amlodipine

43
Q

who gets tricuspid valve endocarditis (right sided)

A

IV Drug users

44
Q

Tx drug user endocarditis

A

Flucloxacillin

45
Q

what bacteria causes endocarditis in early prosthetic valve replacement (within 60 days)

A

staph epidermis

46
Q

Tx of prosthetic valve endocarditis

A

Vancomycin + gentamicin

47
Q

Tx of native valve endocarditis

A

Benzylpenicillin + Gentamicin

48
Q

when should you suspect endocarditis

A 
new/ changing heart murmur
clubbing 
Roth spots/janeway lesions 
fever 
malaise 
weight loss
49
Q

MRS ASS

A

Mitral regurgitation systolic

Aortic stenosis systolic

50
Q

presentation of aortic stenosis

A 
ejection systolic murmur over aortic area can radiate to carotids
exertional dyspnoea 
angina 
dizziness 
4th heart sound  + narrow pulse pressure
51
Q

presentation of aortic regurgitation

A

early diastolic blowing murmur
high volume collapsing pulse
nocturnal dyspnoea
3rd heart sound + wide pulse pressure

52
Q

presentation of mitral stenosis

A 
mid diastolic rumble 
loud 1st heart sound + opening snap 
malar flush 
tapping apex beat 
AF + right heart failure
53
Q

presentation of mitral regurgitation

A

pan systolic murmur
radiates to axilla
jerky pulse
3rd heart sound

54
Q

most common congenital heart defect

A

ventricular septal defect

- loud pan systolic murmur at left sternal edge

55
Q

what organism causes endocarditis after dental work

A

strep viridans

56
Q

tetralogy of fallot

A

ventricular septal defect
pulmonary stenosis
right ventricle hypertrophy
overriding aorta

57
Q

pulmonary stenosis

A

ejection systolic murmur left upper sternal border
left parasternal heave
4th heart sound

58
Q

what causes rheumatic fever

A

strep pyogenes

59
Q

symptoms of rheumatic fever

A

pericarditis/myocarditis/endocarditis
arthritis
erythema

60
Q

wolf Parkinson white

A

bundle of Kent (accessory pathway) – re entry tachycardia

- palpitations, dizziness, collapse

61
Q

stokes Adams attack

A

temporary loss of cardiac output causing sudden collapse/blackouts – loss of consciousness

62
Q

sudden death in young person

A

hypertrophic cardiomyopathy

63
Q

mechanism of action of statins

A

inhibit HMG-CoA reductase (the rate limiting enzyme in hepatic cholesterol)

Exam Revision (32 decks)

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