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tttttttcccccccddddddd > Cardiovascular Medicine > Flashcards

Cardiovascular Medicine Flashcards

1
Q

Myocardial Infarctions are described as a … , … chest pain. The pain sometimes radiates to the … … and … . Generalised symptoms that are associated with MIs are … , … and … .

A

Myocardial Infarctions are described as a CRUSHING, CENTRAL chest pain. The pain sometimes radiates to the LEFT ARM and JAW. Generalised symptoms that are associated with MIs are NAUSEA , SOB and SWEATING.

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2
Q

Angina is exacerbated upon … and relieved by …

A

Angina is exacerbated upon EXERTION and relieved by REST

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3
Q

The pain from aortic dissection is often described as … with a very … onset. It radiates to the … and is accompanied by … … … … . The BP in … is unequal in aortic dissection

A

The pain from aortic dissection is often described as TEARING with a very SUDDEN onset. It radiates to the BACK and is accompanied by PAIN AT OTHER SITES The BP in ARMS is unequal in aortic dissection.

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4
Q

… is the site of pain in pericarditis. It is … . Relief from pericarditis pain comes from … … . The pain may radiate to the … … / … / …

A

RETROSTERNAL/PRECORDIUM is the site of pain in pericarditis. It is PLEURITIC. Relief from pericarditis pain comes from SITTING FORWARD. The pain may radiate to the TRAPEZIUS RIDGE / NECK / SHOULDER.

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5
Q

Respiratory chest pain is … . Pain from pneumothorax is usually of a … onset. It is associated with the risk factors of … syndrome, … and asthma. It is perhaps also accompanied by SOB.

A

Respiratory chest pain is PLEURITIC . Pain from pneumothorax is usually of a SUDDEN onset. It is associated with the risk factors of MARFAN’S syndrome, COPD and asthma. It is perhaps also accompanied by SOB.

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6
Q

Pain from a pulmonary embolism is accompanied by … and … . Risk factors for a PE include … , … and … .

A

Pain from a pulmonary embolism is accompanied by HAEMOPTYSIS and SOB . Risk factors for a PE include LONG FLIGHTS, IMMOBILITY and RECENT SURGERY .

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7
Q

GORD pain is a retrosternal burning pain. It is related to … , … , … . On clinical examination someone with GORD may have … due to the excess acid.

A

GORD pain is a retrosternal burning pain. It is related to meals , lying down and straining. On clinical examination someone with GORD may have HYPERSALIVATION due to the excess acid.

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8
Q

Musculoskeletal chest pain is described as. It is exacerbated by movement, … and … . The patient is able to point to a site where to pain is … .

A

Musculoskeletal chest pain is described as SHARP. It is exacerbated by movement, INSPIRATION and PRESSURE. The patient is able to point to a site where to pain is ‘WORSE’.

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9
Q

The condition where cartilage in the thorax is inflamed is called…

A

COSTOCHONDRITIS/TIETZE’S SYNDROME

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10
Q

Chest pain from anxiety usually has a trigger. It is a tight feels accompanied with …

A

SOB, SWEATING, DIZZINESS, PALPITATIONS

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11
Q

What is pain from pleurisy like?

A

Sharp unilateral pleuritic

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12
Q

Other differentials of chest pain are…

A

Gastritis and myocarditis

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13
Q

In the humble CXR, an enlarged heart suggests … , a cardiac cause of chest pain.

A

In the humble CXR, an enlarged heart suggests CHF , a cardiac cause of chest pain.

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14
Q

In the humble CXR, a globular heart indicates …?

A

In the humble CXR, a globular heart indicates PERICARDIAL EFFUSION

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15
Q

Pulmonary oedema in the CXR suggests decompensated?.. . Rib notching indicates ?..

A

Pulmonary oedema in the CXR suggests decompensated HF . Rib notching indicates COARCTATION OF AORTA.

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16
Q

Angiography is a … scan used in the diagnosis of ?

A

CT, STENOSIS IN CORONARY ARTERY DISEASE

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17
Q

Cardiac MR scans are the first choice for … disease. An advantage us they are …

A

MYOCARDIUM, RADIATION FREE

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18
Q

Nuclear imaging of the heart assesses … at rest and under stress. It is testing for … … distal to a blockage to see if the procedures of … or … are of value.

A

Nuclear imaging of the heart assesses PERFUSION at rest and under stress. It is testing for MYOCARDIUM VIABILITY distal to a blockage to see if the procedures of STENTING or CABG are of value.

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19
Q

In nuclear imaging testing, if hypoperfusion is fixed and not reversible the area of the myocardium is … … and is therefore viable or not?

A

SCAR TISSUE, NOT VIABLE

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20
Q

Which method of echocardiography can be used for continuous heart monitoring during surgery?

A

Transoesophageal

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21
Q

Which drug is used as a pharmacological stressor if a patient cannot exercise?

A

Dobutamine

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22
Q

A stunned myocardium is…..

A

when a section of myocardium shows a form of contractile abnormality

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23
Q

What induces a stunned myocardium?

A

Acute ischaemia

24
Q

A hibernating myocardium is

A

when there is chronicity of the ischaemia and it is irreversible

25
Q

For secondary prevention of after a CV event, a low dose of which anti-platelet drug is given?

A

Aspirin 75mg

26
Q

Clopidogrel, Prasugrel and Ticagrelor are all examples of which drug class?

A

ADP receptor antagonists

27
Q

Clopidogrel, Ticagrelor and Prasugrel are used for II prevention if a pt is intolerant of … or they are used with it after … … or for …

A

Clopidogrel, Ticagrelor and Prasugrel are used for II prevention if a pt is intolerant of aspirin or they are used with it after stent insertion or for ACS

28
Q

Warfarin is being replaced by … and … for treatment of AF and blood clots, but warfarin is still the drug of choice for … … .

A

Warfarin is being replaced by DOAC (APIXIBAN) and DIRECT THROMBIN INHIBITORS (DABIGATRAN) for treatment of AF and blood clots, but warfarin is still the drug of choice for MECHANICAL VALVES .

29
Q

The 3 anticoagulants used for ACS are …

A

LMWH, Xa inhibitors (FONDPARIUX), BIVALIRUDIN

30
Q

Which beta receptor when blocked is negatively inotropic and chronotropic?

A

Beta 1

31
Q

Which beta receptor when blocked causes peripheral vasoconstriction and bronchioconstriction?

A

Beta 2

32
Q

Propranolol is non-selective whereas Bisoprolol is relatively selective for beta.?

A

1

33
Q

Beta blockers are contraindicated in which 3 conditions

A

Asthma, COPD, heart block

34
Q

5 common side effects of beta blockers

A 
Lethargy
Erectile dysfunction
Decreased joie de vivre
Nightmares
Headache
35
Q

ACE inhibitors are commonly used in … , … and post .. . In hypertension with severe CCF, …. acting ACE inhibitors should be used. Their main side effects are …. and … …..

A

ACE inhibitors are commonly used in HYPERTENSION, HF and post MI . In hypertension with severe CCF, LONG acting ACE inhibitors should be used. Their main side effects are DRY COUGH and URTICARIA

36
Q

The loop diuretic used for heart failure is

A

Furosemide

37
Q

The thiazide like diuretic used for heart failure is

A

metolazone

38
Q

The thiazide like diuretic used for hypertension is

A

Indapamide

39
Q

Potassium sparing diuretics

A

Spironolactone, eplerenone, amiloride

40
Q

Nitrates work to dilate veins and large arteries which decreases …… pressure

A

PRELOAD

41
Q

Hydralazide dilates … vessels and Prazosin dilates… and…

A

Resistance , arteries and veins

42
Q

Why are calcium antagonists such as amlodipine and nifedipine often used with a beta blocker?

A

Reflex bradycardia

43
Q

How do calcium antagonists work? What are they used for?

A

Promote coronary peripheral vasodilation, decreasing myocardial O2 consumption. They are used for hypertension and angina.

44
Q

Which calcium antagonists are not to be used with a beta blocker?

A

Non-dihydropines; verpamil and dilitiazam

45
Q

What is a contraindication in the use of calcium antagonists?

A

Heart block

46
Q

Digoxin is used in the treatment of AF. It works by…

A

Blocking the Na/K pump.

47
Q

Amiodarone works by … which reduces the potential for tachyarrhytmias. If taking digoxin with amiodranone, the dose of digoxin must be …

A

Prolonging cardiac action potential, halved

48
Q

Sodium channel blockers are … … … …

A

Class 1 anti arrhythmics.

49
Q

Ivabradine works by blocking the … … . This slows the pulse down with little drop in … … . It is contraindicated in …

A

Ivabradine works by blocking the FUNNY CURRENT. This slows the pulse down with little drop in . It is contraindicated in ACUTE MI, BRADYCARDIA, LONG QT SYNDROME, SHOCK

50
Q

How do stating work?

A

HMG-CoA reductase inhibitors, decreasing LDL cholesterol

51
Q

What are the main features of angina?

A

constricting/discomfort in the chest that may radiate, exacerbated by exertion, relieved with rest or GTN

52
Q

Angina is associated with…

A

dyspnoae, nausea, sweatiness and faintness BUT NOT palpitations or dizziness or pleuritic pain

53
Q

The main cause of angina is

A

atheroma

54
Q

Angina that is caused by coronary artery spasm is known as … angina. Angina that is precipitated by lying flat is … angina. Stable angina is that which is induced by… and relieved … … . Unstable angina is that with an increased risk of … with increasing … and …

A

Angina that is caused by coronary artery spasm is known as VARIANT angina. Angina that is precipitated by lying flat is DECUBITUS angina. Stable angina is that which is induced by EXERTION and relieved AT REST . Unstable angina is that with an increased risk of MI with increasing FREQUENCY AND SEVERITY.

55
Q

Angina is tested with …

A

ECG, ANGIOGRAPHY AND FUNCTIONAL IMAGING

56
Q

Angina is managed with…

A

lifestyle changes and PRN GTN

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