Cardiology - Chest Pain Flashcards

1
Q

chest pain presentations

A

acute chest discomfort
shortness of breath
cardiac arrest - fleeting pain

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2
Q

acute chest pain with ST elevation on ECG (STEMI) the patient should be treated to open with the artery in the cath lab within

a.30 mins
b.60 mins
c.90 mins
d.6 hours

A

c.90 mins

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3
Q

unstable angina

A

myocardial ischaemia but no damage to cells / muscles not as acute presentation

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4
Q

definition of MI

increased troponin and 1 of…

A

ECG change
Symptoms
Pathological Q waves
Echo evidence
thrombus

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5
Q

which vessel supplies the septum of the heart

a.left anterior descending
b.left circumflex
c.right coronary
d. left main circumflex
e.braciocephalic

A

a.left anterior descending

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6
Q

when do the coronary aa fill

a.asystole
b.systole
c.diastole

A

c.diastole

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7
Q

assessment for MI

A

assess patient
ECG and troponin

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8
Q

what should be done if patient is having a STEMI

a.give aspirin
b.refer to cath lab
c.give pain relief
d.resus and observe

A

b.refer to cath lab

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9
Q

stress induced narrowing of the coronary aa occurs in which condition

a.tachyarrhythmia
b.tako tsubo cardiomypathy
c.critical illness eg sepsis
d.pulmonary embolism

A

b.tako tsubo cardiomypathy

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10
Q

what needs to be taken into account when deciding if anti thrombotics could be given

A

patient characteristics
presentation - chronic vs acute
comorbities - CKD,HF diabetes
co med - oral anticoagulant

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11
Q

what is the treatment for dissection of the aorta

A

SURGERY

but first

pain relief, beta blocker and GTN
then theatre

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12
Q

suspected dissection of the aorta what should be done first

a.pain relief, beta blocker and GTN
b.surgery

A

a.pain relief, beta blocker and GTN

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13
Q

pericarditis is inflammation of the lining of the heart
a key symptom is chest pain worsened by taking a deep breath and a friction rub on auscultation
what is the 4 investigations that should be done for this

A

ECG
echo
CXR
CRP/Troponin

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14
Q

patient with pericarditis what is the first line management after being admitted to hospital

a. aspirin and NSAID
b.surgery
c.aspirin, NSAID colchisine and sports ban
d.colchisine, aspirin, NSAID and low dose steroids

A

a. aspirin and NSAID
then after 4-6 weeks in hosp
colchisine and sports ban

if the pericarditis returns
colchisine, aspirin and NSAID and low dose steroid

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15
Q

cardiac differentials for acute chest pain

A

myopericarditis - ECG and trop rise but normal vessels in cath lab

cardiomyopathies

tachyarrhytmias

aortic stenosis

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16
Q

pulmonary differentials for acute chest pain

A

pulmonary embolism
tension pneumothorax

17
Q

vascular differentials for acute chest pain

A

aortic dissection

18
Q

gastro differentials for acute chest pain

A

osophagitis
gastritis
PUD

19
Q

Drugs post MI

A

aspirin
clopidogrel
lmwh

20
Q

when should a troponin test be repeated

A

1 hr
3 hr
6 hr
12 hr

21
Q
A