Cardiology Missed Points Flashcards
Mary is a 28 y.o woman of Caucasian heritage. She is 26 weeks pregnant and has been diagnosed with hypertension. Which of these drugs should she NOT take no matter what?
• 1: Losartan
• 2: Ramipril
• 3: Spironolactone
• 4: Amlodipine
• 5: Bendroflumethiazide
DONT GIVE 1 AND 2
What is the Tx for septic shock
SEPSIS 6
Oxygen,
cultures,
antibiotics,
fluids,
lactate measurement
urine output monitoring
What is the gold standard for infective endocarditis to then definitively Dx
Blood cultures; dukes criteria
2 separate blood cultures with positive IE microorganisms or 3 Positive blood cultures 12 hours apart
B. Echocardiogram positive for IE
Gold standard for pericarditis
ECG; saddle shaped ST elevation
4 signs of infective endocarditis
Jane way lesions
Osler nodes
Roth spots
Splinter haemorrhage
Josh, a 27 y.o man comes into the clinic. He seems perfectly fine but explains that sometimes he gets headaches, nose bleeds and vision gets a bit blurry. He complains that both his legs usually feel very cold and look pale. His HR is 74, RR 16, and BP was 162/96. What is a likely differential?
Coarctation of aorta
Difference between Mobitz type 1 and type 2
Mobitz type 1 is prolonged and then a drop
Mobitz type 2 is constant and then a drop
Tx for supraventicualr tachy
Carotid massage
IV adenosine
LONG QT syndrome
Beta blocker
What’s the complication of long qt syndrome and its management
Torsades de pointes
Tx: IV magnesium sulfate
What’s the typical finding of variant/Prinzmetal angina
Intermittent pain
Pain more often at night
A 23 y.o university student had a sudden loss of consciousness while playing football with his mates. Fortunately, CPR was administered in time and he was saved. A medical student was around and quickly did an examination and found the presence of an ejection systolic murmur. The murmur increases with intensity when standing from a supine position and disappears on squatting.
No past medical history. Family history is significant for a brother who died suddenly in his 20s.
Based on the above history, what is the underlying cause?
A. Aortic stenosis
B. Hypertrophic cardiomyopathy
C. Acute heart failure
D. Vasovagal syncope
E. Cardiogenic shock
Hypertrophic cardiomyopathy - can be inherited and the brother had it
Findings of aortic dissection
Tall and long fingers, sunken chest, high-arched palate, radial-radial delay
Malcolm is a 76 y.o gentleman presenting to the A&E with difficulty breathing and chest pain. It came on gradually an hour ago and it is a lot more severe now. The pain is constant and not associated wit movement. He has a 50-pack year history.
He has lung cancer for which he is on chemo and immunotherapy.
His obs are Temp: 37.1oc, RR: 19, PR: 98, BP: 88/65 mmHg and O2: 98%.
O/E: Elevated JVP, muffled heart sounds, pulsus paradoxus
Based on the most likely diagnosis, what would be the definitive management for this presentation?
A. Percutaneous coronary intervention
B. Surgical drainage
C. Pericardiocentesis
D. Colchicine
E. Pericardiectomy
B
