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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
Q

if first line was a Calcium channel blocker, what is 2nd line?

A

ACE-i or ARB

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26
Q

What is the suffix for the ARBs?

A

SARTAN

candeSARTAN, loSARTAN etc

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27
Q

What is the 3rd line of treatment for hypertension?

A

Add a thiazide like diuretic

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28
Q

If a patient is poorly controlled on an ACE-I, CCB and ARB and their potassium is <4.5, what should be added?

A

Spironolactone

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29
Q

Give 3 signs of hypertension you might see in the eye.

A
  1. Flame haemorrhage, 2. cotton wool spots and

3. hard exudates

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30
Q

What would you feel in someone’s wrist with AF?

A

Irregularly irregular pulse

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31
Q

What is the first line rate control in AF?

A

beta blocker

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32
Q

What risk score is used to calculate the risk of stroke and need for anticoagulation in patients with AF?

A

CHADS2VASC2

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33
Q

What factors may lead you to choose RATE control in a patient with AF?

A

age >65

history of ischaemic heart disease

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34
Q

What factors may lead you to choose RHYTHM control in a patient with AF?

A

Young
Symptomatic
first presentation

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35
Q

What pharmacological cardioversion can be used in patients with structural heart disease?

A

Amiodarone

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36
Q

WHat pharmacological cardioversion should be used in patients without structural heart disease?

A

Flecainide

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37
Q

If you want to cardiovert a patient with AF > 48 hours, what must you do first?

A

Anticoagulate for 3 weeks before OR perform a TOE to see if there is a thrombus

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38
Q

Name 2 vagal manouvers indicated in the acute management of supraventricular tachycardia

A

Valsalval manouevre

Carotid sinus massage

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39
Q

What medication is given to treat SVT?

A

IV adenosine 6mg

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40
Q

What is the treatment of torsades de pointes?

A

IV magnesium sulfate

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41
Q

Where does a type A aortic dissection occur?

A

Before the left subclavian artery

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42
Q

What is the pain like in aortic dissection?

A

Sudden onset chest pain that radiates to the back

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43
Q

What is the gold standard diagnositc test for aortic dissection?

A

CT with contrast

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44
Q

How are type A aortic dissections managed?

A

Surgically

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45
Q

What are the 6 Ps of peripheral vascular disease?

A 
Pain
Pulseless
Perishing cold
Pallor
Paralysis
Paraesthesia
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46
Q

What is the first line treatment of peripheral arterial disease?

A

Clopidogrel

47
Q

How is PAD/PVD diagnosed?

A

Ankle-Brachial index <0.9

and dopplerultrasound

48
Q

What is the ABCD2 score?

A

Risk of stroke following TIA

49
Q

What is Well’s score?

A

Risk of developing DVT

50
Q

What is the CURB-65 score?

A

Assess prognosis of patient with pneumonia

51
Q

What’s the hypokalaemia mnemonic? WHat does it mean?

A

U have no Pot and no T but a long PR and a long QT

52
Q

Describe the ecg features in hypokalaemia

A 
U waves
ST depression
Long QT
Long PR
Small/absent/inverted T eaves
53
Q

What ECG change is seen in hyperkalaemia?

A

Peaked T waves

54
Q

Inverted T waves indicate…

A

Myocardial ischaemia

Pulmonary embolism

55
Q

Increased P wave amplitude is seen in…

A

Cor pulamonale

56
Q

What murmur is seen in aortic stenosis?

A

Ejection systolic

57
Q

What murmur is seen in aortic regurgitation?

A

High pitched, early diastolic blowing murmur

58
Q

Leads V1-V4 correspond to…

A

the LAD

59
Q

Describe the ECG in Mobitsz type 1

A

PR interval gets longer and longer until there is a dropped beat

60
Q

Describe the ECG in Mobitsz type 2, 2nd degree heart block

A

PR constant, P wave not always followed by QRS

61
Q

What is the pulse sign in aortic stenosis?

A

Narrow pulse pressure, slow rising pulse

62
Q

What is the pulse sign in aortic regurgitation?

A

Collapsing pulse, WIDE pulse pressure

63
Q

What murmur in aortic stenosis?

A

Ejection systolic

64
Q

WHhat ECG change is seen in first degree heart block?

A

PR interval > 0.2 seconds

65
Q

Leads II, III and aVF correspond to?

A

Right coronary artery

66
Q

What murmur is associated with marfan’s?

A

aortic regurgitation, diastolic blowing

67
Q

Pan systolic murmur is…

A

Mitral regurgitation and VSD

68
Q

When are you likely to hear a 3rd heart sound?

A

Mitral regurgitation

69
Q

Aortic stenosis murmur?

A

Ejection systolic

70
Q

What is the anticoagulation regime for patients who have had PCI?

A

lifelong aspirin + prasugral or ticagrelor for 12 months

71
Q

What ECG changes are seen in digoxin toxicity?

A

Short QT
ST depression
long PR

72
Q

Pulomanry embolism ECG

A

inverted T waves

73
Q

A narrow pulse pressure and slow rising pulse is associated with…

A

Aortic stenosis

74
Q

Name a drug that can cause hyperkalaemia

A

ACE inhibitors
ARBs
NSAIDs
spironolactone (potassium sparing siuretic)

75
Q

Tall, tented/peaked T waves on ECG indicate…

A

Hyperkalaemia

76
Q

Hypercalcaemia ECG?

A

Short QT interval

77
Q

Name 2 drugs that can cause bronchospasm

A

Beta blockers

Adenosine

78
Q

What is the adult dose of adrenaline to treat anaphylaxis?

A

500 micrograms (0.5ml in 1,000)

79
Q

What is the management of major bleeding caused by warfarin?

A

Stop warfarin
IV vitamin K 5mg
Prothrombin complex concentrate

80
Q

Mitral stenosis murmur

A

late diastolic rumble

81
Q

How does amiodarone work?

A

Block potassium channels

82
Q

Main adverse effect of amiodarone?

A

Thyroid dysfunction, bradycardia

83
Q

What would you see on ECG in cardiac tamponade?

A

Electrical alternans. QRS complex altitudes alternate between beats

84
Q

What is Beck’s triad of Cardiac tamponade?

A
  1. Hypotension
  2. Raised JVP
  3. Muffled heart sounds
85
Q

Delta wave is seen in

A

Wolff-Parkinson White

86
Q

What is the most common cause of mitral stenosis?

A

Rheumatic fever

87
Q

What does the pulse feel like in aortic regurgitation?

A

Collapsing pulse

88
Q

How is INR 5.0-8.0 (minor bleeding) treated?

A

Stop warfarin
IV vitamin K 1-3mg
Resart warfarin when INR is <5

89
Q

What murmur is heard in tetralogy of fallot?

A

Ejection systolic

90
Q

Briefly describe Eisenmenger’s syndrome?

A

When an uncorrected left-to-right shunt reverses`

91
Q

Name 2 causes of a prolonged PR interval?

A

Ischaemic heart disease

Hypokalaemia

92
Q

What are the shockable rhythms?

A

VF and pulseless VT

93
Q

What is the next step if yoiu have shocked someone 3 times and they’re still not responding?

A

1MG adrnelaine

94
Q

When is stage 1 hypertension (135/85) treated with antihypertensives?

A

Under 80 years old or a QRISK score of >10%

95
Q

How is an NSTEMI managed?

A

300mg aspirin and nitrates/morphine to relieve pain

96
Q

How is adrenaline administered during anaphylaxis?

A

Every 5 minutes

97
Q

Anaphylaxis can have a biphasic reaction, how to make sure this doesn’t happen?

A

Observe for 6-12 hours

98
Q

What are the EC G features of Wolff-Parkinson White?

A

Short PR

Wide QRS with a sloped up stroke “delta wave”

99
Q

Treatment of Wolff-Parkinson White?

A

Accessory pathway ablation

100
Q

What is the initial dose of amiodarone for VF?

A

300mg

101
Q

What is the first line treatment for bradycardia and signs of shock?

A

Atropine 500mcg IV

102
Q

What is the treatment of PE in a normotensive patient?

A

LMWH

103
Q

What is the treatment of massive PE?

A

Thrombolysis

104
Q

Delta waves are associated with…

A

Wolff - Parkinson white

105
Q

J waves are associated with…

A

hypothermia

106
Q

How does a supraventricular tachycardia present on ECG?

A

Narrow complex tachycardia with absent P waves

107
Q

What is the first line treatment of supraventricular tachycardia?

A

Vagal manouvers

108
Q

If vagal manouvers don’t improve an SVT, what is 2nd line?

A

IV adenosine 6mg

109
Q

What is Kussmaul’s sign?

A

JVP rises on inspiration in constrictive pericarditis

110
Q

What scoring system is used to diagnose infective endocarditis?

A

Duke’s criteria

111
Q

What is the investigation of choice in PE if the patient has CKD?

A

Ventilation/perfusion scan

112
Q

First line investigation for suspected PE?

A

CTPA - CT Pulmonary angiogram

113
Q

Treatment of symptomatic bradycardia?

A

IV atropine

Phase 3b/finals (19 decks)

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