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PassMed facts > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Which valve is affected by rheumatic fever?

A

Mitral causing mitral stenosis

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2
Q

Management of orthostatic hypotension?

A

Fludrocortisone
Midodrine

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3
Q

ECG changes in aortic dissection?

A

Inferior lead ST elevation

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4
Q

Aortic dissection investigation?

A

CT aortic angiogram

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5
Q

Transfusion threshold in ACS?

A

Hb < 80

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6
Q

Reversible causes of PEA?

A

Tension pneumothroax

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7
Q

Management of acute limb ischaemia?

A

IV heparin and vascular review

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8
Q

Management if GRACE score > 3%?

A

Coronary angiography within 72 hours of admission

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9
Q

ECG changes in posterior MI?

A

Tall R waves in V1 and 2

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10
Q

Management of MI secondary to cocaine use?

A

Benzos

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11
Q

What valve is most commonly affected in IE in IVDU?

A

Tricuspid valve

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12
Q

In previously normal valves which valve is the most commonly affected in IE?

A

Mitral

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13
Q

When can flash pulmonary oedema occur?

A

Mitral regurgitation due to MI

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14
Q

Management of broad complex tachycardia?

A

Amiodarone

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15
Q

Indication for emergency valve replacement in IE?

A

IE plus CCF

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16
Q

ECG changes in hypercalcaemia?

A

Short QT interval

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17
Q

ECG changes in severe hyperkalaemia?

A

Sinusidal/ sine wave

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18
Q

Where is claudication in iliac stenosis?

A

Buttock pain

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19
Q

Where is claudication in femoral stenosis?

A

Calf pain

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20
Q

First line imaging in PAD?

A

Duplex USS

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21
Q

Quinke’s sign?

A

Aortic regurgitation (nail bed pulsation)

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22
Q

Associated murmur with narrow pulse pressure ?

A

Aortic stenosis

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23
Q

ECG changes in Wolf-Parkinson-White?

A

Short PR
Wide QRS
Delta wave

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24
Q

In non-shockable rhythms, when should adrenaline be administered?

A

Immediately

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25
Q

Management of stable, regular narrow complex tachycardia?

A

Vasovagal manoeuvres
Adenosine (6mg IV, if unsuccessful give 12mg IV, if unsuccessful give 18mg IV)
Stilll ineffective give verapamil or beta blocker

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26
Q

Management of stable, regular broad complex tachycardia?

A

Amiodarone 300mg IV over 10-60 minutes

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27
Q

Management of irregular narrow complex tachycardia?

A

Probable AF
Rate control with a beta blocker
Consider digoxin/amiodarone if evidence of HF
Anticoagulate if duration > 48 hours

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28
Q

Management of irregular broad complex tachycardia?

A

AF with possible BBB: treat as narrow complex irregular tachycardia

Polymorphic VT (TDS): Magnesium 2mg over 10 mins

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29
Q

Before administration of flecanide in AF?

A

Echo, check for evidence of structural heart disease

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30
Q

Which anti-hypertensive is required in controlling HTN in phaeochromacytoma?

A

Labetalol (require alpha and beta blockade)

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31
Q

Subclavian steal syndrome?

A

Stenosis of subclavian artery = arm symptoms when in high demand (cramping)

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32
Q

Most effective way of correcting hyperkalaemia?

A

Calcium resonium ennema (as K+ secreted by rectum)

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33
Q

Epsilon wave on ECG?

A

Small deflection buried at the end of the QRS complex
Characteristic of ARVD - Arrhythmogenic Right Ventricular Dysplasia

34
Q

PAD management?

A

Statin 80mg
Clopidogrel
Exercise training

35
Q

Murmur in aortic regurgitation?

A

Early diastolic

36
Q

Leriche syndrome?

A

Classically, it is described in male patients as a triad of symptoms:

  1. Claudication of the buttocks and thighs
  2. Atrophy of the musculature of the legs
  3. Impotence (due to paralysis of the L1 nerve)

Atherosclerotic occlusive disease involving the abdominal aorta and/or both of the iliac arteries

37
Q

Most common causes of infective endocarditis?

A

Staphylococcus aureus
Staphylococcus epidermidis if < 2 months post valve surgery

38
Q

U waves?

A

Hypokalaemia

39
Q

ECG in hypothermia?

A

J waves
Long QT
Bradycardia
First degree heart block

40
Q

Kussmaul’s sign

A

JVP that doesn’t fall with inspiration (constrictive pericarditis)

41
Q

Normal varient in athlete on ECG?

A

Mobitz type 1 (Wenckebach phenomenon)

42
Q

When should nifedipine be avoided?

A

HF

43
Q

Drug contraindicated in VT?

A

Verapamil

44
Q

Heart sound in pulmonary HTN?

A

Loud S2

45
Q

When is pulmonary stenosis loudest?

A

Inspiration

46
Q

Pulses paradoxus?

A

Abnormally large drop in BP during inspiration

47
Q

How is the QT interval measured ?

A

Start of the Q wave to the end of the T wave

48
Q

prolonged QTc interval values?

A

Men: >440
Women: >460

49
Q

If fibrinolysis is given for an ACS, when should an ECG be repeated?

A

After 60-90 minutes

50
Q

Most common cause of IE in IVDU?

A

Staph A

51
Q

Most common cause of IE following surgery for prosthetic heart valve?

A

Strep epidermis (only until up to 2 months post surgery)

52
Q

What can cause a falsely low BNP?

A

Aldosterone antagonists
ACEi
ARB
Beta blockers
Diuretics
Obesity

53
Q

IE cause in very poor dental hygiene?

A

Strep viridian’s (strep sanguinus)

54
Q

Pathophysiology of long QTc syndrome?

A

Loss of function/blockage of K+ channels

55
Q

Persistent ST elevation in anterior leads following MI?

A

Left ventricular aneurysm

56
Q

Mitral stenosis ECG?

A

Broad, notched (bifid) p waves
Most prominent in lead II
Due to atrial dilatation

57
Q

Increased p wave amplitude on ECG?

A

Cor pulmonale

58
Q

Normal PR interval?

A

3-5 small squares
0.12-0.2

59
Q

Artery affected in inferior MI?

A

Right coronary artery

60
Q

Artery affected in anterior MI?

A

Left anterior decending artery

61
Q

Artery affected in anterolateral MI?

A

Left anterior descending artery or left circumflex artery

62
Q

Artery affected in posterior MI?

A

Left circumflex, right coronary

63
Q

Artery affected in lateral MI?

A

Left circumflex artery

64
Q

Symptoms of carotid artery disection?

A

Localised headache
Neck pain
Neuro signs (e.g. Horner’s syndrome)

65
Q

Jerky pulse?

A

HOCM

66
Q

Slow rising pulse?

A

Aortic stenosis

67
Q

How long can CPR continue for if cardiac arrest is due to PE?

A

60-90 Minutes

68
Q

When should betablockers Be stopped in HF patients?

A

Hr <50, 2nd or 3rd degree block or shock

69
Q

Electrical alterans ECG?

A

Cardiac tamponade
(Beat variation in QRS amplitude and morphology)

70
Q

Packed RBC frransfusion in HF and furusemide?

A

If giving > 2 units
Give after every other unit

71
Q

Notching of inferior border of ribs ?

A

Present in 70% of those with co arctation of the aorta

72
Q

Causes of 3rd heart sound?

A

Normal < 30 years
LV failure (cardiomyopathy, constrictive pericarditis)
Mitral regurgitation

73
Q

Causes of 4th heart sound?

A

Aortic stenosis
HOCM
HTN

74
Q

Inheritance of Marfan’s?

A

Autosomal dominant

75
Q

When should lvabradine be considered in HF?

A

Sinus rhythm
Bpm >75
LVEF < 35%
Haven’t responded to ACEi, beta blocker or aldosterone agonist

76
Q

Investigation of superficial thrombophlebitis affecting proximal long saphenous vein?

A

USS to exclude DVT

77
Q

Management of superficial thrombophlebitis?

A

Oral NSAIDs
Compression stockings

78
Q

Management of superficial thrombophlebitis affecting proximal long saphenous vein?

A

Prophylactic dose LMWH for 30 days or foniparinaux for 45 days
Oral NSAIDs for 8 to 10 days info LMWH contraindicated

79
Q

What can make AS murmur quieter?

A

LV systolic dysfunction

80
Q

What drug can cause heart racing?

A

Nifedipine causes peripheral vasodilation which may result in reflex tachycardia

PassMed facts (18 decks)

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