Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 3 Medicine > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Which ECG leads correspond to the lateral surface of the heart?

A

I, aVL, V5, V6

Circumflex artery

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

Which ECG leads correspond to the inferior surface of the heart?

A

II, III & aVF

Right coronary artery

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

Which ECG leads correspond to the septal area of the heart?

A

V1, V2

Left anterior descending artery

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

Which ECG leads correspond to the anterior surface of the heart?

A

V3, V4

R coronary artery

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

What are some non-modifiable risk factors for ACS?

A

Increased age
Male
Family history

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

What are some modifiable risk factors for ACS?

A

Smoking
Diabetes mellitus
Hypertension
Physical inactivity

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

What is a STEMI?

A

Cardiac chest pain with persistent ST elevation

Hs-TnI >100ng/L

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

What is an NSTEMI?

A

Cardiac chest pain
Normal ECG, ST depression or T wave inversion
Raised his-TnI

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

What is unstable angina?

A

Cardiac chest pain
Normal ECG, ST depression or T wave inversion
Normal troponin

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

What symptoms would indicate ACS?

A

Pain in chest, may radiate to jaw, back etc. New onset, or occurring with little exertion in pts with angina
Nausea and vomiting
Sweating
Breathlessness

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

What investigations are required for suspected ACS?

A 
12 lead ECG 
Cardiac enzymes 
FBC - rule out anaemia 
U&Es - inc K+ can cause arrhythmias 
Lipid profile
Random blood glucose, HbA1c
Blood gases - monitor oxygen levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the initial management for a STEMI?

A

IV morphine, with an anti-emetic
Oxygen if hypoxic - aim for >94%
300mg aspirin

60mg prasugrel or 600mg clopidogrel

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

What is the definitive treatment for a STEMI?

A

Primary PCI

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

What drugs should be started after a STEMI?

A

ACE inhibitor or ARB
Aspirin
Bisoprolol
Statin

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

What is initial management of an NSTEMI?

A

Pain relief
Oxygen if hypoxic
300mg aspirin, 180mg ticagrelor
Low molecular weight heparin

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

When should a pt with NSTE-ACS be offered angiography?

A

High risk from GRACE score

Low risk, but Sx are recurring

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

What are some ischaemic complications of an MI?

A

Reocclusion
Infarction in a separate territory
Post-infarction angina

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

What are some mechanical complications of an MI?

A 
Left ventricular dysfunction 
Left/right heart failure 
Ventricular septal rupture 
Free wall rupture 
Acute mitral regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the drug treatment for stable angina?

A 
75mg aspirin
Sublingual GTN 
β-blocker
Non-dihydropyridine CCB (diltiazem, verapamil) 
Statin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some non-cardiac causes of chest pain?

A 
Costochondritis
GORD
Cholecystitis 
Acute pancreatitis 
Pneumonia 
PE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some causes of secondary hypertension?

A

Renal disease
Cushing’s syndrome
Conn’s syndrome
Pregnancy

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

How is hypertension defined?

A

Stage 1 - clinic 140/90mmHg, home/ambulatory 135/85mmHg

Stage 2 - clinic 160/100mmHg, home/ambulatory 150/95mmHg

Severe - 180mmHg systolic, 110mmHg diastolic

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

How can HTN present?

A

Usually asymptomatic

Headache
Sweating, palpitations, anxiety => phaeochromocytoma
Muscle weakness, tetany => hyperaldosteronism

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

What investigations are done to assess for end organ damage in hypertension?

A 
Urine albumin:creatinine ratio 
Haematuria 
Bloods - HbA1c, electrolytes, creatinine, eGFR, total cholesterol, HDL 
Fundoscopy 
12 lead ECG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is non-pharmacological treatment for hypertension?
``` Weight reduction Reduce salt intake Reduce alcohol intake Aerobic exercise Stop smoking ```
26
What is step 1 of treatment for hypertension?
<55yrs - ACE inhibitor, ARB >55yrs, Afro-Caribbean - CCB
27
What is stage 2 of treatment for HTN?
ACE inhibitor/ARB + CCB
28
What is stage 3 of treatment for HTN?
ACE inhibitor/ARB CCB Diuretic (thiazide-like)
29
What is step 4 of treatment for HTN?
ACE inhibitor/ARB CCB Thiazide like diuretic α/β blocker or low dose spironolactone
30
What is accelerated hypertension?
Severe hypertension (systolic >200mmHg, diastolic >130mmHg) Accompanied by end organ damage - encephalopathy, aortic dissection, papilloedema, AKI, MI Hypertensive emergency
31
What is hypertensive urgency?
Systolic >180mmHg Diastolic >120mmHg No end organ damage Grade 3/4 hypertensive retinopathy
32
How would someone with accelerated HTN present?
``` Headache Nausea & vomiting Visual disturbance Chest pain Fits ```
33
What is the treatment for a hypertensive emergency?
Sodium nitroprusside Labetalol GTN Esmolol All IV
34
What are some causes of heart failure?
Ischaemic heart disease Hypertension Valvular heart disease Chronic lung disease
35
What are some symptoms of heart failure?
``` Exertional dyspnoea Orthopnea Paroxysmal nocturnal dyspnoea Fluid retention Nocturnal cough ```
36
What are some signs of heart failure?
``` Tachycardia Low systolic blood pressure Raised JVP Peripheral oedema Displaced apex beat Pulse alterans ```
37
What blood tests are required to investigate heart failure?
``` Renal function FBC LFT TFT Ferritin & transferring - haemochromatosis BNP ```
38
What imaging is required to investigate heart failure?
Echocardiogram | Chest x-ray
39
How does echocardiography help diagnose heart failure?
Measures the end diastolic volume Large => systolic dysfunction Small => diastolic dysfunction
40
What is systolic heart failure?
Ventricles are unable to contract normally => reduced cardiac output Heart failure with reduced ejection fraction <40%
41
What is diastolic heart failure?
Inability for ventricles to relax and fill normally => inc filling pressures Heart failure with preserved ejection fraction
42
What changes can be seen on a CXR in heart failure?
``` Alveolar oedema Kerley B lines Cardiomegaly Dilated upper lobe vessels Pleural effusion ```
43
What is the New York classification of heart failure?
I - no excessive dyspnoea on normal activity II - comfortable at rest, dyspnoea on normal activity III - less than ordinary activity causes dyspnoea IV - dyspnoea at rest, all activity causes discomfort
44
What lifestyle modifications should be advised in heart failure?
Smoking cessation Restrict alcohol consumption Salt restriction Fluid restriction if hyponatraemic
45
What are some commonly used drugs in heart failure?
Diuretics ACE inhibitor, ARB Beta blocker Mineralocorticoid receptor antagonist
46
How are ACE inhibitors beneficial in heart failure?
Improves ventricular function and reduces mortality Can inc K+ therefore monitor U&Es
47
What diuretics are used for symptomatic relief in heart failure?
Loop diuretics - furosemide, bumetanide ``` Add K+ sparing diuretic (spironolactone) if hypokalaemia Add thiazide (metalozone) if refractory oedema ```
48
How are beta blockers beneficial in heart failure?
Increase ejection fraction & exercise tolerance | Decreases mortality
49
What is the treatment for acute pulmonary oedema?
Sit pt upright High flow oxygen if hypoxic Sublingual GTN - vasodilator, only give if systolic BP is >90mmHg & no serious valvular disease IV furosemide IV diamorphine - analgesia & sedation
50
How does CPAP help in acute pulmonary oedema?
Drives fluid out of alveolar spaces into vasculature therefore improving ventilation
51
What are some symptoms of aortic stenosis?
Angina Syncope Heart failure Exertional dyspnoea, decrease in exercise tolerance
52
What are some causes of aortic stenosis?
Senile calcification Congenital biscuspid valve Previous rheumatic fever
53
What are some signs of aortic stenosis?
Ejection systolic murmur - radiates to carotids Slow rising pulse with narrow pulse pressure LV heave Aortic thrill
54
What will an ECG show in aortic stenosis?
LVH or left ventricular strain | LBBB or complete heart block - calcified ring
55
What can a CXR show in aortic stenosis?
Cardiomegaly | Calcification of aortic valve
56
What test is diagnostic of aortic stenosis?
Doppler echo | Estimates gradient across valves
57
What are the indications for surgery in aortic stenosis?
Symptomatic Asymptomatic with left ventricular systolic dysfunction Asymptomatic with abnormal exercise test
58
What are some causes of aortic regurgitation?
Bicuspid aortic valve Infective endocarditis Connective tissue disorders
59
How does aortic regurgitation present?
Exertional dyspnoea, reduction in exercise tolerance Palpitations, angina, syncope
60
What are some signs of aortic regurgitation?
Early diastolic murmur at left eternal edge | Collapsing pulse, wide pulse pressure, displaced apex beat
61
What investigations is diagnostic of aortic regurgitation?
Echo - quantification of severity and assessment of the rest of the heart
62
When is surgery indicated in aortic regurgitation?
Symptomatic Asymptomatic with evidence of early LV systolic dysfunction Asymptomatic with aortic root dilatation
63
What are some causes of mitral regurgitation?
IHD => papillary muscle/chordae tendinae dysfunction Marfan’s Infective endocarditis
64
How does mitral regurgitation present?
Acute => pulmonary oedema, requires emergency valve repair | Chronic => heart failure, breathlessness
65
What are some signs of mitral regurgitation?
Pansystolic murmur over mitral area, radiates to axilla | Displaced apex beat
66
What can an ECG show in mitral regurgitation?
AF | LVH
67
How is echocardiography used in mitral regurgitation?
Assesses LV function, mitral regurgitation severity and aetiology
68
What is medical management of mitral regurgitation?
Control rate if fast AF Anti-coagulation for: AF, prosthetic valve Diuretics
69
When is surgery indicated in mitral regurgitation?
Symptomatic | Asymptomatic with mild-moderate LV dysfunction
70
What are some risk factors for infective endocarditis?
Valvular heart disease Valve replacement IVDU
71
Which valves are most commonly affected in infective endocarditis?
Mitral | Aortic
72
What organisms are commonly responsible for infective endocarditis?
Strep viridans Staph aureus - most common in IVDU Strep bovis - needs colonoscopy => tumour Candida/aspergillus Enterococci HACEK organisms
73
How does infective endocarditis present?
Fever and a new murmur Fatigue, flu like symptoms, weight loss
74
What are some signs of infective endocarditis?
Murmur Splinter haemorrhages Osler’s nodes Janeway lesions
75
What investigations are required for infective endocarditis?
Echo - transoesophageal more sensitive FBC, ESR & CRP, U&Es, LFT At least 3 sets of blood cultures Urine dip => microscopic haematuria CXR ECG - prolonged PR interval => AV block
76
What is major diagnostic criteria for infective endocarditis?
Positive blood cultures: 2 typical, persistently +ve cultures >12 hours apart Endocardial involvement - vegetation, abscess Valvular regurgitation
77
What is the minor diagnostic criteria for infective endocarditis?
``` Predisposition IVDU Pyrexia >38 Embolic phenomena Vasculitis phenomena +ve blood cultures which don’t meet major criteria ```
78
How is response to therapy monitored in infective endocarditis?
Echocardiogram once a week ECG at least twice a week Blood tests - ESR, CRP, FBC, U&Es
79
When is surgery needed in infective endocarditis?
Moderate to severe cardiac failure due to valve compromise Valve dehiscence Uncontrolled infection despite treatment Coxiella burnetii and fungal infections
80
What are some cardiac causes of arrhythmias?
IHD Structural changes Cardiomyopathy
81
What are some non-cardiac causes of arrhythmias?
Alcohol Drugs Thyroid dysfunction
82
How can arrhythmias present?
Palpitations Shortness of breath Chest pain Syncope
83
What is first degree heart block?
PR interval >0.2 seconds
84
What is heart block?
Disruption of the conduction between the sinus and AV node
85
What is second degree heart block, Mobitz 1?
Progressive lengthening of the PR interval, followed by a missed QRS
86
What is second degree heart block, Mobitz 2?
Constant PR interval with sudden missed QRS | May progress to complete heart block
87
What are some causes of first and second degree heart block?
Sick sinus syndrome IHD - inferior MI Drugs - beta blocker, digoxin Athlete
88
What is third degree heart block?
No conduction between atria and ventricles | Pt becomes v bradycardic due to pacing of tissue distal to AVN => haemodynamic compromise
89
What are some causes of third degree heart block?
IHD - inferior MI, will probs resolve Digoxin toxicity Hyperkalaemia
90
What is the immediate management of a pt with third degree heart block who is haemodynamically unstable?
IV atropine 600mcg up to 3mg
91
What is the definitive management of third degree heart block?
Permanent pacing Not required in pts with recent coronary event - high likelihood of recovery
92
What are some causes of AF?
``` Heart failure IHD HTN Mitral valve disease Hyperthyroidism Alcohol, caffeine ```
93
What are symptoms of AF?
Asymptomatic | Chest pain, syncope, palpitations
94
What are signs of AF?
Irregularly irregular pulse | Signs of LVF - dyspnoea, raised JVP, fine lung crackles
95
What investigations are required for AF?
12 lead ECG Bloods - U&E, cardiac enzymes, TFTs Echo
96
What would an ECG show in AF?
Absent P waves | Irregular QRS complexes
97
What is involved in the management of AF?
Anticoagulation Rate control Rhythm control
98
What is the management of acute AF (unstable pt)?
DC cardioversion Amiodarone if this doesn't work Correct electrolyte abnormalities Anticoagulate with heparin
99
What is the management of acute AF, stable pt, onset >48hrs ago?
Rate control - bisoprolol, metoprolol | Rhythm control only if properly anti-coagulated for 3 wks
100
What is the management of acute AF, stable pt, onset <48hrs ago?
Rhythm control - DC cardioversion, flecainide, amiodarone Rate control - beta blocker Anti-coagulate with heparin
101
What rate control should be offered in the long term management of AF?
Beta blocker, rate limiting CCB
102
When should rhythm control be offered for long term management of AF?
Symptomatic, younger pts or presenting for the first time
103
What rhythm control can be offered for long term management of AF?
Elective cardioversion Amiodarone - for HF/left ventricular dysfunction Flecainide - not for IHD
104
What is included in chadsvasc?
``` CCF Hypertension Age >75yrs (2 points) Diabetes Stroke/TIA/VTE (2 points) Vascular disease Age 65-74 Sex - female ```
105
What is included in HASBLED?
``` Hypertension Abnormal liver/renal function Stroke Bleeding Labile INR Elderly >75 yrs Drugs/alcohol ```
106
How is chadsvasc used?
Assess risk of stroke | >2 - high risk, needs anticoagulation
107
What anti-coagulation is offered for AF?
DOAC - rivaroxaban Warfarin
108
What are some causes of narrow complex tachycardia?
Sinus tachycardia Atrial flutter Atrial fibrillation AVRT/AVNRT
109
What is the management of narrow complex tachycardia, no adverse signs?
``` Vagal manoeuvres - valsalva manoeuvre or carotid sinus massage IV adenosine (verapamil if contra-indicated) ```
110
What ECG changes would indicate AVRT/AVNRT?
Narrow QRS Regular No p waves
111
What are causes of broad complex tachycardia?
SVT with BBB Ventricular tachycardia Torsades de Pointes Ventricular fibrillation
112
How is regular broad complex tachycardia managed?
Treat as VT if uncertain IV amiodarone DC cardio version if unstable

Year 3 Medicine (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions