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MRCP > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Which chamber of the heart is measured using JVP?

A

Right atrium

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2
Q

What does the a wave represent in JVP?

A

Atrial contraction

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3
Q

What does the c wave represent in JVP?

A

Closure of the tricuspid valve

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4
Q

What does the x descent represent in JVP?

A

Downward movement of the heart causing atrial stretch and drop in pressure

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5
Q

What does the v wave represent in JVP?

A

Passive filling of the blood into the atrium against a closed tricuspid valve

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6
Q

What does the y descent represent in JVP?

A

Opening of the tricuspid valve with passive movement of blood from the right atrium to the right ventricle

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7
Q

What can cause a raised JVP?

A 
Heart failure
Fluid overload
Severe bradycardia
Inspiration
SVC syndrome
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8
Q

What is Kussmaul’s sign in JVP?

A

Raised JVP on expiration and drop on inspirations (i.e. backwards from normal). It is caused by the inability fo the right heart chambers to increase in size.

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9
Q

How does atrial fibrillation affect the JVP wave?

A

Loss of a wave

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10
Q

How does tricuspid regurgitation affect the JVP wave?

A

Large c-V waves

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11
Q

How does raised right atrial pressure affect the JVP wave?

A

Prominent a waves

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12
Q

How does constriction affect the JVP wave?

A

Prominent and deep x and y descents

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13
Q

How does tamponade affect the JVP wave?

A

Prominent x descent only. Y descent is slow or absent.

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14
Q

What can cause an absent radial pulse?

A

Latrogenic: post-catheterisation or arterial line
Blalock-Taussig shunt for congenital heart disease
Aortic dissection with subclavian involvement
Trauma
Takayasu’s arteritis
Peripheral arterial embolus

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15
Q

What can cause a collapsing pulse?

A

Aortic regurgitation
Arteriovenous fistula
Patent ductus arteriosus

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16
Q

What can cause a slow rising pulse?

A

Aortic stenosis (delayed percussion wave)

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17
Q

What can cause bisferiens pulse?

A

A double shudder due to mixed aortic valve disease with significant regurgitation

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18
Q

What can cause a jerky pulse?

A

Hypertrophic obstructive cardiomyopathy

19
Q

What can cause an alternans pulse?

A

Severe left ventricular dysfunction. Ejection fraction is reduced meaning the end-diastolic volume is elevated. This may stretch the myocytes to improve the ejection fraction of the next heartbeat leading to alternating strong and weak pulses.

20
Q

What can cause a paradoxical pulse?

A

Excessive reduction on inspiration caused by ventricular compression, tamponade, constrictive pericarditis, or severe asthma

21
Q

What is the cardiac apex?

A

The ventricle striking the chest wall during isovolumetric contractions

22
Q

What can cause an absence of the apical impulse?

A

Obesity/emphysema
Right pneumonectomy with displacement
Pericardial effusion or constriction
Dextrocardia

23
Q

What can cause a heaving apical impulse?

A

Left ventricular hypertrophy

24
Q

What can cause a thrusting/hyperdynamic apical pulse?

A

High left ventricular volume (e.g. in mitral regurgitation, aortic regurgitation, PDA, ventricular septal defect)

25
Q

What can cause a tapping apical pulse?

A

Palpable first heart sound in mitral stenosis

26
Q

What can cause a displaced apical pulse?

A

Left ventricular impairment and dilatation

27
Q

What can cause a double apical pulse?

A

(with dyskinesia) left ventricular aneurysm

(without dyskinesia) hypertrophic cardiomyopathy

28
Q

What can cause a pericardial knock?

A

Constrictive pericarditis

29
Q

What can cause a parasternal heave?

A

Right ventricular hypertrophy
Pulmonary hypertension
Chronic obstructive pulmonary disease
Pulmonary stenosis

30
Q

What can cause a palpable third heart sound?

A

Heart failure and severe mitral regurgitation

31
Q

What can cause loud first heart sounds?

A 
Mobile mitral stenosis
Hyperdynamic states
Tachycardic states
Left-to-right shunts
Short PR interval
32
Q

What can cause soft first heart sounds?

A 
Immobile mitral stenosis
Hypodynamic states
Mitral regurgitation
Poor ventricular function
Long PR interval
33
Q

What can cause split first heart sounds?

A 
RBBB
LBBB
VT
Inspiration
Ebstein's anomaly
34
Q

What can cause variable first heart sounds?

A

Atrial fibrillation

Complete heart block

35
Q

What can cause loud second heart sounds?

A

Systemic hypertension
Pulmonary hypertension
Tachycardic states
ASD

36
Q

What can cause soft or absent second heart sounds?

A

Severe aortic stenosis

37
Q

What can cause fixed second heart sounds?

A

ASD

38
Q

What can cause widely split second heart sounds?

A

RBBB
Pulmonary stenosis
Deep inspiration
Mitral regurgitation

39
Q

What can cause a single second heart sound?

A 
Severe pulmonary/aortic stenosis
Hypertension
Large VSD
Tetralogy of Fallot
Eisenmenger's syndrome
Pulmonary atresia
Elderly
40
Q

What can cause a reversed split second heart sound?

A

LBBB
Right ventricular pacing
PDA
Aortic stenosis

41
Q

What can cause left axis deviation?

A 
LBBB
Left anterior hemi-block
LVH
Primum ASD
Cardiomyopathies
Tricuspid atresia
42
Q

What can cause low-voltage ECG?

A 
Pulmonary emphysema
Pericardial effusion
Myxoedema
Severe obesity
Incorrect calibration
Cardiomyopathies
Global ischaemia
Amyloid
43
Q

What can cause right axis deviation?

A

Infancy
RBBB
Right ventricular hypertrophy

44
Q

What are some abnormalities seen in ECGs of athletes?

A 
Sinus arrhythmia
Sinus bradycardia
First-degree heart block
Wenckebach's phenomenon
Junctional rhythm

MRCP (20 decks)

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