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#passmed 2023 > CardioResp > Flashcards

CardioResp Flashcards

1
Q

What is Long QT syndrome caused by?

A

Loss-of-function / blockage of K+ channels

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2
Q

What can Long QT syndrome lead to? (2 things)

A
  1. VT (Torsades de Pointes)
  2. (–> death)
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3
Q

What condition can cause Postural Hypotension?

A

T2DM

(secondary to autonomic dysfunction)

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4
Q

What are the CF of Autonomic dysfunction, caused by T2DM? (3 things)

A
  1. Postural hypotension
  2. Loss of resp arrhythmia (aka HR doesn’t change w deep breathing)
  3. Erectyle dysf
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5
Q

What are the causes of Autonomic vs Sensory Neuropathy?

A
  • Autonomic: DM
  • Sensory: Vit B12 def / Alcohol
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6
Q

What are the causes of Autonomic vs Sensory Neuropathy?

A
  • Autonomic: DM
  • Sensory: Vit B12 def / Alcohol
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7
Q

What is the FIRST line investigation for Angina?

A

Contrast-enhanced CT Coronary Angiogram (cCTA)

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8
Q

What is Bumetanide?

A

Loop diuretic

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9
Q

What elec abn can Loop diuretics cause?

A

HypOkalaemia

l - OO - P , like the O is a loop shape lol

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10
Q

What CF’s mean asthma attack is LIFE threatening? (6 things)

A
  1. Confusion
  2. PEFR < 33%
  3. Sats < 92%
  4. Normal pCO2
  5. Silent chest
  6. Bradycardia / Hypotension
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11
Q

What CF’s mean asthma attack is SEVERE? (4 things)

A
  1. Inability to complete sentences
  2. PEFR 33-50%
  3. RR 25+
  4. Pulse 110+
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12
Q

What is the most common cause of Aortic Stenosis in YOUNG ppl (under 65)?

A

Bicuspid aortic valve

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13
Q

What is the most common cause of Aortic Stenosis in OLD ppl (over 65)?

A

Calcification of the aortic valve

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14
Q

What should you do before you Cardiovert a stable pt w AF, presenting 48+ hrs since onset? (2 things)

A
  1. Anticoag at least 3 wks prior to Cardioversion
  2. Transoesophageal Echo (TOE)
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15
Q

What is the point of Transoesophageal Echo (TOE) before Cardioverting a AF pt?

A

To exclude Left Atrial Appendage (LAA) thrombus

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16
Q

What meds should you give for secondary prevention after MI? (4 things)

A

He had an MI, now he dabs…

  1. Dual anti-platelet
  2. ACE inhibitor
  3. Beta blocker
  4. Statin
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17
Q

For Dual Antiplatelet therapy, after PCI for NSTEMI what are the options?

A

Aspirin + one of:
* Prasugrel / Ticagrelor (if not taking oral anticoag)
* Clopidogrel (if taking oral anticoag)

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18
Q

For Dual Antiplatelet therapy, after PCI for NSTEMI what are the options?

A

Aspirin + one of:
* Prasugrel / Ticagrelor (if not taking oral anticoag)
* Clopidogrel (if taking oral anticoag)

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19
Q

What Anticoag should you use in pt w Mechanical heart valves?

A

Warfarin (not a DOAC)

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20
Q

What are the features of Mitral Stenosis? (3 things)

A
  1. Mid-diastolic murmur
  2. Louder on EXpiration
  3. Loud S1
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21
Q

What is the Tx option for severe Mitral Stenosis?

A

Percutaneous mitral commissurotomy

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22
Q

What things in the bloods will suggest a persons COPD will respond to steroids?

A

High blood eosinophils

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23
Q

What things suggest a pt COPD will respond to steroids? (4 things)

A
  1. Previous Dx of Asthma
  2. High eosinophils
  3. Big variation in FEV1 over time (400+ ml)
  4. Big diurnal variation in Peak Flow (20% +)
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24
Q

If someone has Fever + Heart murmur what should you consider?

A

Inf Endocarditis

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25
Q

How do you Dx Inf Endocarditis?

A

3x blood cultures

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26
Q

What type of bacteria usually causes Inf Endocarditis?

A

Gram positive cocc

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27
Q

What does the ECG show below?

A
  • Big T wave in V1, V2
  • Often first sign of Myocardial ischaemia –> admit dem to hosp
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28
Q

What antiHTN meds is CI in pt w Renal artery stenosis?

A

ACEi (so give ARBS instead)

i already knew this n got q right lol

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29
Q

What ECG changes will a Lung cancer pt most likely have?

A

Short QT interval (bc hypercalcaemia)

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30
Q

What are the CF of hypercalcaemia? (4 things)

A
  1. Bones
  2. Stones
  3. Groans (abd)
  4. Psychiatric Moans
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31
Q

What are the ECG changes of Pericarditis? (2 things)

A
  1. Widespread ST elevation
  2. PR depression
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32
Q

What are the CF of Pericarditis?

A
  1. Pleuritic CP (relieved @ leaning forward)
  2. Dry cough
  3. Pericardial rub
  4. Tachypnoea
  5. Tachycardia
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33
Q

What investigation should you do if you sus Pericarditis?

A

Transthoracic Echo-cardiography

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34
Q

What are the Mx options for Pericarditis? (2 things)

A
  1. TUC
  2. NSAIDs + Colchicine
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35
Q

Which Ca channel blockers are CI with Beta blockers? (2 things)

A
  1. Verapamil
  2. Diltiazem
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36
Q

What should you give if Beta Blocker / Nifedipine (Ca channel blocker) is not working for Angina CF?

A

Ivabradine
(HCN channel blocker)

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37
Q

What is the time window for PCI for a MI?

A

12 hours
(not 2 hours like I previously thought)

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38
Q

What elec abn can Thiazide diuretics cause? (2 things)

A
  1. Hypercalcaemia
  2. Hypocalciuria
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39
Q

What Smoking cessation things are CI in pregnancy? (2 things)

A
  1. Varenicline
  2. Bupropion
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40
Q

What Smoking cessation thing is fine to have during pregnancy?

A

Nicotine replacement therapy

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41
Q

What is a visible side fx of Amiodarone?

A

Grey skin

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42
Q

What is the FIRST line tx for COPD?

A

SABA / SAMA

(aka Salbutamol / Ipratropium)

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43
Q

What is the FIRST line tx for COPD?

A

SABA / SAMA

(aka Salbutamol / Ipratropium)

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44
Q

What does persistent ST elevation (in V1-V6) after an MI, w/o chest pain mean?

A

Left ventricular aneurysm
(MI complication)

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45
Q

What should you give to a VF / pulseless VT after 3 shocks have been given? (2 things)

A
  1. IV Adrenaline 1 mg
  2. IV Amiodarone 300 mg
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46
Q

What is the Dx test for Obstructive Sleep Apnoea?

A

Polysomnography

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47
Q

What is important about Diabetics having an MI?

A

Can present WITHOUT chest pain

(bc neuropathy)

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48
Q

What is HOCM associated with?

A

S4

49
Q

What are the CF of LV free wall rupture (MI complication)? (4 things)

A
  1. Sudden HF
  2. Raised JVP
  3. Pulsus paradoxus (BP drop @ inspiration)
  4. Recent MI (obv)
50
Q

What is important about taking Erythromycin / clarithromycin?

A

Need to stop Statins
(bc interactions)

51
Q

When should you stop Beta blockers used for HF? (3 things)

A
  1. Bradycardia (HR 50-)
  2. 2nd / 3rd Degree HB
  3. Shock (hypotension)
52
Q

What can be used to reduce risk of death in HOCM?

A

ICD

53
Q

What should you give a pt w COPD when they get pneumonia, apart from abx?

A

Prednisolone

(even if COPD not exacerbated)

54
Q

What does a decreased pO2/FiO2 suggest?

A

Acute Resp Distress Syndrome (ARDS)

55
Q

How can an MI give you bilat crackles in entire lung fields? (7 steps)

A
  1. MI
  2. Papillary muscle rupture
  3. Mitral Regurg
  4. Backflow from LV –> LA
  5. Increased pressure in L heart
  6. Pulm vessels can’t drain into L heart
  7. Pulm oedema
56
Q

What should you do w NSTEMI pt w GRACE score of 3+ %?

A

Coronary angiography within 72 hours of admission

57
Q

What are signs specific to RIGHT sided HF? (3 things)

A
  1. Raised JVP
  2. Ankle oedema
  3. Hepatomegaly
58
Q

How do you remember Resp vs Met Acidosis / Alkalosis?

A

ROME

Resp = Opposite
Metabolic = Equal

59
Q

How do you work out Resp Acidosis / Alkalosis?

A

RO = Opposite
* Low pH + High pCO2 = Acidosis
* High pH + Low pCO2 = Alkalosis

60
Q

How do you work out Met Acidosis / Alkalosis?

A

ME = Equal
* Low pH + Low Bicarbs = Acidosis
* High pH + High Bicarbs = Alkalosis

61
Q

How do you interpret Resp component of ABG according to Resus Council UK?

A

Resp component = PaCO2

  • If 6.0+ = Resp acidosis (or resp compensation for met alkalosis)
  • If 4.7- = Resp alkalosis (or resp compensation for met acidosis)
62
Q

How do you interpret Met component of ABG according to Resus Council UK?

A

Met component = Bicarbs

  • If 22- = Met acidosis (or renal compensation for resp alkalosis)
  • If 26+ = Met alkalosis (or renal compensation for resp acidosis)
63
Q

What should be offered annually for all HF pts?

A

Influenza vaccine

64
Q

What is the FIRST line Tx for LV impairment?

A

ACEi + Beta blocker

65
Q

What are the ECG signs of Dextrocardia? (2 things)

A
  1. Inverted P wave in lead 1
  2. Right axis deviation
66
Q

What do you see on a CXR of HF?

A
  1. Alveolar oedema (bat’s wings)
  2. Kerley B lines (interstitial oedema)
  3. Cardiomegaly
  4. Dilated prominent upper lobe vessels
  5. Pleural Effusion
67
Q

What do you hear in the heart w Pulm HTN?

A

Loud S2

68
Q

What are the CF of Dresslers Syndrome (MI complication)? (4 things)

A
  1. Fever
  2. Pleuritic CP
  3. ESR raised
  4. 4 weeks after MI
69
Q

What is the Tx for asymptomatic Sarcoidosis?

A

No Tx

70
Q

What is the FIRST line tx for Sarcoidosis?

A

Prednisolone

71
Q

What is the IMMEDIATE Mx of NSTEMI?

A
  1. Aspirin
  2. Nitrate
  3. Morphine

(Oxygen only if sats under 94)

72
Q

What will you see on a Echo of HOCM? (2 things)

A
  1. Asymmetric Septal Hypertrophy
  2. Systolic Anterior Movement (SAM) of Anterior leaflet of Mitral Valve
73
Q

What should you consider for Acute HF not responding to Tx?

A

CPAP

74
Q

What are the Mx options for Sleep Apnoea? (2 things)

A
  1. WL (first line)
  2. CPAP (if moderate – severe)
75
Q

What is Brugada Syndrome?

A

Heart condition characterized by (Brugada sign):
1. ST elevation (V1-V3)
2. T wave inversion

76
Q

What will you see in Hx of Brugada Syndrome?

A

FHx of sudden death before 45

77
Q

What is the Mx of Brugada syndrome?

A

ICD

78
Q

What are the characteristics of the murmur in HOCM? (3 things)

A
  1. Ejection systolic
  2. Louder @ Valsalva manoeuvre
  3. Quieter on squatting
79
Q

What are the ECG changes in HOCM? (3 things)

A
  1. Big R waves (ventricular hypertrophy)
  2. T wave inversion (looks biphasic in V3)
  3. Deep Q waves (leads II and III)
80
Q

What med is CI in VT?

A

Verapamil
(will cause severe hypotension / VF / cardiac arrest)

81
Q

What is the FIRST line meds for HTN in diabetics?

A

ACEi / ARB (regardless of age)

82
Q

What are the Mx options for Aortic dissection?

A

Type A = IV labetalol (for BP) + Surgery
Tybe B = IV labetalol (for BP)

83
Q

What are some obvious CF of Sarcoidosis? (2 things)

A
  1. Erythema nodosum (raised red shins)
  2. Hypercalcaemia
84
Q

What should you give a COPD pt who has 4+ exacerbations in a year and doesn’t smoke?

A

Azithromycin prophylaxis

85
Q

What is the first line meds for Broad complex Tachycardia with NO adverse features (aka pt feeling well)?

A

Amiodarone (IV)

86
Q

What should you give for pt w Hx of DVT / PE when travelling as prophylaxis?

A

Anti-embolism stockings

87
Q

What is Coarctation of Aorta?

A

Congenital narrowing of descending aorta

88
Q

What are the CF of Coarctation of Aorta? (3 things)

A
  1. HF (in infants)
  2. Systolic murmur
  3. Weakened femoral pulses
89
Q

What is the Mx of Major Bleeding? (3 things)

A
  1. Stop warfarin
  2. IV vit K 5mg
  3. Prothrombin complex concentrate
90
Q

What is the Mx of Minor Bleeding w INR over 8? (3 things)

A
  1. Stop warfarin
  2. IV vit K 1-3mg (repeat PRN after 24 hrs)
  3. Restart warfarin @ INR 5
91
Q

What is the Mx of NO Bleeding w INR over 8? (3 things)

A
  1. Stop warfarin
  2. PO vit K 1-5mg (repeat PRN after 24 hrs)
  3. Restart warfarin @ INR 5
92
Q

What is the Mx of Minor Bleeding w INR 5 - 8? (3 things)

A
  1. Stop warfarin
  2. IV vit K 1-3mg
  3. Restart warfarin @ INR 5
93
Q

What is the Mx of NO Bleeding w INR 5 - 8? (2 things)

A
  1. Withhold 1 or 2 doses of Warfarin
  2. Reduce subsequent maintenance dose
94
Q

What type of lung cancer is Hypertrophic Pulmonary Osteoarthropathy (HPOA) most common in?

A

Squamous cell carcinoma

95
Q

What are the ECG signs of Posterior MI? (2 things)

A
  1. ST depression (V1-V3)
  2. Tall R waves (V1-V2)
    aka depression in anterior leads (so da opposite of a anterior MI)
96
Q

What is the most common causative organism of Infective endocarditis?

A

Staph aureus

97
Q

What can you give (after ABS) for HF if 75+ bpm and LVEF is less than 35%?

A

Ivabradine

98
Q

What GRACE score means a NTESMI pt needs a PCI within 72 hours?

A

More than 3%

99
Q

What are the Mx options for Symptomatic Aortic Stenosis pts?

A

Low / Medium risk pt: Surgical AVR
High risk pt: Transcatheter AVR

100
Q

What are the CF of Acute Pericarditis? (4 things)

A
  1. SOB
  2. Non-prod cough
  3. Pleuritic chest pain (relieved by leaning forward)
  4. Pericaridal rub (scratchy rubbing sound, best heard @ systole)
101
Q

What ECG change is most common in Acute Pericarditis?

A

PT depression
(PeRicari-die-tis)

102
Q

What are the target sats for COPD pt if CO2 is NORMAL on ABG?

A

94-98%

103
Q

What should you do with the anticoagulant of AF pt who has Catheter ablation?

A

Carry on anticoagulant (if chadvasc says so)
(ablation doesn’t change anything)

104
Q

What murmur do you hear in VSD?

A

Pansystolic murmur
(ASD n VSD r part of ASMR innit)

105
Q

What meds do you need to stop when starting Macrolide abx (e.g clarithromycin)?

A

Statins
(risk of rhabdomyolysis)

106
Q

What is the Step wise approach for COPD? (3 steps)

A
  • Step 1: SABA / SAMA
  • Step 2 NO Asthma CF: LABA + LAMA
  • Step 2 Asthma CF: LABA + ICS
  • Step 3: LABA + LAMA + ICS (so add missing one n obv SABA)
107
Q

What is the difference in Adrenaline (dose + route) in Anaphylaxis vs Cardiac arrest?

A
  • Anaphylaxis: IM 500 mcg
  • Cardiac arrest: IV 1 mg
108
Q

What is the Dx when CXR shows upper lung fibrosis, presents like interstitial fibrosis but isn’t?

A

Radiation pneumonitis
(caused by radiotherapy for previous lung cancer)

109
Q

What lung cancer is assoc w Gynaecomastia?

A

Adenocarcinoma
(obv coz enzymes n stuff)

110
Q

What are the most common pathogens causing Inf Endocarditis? (2 things)

A
  1. Staph aureus
  2. Staph epidermis (if less than 2 months after valve surgery)
111
Q

When can Mobitz 1 Wenceback be normal?

A

Athletes

112
Q

What are the Antiplatelet rules in NSTEMI?

A

Aspirin + either:
1. Ticagrelor (if not high bleeding risk) (give tiger if safe)
2. Clopidogrel (if high bleeding risk)

113
Q

What are some urgent referral things for Lung cancer? (2 things)

A
  1. Hyponatraemia
  2. Raised platelets
  3. WL
114
Q

What might you see on CXR for PE? (2 things)

A
  1. Normal XR (most of the time)
  2. Wedge-shaped opacification (20%)
115
Q

What should you start AF pt on after a stroke to prevent another stroke?

A

Warfarin

116
Q

Which type of lung cancer has Cavitating lesions?

A

Squamous cell cancer

117
Q

What meds is the most common cause of Drug induced angioedema?

A

ACEi

118
Q

What are the criteria for LTOT?

A

PaO2 less than 7.3 // OR //
PaO2 less than 7.3 with:
1. Peripheral oedema
2. Pulm HTN
3. Polycthaemia

119
Q

What are the criteria for LTOT?

A

PaO2 less than 7.3 // OR //
PaO2 less than 8 with:
1. Peripheral oedema
2. Pulm HTN
3. Polycthaemia

#passmed 2023 (39 decks)

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