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Phase 3b/finals > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What would you see on ECG in angina?

A

ST depression

T wave flattening

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2
Q

What 4 medications should a patient with angina be managed on?

A
  1. Aspirin
  2. Statin
  3. Sublingual GTN
  4. Beta blocker or CCB
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3
Q

Which leads are the ANTERIOR leads? Which vessel do they correspond to?

A

V1-V4

LAD, left anterior descending

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4
Q

Which leads are the INFERIOR leads? Which vessel do they correspond to?

A

II, III, aVF

Right coronary artery

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5
Q

Which leads are the LATERAL leads? Which vessel do they correspond to?

A

I, V5-V6

Left circumflex

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6
Q

Other than aspirin, which antiplatelet may be added in the treatment of a STEMI/NSTEMI?

A

ticagrelor

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7
Q

What is the first line treatment of heart failure?

A

ACE-inhibitor AND beta-blocker

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8
Q

If heart failure symptoms are not adequately treated with ACE-i and Beta-blocker, what should be added?

A

aldosterone antagonist e.g. spironolactone

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9
Q

What vaccines should be considered in those with heart failure?

A

1 off pneumococcal vaccine and yearly flu vaccine

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10
Q

What is cor pulmonale?

A

Right heart failure secondary to lung disease/pulmonary hypertension

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11
Q

What organism causes rheumatic fever?

A

Strep pyogenes

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12
Q

What would you see in the heart in rheumatic fever?

A

Aschoff bodies

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13
Q

Which valve is most commonly affected in IVDU with endocarditis?

A

Tricuspid valve

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14
Q

What is the most common causative organism in endocarditis?

A

Staph aureus

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15
Q

Sudden death in a young athlete may be caused by..

A

Hypertrophic obstructive cardiomyopathy

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16
Q

What heart defects are associated with downs syndrome?

A

PDA

Septal defects

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17
Q

What is the most common kind of ASD?

A

Ostium secundum

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18
Q

Describe the symptoms of pericarditis

A

Sharp chest pain radiating to the trapzius ridge, relieved by sitting forward

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19
Q

On ausultation in pericarditis what do you hear?

A

Pericardial rub

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20
Q

What is the ECG finding in pericarditis?

A

Saddle shaped ST elevation, PR depression

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21
Q

What investigation must you do for pericarditis?

A

Transthoracic echocardiogram

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22
Q

What is the first line treatment of pericarditis?

A

NSAIDs and colchicine

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23
Q

What is the first line treatment for hypertension in patients UNDER 55 or with type 2 diabetes?

A

ACE inhibitor (ARB if ACE-i is not tolerated e.g. due to cough)

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24
Q

What is the first line treatment for hypertension in patients OVER 55 or who are afro-carribean?

A

Calcium channel blocker

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25
if first line was a Calcium channel blocker, what is 2nd line?
ACE-i or ARB
26
What is the suffix for the ARBs?
SARTAN | candeSARTAN, loSARTAN etc
27
What is the 3rd line of treatment for hypertension?
Add a thiazide like diuretic
28
If a patient is poorly controlled on an ACE-I, CCB and ARB and their potassium is <4.5, what should be added?
Spironolactone
29
Give 3 signs of hypertension you might see in the eye.
1. Flame haemorrhage, 2. cotton wool spots and | 3. hard exudates
30
What would you feel in someone's wrist with AF?
Irregularly irregular pulse
31
What is the first line rate control in AF?
beta blocker
32
What risk score is used to calculate the risk of stroke and need for anticoagulation in patients with AF?
CHADS2VASC2
33
What factors may lead you to choose RATE control in a patient with AF?
age >65 | history of ischaemic heart disease
34
What factors may lead you to choose RHYTHM control in a patient with AF?
Young Symptomatic first presentation
35
What pharmacological cardioversion can be used in patients with structural heart disease?
Amiodarone
36
WHat pharmacological cardioversion should be used in patients without structural heart disease?
Flecainide
37
If you want to cardiovert a patient with AF > 48 hours, what must you do first?
Anticoagulate for 3 weeks before OR perform a TOE to see if there is a thrombus
38
Name 2 vagal manouvers indicated in the acute management of supraventricular tachycardia
Valsalval manouevre | Carotid sinus massage
39
What medication is given to treat SVT?
IV adenosine 6mg
40
What is the treatment of torsades de pointes?
IV magnesium sulfate
41
Where does a type A aortic dissection occur?
Before the left subclavian artery
42
What is the pain like in aortic dissection?
Sudden onset chest pain that radiates to the back
43
What is the gold standard diagnositc test for aortic dissection?
CT with contrast
44
How are type A aortic dissections managed?
Surgically
45
What are the 6 Ps of peripheral vascular disease?
``` Pain Pulseless Perishing cold Pallor Paralysis Paraesthesia ```
46
What is the first line treatment of peripheral arterial disease?
Clopidogrel
47
How is PAD/PVD diagnosed?
Ankle-Brachial index <0.9 | and dopplerultrasound
48
What is the ABCD2 score?
Risk of stroke following TIA
49
What is Well's score?
Risk of developing DVT
50
What is the CURB-65 score?
Assess prognosis of patient with pneumonia
51
What's the hypokalaemia mnemonic? WHat does it mean?
U have no Pot and no T but a long PR and a long QT
52
Describe the ecg features in hypokalaemia
``` U waves ST depression Long QT Long PR Small/absent/inverted T eaves ```
53
What ECG change is seen in hyperkalaemia?
Peaked T waves
54
Inverted T waves indicate...
Myocardial ischaemia | Pulmonary embolism
55
Increased P wave amplitude is seen in...
Cor pulamonale
56
What murmur is seen in aortic stenosis?
Ejection systolic
57
What murmur is seen in aortic regurgitation?
High pitched, early diastolic blowing murmur
58
Leads V1-V4 correspond to...
the LAD
59
Describe the ECG in Mobitsz type 1
PR interval gets longer and longer until there is a dropped beat
60
Describe the ECG in Mobitsz type 2, 2nd degree heart block
PR constant, P wave not always followed by QRS
61
What is the pulse sign in aortic stenosis?
Narrow pulse pressure, slow rising pulse
62
What is the pulse sign in aortic regurgitation?
Collapsing pulse, WIDE pulse pressure
63
What murmur in aortic stenosis?
Ejection systolic
64
WHhat ECG change is seen in first degree heart block?
PR interval > 0.2 seconds
65
Leads II, III and aVF correspond to?
Right coronary artery
66
What murmur is associated with marfan's?
aortic regurgitation, diastolic blowing
67
Pan systolic murmur is...
Mitral regurgitation and VSD
68
When are you likely to hear a 3rd heart sound?
Mitral regurgitation
69
Aortic stenosis murmur?
Ejection systolic
70
What is the anticoagulation regime for patients who have had PCI?
lifelong aspirin + prasugral or ticagrelor for 12 months
71
What ECG changes are seen in digoxin toxicity?
Short QT ST depression long PR
72
Pulomanry embolism ECG
inverted T waves
73
A narrow pulse pressure and slow rising pulse is associated with...
Aortic stenosis
74
Name a drug that can cause hyperkalaemia
ACE inhibitors ARBs NSAIDs spironolactone (potassium sparing siuretic)
75
Tall, tented/peaked T waves on ECG indicate...
Hyperkalaemia
76
Hypercalcaemia ECG?
Short QT interval
77
Name 2 drugs that can cause bronchospasm
Beta blockers | Adenosine
78
What is the adult dose of adrenaline to treat anaphylaxis?
500 micrograms (0.5ml in 1,000)
79
What is the management of major bleeding caused by warfarin?
Stop warfarin IV vitamin K 5mg Prothrombin complex concentrate
80
Mitral stenosis murmur
late diastolic rumble
81
How does amiodarone work?
Block potassium channels
82
Main adverse effect of amiodarone?
Thyroid dysfunction, bradycardia
83
What would you see on ECG in cardiac tamponade?
Electrical alternans. QRS complex altitudes alternate between beats
84
What is Beck's triad of Cardiac tamponade?
1. Hypotension 2. Raised JVP 3. Muffled heart sounds
85
Delta wave is seen in
Wolff-Parkinson White
86
What is the most common cause of mitral stenosis?
Rheumatic fever
87
What does the pulse feel like in aortic regurgitation?
Collapsing pulse
88
How is INR 5.0-8.0 (minor bleeding) treated?
Stop warfarin IV vitamin K 1-3mg Resart warfarin when INR is <5
89
What murmur is heard in tetralogy of fallot?
Ejection systolic
90
Briefly describe Eisenmenger's syndrome?
When an uncorrected left-to-right shunt reverses`
91
Name 2 causes of a prolonged PR interval?
Ischaemic heart disease | Hypokalaemia
92
What are the shockable rhythms?
VF and pulseless VT
93
What is the next step if yoiu have shocked someone 3 times and they're still not responding?
1MG adrnelaine
94
When is stage 1 hypertension (135/85) treated with antihypertensives?
Under 80 years old or a QRISK score of >10%
95
How is an NSTEMI managed?
300mg aspirin and nitrates/morphine to relieve pain
96
How is adrenaline administered during anaphylaxis?
Every 5 minutes
97
Anaphylaxis can have a biphasic reaction, how to make sure this doesn't happen?
Observe for 6-12 hours
98
What are the EC G features of Wolff-Parkinson White?
Short PR | Wide QRS with a sloped up stroke "delta wave"
99
Treatment of Wolff-Parkinson White?
Accessory pathway ablation
100
What is the initial dose of amiodarone for VF?
300mg
101
What is the first line treatment for bradycardia and signs of shock?
Atropine 500mcg IV
102
What is the treatment of PE in a normotensive patient?
LMWH
103
What is the treatment of massive PE?
Thrombolysis
104
Delta waves are associated with...
Wolff - Parkinson white
105
J waves are associated with...
hypothermia
106
How does a supraventricular tachycardia present on ECG?
Narrow complex tachycardia with absent P waves
107
What is the first line treatment of supraventricular tachycardia?
Vagal manouvers
108
If vagal manouvers don't improve an SVT, what is 2nd line?
IV adenosine 6mg
109
What is Kussmaul's sign?
JVP rises on inspiration in constrictive pericarditis
110
What scoring system is used to diagnose infective endocarditis?
Duke's criteria
111
What is the investigation of choice in PE if the patient has CKD?
Ventilation/perfusion scan
112
First line investigation for suspected PE?
CTPA - CT Pulmonary angiogram
113
Treatment of symptomatic bradycardia?
IV atropine

Phase 3b/finals (19 decks)

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