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Year 5 Medicine > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

What does the combination of facial and contralateral body loss of pain sensation along with nystagmus and ataxia make up and what artery causes this?

A

Lateral Medullary syndrome - posterior inferior cerebellar artery (PICA) stroke

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2
Q

What investigation is firstline in DVT with severe renal impairment?

A

V/Q Scan

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3
Q

What is De Musset’s Sign ( head bobbing) a sign of?

A

Aortic Regurgitation

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4
Q

What heart murmur is pansystolic?

A

Mitral regurgitation

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5
Q

What heart murmur is associated with marinas syndrome?

A

Mitral regurgitation

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6
Q

Treatment of stroke presenting within 4.5 hours?

A

Altepase and thrombectomy

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7
Q

How does a pontine haemorrhage present?

A

Reduced GCS, Paralysis and bilateral pin point pupils

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8
Q

What is the treatment for haemodynamically unstable PE patients?

A

Altepase

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9
Q

What BP Should there be prior to thrombolysis?

A

Less than 185/110

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10
Q

How is GRACE score interpreted for NSTEMI?

A

If >3% offer coronary angiography with follow up PCI if necessary within 72 hours

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11
Q

What artery is associated with amaurosis fugax?

A

Atherosclerosis of the ipsilateral internal carotid artery

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12
Q

What should be added if angina not controlled with beta blocker?

A

CCB

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13
Q

What is a life threatening complication of ACS?

A

Cardiogenic shock

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14
Q

What is the inheritance of haemachromatosis ?

A

Autosomal Recessive

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15
Q

What is target INR for patients with recurrent PE?

A

3.5

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16
Q

What is normal target INR?

A

2.5

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17
Q

What medications are contraindicated with broad complex tachycardia?

A

Verapamil and diltiezam

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18
Q

How is critical limb ischaemia described?

A

pain at rest for greater than 2 weeks, often at night but not helped by analgesia

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19
Q

When is carotid endarterectomy considered?

A

In a patient who has had a TIA with carotid artery stenosis exceeding 50% on the side of the contralateral symptoms

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20
Q

How to prevent nitrate tolerance in ACS patients?

A

Change dosing to 9am and 8 pm

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21
Q

How is primary hyperaldosteronism managed?

A

Spironolactone

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22
Q

What is contralateral hemiparesis and sensory loss with the lower extremity being more affected than the upper stroke vessel?

A

Anterior cerebral artery

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23
Q

What is a normal QRS complex size?

A

0.08-0.10 seconds - 80-100 milliseconds

24
Q

What is the intervention of choice for severe mitral stenosis?

A

Percutaneous mitral commissurotomy

25
Q

What heart murmur is associated to be mid-diastolic hear better in expiration alongside a loud S1?

A

Mitral stenosis

26
Q

What is locked in syndrome caused by and how does it present?

A

Basilar artery infarct
Decreased GCS and advanced motor symptoms or headache and vision changes prior to onset of permanent symptoms

27
Q

What antibiotic class can cause torsades de pointes?

A

Macrolides

28
Q

How is carotid artery stenosis diagnosed?

A

Duplex ultrasound

29
Q

How does a lacunar stroke present?

A

Unilateral motor disturbance affecting the face, arm, leg or all 3
Complete one sided sensory loss
Ataxia hemiparesis

30
Q

When do you not give anticoagulation in AF?

A

If under 65 and no risk factors other than sex

31
Q

What is the most common cause of death in patients following a myocardial infarction?

A

Ventricular Fibrillation

32
Q

What indicates mitral valve leaflets are still mobile in mitral stenosis?

A

Opening snap

33
Q

What cardiac medication can cause sexual dysfunction?

A

Thiazide like diuretics - indapamide

34
Q

What medication can be used in VT instead of amiodarone?

A

Lidocaine

35
Q

How does left ventricular free wall rupture usually present?

A

Acute heart failure 10 days post MI - raised JVP, pulses paradoxus and diminished heart sounds

36
Q

What is the treatment of bradycardia with adverse features?

A

500mcg atropine up to 3mg

37
Q

What is first line medications for angina treatment?

A

BB/CCB - atenolol/ diltiezam

38
Q

What is firstline treatment for heart failure with reduced LVEF?

A

Beta Blocker and ACE

39
Q

What bacteria is most common cause of endocarditis <2 months post valve surgery?

A

Staph epidermidis

40
Q

How do you differentiate between cardiac tamponade and constrictive pericarditis?

A

Kussmauls sign - raised jvp that doesnt fall on inspiration

41
Q

What is a systolic murmur that radiates to the carotids indicative of?

A

Aortic stenosis

42
Q

What ecg changes are seen in pericarditis?

A

Concave ST elevation and PR depression

43
Q

What is webers syndrome?

A

Midbrain stroke - ipsilateral CNIII palsy and contralateral hemiparesis

44
Q

What medications cause flattening of t waves?

A

Antiarrhythmics, diuretics and digoxin

45
Q

How many shocks can you deliver during witnessed cardiac arrest?

A

3

46
Q

What is gold standard investigation for cardiac tamponade?

A

Echo

47
Q

If angina not controlled by beta blocker what is added?

A

Amlodipine

48
Q

When should a person with AF and ischaemic stroke start anticoagulation?

A

Aspirin daily, anticoagulants 2 weeks after

49
Q

What medications should be stopped before initiation of sucbitril valsartan?

A

ACE or arb

50
Q

What medications should stopped in second degree heart block?

A

BB, CCB or digoxin

51
Q

What is the aortic stenosis valve gradient indicative of valve replacement?

A

> 40 mmHg or significant left ventricular dysfunction

52
Q

What is indicative of cardiac tamponade on ECG?

A

Electrical alternans

53
Q

How does a posterior MI present on ECG?

A

Tall R waves V1-V2

54
Q

What beta blocker is known to cause Qtc prolongation?

A

Soltalol

55
Q

What is the mechanism of action of alteplase?

A

Activates plasminogen to form plasmin

56
Q

What heart murmur becomes louder on inspiration?

A

Tricuspid regurgitation

57
Q

What ECG change is seen in dextrocardia?

A

Inverted p wave in lead 1, right axis deviation and loss of r wave progression

Year 5 Medicine (17 decks)

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