Cardiology MRCP I Flashcards by Ali Bazroon

Physical examination

Causes of high a wave

T.S, P.S, P HTN And R.V.H + Right atrial enlargement

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Pharmacology

ECG changes of digoxin toxcity?

ST Depression > T inversion > Short QT > Bradycardia.

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ACS

First line medication for angina symptoms?

Either BB or N-DHP CCB Like Verapamil or diltiazim.

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ACS

In inferior MI, what is the most common type of arrhythmia to develop?

Inferior MI = AV Block Post MI

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ACS

Most common cause of death post MI?

VFIB

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Logistics

When can patient drive after CABG?

1 Month

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Logistics

When can patient drive after 1 episode of TIA?

1 Month

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Logistics

When can patient drive after pituitary surgery?

6 months

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Logistics

When can the patient drive after been investigated for one episode of seizure all work up was negative?

6 months
1 year if there was a brain lesion

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Vascular

Which type of aortic dissection require immediate surgery?

Type A
While Type B Can be managed with conservatine management (control BP)

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ACLS

First step after witnessed cardiac arrest with rhythm showing VF?

3 Consecutive shock then start CPR.

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ACLS

When to give amiodarone in patient with VF rhythm?

First dose after the third shock
second after the fifth

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ACLS

In which situation you will continue CPR for 60-90 minutes?

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Investigations

Aschoff bodies seen in

Rheumatic fever

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VHD

Poor prognostic factors for aortic stenosis?

Narrow pulse pressure
Soft S2

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VHD

Indications for stress exercise test in aortic stenosis?

Asymptomatic patinet + severe features on echo

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VHD

Interpretation of Dobutamine stress test?

It differentiate between AS And pseudo AS

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Arrhythmia

Is aspirin indicated to reduce rate of stroke recurrence in patient with Afib?

No, use DOAC Only

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ECG

S4 Is concides with which part of ECG?

It represent atrial depolarization over thick ventricle.
P-wave

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ECG

Hypercalcemia causes short QT. T or F?

True

ACS

Is it better to give nitrate at morning 8 and 10 night or morning and afternoon?

It is importnat to keep 14 hours free-nitrate interval to avoid nitrate tolerance. So q12hours regimen is not recommended

Pharmacology

Antidote for Dabigatran?

Idarucizumab

Physical examination

3 causes of collapsing pulse

A.R
Anemia
Hyperthyroidism

Physical examination

What isPulsus paradoxus?

Decrease 10 mm Hg in SBP during inspiration
Seen in asthma and tamponade

# Arrhythmia Q: When might digoxin monotherapy be preferred for rate control in AF?

A: In patients with heart failure and a sedentary lifestyle.

# Coagulation Patient with epistaxis and INR 9 Next step?

- Vitamin K IV 5 mg + stop warfarin + check after 24 hours

# ECG QT prolongation + deafness

Jervel lenge nelson syndrome

# Driving When can a lorry driver back to his work after Heart failure management?

Prohibited till He has LVEF > 40 %. Even if his EF is 30 % + Asymptomatic he is not allowed.

# Arrhythmia What is the definitive management for WPW?

Accecory pathway ablation. Other medical management: Amiodarone or Fleceinamide or Sotalol | Note: Sotalol should be avoided if there is co-exited Afib

# Arrhythmia SVD + ECG showed V1 ST elevation followed by T-DEPRESSION. Diagnosis? mutation involved?

Brugada SYNDROME Management: ICD

# Arrhythmia What are the auscultation findings in patient with complete heart block?

General exam: cannon a wave Auscultation: Different S1 intensity Others: Narrow pulse pressure.

# Physical examination What are the causes of S3?

- Normal in young adults - M.R - Constrictive pericarditis. - Early sign of L.V.F

# Arrhythma First line managemnet of SVT?

Vagal. Failed? 6 Adenosine. Failed? 12. Failed? 18 If the patient has asthma? Give Verapamil

Young lady with DVT And stroke. Etiology of her stroke?

Embolic. Most likely secondary to PFO. Association with migraine increase the risk of thrombosis.

ACE inhibitor SE?

Angioedema (Rare) First dose hypotension. Scenario: patient feel foggy after starting ACE

Most appropriate medical management for WPW with Afib?

Flecainide (IC) Remember risk of SCD BB CCB And sotalol are CI. Don’t block the AV Node

Patient on medical therapy for angina. Presented with persistent angina pain. ECG is normal. Next step?

CT coronary angiogram

Patient on medical therapy for angina. Presented with persistent angina pain. ECG is normal. Next step?

CT coronary angiogram

Test

What physical examination finding suggests strongly in mitral stenosis that the valve is still mobile?

Opening snap

What feature in physical examination finding suggests severe M.S?

Opening snap near S2

What electrolyte abnormality causes QT Prolongation?

Low Ca, Mg And K (Any of them)

What is the first cardiac enzyme rise after MI?

Myoglobin.

What is the best marker to detect re-infarction after 5 days?

CK-MB

Curative management option for atrial flutter?

Ablation of isthmuth in tricuspid valve

First investigation to do in a patient with palpitation + normal ECG?

Holter monitoring. 24 hours if frequent and daily symptoms or longer up to 72 hours if occur every few days. If did not detect any you can go for Implantable loop device.

Test