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Year 1 Incorrect Questions > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Cause dementia, prescribed beta blocker and bradycardia

A

Beta-blocker overdose

Treat w glucagon

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2
Q

When is atropine required in bradycardia?

A

Adverse features

Risk factors for asystole

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3
Q

First line for brady management

A

Thyroid function, electrolytes, observe

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4
Q

Brady treatment after maximum atropine?

A

Isoprenaline 5mg/m, transuctaneous pacing, adrenaline 2-10mg/m

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5
Q

ECG finding of A wave in complete heart block

A

Cannon A-waves

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6
Q

Management of AF with heart failure

A

Digoxin

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7
Q

ALS Algorithm in SVT

A

Vagal Manoeuvres

IV Adenosine

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8
Q

Additional Adenosine Treatment

A

6mg
12mg
18mg

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9
Q

Atrial flutter treatment

A

2.5mg bisoprolol, PO

Beta blocker

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10
Q

Haemodynamically unstable BP?

A

Systolic <90mmHg

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11
Q

AF treatment without HF

A

Beta blocker

if contraindicated, Diltiazem

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12
Q

Contraindication for adenosine

A

Asthma

give verapamil instead

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13
Q

Imaging for aortic dissection

A

CT

Trans-oeso echo (TOE)

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14
Q

Stanford Type B management

A

(Desc aorta - Medical management)

Labetalol to control BP

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15
Q

Type A dissection features

A

Asc aorta
Located anteriorly
Thicker than desc aorta

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16
Q

Coronary artery dissection on ECG

A

ST elevation in inferior leads

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17
Q

Mos common cause of aortic regurg

A

Rheumatic HD

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18
Q

Best inv for aortic regurg

A

TTE

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19
Q

Symptomatic AR treatment w HF symptoms

A

Surgical valve replacement

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20
Q

Pulse pressure in AR?

A

Wide PP

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21
Q

Pulse in aortic stenosis

A

Slow-rising

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22
Q

Determining severity of aortic stenosis

A

Elevated pressure gradient >40mmHg across valve

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23
Q

Does aortic sclerosis radiate to carotids?

A

No

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24
Q

Surgery in symptomatic severe AS?

A

TAVI

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25
Q

AF treatment <48h onset

A

LMWH and DC cardioversion

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26
Q

What CHA2DS2-VASc score should AF patients have to be anticoagulated?

A

0

All AF patients should be anticoagulated

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27
Q

First line rate control for fast AF in haem stable

A

Cardioselective blocker - bisoprolol

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28
Q

Anticoag drugs in AF

A

Apibaxin
Dabigatran
Rivaroxaban

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29
Q

Asymptomatic AF with score 0 - which anticoag?

A

None

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30
Q

Treatment of fast AF with failed rhythm control

A

Digoxin, carvdilol, warfarin

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31
Q

Drugs causing TdP

A

Antibiotics

Antiarrhythmics

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32
Q

Rate of compressions in vent tachy

A

100-120 per min

30:2 breaths

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33
Q

First line for haemo stable vent tachy

A

Amiodarone

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34
Q

HF on auscultation

A

Bibasal crackles

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35
Q

Magnesium sulfate in vent tachy

A

TdP with no adverse features (If QRS is twisting around baseline)

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36
Q

Definitive management of Brugada

A

ICD

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37
Q

How long should a patient wait after angio to drive?

A

1 week

6 months if ICD is implanted

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38
Q

Chest pain <12h onset

A

Angio + PCI

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39
Q

Type of stroke risk after angio

A

Embolic

40
Q

Haem unstable and failure to respond to med therapy… type of pacing?

A

Trans-cutaneous/venous pacing

41
Q

Dual chamber pace rhythm

A

2 spikes

1 before P, 1 before QRS - means there’s 2 leads pacing the rhythm

42
Q

Pacing for sinus arrest >3s

A

Permanent pacemaker

43
Q

Amyloidosis

A

Amyloid protein depos in body tissues e.g. kidneys, heart

Leads to restrictive cardiomyopathy (sparkling on echo)

44
Q

How does heart compensate during HF?

A

Elevated right atrial pressure

45
Q

What vessels control blood flow through capillaries?

A

Arterio-venous anastomoses

46
Q

Changes in arteries w sympathetic stimulation

A

Vasoconstriction
Incr systemic vasc resistance
Reduced distal blood flow

47
Q

Dextrocardia

A

Heart points to RHS

48
Q

Function of autoregulation

A

Maintaining constant blood flow in organs such as the kidney and brain

49
Q

MAP=

A

COxTPR

e.g. 6.3 x 20 = 126

50
Q

Isovolumetric Contraction

A

AV valves closed

Semilunar valves closed

51
Q

Sudden decr in blood pressure causes increases in…

A

Vasoconstriction
HR
Force of myocardial contraction

52
Q

Indication for IE valve surgery

A

HF symptoms (bilateral crackles, elev JVP, SOB)

53
Q

If strep. bovis is found in IE what investigation must be performed?

A

Colonoscopy

54
Q

Common acute murmur seen 2-10 days post-MI

A

Mitral regurgitation

55
Q

Management of asympto mitral stenosis w no HF symptoms

A

6 month follow-up

56
Q

Features of cornary artery vasospasm

A

Central chest pain on exertion

Strongly assoc w cocaine

57
Q

GRACE score

A

Estimates in-hosp mortality and 6-month post-discharge mortality

58
Q

What anti-coag should be given w dual anti-platelet in acute MI?

A

LMWH

59
Q

Left bundle branch block on ECG

A

Broad QRS
Dominant S wave in V1
Notched R waves (M shaped QRS)
**Treat same as STEMI

60
Q

What ECG do you need for a posterior infarct?

A

15-lead ECG

3 extra leads (V7, 8, 9

61
Q

What clotting factors does warfarin act on?

A

1972

10, 9, 7, 2

62
Q

Brown deposition in legs?

A

Haemosiderin deposition

63
Q

Left renal artery origin?

A

L1

64
Q

5 Features of HF on CXR

A 
Alveolar oedema
B lines
Cardiomegaly
Diversion of vessels
Effusion
65
Q

LV ejection fraction =

A

(stroke vol/end diastolic LV vol) x 100

66
Q

What vessel is beside the inferior parathyroid gland?

A

Common carotid

67
Q

Reduced ejection fraction in HF?

A

Less than 40%

68
Q

Where is great saphenous vein?

A

Anterior to medial malleolus

69
Q

JVP waveform features

A

Upward deflections
a wave = atrial contraction
c wave = ventricular contraction
v wave = atrial venous filling

Downward deflections
x wave = atrium relaxes and tricuspid valve moves down
y wave = ventricular filling

70
Q

Jones Criteria for RF

A

Major - arthritis, pancarditis, Sydenham’s chorea, erythema marginatum, subcutaneous nodules

Minor - fever, athralgia, raised acute phase protein (ERS and CRP), prolonged PR interval

71
Q

Diag of RF

A

Evidence of recent strep infection
PLUS
2 majors OR 1 major, 2 minor

72
Q

Treatment of RF

A

Benzylpenicillin

73
Q

LBBB vs RBBB pneumonic

A

V1 QRS looks like W and V6 QRS looks like M - WiLLaM

V1 looks like M and V6 looks normal (sometimes slurred S) - MaRRoW

74
Q

Sick sinus on ECG

A

Sinus bradycardia
Sinoatrial block
Periods of sinus arrest
Abnormally long pauses after a premature beat

75
Q

1st line inv after ECG for angina

A

CT coronary angio
Indicated for atypical/atypical angina pain
OR
ECG ischaemic changes in chest pain w <2 angina features

76
Q

Angina treatment if BBs and Ca blockers are contraindicated

A

Long-acting nitrate e.g. Isosorbide Mononitrate
Ivabradine
Nicorandil
Ranolazine

77
Q

Contraindication to CTCA

A

Renal impairment which risks contrast induced nephropathy

Instead use myocardial perfusion imaging

78
Q

Tricuspid regurg on JVP waveform

A

Prominent V wave

79
Q

WPW on ECG

A

Delta waves (slurred upstroke in the QRS)
Short PR interval (<120ms)
Broad QRS
If a re-entrant circuit has developed the ECG will show a narrow complex tachycardia

80
Q

First line treatment for WPW

A

Catheter ablation of the accessory conduction pathway

81
Q

Why do ACE inhibitors cause a dry cough?

A

Increased bradykinin

82
Q

Side effects of thiazide diuretics

A

Hypokalaemic metabolic alkalosis, impaired glucose tolerance, impotence

83
Q

First line for suspected STEMI secondary to pericarditis if NSAIDs are contraindicated

A

Colchicine or steroids

84
Q

ECG changes characteristic of digoxin treatment

A

Down-slopping ST segments seen in leads V4-V6, I and aVL
(ST segment = hockey stick)

85
Q

What type of cardioversion of haem unstable patient with AF?

A

Synchronised DC cardioversion under sedation

86
Q

Recent viral illness and sudden onset chest pain with no ECG changes

A

Myocarditis

87
Q

Indications for permanent pacing

A

Severe HF (unresponsive to meds)
Complete Av block
Mobits 2
Sympomatic bradycardia
Symptomatic sick sinus
Drug-resistant tacharrythmias

88
Q

Most common type of VSD?

A

Type 2 - membranous

89
Q

Most common cause of myocarditis

A

Coxsackievirus B

90
Q

Initial management of SVT

A

Vagal manoeuvres e.g. blow into empty syringe

91
Q

Murmur assoc with SLE

A

Mitral stenosis

92
Q

What are the components of Tetralogy of Fallot?

A

VSD
Pulmonary stenosis
Right ventricular hypertrophy
Overriding aorta

93
Q

Is R common carotid a direct branch of aorta?

A

No (only the left)

94
Q

ID vessels of heart on CT from left right

A

SVC, asc aorta, pulm artery, pulm vein

95
Q

Which leads would show ST elevation in anterolateral STEMI?

A

V1-V4

Year 1 Incorrect Questions (7 decks)

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