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4th Year Gen Med > Cardiology pathology > Flashcards

Cardiology pathology Flashcards

1
Q

What is the most significant risk factor for aortic disseaction?

A

Hypertension especially if uncontrolled

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2
Q

What is the pathophysiology of aortic dissection?

A

Weakening of the aortic wall leads to tearing of the tunica intima of the aorta which then forms a sub haematoma.

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3
Q

Describe the pain classically experienced in aortic dissection?

A

Tearing sharp pain radiating to between the scapula.

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4
Q

How is dressler’s syndrome managed?

A

With NSAIDs

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5
Q

When does Dressler’s syndrome typically present?

A

2-6 weeks post MI

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6
Q

What is thought to be the pathology of Dressler’s syndrome?

A

An autoimmune response to antigenic proteins which are formed as the myocardium recovers from the MI

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7
Q

List 10 complications which can occur from a myocardial infarction?

A 
Cardiac arrest
Bradyarrhythmias
Tachyarrhythmias
Dressler' Syndrome / Pericarditis
LV Aneurysm
Cardiogenic shock
Left ventricular wall rupture
VSD
Acute mitral regurgitation
Chronic heart failure
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8
Q

Which complication post MI is the most common cause of death?

A

Ventricular tachycardia / V fib - cardiac arrest

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9
Q

What classification system is used to grade heart failure?

A

New York Heart Association (NYHA system)

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10
Q

Where is the most common site for aortic dissection?

A

Proximal aorta

Distal aorta only occurs 1/3rd of the time

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11
Q

In an aortic dissection can there be ST elevation?

A

Yes signs of an inferior MI will possibly be seen on ECG

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12
Q

What ECG changes will be seen in hypothermia?

A 
Bradycardia
Long QT interval
J waves
Arrhythmias 
1st Degree heart block
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13
Q

Ischaemic changes with ST elevation in leads II III and aVF means which vessel is affected?

A

Right coronary

Inferior MI

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14
Q

Ischaemic changes in leads I aVL V5 V6 means which vessel has been affected?

A

Left circumflex

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15
Q

In patients who have had successful catheter ablation for AF, what is then the appropriate management for their warfarin? (Stop / continue / change)

A

Continue lifelong

According to their CHADSVASC score this is the most appropriate option

Catheter ablation does not reduce the stroke risk, it only controls the rate

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16
Q

What are some complications which may occur from catheter ablation?

A

Cardiac tamponade
Stroke
Pulmonary valve stenosis

17
Q

In patients with hypercalcaemia (especially seen secondary to malignancy) what ECG changes would you anticipate?

A

Shortening of the QT interval

18
Q

What antihypertensive medication may cause erectile dysfunction?

A

Beta blockers

19
Q

What medication should beta blockers not be co-prescribed with and why?

A

Verapamil

Can lead to bradycardia, heart block and CCF

20
Q

In all patients with suspected congestive cardiac failure, what is the first line investigation?

A

BNP

21
Q

What medications are contraindicated in aortic stenosis>

A

Nitrates

22
Q

What group of antibiotics can cause torsade des pointes syndrome? (Give an example)

A

Macrolides

Clarithromycin

23
Q

What electrolyte imbalances can cause a prolonged QT?

A

Hypocalcemia
Hypokalaemia
Hypomagnesaemia

24
Q

List some medications which can cause a prolonged QT interval?

A 
TCAs
Citalopram
Sotalol
Class Type 1a antiarrhythmic
Methadone
Ondansetron
chloroquine
terfenadine**
erythromycin
haloperidol
Tramadol
Metoclopramide
25
Q

How long before surgery should warfarin therapy be stopped?

A

5 days

26
Q

What is the 1st line investigation for PE?

A

CTPA

27
Q

When would a CTPA not be appropriate as a 1st line investigation for PE?

A

in renal impairment or allergy to contrast

28
Q

What is the most common ECG finding seen in a PE?

A

Sinus tachycardia

While textbooks always quote S1 Q3 T3 it is rarely seen

29
Q

What medication is given to manage torsade des pointes?

A

IV magnesium sulfate

30
Q

How is symptomatic bradycardia managed?

A

IV atropine

31
Q

Following an ECG and bloods in palpitations, what would be the next most appropriate investigation?

A

Holter monitor

32
Q

Polycystic kidneys is associated with what type of valve dsease?

A

Mitral valve prolapse

33
Q

Tall R waves seen on V1 V2 ECG are usually pathognomonic of what?

A

Posterior MI

34
Q

What is the cause of death most times in patients with HOCM?

A

Ventricular arrhythmias

35
Q

What antihypertensives are the most likely cause of angioedema>

A

ACE inhibitors

36
Q

A patient with Acute coronary syndrome is managed medically and opts not to have angioplasty. What are the rules for driving for this patient?

A

Cannot drive for 4 weeks

If he’d had angioplasty it would’ve been 1 week

4th Year Gen Med (10 decks)

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