Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

YEAR 3: Conditions Knowledge > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Define the diagnostic criteria for abdominal aortic aneurysm

A

Diameter of >3cm or >50% larger than normal size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Recall 3 groups of risk factors for AAA and give examples of each

A

CV: hyperlipidaemia, atherosclerosis
Inflammatory: takasayu’s arteritis
Connective tissue: Marfan’s, Ehlers-Danlos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is pain felt in a ruptured AAA?

A

Abdomen, back or loin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the nature of pain in a rutured AAA

A

sudden + severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Recall the symptoms of a ruptured AAA

A

Pain
Syncope
Shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Recall the signs of AAA

A

3Bs: bulging, bruits, bruising
Pulsatile and laterally expansile mass
Abdominal bruit
Grey Turner’s sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Grey Turner’s sign?

A

Flank bruising

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes Grey-Turner’s sign in AAA?

A

Retroperitoneal damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What scans can be used to detect AAA?

A

US can see aneurysm but not rupture

CT contrast can see rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define aortic dissection

A

Tear in aortic intima –> blood surge into aortic wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the difference between types A and B aortic dissection?

A

Type A = in ascending aorta

Type B = in descending aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can surrounding arteries be damaged in aortic dissection?

A

Expansion of the false lumen can obstruct the subclavian/ coeliac/ carotid or renal arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the main risk factor for aortic dissection?

A

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Between which 2 layers of the aortic wall does a false lumen develop in aortic dissection?

A

Inner and outer tunica media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the main symptom of aortic dissection?

A

Tearing chest pain that may radiate to the back between the shoulder blades

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If the carotid artery is obstructed by an aortic aneurysm, what would the symptoms be?

A

Hemiparesis
Dysphasia
Loss of consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why might an aortic dissection present with abdominal pain?

A

Obstruction of coeliac artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Recall the signs of aortic dissection

A

Wide Pulse Pressure
Aortic Regurgitation
Back Murmur
Blood pressure difference between arms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What might hypotension with aortic dissection indicate?

A

Cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What form of specialised imaging could be used in aortic dissection as well as CXR and CT?

A

Cardiac catheterisation and aortography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define aortic regurgitation

A

Reflux from aorta into left ventricle during diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Recall the 2 groups of causes of aortic regurgitation and give examples of both

A
  1. Valve abnormality: infective endocarditis, trauma

2. Aortic root dilatation: HTN, aortitis, arthritides, aortic dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What arthritides are present in the case of aortic regurgitation?

A

Aortic valve incompetence due to reumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which 2 measures of cardiac output are changed by aortic regurgitation and why is this?

A

End Diastolic Volume (EDV) and Stroke Volume (SV) are elevated due to LV dilatation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Recall the consequence of chronic and acute aortic regurgitation

A

Chronic: leads to heart failure
Acute: leads to a sudden CV collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Important: Recall the 4 key signs of aortic regurgitation

A

Early diastolic murmur
Collapsing pulse
Wide Pulse Pressure
Displaced and heavy apex beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Define aortic stenosis

A

Narrowing of left ventricular outflow at level of aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the most common cause of aortic stenosis?

A

Rheumatic heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When symptomatic, what symptoms may aortic stenosis cause?

A

Angina
Syncope on exercise
Symptoms of left heart failure: dyspnoea and orthopnoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Recall the signs of aortic stenosis

A 
Narrow Pulse Pressure
Ejection Systolic Murmur
Thrusting Apex Beat
Aortic Thrill
Slow-rising Pulse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Think of 2 ECG signs that may be seen in aortic stenosis

A

Signs of LV hypertrophy

LBBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which patients are most at risk of arterial ulcer?

A

Those with severe atheroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the hallmark symptom of arterial ulcers?

A

Night pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Describe the appearance of an arterial ulcer

A

Punched-out

Hairless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the effects of an arterial ulcer downstream of the artery it affects?

A

Nail dystrophy

Absence of pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the key investigation for arterial ulcers?

A

Duplex ultrasonography of lower limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the 3 subdivisions of atrial fibrillation?

A

Permanent
Persistent
Paroxysmal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What symptoms are possible with atrial fibrillation?

A

Palpitations

Syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the main complication risk of atrial fibrillation?

A

Thromboembolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Describe the pulse in atrial fibrillation

A

Irregularly irregular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What key examination finding is indicative of atrial fibrillation?

A

Difference between apical beat and radial pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Which electrolytes need to be measured in AF, and why?

A

K+, Mg2+, Ca2+

There is a risk of digoxin toxicity if potassium or magnesium are low, or if calcium is high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the characteristic appearance of atrial flutter on ECG?

A

Saw tooth baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How is rhythm controlled in acute atrial fibrillation?

A

If <48 hours: DC cardioversion, chemical cardioversion (amiodarone/flecainide)
If >48 hours since onset: anticoagulate, then do as above

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Recall 3 drugs used to control rate in AF

A

Digoxin
Verapamil
Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How is longterm medication for AF decided?

A

Depends on stroke risk
Low risk patients = aspirin
High risk patients = warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How do you measure stroke risk?

A

CHADS-vasc score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Recall the reversible causes of cardiac arrest

A 
4 Hs and 4Ts
Hypokalaemia
Hypothermia
Hypovolaemia
Hypoxia
Tamponade
Tension pneumothorax
Thromboembolic
Toxins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What drug is given in cases of asystole?

A

Atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Which drugs are given between each round of CPR in VF cardiac arrest?

A 
shock + no drug
CPR
shock + adrenaline
CPR
shock + amiodarone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are the defining characteristics of heart failure?

A

Cardiac output does not equal demand

Venous pressure is NORMAL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Recall the mnemonic for and the causes of left heart failure

A 
Heart failure leaves you sitting in a CHAIR
Cardiomyopathy
Hypertension
Aortic valve disease
Ischaemic heart disease
Regurgitation (mitral)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Recall 5 causes of right heart failure

A 
Cardiomyopathy
Tricuspid regurgitation
Respiratory causes
Infarction
As secondary to LHF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Recall 4 causes of biventricular heart failure

A

Cardiomyopathy
Myocarditis
Arrhythmia
Drug toxicity (–> arrhythmia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Recall 3 causes of HIGH output heart failure

A

Demand is increased so:
Pregnancy
Anaemia
Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Recall the 3 key symptoms of left heart failure

A

Dyspnoea
Paroxysmal nocturnal dyspnoea
Orthopnoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Recall one weird sign that is present in acute left ventricular failure

A

Pink frothy sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are left heart failure symptoms a result of?

A

Pulmonary congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Recall the symptoms of right heart failure

A

Swollen ankles and oedema
Reduced exercise tolerance
Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

In which type of heart failure is the apex beat displaced?

A

Left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

In which type of heart failure is there tachycardia and tachypnoea?

A

Left, acute LV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Which type of heart failure can produce hepatomegaly?

A

Right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Which type of heart failure presents with a murmur, and what is it?

A

Left

Mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Which type of heart failure causes a raised JVP?

A

Right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Bilateral basal crackles are present in which type of heart failure?

A

Left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is the key sign to look for in any LV systolic impairment?

A

Pulsus alternans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Which 2 specific markers do you need to remember to order in the blood tests during acute cardiac failure?

A

Troponin

BNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What do inverted T waves show on an ECG?

A

Ischaemic changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What do you use to measure valve wedge pressures?

A

Swan-Ganz catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

How do you treat cardiogenic shock in acute cardiac failure?

A

Inotropes like dobutamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Recall the types of cardiomyopathy

A

Dilated
Restrictive
Hypertrophic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Give 3 causes of dilated cardiomyopathy

A

Post-viral
Thyrotoxicosis
Drugs/alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Recall 3 causes of restrictive cardiomyopathy

A

sarcoidosis
amyloidosis
haemachromatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Which type of cardiomyopathy is usually asymptomatic?

A

hypertrophic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Recall the general symptoms of heart failure

A 
TOAD: 
Tired/ thromboembolism
Arrhythmias
Oedema
Dyspnoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

In which types of cardiomyopathy would the JVP be raised?

A

dilated + restrictive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Recall 3 signs of dilated cardiomyopathy

A

JAM
JVP raised
Apex beat displaced
Mitral AND tricuspic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Which type of cardiomyopathy can result in hepatomegaly?

A

Restrictive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

How will restrictive cardiomyopathy affect an ECG?

A

Low voltage complexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Define constrictive pericarditis

A

Chronic pericardial inflammation leading to thickening and scarring of cardiac tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Recall the usual aetiology of constrictive pericarditis

A

Usually idiopathic but can be viral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is the usual timeline of onset of constrictive pericarditis?

A

Gradual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

In advanced cases of constrictive pericarditis, how does the patient appear?

A

Jaundiced and cachexic

May have signs of right heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is the diagnostic test for constrictive pericarditis?

A

Echocardiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What must you always examine for in cases of DVT?

A

PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

How does DVT feel for the patient?

A

May actually be painless, just a swollen limb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What special sign can be elicited in DVT?

A

Homan’s sign

Force dorsiflexion of the ankle causes pain

88
Q

What risk score is used to calculate DVT risk?

A

Well’s score

89
Q

What is the gold standard investigation for DVT?

A

Doppler ultrasound

90
Q

Recall the steps of management of DVT

A
  1. Anticoagulate with heparin and warfarin
    Wait till INR is in target range of 2-3
    If it extends beyond the knee: observed anticoagulation for 6 months
    If it does not extend beyond the knee: observed anticoagulation for 3 months
  2. IVC filter
  3. Prophylactic stockings and heparin
91
Q

Compare the epidemiology of gangrene and nectrotising fasciitis

A

Gangrene is common

Necrotising fasciitis is rare

92
Q

Recall the different types of gangrene

A
  1. Wet with superimposing infection
  2. Gas
  3. Dry
93
Q

What is the cause of gas gangrene?

A

Clostridia perfringens

94
Q

Compare the seriousness of gangrene and necrotising fasciitis

A 
Gangrene = limb-threatening
NF = life-threatening
95
Q

Define necrotising fasciitis

A

Life-threatening polymicrobial infection causing tissue necrosis and rapidly spreading across fascial planes

96
Q

Recall 4 risk factors for gangrene

A

Diabetes
Peripheral vascular disease
Malignancy
Steroid/immunosuppressant drugs

97
Q

Why does gangrene appear black?

A

Hb breakdown

98
Q

Which type of gangrene is most odourous?

A

Wet

99
Q

Which type of gangrene causes crepitus?

A

Gas

100
Q

Recall 2 signs of necrotising fasciitis that differentiate it from gangrene

A

Haemorrhagic blistering

Signs of sepsis

101
Q

How is 1st degree heart block seen on an ECG?

A

Prolonged conduction through AVN

102
Q

Differentiate between mobitz type 1 and 2 heart block

A

Type 1 = progressive prolongation of AVN conduction until skipped beat
Type 2 = intermittent/ regular conduction failure

103
Q

Recall the 2 major causes of heart block

A

IHD

MI

104
Q

What symptoms does heart block cause?

A

Stokes-adams attacks

105
Q

What is a stokes-adams attack?

A

syncope caused by ventricular asystole

106
Q

In which grades of heart block are stokes-adams attacks seen?

A

MNII/ 3rd

107
Q

Recall a specific sign of 3rd degree heart block

A

Cannon A waves in JVP

108
Q

Recall 3 blood tests to order in heart block

A

Troponin
Cardiac enzymes
DIGOXIN

109
Q

What is the first step in management of acute heart block?

A

IV atropine

110
Q

What are the diagnostic criteria for hypertension?

A

BP >140/90 on 3 separate occasions

111
Q

What are the diagnostic criteria for malignant hypertension?

A

> 180/120

112
Q

What % of hypertension cases are essential?

A

90%

113
Q

Recall 4 possible causes of secondary HTN

A

Pregnancy
Renal
Endocrine
Drugs

114
Q

What might be seen on fundoscopy in hypertension?

A

Silver wiring

115
Q

Recall the management of malignant hypertension

A

IV beta blocker
Labetolol
Hydralesine
Sodium nitroprusside

116
Q

What is the main risk to be aware of when treating malignant hypertension?

A

If you drop the BP too rapidly it may cause a cerebral infarction due to autoregulatory vasoconstricting response

117
Q

What is the target BP for type 2 diabetics?

A

Without CKD - Clinic BP <140/90 (higher if older)
With significant CKD (stage 3, high albumin creatinine ratio) - Clinic BP <130/80

ABPM should be 5 lower

118
Q

Recall the 3 most commonly implicated pathogens in infective endocarditis

A

Streptococcus
Staphylococcus
Enterococcus

119
Q

Recall the mnemonic for and the symptoms of infective endocarditis

A 
Severe Cardiac Affliction Makes Many Feverish
Skin lesions
Confusion
Arthralgia
Myalgia
Malaise
Fever
120
Q

Recall the mnemonic for and signs of infective endocarditis

A 
Numerous Signs Can Point To Valve Sickness
New regurgitant murmur
Splenomegaly
Clubbing
Pyrexia
Tachycardia
Vascular lesions (Osler's nodes. Janeway lesions, roth spots, splinter haemorrhages) 
Signs of arrhythmia
121
Q

What will the FBC show in infective endocarditis?

A

Anaemia of chronic disease

Neutrophilia

122
Q

Recall 2 findings on urine dipstick in infective endocarditis

A

Microscopic haematuria

Proteinurua

123
Q

How are investigation results compiled to make a diagnosis of infective endocarditis?

A

Duke’s classification

124
Q

What is the treatment for infective endocarditis?

A

Antibiotics for 4-6 weeks

125
Q

Which antibiotics are first line in a streptococcal infective endocarditis?

A

Benzylpenicillin and gentamycin

126
Q

Which 4 conditions come under the umbrella term of “ischaemic heart disease”?

A

Stable angina
Unstable angina
STEMI
NSTEMI

127
Q

Summarise the pathophysiology of atherosclerotic plaque production

A

Macrophages engulf LDL –> foam cells
GF released by foam cells
Collagen produced by SMCs

128
Q

Recall the signs of MI (non-silent)

A

Pale
Sweaty
Slightly pyrexial

129
Q

Which markers should be checked in the blood in suspected cases of the acute coronary syndrome?

A

AST (raised 24 hours post-MI)

LDH (raised 48 hours post-MI)

130
Q

Recall 2 signs that may be seen on an ECG of unstable angina or NSTEMI

A

Inverted T waves or ST depression

131
Q

What sort of branch block is often seen in STEMIs?

A

LBBB

132
Q

What constitutes a “fail” on an exercise ECG?

A

failure to produce 85% of max predicted HR

133
Q

Which 4 investigations should be done in patients presenting with likely ischaemic heart disease?

A

Bloods
ECG
Exercise ECG
Echo

134
Q

If stable angina patients are on max doses of GTN spray and prophylactic medication but pain persists, what can be done?

A

PCI or CABG

135
Q

Recall the mnemomic for and the management of unstable angina/NSTEMI

A 
MONABASH
Morphine
Oxygen
Nitrates
Anticoagulants
Beta-blockers
ACE-inhibitors
Statins
Heparin
136
Q

How does STEMI management differ from NSTEMI?

A

Same but in addition:
Clopidogrel
PCI asap
Thrombolysis if within 12 hours and there are ECG changes

137
Q

Define mitral regurgitation

A

Flow of blood from the left ventricle to the left atrium during systole

138
Q

In which demographic is mitral valve prolapse common?

A

Young females

139
Q

What is the most common cause of mitral valve damage?

A

Rheumatic heart disease

140
Q

What are the symptoms of acute and chronic mitral regurgitation? (mnemonic for chronic symptoms)

A

Acute: LV failure
Chronic: APEX (Atrial fibrillation, Palpitations, Exertional dyspnoea, eXtreme tiredness)

141
Q

Describe the pulse in mitral regurgitation

A

Irregularly irregular (as AF is present)

142
Q

Describe the ECG in mitral regurgitation

A

May be normal

May have p mitrale = broad, notched p waves

143
Q

Which heart murmur causes left atrial dilation on echo?

A

Mitral regurgitation

144
Q

Describe the LVEF in mitral regurgitation

A

Reduced

145
Q

What is the most common cause of mitral stenosis?

A

Rheumatic fever

146
Q

What are the symptoms of mitral stenosis?

A 
APEX
AF
Palpitations
Exertional dyspnoea
eXtreme tiredness
ALSO ORTHOPNOEA
147
Q

Recall the mnemonic for and the signs of mitral stenosis

A

If inspection Points to Mitral Pathology so Commence Heart Protection
Irregularly
Irregular
Pulse

Malar flush

Peripheral
Cyanosis

Heaves
(Parasternal)

148
Q

In which conditions might p mitrale be seen on ECG?

A

mitral regurgitation and mitral stenosis

149
Q

What would a CXR show in mitral valve disease

A

Left atrial enlargement

150
Q

What is the most common cause of myocarditis and pericarditis in Europe?

A

Coxsackie B virus

151
Q

Recall the different types of pericarditis

A

Acute
Subacute
Chronic

152
Q

Which disease increases risk of myocarditis and pericarditis?

A

SLE

153
Q

Describe the symptoms of myocarditis

A

“flu like” prodromal fever
Breathlessness
Palpitations

154
Q

Describe the symptoms of pericarditis

A

Chest pain that extends to the pleura, relieved by sitting forwards

155
Q

Recall 2 signs of pericarditis

A

Friction rub

Tamponade

156
Q

What ECG changes are seen in myocarditis?

A

Non-specific T and ST changes

157
Q

What ECG changes are seen in pericarditis?

A

Widespread saddle-shaped ST elevation

158
Q

What is the treatment for cardiac tamponade?

A

Pericardiocentesis (emergency)

159
Q

What is the treatment for constrictive pericarditis?

A

Pericardectomy

160
Q

Recall 3 possible complications of pericarditis

A

Pericardial effusion
Tamponade
Arrhythmias

161
Q

What are the different types of peripheral vascular disease?

A 
Intermittent claudication
Critical limb ischaemia
Acute limb ischaemia
Arterial ulcers
Gangrene
162
Q

In which artery is the pathology when there is intermitent claudication of the thigh or leg?

A

Femoral

163
Q

In which artery is the pathology when there is intermitent claudication of the buttock?

A

Iliac

164
Q

What classification is used for critical limb ischaemia?

A

Fontaine

165
Q

Recall the mnemonic for and the signs of peripheral vascular disease

A 
6Ps
Pulseless
Pain
Pale
Paralysis
Perishingly cold
Paraesthesia
166
Q

What is the first-line investigation in peripheral vascular disease?

A

colour duplex ultrasound

167
Q

Recall 2 major risk factors for pulmonary hypertension

A

Left ventricular failure

Pulmonary emboli

168
Q

Recall the mnemonic for and symptoms of pulmonary hypertension

A 
AT BEST
Angina
Tachycardia
Breathlessness
Exertional dyspnoea
Syncope
Tiredness
169
Q

Which heart murmurs result when there is pulmonary hypertension?

A

Pulmonary and tricuspid regurgitation

170
Q

Recall 3 signs of pulmonary HTN

A

Tricuspid and pulmonary regurgitation
Raised JVP
Peripheral oedema

171
Q

What can confirm a diagnosis of pulmonary hypertension

A

Right heart catheterisation

172
Q

Define supraventricular tachycardia

A

Regular, narrow-complex tachycardia: no p waves, supraventricular origin

173
Q

Recall the 2 possible pathologies underlying a supraventricular tachycaradia

A

AVRT

AVNRT

174
Q

Which drug carries risk of causing supraventricular tachycardia?

A

Digoxin

175
Q

What are the signs of Wolff-Parkinson White?

A

Tachycardia

Secondary cardioyopathy

176
Q

How can you differentiate between AVRT and AVNRT on ECG?

A

AVRT –> delta waves (slurred QRS upstroke + short PR)

AVNRT - relatively normal, just a narrow QRS and tachycardia

177
Q

What are delta waves?

A

Slurred QRS upstrokes on ECG

178
Q

Recall the steps of medical management of supraventricular tachycardia

A
  1. IV adenosine
  2. If haemodynamically stable: IV beta blocker, dilitiazem and verapamil
  3. If haemodynamically unstable: DC cardioversion
179
Q

How can an AVRT or AVNRT be cured?

A

Radiofrequency ablation

180
Q

Define tricuspid regurgitation

A

Backflow of blood from right ventricle to right atrium during systole

181
Q

What is the most common cause of tricuspid regurgitation?

A

Infective endocarditis

182
Q

Recall the mnemonic for and symptoms of tricuspid regurgitation

A

Learn Symptoms By Just Nailing Acronyms: Tricuspid Errors Produce Heart Palpitations
Leg
Swelling

Breathlessness

Jaundice

Nausea

Anorexia

Tiredness

Epigastric
Pain

Headache

Palpitations

183
Q

How does the JVP appear in tricuspid regurgitation?

A

Raised with giant V waves due to high right ventricular pressure

184
Q

What sort of murmur is tricuspid regurgitation?

A

Pansystolic

185
Q

What is another name for cor pulmonale?

A

Right sided heart failure

186
Q

What would be seen on a CXR in tricuspid regurgitation?

A

Right atrial hypertrophy

187
Q

Recall 4 causes of secondary varicose veins

A 
Valve damage following DVT
Outflow obstruction:
- pregnancy
- ascites
- pelvic malignancy
188
Q

Recall 3 symptoms of varicose veins

A

Itching
Swelling
Bleeding

189
Q

How should you examine varicose veins?

A

With pt standing up: TAP TEST

190
Q

How do you perform a tap test?

A

Feel distally whilst tapping saphenofemoral junction - if you feel something the valves are incompetent

191
Q

Other than the tap test, what test can show valve incompetency?

A

Trendelenberg

192
Q

What investigation may be done for varicose veins?

A

Duplex ultrasound

193
Q

What are two possible complications of varicose veins and how do you treat these?

A

Venous telangiectasia and reticular veins

Scleropatherapy

194
Q

Which vein is usually implicated in varicose veins?

A

Long saphenous

195
Q

What is the cause of vasovagal syncope?

A

Excessive vasovagal discharge

196
Q

What are 2 common triggers of a vasovagal syncope episode?

A

Emotion

Orthostatic stress

197
Q

Alongside a faint, what symptoms may be experienced in vasovagal syncope?

A

Sweating

Dizziness

198
Q

Where is the most common site of venous ulcers?

A

Just superior to medial malleolus

199
Q

What is the pathophysiology of venous ulcers?

A

Valve incompetency –> venous stasis –> increased venous pressure -> ulceration

200
Q

Describe the appearance of a venous ulcer

A

Irregular margin

201
Q

In addition to a venous ulcer, what skin changes may be seen in the area?

A

Stasis eczema

Dark colour from haemosiderin deposition

202
Q

What is the main investigation to do in venous ulcers?

A

ABPI (ankle brachial pressure index)

203
Q

What is the treatment for venous ulcers?

A

Graduated compression

204
Q

Define ventricular fibrillation

A

Irregular broad complex tachycardia

205
Q

What will VF survivors need as part of their long-term management?

A

ICD (defibrillator implant)

206
Q

What is the main complication seen in survivors of VF?

A

Anoxic encephalopathy

207
Q

Define ventricular tachycardia

A

Regular broad-complex tachycardia with AV dissociation

208
Q

Describe the aetiology of ventricular tachycardia

A

Electrical impulses arise from ventricular ectopic focus

209
Q

Recall some signs indicative of ventricular tachycardia

A

Raised JVP with hypotension due to inefficient pumping

Respiratory distress with bibasal crackles

210
Q

Which is more common out of SVT and VT?

A

VT

211
Q

If somebody has VF but is not in cardiac arrest, how should you manage them?

A

Unstable: DC cardioversion
Stable: Amiodarone

212
Q

Define Wolff-Parkinson-White syndrome

A

Congenital supraventricular tachycardia

Pre-excitation syndrome

213
Q

Recall the aetiology of Wolff-Parkinson-White

A

Bundle of Kent accessory pathway

214
Q

What are the symptoms of WPW?

A

Dizziness
Syncope
Palpitations

215
Q

What unusual sign may be observed in paroxysmal WPW?

A

May be followed by polyuria: atrial dilatation –> ANP production –> polyuria

216
Q

In what case would a WPW patient have a normal ECG?

A

If Bundle of His and Bundle of Kent have same conduction speed

217
Q

What is the main possible abnormality on ECG in WPW?

A

Shortened PR interval

YEAR 3: Conditions Knowledge (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions