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OSCE Pharmacology > Cardiovascular and Respiratory > Flashcards

Cardiovascular and Respiratory Flashcards

1
Q

Give 7 modifiable risk factors for cvs disease.

A 
Hypertension - over 140/90
Hyperlipidaemia - total cholesterol/HDL over 4.5 and triglycerides over 1.5
Diabetes
Smoking
Alcohol
Low exercise
Stress
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2
Q

Give 5 complications of hypertension

A 
Stroke
MI
Heart failure
Kidney failure
Retinopathy
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3
Q

Give as many causes of secondary hypertension as you can.

A

High renin due to:
High sympathetic - Phaechromocytoma
Low renal perfusion - renal artery stenosis
Low GFR - renal failure

High aldosterone effect - Cushing’s and Conn’s

Preeclampsia

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4
Q

How would you treat hypertension?

A

Young, diabetes, ckd

  1. Ace
  2. Add Ca channel or diuretic

Or if older or black

  1. Ca channel
  2. Add diuretic
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5
Q

What would a pacemaker look like on inspection?

A

Lump around second intercostal space mid clavicular line

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6
Q

What is the name of a scar which runs down the middle of the chest? What might cause it?

A

Median sternotomy scar

CABG (especially if leg scar)
Valve repair or replacement
Congenital defect

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7
Q

How would you listen for aortic stenosis? What would it sound like?

A

Late systolic murmur
Crescendo

Radiates to carotid.

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8
Q

How would you listen for mitral stenosis? What would it sound like?

A

Mid diastolic

Apex with the bell and lean

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9
Q

How would you listen for mitral regurgitation? What would it sound like?

A

Pan systolic

Axilla

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10
Q

How would you listen for aortic regurgitation? What would it sound like?

A

Diastolic

Left sternal edge lean forwards and expire

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11
Q

Give 6 important causes of AF.

A 
Ischaemic heart (post MI)
Hypertension
Mitral regurgitation 
Pneumonia 
Thyrotoxicosis
Alcohol
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12
Q

Give two causes of an irregularly irregular pulse and how to differentiate them.

A

AF
Ventricular ectopic beats

Ventricular ectopic beats will disappear in exercise

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13
Q

Give 3 causes of peripheral cyanosis

A

Reynauds
Peripheral vascular disease
Heart failure

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14
Q

Give 2 causes of central cyanosis.

A

Right to left cardiac shunt

Hypoxic lung disease

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15
Q

What might cause an elevated JVP?

A

Right heart failure
PE
Cardiac tamponade
Tension pneumothorax

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16
Q

What are the waves of the JVP? What does it mean if they are large?

A

A - atria contracting. If large complete heart block

V - tricuspid regurgitation

17
Q

Give four important causes of heart failure.

A

Pump failure: MI, arrhythmia
High preload: valve regurgitation
High after load: hypertension, valve stenosis
Cor pulmonale

18
Q

Give some of the stigmata of infective endocarditis.

A 
Clubbing
Splinter haemorrhages
Splenomegaly
Osler nodes
Janeway lesions
19
Q

Give some complications that occur with prosthetic valves.

A

Infective endocarditis
Thrombosis
Warfarin related problems

20
Q

Give 4 unmodifiable risk factors for cvs disease?

A

Age
Sex
Ethnicity - South Asian
Family history

21
Q

What are the principal cardio-respiratory causes of clubbing?

A

Lung Cancer
Interstitial lung disease (inc TB, sarcoidosis)
Bronchiectasis
Infective endocarditis

22
Q

What does a flapping tremor indicate?

A

Hypercapnia

Could be type 2 respiratory failure, renal failure, or hepatic failure

23
Q

What are the signs of anaemia?

A 
Conjunctival pallor
Peripheral cyanosis
Cold hands
Bounding pulse
Large smooth tongue - glossitis
24
Q

What might cause a bounding pulse?

A

Aortic regurgitation

Hypercapnia
Anaemia

Septic shock
Anaphylactic shock

25
Q

What might cause hyperinflation of the chest?

A

COPD

Asthma

26
Q

What might cause a mediastinal shift?

A

Tension Pneumothorax
Complete lung collapse (atelectasis)
Big pleural effusion

27
Q

What might sound dull to percussion? What might sound hyper resonant?

A

Dull - fibrosis/consolidation
Stony dull - fluid

Hyper resonant - air

28
Q

What causes consolidation in the lung?

A

Transudate
Exudate
Blood
Inflammation and fibrosis

29
Q

What are the signs of hyperinflation of the chest?

A

Barrel appearance
Reduced cricosternal distance
Increased AP diameter
Hyper resonant to percussion

30
Q

Give 3 causes of bilateral crackles.

A

Heart failure - pulmonary oedema
ILD
Cystic fibrosis

31
Q

Give 5 causes of ILD

A 
Idiopathic
Sarcoidosis
SLE
Asbestos
Drug induced - methotrexate, Amiodarone, nitrofurantoin, cisplatin
32
Q

Give 3 causes of a transudative pleural effusion.

A

Heart failure
Cirrhosis
Hypo albumen

33
Q

Give 3 examples of an exudative pleural effusion.

A

Infection
Cancer
PE

OSCE Pharmacology (10 decks)

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