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Revision > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Aortic stenosis findings

A
  • narrow pulse pressure
  • slow rising pulse
  • thrill at apex
  • fourth heart sound in hypertrophy
  • soft or absent S2
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2
Q

Atorvastatin

A

If QRISK greater that 10% consider giving atorvastatin

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3
Q

Amlodipine

A

IF older than 55 or Afro-Caribbean give calcium channel blocker

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4
Q

Heart failure- longer life

A

ACE inhibitors, beta blockers and spironolactone

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5
Q

Nifedipine

A

If angina is not controlled with a beta-blocker then add calcium channel blocker

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6
Q

PE

A
  • pleuritic chest pain
  • dyspnoea
  • haemoptysis
  • tachycardia
  • S1Q3T3
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7
Q

Losartan

A

Angiotensin receptor blocker that can be added second line in hypertension treatment

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8
Q

Fibrinolysis

A

Needs to be given within 12 hrs if primary PCI cannot be given in under 120 mins

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9
Q

Heart block in heart failure

A

If left bundle branch block seen after ACE inhibitor, beta blocker and aldosterone therapy consider cardiac resynchronisation therapy

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10
Q

Thiazide-like diuretics

A

Include indapamide and can cause erectile dysfunction

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11
Q

Thiazide diuretics

A

Can worsen glucose tolerance

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12
Q

Furosemide

A

Loop diuretics can cause ototoxicity

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13
Q

PCI

A

If MI persists post fibrinolysis then consider PCI

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14
Q

Thiazide diuretics

A

Can cause hyponatraemia

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15
Q

HOCM

A
  • asymmetric septal hypertrophy and systolic anterior movement (SAM)
  • autosomal dominant inheritance
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16
Q

INR

A

In cases of recurrent VTE or PE then aim for INR of 3.5

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17
Q

S3

A
  • normal in those under 30

- suggestive of dilated cardiomyopathy

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18
Q

Hypertension and diabetes

A

ACE inhibitor is first line

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19
Q

Rhythm control

A

Treatment of AF that is coexistent with heart failure, first onset or an obvious reversible cause is found

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20
Q

Stable suspected CAD

A

CT angiography

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21
Q

Beta blockers

A

Reduce hypoglycaemic awareness

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22
Q

Ivabradine

A

Long acting vasodilator used in treatment of angina if verapamil not tolerated

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23
Q

Thiazides

A

Can cause hypokalaemia

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24
Q

Aortic dissection

A

If patient is clinically unstable transoesophageal echo can be used

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25
Q

Spironolactone

A

Mineralocorticoid receptor agonist given in heart failure with reduced ejection fraction

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26
Q

ACE inhibitor and renal function

A

Increase in creatinine of up 30% from baseline is accepted

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27
Q

1 shock defib

A

Used to manage VF and pulseless VT as soon as identified

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28
Q

INR 5-8 (no bleeding)

A

Withhold 1 or 2 doses and reduce subsequent maintenance dose

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29
Q

Thiazide diuretics

A

Can cause hypercalcaemia and hypocalciuria

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30
Q

Hypokalaemia

A
  • tiredness
  • constipation
  • cramping
  • u waves on ECG and prolonged QT interval
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31
Q

Posterior MI

A

ECG with tall R waves in V1-2

32
Q

Symptomatic bradycardia

A

First with 3mg IV atropine then with external pacing

33
Q

Ventricular septal defect

A

Classically associated with a pansystolic murmur

34
Q

Acute pulmonary oedema

A

Complication of MI

  • SOB
  • productive cough
  • sweaty
  • raised JVP
  • end-inspiratory crackles
  • manage with IV diuretics
35
Q

PE investigation

A

If Wells score less than 4 and D-dimer negative then stop anticoagulation and consider alternative diagnosis

36
Q

Acute pericarditis

A
  • suspect in cases of retrosternal chest pain, worse on lying down with signs of raised WBCs
  • investigate with transthoracic echo
37
Q

PE

A

CTPA is first line investigation

38
Q

Diabetes in cardiac ward care

A

If high dependency stop medications and start IV insulin infusion

39
Q

Acute pericarditis ECG

A

Widespread ST elevation and PR depression

40
Q

Bumetanide

A

A loop diuretic that acts on the Na-K-Cl cotransporter in the ascending limb of the loop of Henle

41
Q

Atorvastatin

A

-primary prevention of MI 20mg
-secondary prevention of MI
40mg

42
Q

LBBB

A

New LBBB is significant in the presence of chest pain and indicates the need for thrombolysis or PCI

43
Q

Thiazides

A

Can cause hypokalaemia and heart block

44
Q

Bradycardia

A

500 micrograms of IV atropine

45
Q

Tachyarrhythmia

A

Systolic BP less than 90 needs DC cardioversion

46
Q

Massive PE and hypotension

A

Thrombolyse

47
Q

Posterior STEMI

A
  • ST depression in leads V1-V3

- tall R waves in V1-2

48
Q

Hypercalcaemia

A
  • bone pain
  • rental stones
  • abdominal groans
  • psychic moans
49
Q

Nifedipine

A

A Ca channel blocker that can be used in angina uncontrolled by a beta blocker

50
Q

Electrical alternans

A

Suggestive of cardiac tamponade

51
Q

Constrictive pericarditis

A
  • Kussmauls sign negative so JVP does not fall with inspiration
  • pericardial knock
52
Q

AF

A

Begin with Ca channel blocker or beta blocker then add digoxin

53
Q

Adenosine

A

Used to treat SVT when Valsalva manoeuvres fail

-can cause warmth and flushing

54
Q

Hypertension

A

BP greater than 140

55
Q

Atrial fibrillation

A

Offer direct oral anticoagulant

56
Q

BP>180/120

A

In the presence of confusion, chest pain, signs of heart failure or AKI then admit for specialist assessment

57
Q

Heart failure vaccination

A

Offered yearly influenza and one off pneumococcal vaccination

58
Q

Spironolactone

A

A mineralocorticoid receptor antagonist offered in heart failure alongside ACEi and beta blocker

59
Q

Hypothermia

A

Presents with bradycardia and J waves on ECG

60
Q

Hypertension (black or afro-caribbean)

A

First line with Ca channel blocker then add angiotensin receptor blocker

61
Q

Hyperacute T waves

A

Big T waves that come before a myocardial infarction

62
Q

Rheumatic fever

A

Develops following reaction to streptococcus pyogenes infection

  • recent strep infection
  • erythema marginatum
  • twitching or chorea
  • polyarthritis
  • carditis and valvulitis
  • subcutaneous nodules
63
Q

Decompensated AF

A

Manage with DC cardioversion

64
Q

Aortic stenosis

A

Late presentation with exertional syncope

65
Q

Hypokalaemia

A

Can lead to long QT syndrome

66
Q

Acute pericarditis

A

One risk factor is SLE

67
Q

Constrictive pericarditis

A

Positive Kussmaul’s sign with JVP rising on inspiration

-chest pain worse on inspiration

68
Q

Bendroflumethiazide

A

Can cause hypercalcaemia

69
Q

Aortic dissection

A
  • tearing pain into back
  • sinus tachycardia
  • weak brachial pulse
  • variation in arm bp
70
Q

Bradycardia

A

If patients show signs of shock give 500 micrograms of IV atropine repeated up to 3mg

71
Q

Lateral MI

A
  • ST elevation in I and aVL with slight V5+V6

- left circumflex

72
Q

HOCM

A

Give an implantable cardioverter defibrillator

73
Q

Broad complex tachycardia

A

If no adverse features give IV amiodarone

74
Q

Acute pericarditis ECG

A

Often show saddle-shaped ST elevation

75
Q

Quincke’s sign

A

Nailbed pulsation seen in aortic regurg

Revision (18 decks)

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