Cardiology Chapter 1

Question 1

Angina Pectoris: where does it radiate?

Answer 1

Jaw, neck, arms, teeth

Question 2

What causes Angina?

Answer 2

ATHEROMA, anaemia, AS, tachyarrhythmias

Question 3

What are the key characteristics of unstable angina?

Answer 3

increasing frequency/severity, at rest, inc. risk of MI

Question 4

Decubitus vs Variant angina

Answer 4

lying flat vs caused by coronary art. spasm

Question 5

What’s the first-line management of angina?

Answer 5

Lifestyle advice

Question 6

ACS - which conditions does this encompass

Answer 6

unstable angina and evolving MI

Question 7

Name modifiable risk factors of ACS

Answer 7

smoking, htn, DM, hyperlipidemia, obesity, sedentary lifestyle, cocaine use

Question 8

Which cardiac enzyme concentration returns to normal after 48-72hrs

Answer 8

CK-MB

Question 9

How do you manage ACS?

Answer 9

Mona (Morphine 5-10mg IV+metoclopramide 10mg IV), oxygen, nitrates GTN, aspirin 300mg) p809-12

Question 10

Name 3 complications of MI

Answer 10

Heart Block, Pericarditis, Ventricular septal defect

Question 11

Indications for cabg

Answer 11

to improve survival: left main stem disease, triple vessel disease involving prox LAD
to relieve symptoms: angina unresponsive to drugs, unstable angina, if angioplasty is unsuccessful

Question 12

Name causes of arrhythmia:

Answer 12

cardiac: MI, LV aneurism, mitral valve disease; non-cardiac: caffeine, smoking, alcohol, pneumonia, metabolic imbalance, phaeochromocytoma

Question 13

Blood tests for arrhythmias

Answer 13

FBC, U&E, blood glc, Ca, Mg, TSH, ECG

Question 14

What’s the difference between a pacemaker and an implanted defib?

Answer 14

Impl. defib save lives. Pacemakers change rhythm - overdrive tachys, treat bradys, prophylaxis ag. conduction disturbance

Question 15

What’s the definition of narrow complex tachycardia?

Answer 15

> 100bom and QRS of <120ms

Question 16

Name three differentials of NCtachy –> all of these are subtypes of NCT

Answer 16

Sinus tachy, Supraventricular tachy, junctional tachy

Question 17

How can you find the underlying atrial rhythm>

Answer 17

Vagal manoeuver, adenosine - cause temp. av block and show underlying atrial rhythm

Question 18

What is the underlying pathology oF WPW

Answer 18

congenital accessory cond. pathway

Question 19

What are the principles of management for BCtachy

Answer 19

identify underlying rhythm. If in doubt, treat as ventricular tachy; commonest

Question 20

What’s the aetiology of ventricular ectopics?

Answer 20

Extrasystoles commonest post-MI arrhyth. -> can turn into VF; also seen in health

Question 21

HF - symptoms of left ventricular failure

Answer 21

dyspnoea, poor exercise tolerance, fatigue, orthopnoea, nocturia, cold peripheries

Question 22

What is low output HF

Answer 22

CO decreased and fails to increase normally with exertion

Question 23

Diagnosis of HF

Answer 23

ecg and BNP; if one abnormal, do echo

fbc, u&e, cxr

Question 24

What’s the prognosis on hospital admission with HF

Answer 24

5yr mortality is 75%

Question 25

List the drugs used in HF and which red. mortality *

Answer 25

Diuretics
Ace-i*
B-Blocker*
spironolactone* - red. by 30%
digoxin
vasodilators

Question 26

What’s the bp in malignant HTN

Answer 26

sys >200, dias>130 - vascular damage

Question 27

Causes of 2ary HTN

Answer 27

Renal disease, endocrine disease, coarctation, pregnancy, steroids, pill, mao-inh.

Question 28

HTN: Which tests to assess end-organ damage?

Answer 28

ECG, urinalysis

Question 29

HTN: In what cases is Ca-channel blocker a first-line treatment?

Answer 29

≥55 and Black patients

Question 30

What’s the treatment goal for HTN?

Answer 30

<140/90; 130 for diabetics; 150 for >80yo