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Medicine Year 3 > Cardioresp > Flashcards

Cardioresp Flashcards

1
Q

Describe the kind of murmur heard in aortic stenosis

A 
Crescendo decrescendo (diamond)
Systolic murmur
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2
Q

Describe the murmur heard in aortic regurgitation and where best to auscultate for this

A

Diastolic murmur

Left seternal border

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3
Q

Describe the diagnostic findings of tension pneumothorax on CT and X-ray

A

Visceral pleural line visible

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4
Q

Describe the system used to assess need for hospitalisation in CAP

A

CRB-65

New mental confusion
Respiratory rate >30
Blood pressure <90 systolic
Age >65

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5
Q

Likely diagnoses of a patient presenting with central chest pain, fever, high pitched squeaky ‘rub’ heard at the left sternal edge and ST segment changes on ECG

A
  • Pericarditis (upward conceived ST segment elevation with PR depression)
  • STEMI
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6
Q

Discuss the components of dual anti-platelet therapy and use in ACS

A
  • Aspirin 300mg and clopidogrel or ticagrelor or prasugrel

- NSTEMI

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7
Q

Which genetic disorder should be tested for in a younger patient presenting with signs and investigations positive for COPD

A

Alpha-1 Antitrypsin deficiency

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8
Q

How to differentiate a pleural effusion from pulmonary oedema

A

Effusion —>
Stony dull to percussion
Reduced tactile vocal fremetus
Reduced breath sounds on auscultation

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9
Q

What is Wolff Parkinson white syndrome

A

Supraventricular tachycardia caused by an accessory pathway

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10
Q

Possible causes of an ejection systolic murmur

A
  • Aortic stenosis
  • Pulmonary stenosis
  • Atrial septal defect, tetralogy of Fallot
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11
Q

Management of acute supravebtricular tachycardia

A

If patient is compromised DC cardioversion

Otherwise

1) Vagal manoeuvres
2) IV adenosine

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12
Q

Management of acute AF

A

If patient is showing adverse signs (shock, myocardial Ischaemia chest pain or ECG changes syncope and heart failure) DC cardioversion and amiodarone if unsuccessful

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13
Q

Occlusion of the right coronary artery causing an inferior MI may lead to bradycardia, true or false

A

True

As the right coronary artery supplies the SAN node

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14
Q

What is the standard therapy for treating active TB

A

Initial phase

  • Rifampicin
  • Isoniazid
  • Pyrazinamide
  • Ethambutol

continuation
- Rifampicin
Isoniazid

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15
Q

Most common cause of community acquired pneumonia?

A

Strep. pneumoniae

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16
Q

Which organism is likely responsible for a pneumonia with haemolytic anaemia and erythema multiform

A

Mycoplasma pneumoniae

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17
Q

Suggest a suitable mask to administer oxygen for a critically ill patient in shock who is hypoxic

A

15 L/min reservoir mask

Target stats of 94-98%

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18
Q

Likely diagnosis for patient with chest pain and a raised JVP on inspiration

A

constrictive pericarditis

Kussmaul’s sign

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19
Q

Discuss diagnostic values of spirometry for asthma

A

FEV1/FVC <80% (20% drop in FEV1)

and

12% and 200mL reversibility of FEV1 following bronchodilator

20
Q

What is the 3rd stage in the management of inadequate asthma control

A

Addition of LABA e.g salmetrol (BTS)

Addition of LTRA (NICE)

21
Q

Pathophysiological process of pulmonary hypertension in COPD

A

Hypoxic pulmonary vasoconstriction –> narrowing of pulmonary vasculature and fibrosis –> right sided heart failure

22
Q

What happens to the DLCO/TLCO in interstitial lung disease

A

decreased transfer factor

23
Q

Common causative agent of hospital acquired pneumonia

A

gram negative
S. Aureus
S. pneumonia
anaerobes

24
Q

Definition of hospital acquired pneumonia

A

24hrs after hospital admission, or within 7 days of discharge

25
Q

Typical causative pathogen of cavitating multifocal consolidation pneumonia

A

S. Aureus

26
Q

Common causative agent of pneumonia in COPD patients

A

Haemophilius Influenzae

27
Q

Pneumonia associated with haemolytic anaemia and erythema multiform

A

Mycoplasma Pneumoniae

28
Q

Risk factors for TB

A

HIV/AIDS
Poverty and overcrowding
immunosuppression
Heavy alcohol consumption

29
Q

Suggest possible causes for a pleural effusion with raised LDH and protein levels

A

Infective
Inflammatory causes - RA/SLE, pancreatitis
Dressler’s syndrome
Neoplasm

30
Q

Discuss cause of bifid P waves on ECG

A

P mitrale caused by left atrial enlargement due to mitral valve disease

31
Q

Features of mitral stenosis

A 
Hx of rheumatic heart disease 
AF
Malar Flush 
Mid-diastolic murmur (low pitched)
Features of pulmonary hypertension
32
Q

Examination findings of the patient with aortic stenosis

A
  • Ejection systolic murmur, crescendo decrescendo which radiates to carotids
  • Slow rising pulse
  • Heaving apex beat
  • Systolic thrill
33
Q

Commonly seen pathogen in bronchiectasis infective flare

A

pseudomonas aerginosa

34
Q

Common causative pathogen in atypical pneumonia, spread by domesticated and exotic birds

A

Chlamydia psttaci

35
Q

Causes of preserved ejection fraction HF (diastolic)

A

Chronic hypertension leading to —>

Ventricular Hypertrophy
Stiffened muscle -fibrotic scar tissue

Aortic stenosis

Cardiomyopathies, hypertrophic and restrictive

36
Q

In a patient with pneumonia, dry cough and atypical chest signs, hyponatraemia and lymphopenia is most associated with which organism?

A

Legionella pneumoniae

37
Q

In a patient with pneumonia, high fever, rapid onset and herpes labialis is most associated with which organism?

A

Strep. p

38
Q

State the paraneoplastic features associated with small cell lung cancer

A

ADH
ACTH - Cushing’s
Lambert-Eaton syndrome

39
Q

State the paraneoplastic features of squamous cell lung cancer

A
  • PTH-rp causing hypercalacaemia
  • Hypertrophic pulmonary osteoarthropathy
  • Hyperthyroidism due to ectopic TSH
40
Q

A 70-year-old woman is found to have a pan-systolic murmur after presenting with dyspnoea. A soft S1 and split S2 is also noted

A

mitral regurgitation

41
Q

Progressive prolongation of the PR interval until a dropped beat occurs -

A

second degree heart block (Mobitz type I or Wenkebach)

42
Q

Which valvular heart disease results in an S4 heart sound

A

Aortic stenosis

43
Q

Causes of transudative pleural effusions

A 
Congestive Heart Failure (CHF) 
Hepatic cirrhosis 
Hypoproteinemia 
Nephrotic syndrome 
Acute atelectasis 
Myxedema 
Peritoneal dialysis 
Meig's syndrome 
Obstructive uropathy
44
Q

Which valvular heart disease may be associated with polycystic kidney disease

A

Mitral valve prolapse

45
Q

Post MI complication associated with acute onset HF and pan systolic murmur

A

Ventricular septal defect

Medicine Year 3 (6 decks)

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