Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Student Finals > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Atrial Fibrillation

Definition (3)

A

Chaotic, irregular atrial rhythm at 300-600bpm
AV node responds intermittently, hence irregular ventricular rate
Cardiac output drops by 10-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Atrial Fibrillation

Aetiology (9)

A 
Heart Failure
Hypertension 
MI 
PE 
Mitral valve disease 
Pneumonia 
Hyperthyroidism 
Caffeine/alcohol 
Low potassium/magnesium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Atrial Fibrillation

Signs + symptoms (5)

A 
Mostly asymptomatic 
Chest pain 
Palpitations 
Dyspnoea 
Irregularly irregular pulse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Atrial Fibrillation

Investigations (3)

A

ECG: absent P waves, irregular QRS
Bloods: U&Es, cardiac enzymes, TFTs
Echo: left atrial enlargement, mitral valve disease, poor LV function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Atrial Fibrillation

Acute treatment <48 hours (4)

A

Emergency cardioversion (amiodarone/flecainide)
Treat associated illness
Control ventricular reate: 1st verapamil/bisoprolol, 2nd digoxin/amiodarone
Anticoagulation: LMWH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q 
Atrial Fibrillation 
Chronic treatment (3)
A

Rate control: B-blocker/rate-limiting CCB 1st, then add digoxin, then add amiodarone
Anticoagulation: warfarin (INR aim 2-3), or aspirin if contraindicated
Rhythm control: only if symptomatic, do cardioversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Atrial Fibrillation

CHA2DS2-VASc Score (4)

A

Quantifies risk of stroke
Consider anticoagulation
1 point for: part failure, diabetes, hypertension, vascular disease, age >65, female
2 points for: age >75, prior TIA/stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Atrial Flutter

Definition (2)

A

Small group of ectopics

Continuous atrial depolarisation (regular rhythm but faster than waves)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Atrial Flutter

Investigations (1)

A

ECG: sawtooth baseline +/- 2:1 AV block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Atrial Flutter

Treatment (2)

A

Anticoagulation then cardioversion

Amiodarone to restore sinus rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Heart Failure

Aetiology (5)

A 
Previous MI 
Hypertension 
Heart valve disease 
Cardiomyopathy 
Arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Heart Failure

Definition (1)

A

Cardiac output is inadequate for the body’s requirements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q 
Heart Failure 
Systolic Failure (3)
A

Inability of ventricle to contract normally
Reduced cardiac output
Caused by ischaemic heart disease, MI, cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
Heart Failure 
Diastolic Failure (2)
A

Inability of ventricle to relax and fill normally

Caused by constrictive pericarditis, tamponade, hypertension, restrictive cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Heart Failure

Left ventricular failure (6)

A

Body doesn’t get enough oxygenated blood, blood backs up into lungs causing SOB + fluid build up
Dyspnoea
Fatigue
Orthopnoea
Paroxysmal nocturnal dyspnoea and nocturnal cough
Weight loss + muscle wasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Heart Failure

Right ventricular failure (4)

A

Usually triggered by left-sided heart failure or lung disease as the right ventricle has to work harder
Peripheral oedema
Ascites
Nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Heart Failure

Investigations (3)

A

CXR: cardiomegaly, prominent upper lobe vessels, pleural effusion
Echo: valvular disease, LV dysfunction
BNP: elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Heart Failure

Treatment of acute heart failure (6)

A

O2
Diamorphine
Furosemide
GTN spray
If systolic BP >100 start nitrate infusion
If worsening give more furosemide, consider CPAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Heart Failure

Treatment of chronic heart failure (4)

A

Diuretics: furosemide, bumetanide (these lower K so may need to add K-sparing diuretic- spironolactone)
ACE-i: improves symptoms
B-blockers: start low and go slow
Digoxin: strengthens force of contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q 
Arrhythmias 
Cardiac causes (5)
A 
MI 
Coronary artery disease 
LV aneurysm 
Mitral valve disease 
Cardiomyopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Arrhythmias

Non-cardiac causes (4)

A

Caffeine/smoking/alcohol
Pneumonia
Drugs (B2 agonists, digoxin)
Metabolic imbalance (K, Ca, Mg, hypoxia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Arrhythmias

Presentation (5)

A 
Some asymptomatic + incidental, eg. AF 
palpitation 
Chest pain 
Syncope 
Hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Arrhythmias

Investigations (3)

A

Bloods: FBC, U+E, glucose, Ca, Mg
ECG: short PR interval (WPW syndrome), long QT interval (drugs, metabolic imbalance, congenital), U waves (hypokalaemia)
Echo: structural disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Arrhythmias

Bradycardia (4)

A

Fewer than 60bpm
If >40bpm + asymptomatic, no treatment needed
Causes: drugs, sick sinus syndrome, hypothyroidism, B-blocker, digoxin
If rate <40bpm or symptomatic then give atropine, if no response insert temporary pacing wire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Arrhythmias

Supra ventricular tachycardia (3)

A

P wave absent/inverted after QRS
Narrow complex tachycardia (rate >100bpm, QRS width <120ms)
Treatment: 1st line vagal manoeuvres, 2nd line IV adenosine, 3rd line verapamil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Arrhythmias

Wolff-Parkinson White Syndrome

A

Congenital accessory conduction pathway between atria and ventricles
ECG: short PR interval, wide QRS complex
Present with SVT
Treatment: ablation of accessory pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q 
Arrhythmias 
Ventricular Tachycardia (4)
A

Broad complex tachycardia (rate >100bpm, QRS >120ms)
Acute management: IV amiodarone or IV lidocaine
Maintenance anti arrhythmic: oral amiodarone
Prevention of recurrent VTs: implantation of automatic defibrillators (ICD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q 
Acute Coronary Syndromes 
Risk Factors (8)
A 
Age 
Male 
Family history of IHD 
Smoking 
Hypertension 
Diabetes 
Hyperlipidaemia 
Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Acute Coronary Syndromes

Diagnostic Criteria of Acute MI (4)

A

Increase followed by decrease in cardiac biomarkers
Symptoms of ischaemia
ECG changes
Loss of myocardium on imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Acute Coronary Syndromes

Symptoms (5)

A 
Central chest pain lasting >20 mins 
Nausea 
Sweatiness 
Dyspnoea 
Palpitations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Acute Coronary Syndromes

Signs (6)

A 
Pallor 
Sweatiness 
Pulse high or low 
BP high or low 
4th heart sound 
May have signs of heart failure (increased JVP, 3rd heart sound, basal crepitations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Acute Coronary Syndromes

Investigations (4)

A

ECG: tall T waves, ST elevation or new LBBB over hors, T wave inversion and pathological Q waves, over hours- days
CXR: cardiomegaly, pulmonary oedema, widened mediastinum
Bloods: FBC, U+E, glucose, lipids
Cardiac enzymes: cardiac troponin (T + I) levels rise within 3-12 hours and peak at 24-48 hours and creatinine kinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q 
Acute Coronary Syndromes 
Differential Diagnosis (6)
A 
Angina 
Pericarditis 
Myocarditis 
Aortic dissection 
Pulmonary embolism 
Oesophageal reflux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Acute Coronary Syndromes

Pre-hospital management (3)

A

Aspirin 300mg
Sublingual GTN
analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Acute Coronary Syndromes

Hospital management of STEMI (4)

A

Primary angioplasty or thrombolysis
B-blocker
ACE-i if normotensive
CClopidogrel for 30 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Acute Coronary Syndromes

Hospital management of NSTEMI (3)

A

B-blocker
Antithrombotic fondaparinux if low risk
Consider clopidogrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q 
Acute Coronary Syndromes 
Subsequent Management (8)
A 
Bed rest 48h 
Aspirin 
Thomboprophylaxis 
B-blocker
ACE-i 
Statin 
Address modifiable risk factors 
Work after 2 months, sex after 1 month, flying after 2 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Acute Coronary Syndromes

Complications of MI (9)

A 
Cardiac arrest 
Bradycardia (give atropine/temporary cardiac pacing) 
AV block 
Tachycardias 
RV failure 
Pericarditis 
Embolism 
Cardiac tamponade 
Mitral regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Angina

Definition (1)

A

Due to myocardial iscahemia and presents as central chest tightness, which is brought on by exertion and relieved by rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Angina

Aetiology (6)

A 
Atheroma (reduced coronary blood flow, reduced O2 transport, increased myocardial O2 demand) 
Age 
Male 
Smoking 
Hypertension 
Tachyarrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Angina

Stable vs Unstable (2)

A

Stable- induced by effort, relieved by rest

Unstable- increasing frequency/severity, occurring at minimal exertion or at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Angina

Investigations (4)

A

ECG: mostly normal but may have ST depression or flat/inverted T waves
Angiography
Exercise tolerance test
Functional imaging (stress echo or MRI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Angina

Canadian Classification of Severity (4)

A

I- only significant exertion
II- moderate exertion
III- mild exertion
IV- at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Angina

Treatment (8)

A

Modify risk factors: smoking, exercise, weight loss, cholesterol, hypertension
Aspirin: reduces mortality
B-blocker: reduces symptoms and prevent attacks
CCBs: relax arteries
Nitrates: GTN spray/sublingual tablets for symptoms and regular oral nitrate (isosorbide mononitrate) for prophylaxis
Refer if sudden onset, uncontrollable post MI/CABG, unstable
CABG: reroutes blood around affected artery
PCI: widening of artery with stent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Pulmonary Oedema

Definition (2)

A

Excess fluid in the lungs

Leads to impaired gas exchange and may cause respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Pulmonary Oedema

Aetiology (2)

A

Left ventricular failure

Injury to lung parenchyma/vasculature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Pulmonary Oedema

Signs and symptoms (4)

A

Difficulty breathing
Haemoptysis
Sweating
End-inspiratory crackles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Pulmonary Oedema

Investigations (2)

A

CXR: fluid in alveolar walls, Kerley B lines
Echo: heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Pulmonary Oedema

Treatment (2)

A

Oxygen if hypoxic

Treat underlying cause eg. heart failure, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q 
Hypertension 
Risk factors (10)
A 
Smoking 
Diabetes 
Renal disease 
Male 
Hyperlipidaemia 
Previous MI/stroke  
Genetics 
Race 
Age 
Sodium intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Hypertension

Stages of Disease (4)

A

Prehypertension: 120/80mmHg
Stage 1: 140/90mmHg (mild)
Stage 2: 160/100mmHg (moderate)
Stage 3: 180/110mmHg (severe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Hypertension

Pathology (2)

A

Increased reactivity of resistance vessels and resultant increase in peripheral resistance
Kidneys unable to secrete appropriate amounts of sodium for any given BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Hypertension

Types (3)

A

Essential hypertension: cause unknown
Malignant hypertension: rapid rise in BP leading to vascular damage, severe hypertension and bilateral retinal haemorrhage and exudates, may have papilloedema
Secondary hypertension: renal disease- glomerulitis, systemic sclerosis, PCKD, chronic pyelonephritis OR endocrine disease- Cushing’s, Conn’s, pheochromocytoma OR pregnancy OR steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Hypertension

Treatment step 1 (3)

A

Over 55 or Afro-Caribbeans: CCB
CCB intolerant or heart failure risk: thiazide type diuretic
Under 55: ACE-i or ARB if ACE-i intolerant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Hypertension

Treatment step 2 (1)

A

Add thiazide type diuretic to CCB or ACE-i

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Hypertension

Treatment step 3 (1)

A

CCB + ACE-i + diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Hypertension

Treatment step 4 (2)

A

Add spironolactone if serum K+ <4.5mmol/l

Higher dose thiazide type diuretic if K+ >4.5mmol/l

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Hypertension

Treatment in pregnancy (2)

A

Never ACE-i

Thiazide type diuretic and/or amlodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Aortic Stenosis

Aetiology (3)

A

Degeneration (old age calcification)
Rheumatic heart disease
Congenital bicuspid valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Aortic Stenosis

Signs + symptoms (8)

A 
Triad of angina, syncope and heart failure 
Dyspnoea 
Dizziness/syncope 
Slow rising pulse 
Heaving, non-displaced apex beat 
LV heave 
Aortic thrill 
Ejection systolic murmur, radiating to carotids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Aortic Stenosis

Investigations (3)

A

ECG: left bundle branch block or complete AV block may be present
CXR: left ventricular hypertrophy, calcified aortic valve
Echo: diagnostic +/- doppler echo to assess severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Aortic Stenosis

Treatment (2)

A

Aortic valve repair/replacement

TAVI if unfit for surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q 
Aortic Regurgitation 
Acute causes (3)
A

Infective endocarditis
Ascending aortic dissection
Chest trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q 
Aortic Regurgitation 
Chronic causes (4)
A

Congenital: bicuspid aortic valve
Connective tissue disorders: Marfan’s, Ehlers-Dalos
Rheumatic fever
Rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Aortic Regurgitation

Signs + symptoms (6)

A 
Exertion dyspnoea 
Orthopnoea 
Paroxysmal nocturnal dyspnoea 
Collapsing pulse 
Displaced apex beat 
Early diastolic murmur (heard best in expiration sat forward)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Aortic Regurgitation

Investigations (4)

A

ECG: LVH
CXR: cardiomegaly, pulmonary oedema, dilated ascending aorta
Echo: diagnostic
Cardiac catheterisation: assess severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Aortic Regurgitation

Treatment (2)

A

Aortic valve replacement/repair

Medical therapy to reduce systolic hypertension: ACE-i

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Mitral Stenosis

Aetiology (3)

A

Rheumatic
Congenital
Prosthetic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Mitral Stenosis

Signs + symptoms (12)

A 
Begin when valve orifice <2cm 
Dyspnoea 
Fatigue 
Palpitations 
Chest pain 
Systemic emboli 
Haemoptysis 
Malar flush (reduced cardiac output) 
Low-volume pulse 
AF 
Tapping non-displaced apex beat 
Loud S1, rumbling mid-diastolic murmur, best heard in expiration lying on side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Mitral Stenosis

Investigations (3)

A

ECG: AF
CXR: left atrial enlargement, pulmonary oedema, mitral valve calcification
Echo: diagnostic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Mitral Stenosis

Treatment (4)

A

Rate control and anticoagulation if in AF
Diuretics: reduced preload and pulmonary venous congestion
Balloon valvuloplasty if non-calcified
Open mitral valvotomy or replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Mitral Stenosis

Complications (3)

A

Pulmonary hypertension
Emboli
Pressure from large LA on local structures (eg. hoarseness, dysphagia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Mitral Regurgitation

Aetiology (5)

A 
Degenerative calcification and thickening of valve 
Rheumatic heart disease 
Mitral valve proplapse 
Infective endocarditis 
LV dilatation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Mitral Regurgitation

Signs + symptoms (8)

A 
Soft S1, split S2 with radiation to axilla, low pitch (bell) 
Dyspnoea 
Fatigue 
Palpitations 
Infective endocarditis 
AF
Displaced apex beat 
RV heave
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Mitral Regurgitation

Investigations (4)

A

CXR: enlarged LA + LV, mitral valve calcification, pulmonary oedema
ECG: AF
Cardiac catheterisation
Echocardiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Mitral Regurgitation

Treatment (3)

A

Rate control and anticoagulation if AF
Diuretics: improve symptoms
Surgical repair/replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Pulmonary Stenosis

Aetiology (2)

A

Congenital (Turner’s, Noonan’s, William’s, Fallot’s tetralogy)
Rheumatic fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Pulmonary Stenosis

Signs + symptoms (6)

A 
Dyspnoea 
Fatigue 
Oedema 
Ascites
RV heave
Ejection systolic murmur radiating to left shoulder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Pulmonary Stenosis

Investigations (3)

A

ECG: right bundle ranch block
CXR: prominent pulmonary arteries
Cardiac catheterisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Pulmonary Stenosis

Treatment (1)

A

Valvuloplasty/valvotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Pulmonary Regurgitation

Aetiology (1)

A

Pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Pulmonary Regurgitation

Signs + symptoms (1)

A

Decrescendo murmur in early diastolic at left sternal edge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Tricuspid Stenosis

Aetiology (3)

A

Mainly rheumatic fever
Congenital
Infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Tricuspid Stenosis

Signs + symptoms (5)

A 
Fatigue 
Ascites 
Oedema 
AF 
Early diastolic murmur heard at left sternal edge in inspiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Tricuspid Stenosis

Investigations (1)

A

Echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Tricuspid Stenosis

Treatment (2)

A

Diuretics

Surgical repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Tricuspid Regurgitation

Aetiology (3)

A

RV dilatation
Rheumatic fever
Infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Tricuspid Regurgitation

Signs + symptoms (6)

A 
Fatigue 
Ascites
Jaundice 
Oedema
RV heave
Pan systolic murmur, heard best at lower sternal edge in inspiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Tricuspid Regurgitation

Treatment (3)

A

Treat underlying cause
Diuretics, digoxin, ACE-i
Valve replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Infective Endocarditis

Aetiology (4)

A

Staph. aureus: IVDU
Strep. viridans: valvular surgery
Strep. mutans: dental procedures
Diabetic soft tissue infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q 
Infective Endocarditis
Risk Factors (4)
A

IVDU
Renal failure
Organ transplant
Diabetes

92
Q

Infective Endocarditis

Signs + Symptoms (7)

A

Septic signs: fever, riggers, night sweats, weight loss
Cardiac lesions: any new murmur/evolving pre-existing murmur
Vasculitis
Roth spots (retinal haemorrhage)
Splinter haemorrhages
Osler’s nodes (painful pulp infarcts in fingers/toes)
Emboli

93
Q

Infective Endocarditis

Investigations (7)

A 
Blood cultures: 3 sets at different sites >6 hours between 
FBC: normochromic normocytic anaemia 
ESR + CRP: high 
Urinalysis: microscopic haematuria 
CXR: cardiomegaly 
ECG: long PR interval 
Echo: shows vegetations
94
Q 
Infective Endocarditis 
Duke Criteria 
Major criteria (2) 
Minor criteria (5) 
Definitive (3)
A

Major:
Positive blood culture (typical organism)
Endocardium involved (+ve echo or new regurgitation)
Minor:
Predisposition (eg. IVDU)
Fever >38
Vascular/immunological sign
Positive blood culture not meeting major criteria
Positive echo not meeting major criteria
Definitive:
2 major
1 major + 3 minor
5 minor

95
Q

Infective Endocarditis

Treatment (6)

A

Blind therapy native valve: amoxicillin +/- gentamicin (IV)
Blind therapy prosthetic valve: vancomycin + gentamicin + rifampicin (PO/IV)
Staph. in native valve: flucloxacillin >4 weeks
Staph. in prosthetic valve: flucloxacillin + rifampicin + gentamicin >6 weeks
Strep: benzylpenicillin
Surgery if heart failure/valvular obstruction/repeated emboli/fungal endocarditis

96
Q

Acute Myocarditis

Definition (1)

A

Inflammation of myocardium

97
Q

Acute Myocarditis

Aetiology (5)

A 
Mostly idiopathic 
Viral (flu, hepatitis, HIV) 
Bacterial (Clostridia, TB)
Drugs (cyclophosphamide, penicillin) 
Toxins
98
Q

Acute Myocarditis

Signs + Symptoms (6)

A 
Fatigue
Dyspnoea
Chest pain 
Fever
Palpitation 
Tachycardia
99
Q

Acute Myocarditis

Investigation (2)

A

ECG: ST elevation/depression, T wave inversion, atrial arrhythmias
Troponin: positive I or T

100
Q

Acute Myocarditis

Treatment (1)

A

Treat underlying cause, patients may recover or get heart failure

101
Q

Dilated Cardiomyopathy

Definition (1)

A

Dilated heart of unknown cause

102
Q 
Dilated Cardiomyopathy 
Risk Factors (5)
A 
Alcohol 
Hypertension 
Viral infection 
Congenital (X-linked) 
Peri/post partum
103
Q

Dilated Cardiomyopathy

Signs + Symptoms (9)

A 
Fatigue 
Dyspnoea
Pulmonary Oedema
Emboli 
AF/VT
Tachycardia 
Displaced apex beat 
Mitral/tricuspid regurgitation 
Elevated JVP
104
Q

Dilated Cardiomyopathy

Investigations (4)

A

ECG: tachycardia, non-specific T wave changes
CXR: cardiomegaly, pulmonary oedema
Coronary angiography to rule out coronary artery disease
Echocardiography: dilate d heart, low ejection fraction

105
Q

Dilated Cardiomyopathy

Treatment (6)

A 
ACE-i
Diuretics 
Anticoagulants as required 
Digoxin 
Cardiac transplant 
ICDs
106
Q

Hypertrophic Cardiomyopathy

Aetiology (1)

A

Genetic

107
Q

Hypertrophic Cardiomyopathy

Definition (2)

A

LV outflow tract obstruction from asymmetric septal hypertrophy
Leading cause of sudden cardiac death in the young

108
Q

Hypertrophic Cardiomyopathy

Signs + Symptoms (7)

A 
Sudden death often first manifestation 
Angina
Dyspnoea
Palpitations
Syncope
CCF
Harsh ejection systolic murmur
109
Q

Hypertrophic Cardiomyopathy

Investigations (2)

A

ECG: LVH, progressive T wave inversion, deep Q waves, AF
Echocardiography: asymmetrical septal hypertrophy

110
Q

Hypertrophic Cardiomyopathy

Treatment (3)

A

B-blockers or verapamil for symptoms (reducing ventricular contractility)
Amiodarone for arrhythmias
Implantable defibrillator

111
Q

Restrictive Cardiomyopathy

Definition (1)

A

Walls of ventricles to rigid to expand as they fill

112
Q

Restrictive Cardiomyopathy

Aetiology (5)

A 
Idiopathic 
Amyloidosis 
Haemochromatosis 
Sarcoidosis
Scleroderma
113
Q

Restrictive Cardiomyopathy

Signs + Symptoms (4)

A 
(Signs of RVF): 
Elevated JVP 
Hepatomegaly 
Oedema 
Ascites
114
Q

Restrictive Cardiomyopathy

Investigations (2)

A

Echo: thickening

Cardiac catheterisation

115
Q

Restrictive Cardiomyopathy

Treatment (4)

A

Treat cause
ACE-i: reduce work
B-blockers: reduce rat and force of heart contraction
Diuretics: reduce fluid build up

116
Q

Acute Pericarditis

Definition (1)

A

Inflammation of the pericardium

117
Q

Acute Pericarditis

Aetiology (5)

A 
Idiopathic 
Viruses (flu, HIV, Epstein-Barr)
Bacteria (pneumonia, TB, Staphs, Streps) 
Fungi 
MI
118
Q

Acute Pericarditis

Signs + Symptoms (4)

A

Chest pain (worse on inspiration or lying flat)
Pericardial friction rub may be heard
Fever
Elevated JVP

119
Q

Acute Pericarditis

Investigations (2)

A

ECG: concave ST elevation
Bloods: FBC, ESR, U+E, troponin may be raised

120
Q

Acute Pericarditis

Treatment (3)

A

Analgesia
Treat cause
Colchicine

121
Q

Pericardial Effusion

Pathology (3)

A

Collection of fluid within pericardial sac
Commonly accompanies acute pericarditis
When a large volume collects there is compromised ventricular filling- cardiac tamponade

122
Q

Pericardial Effusion

Aetiology (5)

A 
Idiopathic 
Viruses (flu, HIV, Epstein-Barr) 
Bacteria (pneumonia, TB, Staphs, Streps) 
Fungi 
MI
123
Q

Pericardial Effusion

Signs + Symptoms (4)

A

Raised JVP
Fatigue
SOB
Bronchial breathing at left base

124
Q

Pericardial Effusion

Investigations (2)

A

CXR: enlarged heart
ECG: alternating QRS morphologies

125
Q

Pericardial Effusion

Treatment (2)

A

Treat cause

Pericardiocentesis

126
Q

Constrictive Pericarditis

Definition (1)

A

Heart encased in a rigid pericardium

127
Q

Constrictive Pericarditis

Aetiology (2)

A

Often unknown

After pericarditis

128
Q

Constrictive Pericarditis

Signs + Symptoms (4)

A

Right heart failure
Elevated JVP
S3
Soft heart sounds

129
Q

Constrictive Pericarditis

Investigations (1)

A

CXR: small heart +/- pericardial calcification

130
Q

Constrictive Pericarditis

Treatment (1)

A

Surgical excision

131
Q

Cardiac Tamponade

Definition (1)

A

Accumulation of pericardial fluid raises intrapericardial pressure, hence poor ventricular filling and fall in cardiac output

132
Q

Cardiac Tamponade

Aetiology (4)

A

Any pericarditis
Aortic dissection
Haemodialysis
Warfarin

133
Q

Cardiac Tamponade

Signs + Symptoms (4)

A

High pulse
Low BP
High JVP
Muffled heart sounds

134
Q

Cardiac Tamponade

Investigations (3)

A

Beck’s triad: falling BP, rising JVP, muffled heart sounds
CXR: big globular heart
Echo: diagnostic echo-free zone around heart

135
Q

Cardiac Tamponade

Treatment (1)

A

Urgent drainage

136
Q

Atrial Septal Defect

Definition (4)

A

Hole connecting the atria
Osmium primum defects (opposing endocardial cushions) are associated with AV valve anomalies
Osmium secundum defects (high in septum) are commonest
Primum ASDs present early, secundum are often asymptomatic until adulthood as compliance of the ventricles decreases leading to early heart failure

137
Q

Atrial Septal Defect

Signs + Symptoms (5)

A 
AF
High JVP 
Wide, fixed split S2 
Pulmonary ejection systolic murmur 
Pulmonary hypertension
138
Q

Atrial Septal Defect

Investigations (3)

A

ECG: right bundle branch block and prolonged PR interval
CXR: small aortic knuckle, progressive atrial enlargement
Echo: diagnostic

139
Q

Atrial Septal Defect

Treatment (2)

A

In children- closure

In adults- transcatheter closure or surgical closure if asymptomatic

140
Q

Ventricular Septal Defect

Definition (1)

A

Hole connecting ventricles

141
Q

Ventricular Septal Defect

Signs + Symptoms (3)

A

Severe heart failure/asymptomatic in infancy
Harsh pan systolic murmur at left sternal edge with a systolic thrill (smaller holes give louder murmurs)
Pulmonary hypertension (typically larger holes)

142
Q

Ventricular Septal Defect

Complications (3)

A

Aortic regurgitation
Infective endocarditis
Pulmonary hypertension

143
Q

Ventricular Septal Defect

Investigations (3)

A

ECG
CXR
Cardiac catheter

144
Q

Ventricular Septal Defect

Treatment (2)

A

Medical at first, as many close spontaneously

Indications for surgical closure: failed medical therapy, symptomatic

145
Q

Coarctation of the Aorta

Definition (2)

A

Congenital narrowing of the descending aorta

Usually occurs just distal to the origin of the left subclavian artery

146
Q

Coarctation of the Aorta

Associations (2)

A

Bicuspid aortic valve

Turner’s syndrome

147
Q

Coarctation of the Aorta

Signs + Symptoms (4)

A

Radio femoral delay
Weak femoral pulse
Hypertension
Systolic murmur (best heard over left scapula)

148
Q

Coarctation of the Aorta

Complications (2)

A

Heart failure

Infective endocarditis

149
Q

Coarctation of the Aorta

Investigations (2)

A

CT/MRI aortogram

CXR

150
Q

Coarctation of the Aorta

Treatment (2)

A

Surgery

Balloon dilatation +/- stenting

151
Q

Fallot’s Tetralogy

Embryology (1)

A

Abnormalities in separation of the trunks arterioles into the aorta and pulmonary arteries that occur early in gestation

152
Q

Fallot’s Tetralogy

Features (4)

A

Ventricular septal defect
Pulmonary stenosis
Right ventricular hypertrophy
Aorta overriding the VSD

153
Q

Fallot’s Tetralogy

Signs + Symptoms (3)

A

Severity depends on degree of pulmonary stenosis
Infants gradually become cyanotic (after closure of ductus arteriosus)
During hypoxic spell, child becomes restless and agitated

154
Q

Fallot’s Tetralogy

Investigations (3)

A

Echo: shows anatomy and degree of stenosis
CXR: boot-shaped heart
Cardiac CT/MRI

155
Q

Fallot’s Tetralogy

Treatment (3)

A

Give O2
Morphine to sedate and relax pulmonary outflow
Surgery

156
Q

Marfan’s Syndrome

Definition (1)

A

Connective tissue disorder (autosomal dominant fibrillar gene)

157
Q 
Marfan's Syndrome
Major Criteria (5)
A 
Diagnostic if >2 
Lens dislocation 
Aortic dissection 
Dural ectasia 
Skeletal features: long fingers, arm span > height, pectus deformity, scoliosis
158
Q 
Marfan's Syndrome
Minor Signs (3)
A

Mitral valve prolapse
High-arches palate
Joint hypermobility

159
Q

Marfan’s Syndrome

Treatment (2)

A

B-blockers: slow dilatation of aortic root

Annual echoes with elective surgical repair when aortic diameter >5cm

160
Q

Noonan’s Syndrome

Inheritance (1)

A

Autosomal dominant

161
Q

Noonan’s Syndrome

Signs + Symptoms (5)

A

Short stature
Characteristic facial features (ptosis, down-slanting eyes, low-set ears)
Congenital heart defects (hypertrophic cardiomyopathy + pulmonary stenosis)
Webbed neck
Learning disability

162
Q

Turner’s Syndrome

Inheritance (1)

A

45XO

163
Q

Turner’s Syndrome

Signs + Symptoms (7)

A 
Coarctation of aorta 
Absent kidney 
Short stature 
Webbed neck 
Behavioural difficulties 
Hearing loss 
Gonadal dysgenesis resulting in absent puberty and impaired growth
164
Q

Turner’s Syndrome

Treatment (2)

A

Human growth factor for short stature

Supplemental oestrogen to initiate puberty

165
Q

William’s Syndrome

Inheritance (1)

A

Random deletion of chromosome 7 and genes

166
Q

William’s Syndrome

Signs + Symptoms (5)

A

Cardiac defects (aortic stenosis)
GI problems
Characteristic facial features (broad forehead, short nose, full cheeks, ‘elfin’)
Hypercalcaemia
Intellectual disability (particularly visuospatial)

167
Q

22q11 Deletion Syndrome

Inheritance (1)

A

Random deletion of genes on chromosome 22

168
Q 
22q11 Deletion Syndrome 
CATCH 22 (6)
A 
Cardiac abnormality (interrupted aortic arch, tetralogy of Fallot) 
Abnormal facies 
Thyme hypoplasiai (frequent infections) 
Cleft palate 
Hypoparathyroidism + hypocalcaemia 
22q11 deletion
169
Q

Ehlers-Dalos Syndrome

Definition (1)

A

Group of rare inherited conditions that affect connective tissue

170
Q

Ehlers-Dalos Syndrome

Signs + Symptoms (4)

A

Hyper mobility
Mitral valve prolapse
Fatigue
Easy bruising

171
Q

Acute Limb Ischaemia

Definitions (2)

A

Acute: ischaemia <14 days

Acute on chronic: worsening signs + symptoms <14 days

172
Q

Acute Limb Ischaemia

Aetiology (5)

A

Thrombosis in situ (60%): stenosed vessel plaque rupture
Embolism (30%): atrial fibrillation, valve disease, iatrogenic from surgery
Graft/stent occlusion
Trauma
Aortic dissection

173
Q

Acute Limb Ischaemia

Signs + Symptoms ( 6)

A 
Pain 
Pallor 
Perishingly cold 
Paraesthesia 
Paralysis 
Pulseless
174
Q

Acute Limb Ischaemia

Thrombosis vs Embolus

A

Onset: hrs-days vs sudden
Severity: less vs profound ischaemia
History of claudication: present vs absent
Contralateral pulses: absent vs present
Diagnosis: angiography vs clinical
Treatment: thrombolysis/bypass surgery vs embolectomy + warfarin

175
Q

Acute Limb Ischaemia

Investigations (5)

A 
ECG
FBC, U+E, INR 
CXR
Doppler
Angiography
176
Q

Acute Limb Ischaemia

Treatment (4)

A

Embolectomy
Thrombolysis
Amputation
Emergency reconstruction

177
Q

Chronic Limb Ischaemia

Definition (2)

A

Ischaemia stable for >14 days

Ankle artery pressure <50mmHg

178
Q

Chronic Limb Ischaemia

Aetiology (1)

A

Atherosclerosis

179
Q 
Chronic Limb Ischaemia 
Risk Factors (7)
A 
Male 
Age 
Genetic 
Smoking 
Hypertension 
Hyperlipidaemia 
Diabetes
180
Q

Chronic Limb Ischaemia

Signs + Symptoms (4)

A

Intermittent claudication: cramping pain after walking and rapidly relieved by rest
Critical limb ischaemia: rest pain (especially at night, usually in foot and patient hangs foot out of bed), ulceration, gangrene
Skin: cold, white, absent hair
Buerger’s Angle decreased (20-30 = ischaemia): angle to which leg has to be raised before it becomes pale whilst lying down

181
Q

Chronic Limb Ischaemia

Fontaine Classification for Peripheral Artery Disease (4)

A

1 asymptomatic
2 intermittent claudication
3 ischaemic rest pain
4 ulceration/gangrene (critical ischaemia)

182
Q

Chronic Limb Ischaemia

Investigations (5)

A

Bloods: FBC, ESR, CRP (exclude diabetes + arteritis), U+Es
ECG: cardiac ischaemia
ABPI: normal 1-1.2, peripheral artery disease 0.5-0.9, critical ischaemia <0.5
Colour doppler ultrasound scan 1st line imaging
CT/MR angiography

183
Q

Chronic Limb Ischaemia

Treatment (5)

A

Risk factor modification: quit smoking, treat hypertension and hyperlipidaemia, prescribe anti platelet to prevent progression (clopidogrel 1st line)
Management of claudication: supervised exercise programmes, vasoactive drugs
Percutaneous transluminal angioplasty (PTA) +/- stunting
Surgical reconstruction (fem-pop bypass, fem-fem crossover)
Amputation

184
Q

Carotid Artery Disease

Pathogenesis (3)

A

Turbulent flow at carotid bifurcation promoting atherosclerosis and plaque formation
Plaque rupture causes complete occlusion or distal emboli
Cause 20% of strokes and TIAs

185
Q

Carotid Artery Disease

Investigations (2)

A

MR angiography

Duplex carotid doppler

186
Q

Carotid Artery Disease

Treatment (3)

A

Aspirin/clopidogrel
Endarterectomy
Stunting if there is a concern over increased stroke risk of endarterectomy, especially in patients >70

187
Q

Aneurysms

Definition (1)

A

Abnormal dilatation of a blood vessel >50% of its normal diameter

188
Q

Aneurysms

Classification (3)

A

True aneurysm: involving all layers of the wall, fusiform (AAA) or saccular (Berry)
False aneurysms: collection of blood around a vessel wall that communicates with the vessel lumen, usually iatrogenic (eg. cannulation)
Dissection: vessel dilatation caused by blood splaying apart the media to form a channel within the vessel wall

189
Q

Aneurysms

Complications (4)

A

Rupture
Thrombosis
Distal embolism
Fistula

190
Q

Popliteal Aneurysm

Signs and Symptoms (3)

A

Palpable popliteal pulse
50% bilateral
Thrombosis + distal embolism is main complication leading to acute limb ischaemia

191
Q

Popliteal Aneurysm

Treatment (2)

A

Acute: embolectomy or fem-distal bypass
Stable: elective grafting + tie off vessel

192
Q

Abdominal Aortic Aneurysm

Definition (1)

A

Dilatation of abdominal aorta >3cm

193
Q

Abdominal Aortic Aneurysm

Aetiology (2)

A

Degeneration of elastic lamellae and smooth muscle loss

Genetic component

194
Q

Abdominal Aortic Aneurysm

Signs + Symptoms (3)

A

Often asymptomatic
Abdominal/back pain
Acute rupture: continuous pain, collapse, shock, expansile abdominal mass

195
Q

Abdominal Aortic Aneurysm

Investigations (3)

A

Abdominal X-ray: calcification
Abdominal ultrasound: screening + monitoring
CT/MRI: gold standard

196
Q

Abdominal Aortic Aneurysm

Treatment (4)

A

Manage cardiovascular risk factors, especially BP
Monitoring: <4cm yearly, 4-5.5cm 6 monthly
Elective surgery for aneurysms >5.5cm or expanding >1cm per year- open or EVAR
Emergency management: O2, cross match, major haemorrhage protocol, analgesia, antibiotic prophylaxis (ceftriaxone and metronidazole), theatre- clamp + insert graft

197
Q

Thoracic Aortic Dissection

Definition (1)

A

Tear in inner aortic wall causes blood to force walls apart

198
Q

Thoracic Aortic Dissection

Aetiology (4)

A

Hypertension
Atherosclerosis
Marfan’s syndrome
Ehlers-Dalos syndrome

199
Q 
Thoracic Aortic Dissection
Stanford Classification (2)
A 
Type A (proximal): 70%, involves ascending aorta +/- descending, higher mortality due to probable cardiac involvement, usually need surgery 
Type B (distal): 30%, involves descending aorta only, usually conservative management
200
Q

Thoracic Aortic Dissection

Signs + Symptoms (4)

A

Sudden onset chest pain radiating to back
Unequal arm pulses + BP as dissection extends
Hemiplegia (carotid artery), paralysis (ant. spinal artery) as dissection extends
If dissection moves proximally- aortic regurgitation, inferior MI, cardiac arrest

201
Q

Thoracic Aortic Dissection

Investigations (3)

A

ECG: exclude MRI
Bloods: crossmatch, FBC, U&E, clotting, amylase
CT/MRI or TOE (transoesophagel echocardiography)

202
Q

Thoracic Aortic Dissection

Treatment (2)

A

Type A- surgery

Type B- conservative unless persistent/complicated (keep BP low with B-blocker labetalol/esmolol)

203
Q

Gangrene

Definition (1)

A

Death of tissue from poor vascular supply (sign of critical ischaemia)

204
Q

Gangrene

Classification (3)

A

Wet: tissue death and infection (associated with discharge)
Dry: necrosis in absence of infection
Gas: subset of necrotising myositis (caused by Clostridiol species)

205
Q

Gangrene

Treatment (3)

A

Wet: analgesic, broad-spectrum IV antibiotics, surgical debridement +/- amputation
Dry: restoration of blood supply +/- amputation
Gas: remove all dead tissue (eg. amputation), benzylpenicillin +/- clindamycin, hyperbaric O2 can reduce number of debridements

206
Q

Varicose Veins

Definition (1)

A

Tortuous, dilated veins of the superficial venous system

207
Q

Varicose Veins

Pathology (3)

A

Valves become incompetent

Venous hypertension develops leading to dilatation

208
Q

Varicose Veins

Aetiology (4)

A

Obstruction: DVT, fetus
Valve destruction: DVT
Overactive muscle pumps: cyclists
Prolonged standing/obesity

209
Q

Varicose Veins

Signs + Symptoms (8)

A 
Pain, cramping 
Tingling 
Bleeding 
Oedema 
Eczema 
Ulcers 
Haemosiderin (pigment formed due to haemoglobin breakdown- yellow/brown) 
Phlebitis (inflammation of venous walls, painful)
210
Q

Varicose Veins

Investigations (1)

A

Duplex ultrasound scan (doppler)

211
Q 
Varicose Veins
Referral criteria (5)
A 
Bleeding 
Pain 
Ulceration 
Superficial thrombophlebitis 
Severe impact on QoL (not cosmetic alone)
212
Q

Varicose Veins

Treatment (6)

A

Treat any underlying cause
Education (avoid prolonged standing, leg elevation, lose weight regular walking as calf muscle action aids venous return, support stockings)
Radio frequency ablation: catheter inserted into vein and heated to close vein
Endogenous laser ablation
Injection + sclerotherapy: liquid/foam
Surgery

213
Q

Leg Ulcers

Definition (1)

A

Interruption in the continuity of an epithelial surface

214
Q

Leg Ulcers

Aetiology (6)

A

Venous (most common)- painless, shallow, commonly medial malleolus
Arterial- painful, deep, punched out, occur at pressure points
Diabetic
Vasculitic
Malignant
Traumatic (pressure)

215
Q

Leg Ulcers

Examination (10)

A

Site: venous above medial malleolus common
Temperature: if cold-ischaemic, warm- local factors
Surface area
Shape
Edge: sloping- healing, punched out- ischaemic, everted- malignant
Base: slough- grey/yellow mixture of fibrin and cell breakdown products, granulation tissue- pink base, evidence of healing
Depth
Discharge: culture before antibiotics
Associated lymphadenopathy: infection/malignancy
Sensation: decreased around ulcer- neuropathy

216
Q

Leg Ulcers

Treatment (4)

A

Treat cause and focus on prevention
Compression bandaging
Surgery for deriding sloughy necrotic tissue (desloughing)
Antibiotics only if infected

217
Q 
Leg Swelling
Bilateral Swelling (3)
A

Increased venous pressure (right heart failure, venous insufficiency, drugs eg. nifedipine)
Decreased oncotic pressure (nephrotic syndrome)
Lymphoedema

218
Q 
Leg Swelling
Unilateral Swelling (4)
A

Venous insufficiency
DVT
Infection/inflammation
Lymphoedema

219
Q

Deep Vein Thrombosis

Aetiology (3)

A

Stasis eg. bed rest, travel
Hyper coagulability eg. pregnancy
Vessel damage eg. atherosclerosis

220
Q

Deep Vein Thrombosis

Signs + Symptoms (4)

A

Unilateral limb swelling
Pain in calf
Warmth in calf
Erythema

221
Q

Deep Vein Thrombosis

Long Term Consequences (1)

A

Post-phlebitic syndrome (swelling, discomfort, pigmentation, ulceration)

222
Q

Deep Vein Thrombosis

Investigations (2)

A

D-dimer: sensitive but not specific

Ultrasound

223
Q 
Deep Vein Thrombosis 
Wells Score (10)
A

<1 point: DVT unlikely, do D-dimer
>2 points: DVT likely, do D-dimer and ultrasound
Active cancer: 1
Paralysis/immbolisation of leg: 1
Recently bedridden >3 days/major surgery in past 12 weeks: 1
Local tenderness along distribution of deep venous system: 1
Entire leg swollen: 1
Calf swelling >3cm compared with asymptomatic leg: 1
Pitting oedema: 1
Previous DVT: 1

224
Q

Deep Vein Thrombosis

Prevention in Hospital (4)

A

Early mobilisation
Anti-embolism stockings (compression)
Daily injections of low molecular weight hearing or fondaparinux if bleeding risk
Pill stopped 4 weeks pre-op

225
Q

Deep Vein Thrombosis

Treatment (3)

A

LMWH/fondaparinux
Start warfarin simultaneously and continue post-op for 3 months
Stop heparin when INR 2-3

Med Student Finals (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions