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Pathology and final year > CARDIORESPIRATORY > Flashcards

CARDIORESPIRATORY Flashcards

1
Q

Complications of an MI

A

Immediate:
- cardiac arrest
- cardiogenic shock
- acute mitral regurgitation (more common with inferio-posterior infarction)
- arrhythmias

-Pericarditis (within 48hrs or Dresslers 2-6weeks after)
-large ventricular free wall rupture (1-2 weeks post)
- ventricular septal defect (within first week)
- chronic heart failure

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2
Q

Mining occupation, upper zone fibrosis, egg-shell calcification of hilar nodes

A

Silicosis

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3
Q

X ray findings in asbestosis

A

lower zone fibrosis and pleural thickening, and there is not commonly hilar calcification.

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4
Q

clinical examination findings for a collapsed right upper zone

A

Trachea deviated to the right
reduced breath sounds
dullness to percuss

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5
Q

causes a cavitating mass on chest radiograph?

A

squamous cell carcinoma
pulmonary infarct
granulomatosis with polyangiitis
bacterial lung abscess
mycetoma

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6
Q

causes of a loud S1

A

hyperdynamic states
- exercise
- pregnancy
- fever/ sepsis
- anaemia

reduced PR interval- WPW syndrome

mitral stenosis

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7
Q

what makes the sound of:
S1
S2
S3
S4

A

S1- closure of MV and TV
S2- closure of AV and PV
S3- Excess ventricular filling
S4- increased arterial ‘kick’ during diastole

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8
Q

causes of a soft S1

A

hypodynamic states
- HF

increased PR interval (increased ventricular filling and pushing valve leaflets closer together)
- heart block

Mitral regurg

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9
Q

causes of a loud S2

A

systemic hypertension
pulmonary hypertension

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10
Q

causes of a soft S2

A

aortic stenosis and aortic regurg

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11
Q

causes of a split S2

A

physiological during inspiration

wide split S2-
- delayed RV ejection: RBBB, pulmonary hypertension,pulmonary stenosis, PE
- increased LV ejection: WPW

Fixed split S2 (same in insp and expiration)
- ASD

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12
Q

causes of pitting oedema

A

HF
liver cirrhosis
nephrotic syndrome

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13
Q

casues of non pitting oedema

A

lymphoedema
pretibial myxedema

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14
Q

cuases of constrictive pericarditis

A

idiopathic
TB
systemic inflammatory conditions- RA, SLE, sarcoid

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15
Q

Signs and symptoms of constrictive pericarditis

A

SOB
chest pain

Kussmal breathing - raised JVP on inspiration

signs of right HF - pulmonary oedema

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16
Q

what is constrictive pericarditis

A

formation of granulation tissue within the pericardium resulting in loss of stretch and cardiac filling

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17
Q

causes of restrictive cardiomyopathy

A

amyloidosis
sarcoidosis
myeloma (deposition of AL amylois)

presents similarly to constrictive pericarditis

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17
Q

what is brugada syndrome?

A

AD inherited heart condition

predisposes to fatal arrhythmias

RBBB and ST elevation in V1-3

strong FHx of unexplained cardiac death or syncope

17
Q

sparkling sign on echocardiogram sign of

A

amyloid deposition in the myocardium

18
Q

anti hypertensive drugs safe to use in pregnancy

A

labetelol
nifedipine
methyldopa
hydralazine

19
Q

treatment for oligogyric crisis

A

procyclidine

20
Q

what conditions are a contraindication for beta blockers

A

asthma
COPD
raynauds
peripheral vascular disease
bradycardia
prinzmatal angina

21
Q

causes of haemoptysis

A

resp:
PE
lung cancer
TB

Cardio
RHF
Mitral stenosis

systemic
GPA
goodpastures syndrome

22
Q

causes of pericarditis

A

infections
- coxackie B, EBV, mumps

infaarct
- ost MI dresslers

inlammation
- RA, SLE, sarcoid

23
Q

antibiotics that cause long QTc

A

macrolides (azithro, erythro, clarythromycin)
quinolones (ciproflox, levofloxacin)

24
Q

aortic regurgitiation signs

A

wide pulse pressure
collapsing pulse
De musset’s sign- head bobbing with pilse

rare:
Quinckes sign- nail bed pulsation
corrigans sign: carotid pulseation
pistol shot sign heard over the femorals

25
Q

long term management of mechanical valve replacement

A

warfarin sodium

now have home INR testing kits

26
Q

discharge management following asthma attack

A

non-pharm:
personalised asthma management plan

pharm:
salbutamol
betamethasone and slmaterol inhaler
oral pred

27
Q

causes of clubbing

A

resp:
bronchiectaasis
lung carcinoma
lung abscess
extrinsic allergic alveolitis
cycstic fibrosis
Idiopathic pulmonary fibrosis

cardio
cyanotic heard disease

gastro
ulccerative colitis

neuro
neurogenic tumors

28
Q

management of moderate acute exacerbation of COPD

A

increase frequency of bronchodilator/ nebulised
30mg oral pred for 5 days

signs of infection:
antibiotix: amoxicillin/ clarythromycin/ doxycycline

29
Q

management of severe exacerbation of COPD

A

oxygen: caustion of CO2 retention, ABG, check Hx, 88-92% target if retainer
venturi mask 28%
NIV if retention

salbutamol/ ipratroprium nebs

IV steroids (hydrocortisone)

30
Q

management for ABPA

A

oral steroids

31
Q

Management of STEMI

A

ACUTE
supportive:
- analgaesia (IV morphine)
- metocopromide
- oxygen if required
- nitrates if SBP >110

medical
- STAT dose aspirin (300mg)
- loading dose of ticagrelor (180mg)

interventional:
- call cardiology and arrange for a primary PCI ASAP (within 2hrs of presentation)
- if not possible within 2 hrs then thrombolyse with alteplase

LONGTERM
- address CVD RFs: smoking cessation, DM control, statin

32
Q

Management of NSTEMI

A

Supportive:
- analgaesia + metoclopromide
- oxygen
- GTN, bblocker, CCB

medical
- Aspirin 300mg + ticagrelor 180mg
- fondaparinux or LMWH

calculate GRACE score (6 month mortality)

> 3%
Intervention:
- revascularisation within 72hrs
- ticagrelor + unfractionated heparin

<3%
conservative:
- ticagrelor

Important investigations
- Echo to establish LV funtion

33
Q

Management od unstable angina

A
34
Q

Management of stable angina

A

Symptom control
vasodilators:
-GTN spray
- CCBs (amlodipine)

rate slowing:
- beta blockers
- ivabridine (acts on SAN)

35
Q

Management of AS

A

asymptomatic:
- annual f/u in clinic and echocardiogram
- safety netting

symptomatic
- TAVI
-iopen AV surgery

36
Q

Management of MR

A

Management of acute symptoms:
- A-E
-oxygen
-IV frusomide if overloaded
- manage ACS if appropriate

MR
- TOE
- mitral valve repair or replacement
- biologic or metallic

37
Q

what AV pressure gradient should prompt AV replacement

A

> 50mmHg

38
Q

causes of 3rd decree heart block

A

ischaemia (esp inferior MI)
medication (CCB, digoxin, bblockers, amiodarone, donepazil)
fibrosis

39
Q

becks triad

A

hypotension
raised JVP
muffled heart sounds

40
Q

which lung cancer is associated with cavitating lesions?

A

squamous cell

41
Q
A

Pathology and final year (21 decks)

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