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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
What heart murmur is associated to be mid-diastolic hear better in expiration alongside a loud S1?
Mitral stenosis
26
What is locked in syndrome caused by and how does it present?
Basilar artery infarct Decreased GCS and advanced motor symptoms or headache and vision changes prior to onset of permanent symptoms
27
What antibiotic class can cause torsades de pointes?
Macrolides
28
How is carotid artery stenosis diagnosed?
Duplex ultrasound
29
How does a lacunar stroke present?
Unilateral motor disturbance affecting the face, arm, leg or all 3 Complete one sided sensory loss Ataxia hemiparesis
30
When do you not give anticoagulation in AF?
If under 65 and no risk factors other than sex
31
What is the most common cause of death in patients following a myocardial infarction?
Ventricular Fibrillation
32
What indicates mitral valve leaflets are still mobile in mitral stenosis?
Opening snap
33
What cardiac medication can cause sexual dysfunction?
Thiazide like diuretics - indapamide
34
What medication can be used in VT instead of amiodarone?
Lidocaine
35
How does left ventricular free wall rupture usually present?
Acute heart failure 10 days post MI - raised JVP, pulses paradoxus and diminished heart sounds
36
What is the treatment of bradycardia with adverse features?
500mcg atropine up to 3mg
37
What is first line medications for angina treatment?
BB/CCB - atenolol/ diltiezam
38
What is firstline treatment for heart failure with reduced LVEF?
Beta Blocker and ACE
39
What bacteria is most common cause of endocarditis <2 months post valve surgery?
Staph epidermidis
40
How do you differentiate between cardiac tamponade and constrictive pericarditis?
Kussmauls sign - raised jvp that doesnt fall on inspiration
41
What is a systolic murmur that radiates to the carotids indicative of?
Aortic stenosis
42
What ecg changes are seen in pericarditis?
Concave ST elevation and PR depression
43
What is webers syndrome?
Midbrain stroke - ipsilateral CNIII palsy and contralateral hemiparesis
44
What medications cause flattening of t waves?
Antiarrhythmics, diuretics and digoxin
45
How many shocks can you deliver during witnessed cardiac arrest?
3
46
What is gold standard investigation for cardiac tamponade?
Echo
47
If angina not controlled by beta blocker what is added?
Amlodipine
48
When should a person with AF and ischaemic stroke start anticoagulation?
Aspirin daily, anticoagulants 2 weeks after
49
What medications should be stopped before initiation of sucbitril valsartan?
ACE or arb
50
What medications should stopped in second degree heart block?
BB, CCB or digoxin
51
What is the aortic stenosis valve gradient indicative of valve replacement?
>40 mmHg or significant left ventricular dysfunction
52
What is indicative of cardiac tamponade on ECG?
Electrical alternans
53
How does a posterior MI present on ECG?
Tall R waves V1-V2
54
What beta blocker is known to cause Qtc prolongation?
Soltalol
55
What is the mechanism of action of alteplase?
Activates plasminogen to form plasmin
56
What heart murmur becomes louder on inspiration?
Tricuspid regurgitation
57
What ECG change is seen in dextrocardia?
Inverted p wave in lead 1, right axis deviation and loss of r wave progression

Year 5 Medicine (17 decks)

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