Cardiology

Question 1

Key indicators of Cor Pulmonale?

Right side heart failure

Answer 1

JUGULAR VEIN DISTENTION – 7cm away from the sternal angle

PARASTERNAL HEAVE - impulse felt with the fingers LEFT of the sternum. Caused by chronic contractions of the right heart against higher pressure.

Haemoptysis (bc ruptured pulmonary artery)

Hepatojugular reflex (‘NUTMEG LIVER’ –> jaundice/ hepatomegaly/ ascites)

Peripheral pitting oedema

Palpitations

Question 2

Key indicators of left side heart failure

Answer 2

Causes Pulmonary Congestion + oedema

Coughing up PINK TINGED SPUTUM

CYANOSIS

NOCTURNAL DYSPNOAE (wake up feeling like you’re drowning)

Dyspnoea when LYING DOWN

Question 3

Key symptoms of Aortic Stenosis

Answer 3

Usually asymptomatic unless you exert yourself

SAD
Syncope
Angina
Dyspnoae/ Dizziness/ Delayed weak pulse

Early systolic ejection click
Slow rising pulse

Question 4

What causes aortic stenosis?

Answer 4

Usually calcification (wear + tear) + hyperlipidaemia.

Also be Rheumatic heart disease (major cause for Mitral stenosis)

Question 5

Key symptoms of Rheumatic heart disease?

SAME SYMPTOMS FOR PANCARDITIS

Answer 5

J<3NES

Joint pain (migratory arthritis)
Pancarditis 
Nodules (Aschoff's bodies)
Erythema marginatum (red rash with clear borders)
Syndenham Chorea (jerky movements)

PLUS fever + vegetations on heart valves + raised CRP in blood

Question 6

What causes Rheumatic heart disease?

Answer 6

Staph A

Caused by molecular mimicry of M proteins following infection

Question 7

What are the 6 P’s of acute ischaemia

Answer 7

Pallor
Pulseless
Pain 
Polar (cold)
Parasthesis
Paralysis

Question 8

What are the key indicators of Giant Cell Arteritis?

Answer 8

Headache 
Amaurosis Fugax
Jaw claudication
Fever
Weight loss

Question 9

Key indicators of Endocarditis?

FROM JANE

Answer 9

Fever
Roth Spots (in eye)
Osler’s nodes
Murmurs (left side)

Janeway lesions
Anaemia
Nail splinter haemorrhage
Emboli (septic)

Question 10

Key indicators of acute Pericardiits?

Answer 10

Fever + non productive cough

PLEURITIC CHEST PAIN that improves when sat/ leaning forward

PERICARDIAL FRICTION RUB

PERICARDIAL EFFUSION

Question 11

Key indicators of constrictive pericarditis? (chronic)

Fluid overload symptoms bc heart can’t fully empty

Answer 11

JUGULAR VEIN DISTENTION

Tachycardic

Fever, leucocytosis, pericardial effusion

CARDIAC TAMPONADE

Question 12

Key indicators of dilated cardiac myopathy?

Heart becomes dilated, enlarged + heavy

Answer 12

SOB

Fatigue

Leads to left + right side heart failure + mitral regurge

Question 13

Key indicators of hypertrophic cardiomyopathy?

Usually autosomal dominant, but also caused by incr blood pressure which causes left ventricular hypertrophy

Answer 13

Usually asymptomatic

ANGINA PECTORIS

SYNCOPE

Vertigo

Dyspnoae

Sudden cardiac death

Question 14

Key indicators + causes of restrictive cardiomyopathy?

Answer 14

Secondary to inflammatory fibrosis e.g. sarcoidosis, scleroderma

Symptoms - left and right side heart failure

Question 15

Key indicators of Meningitis?

Answer 15

Non blanching rash

Photophobia

neck stiffness (BRUDZINKI)

Kernig’s sign – flex thigh at at 90o and try to extend, patient will experience pain and there will be resistance

Question 16

Key indicators of Encephalitis?

Answer 16

SEIZURES

FOCAL NEUROPATHY

Headache, fever

Question 17

Key indicators of Brain abscess?

Answer 17

Fever, headache, seizures, behaviour changes, stiff neck

PAPILOEDEMA

Question 18

What are the 3 indicators of Cardiac Tamponade

Answer 18

Low arterial BP

Distended neck veins

Distant muffled heart sounds

Question 19

Symptoms of aortic aneurysm?

Answer 19

Can come on AFTER LIFTING
HYPOTENSION
neurological signs
CHEST PAIN RADIATING TO BACK

Question 20

Classic presentation of an MI

Answer 20

CENTRAL CHEST PAIN THAT WAKES YOU FROM SLEEP (could also be angina)

NOCTURNAL COUGH

SOB

Question 21

Pulmonary Embolus - cardiac presentation

Answer 21

RAISED JVP

HYPOTENSION

Non productive cough

Question 22

Patient presents with

JUGULAR VEIN DISTENTION 
PARASTERNAL HEAVE 
Haemoptysis 
Hepatojugular reflex
Peripheral pitting oedema
Palpitations

What do they have?

Answer 22

Cor Pulmonale

Question 23

Patient presents with 
Coughing up PINK TINGED SPUTUM 
CYANOSIS
NOCTURNAL DYSPNOAE (wake up feeling like you're drowning)
Dyspnoea when LYING DOWN

Answer 23

Left sided heart failure

Question 24

What condition (other than right side heart failure) can cause a patient to present with Jugular vein distention?

Answer 24

Pulmonary Embolus

Question 25

Patient admitted after having collapsed in town.
Has a jerky impulse, inspiratory crackles, chest pain, mid-systolic murmur.

What does she have?

Answer 25

Hypertrophic cardiomyopathy

Question 26

Patient presents with severe SOB, incr over the last few months. Previously admitted with 3 MI’s.

What does he have?

Answer 26

Ischaemic cardiomyopathy

Question 27

Woman with SLE presents with sharp central chest pain that is worse lying back and relieved when leaning forward. What does she have?

Answer 27

Acute pericarditis (pleuritic chest pain relieved when leaning forward)

Question 28

What is Corrigan’s pulse?

Answer 28

Collapsing pulse.

Caused by aortic regurge

Question 29

What is De Musset’s sign?

Answer 29

Bobbing of head in sync with heart beating.

Caused by aortic regurge