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YR3: OSCE > Cardiovascular system > Flashcards

Cardiovascular system Flashcards

1
Q

Give 2 features of AF on ECG and why AF is dangerous

A

Irregularly irregular rhythm
No distinct p waves
Turbulent flow pattern increases clot risk

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2
Q

Describe 2nd degree heart block mobitz I

A

Gradual prolongation of PR interval until a beat is skipped

Regularly irregular

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3
Q

Describe 2nd degree heart block mobitz II

A

P waves regular, but only some followed by QRS
No PR prolongation
Regularly irregular

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4
Q

Describe 3rd degree heart block

A

P waves regular, QRS regular, no relationship

Atria + ventricles beat asynchronously

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5
Q

Describe ventricular fibrilation

A

Rate irregular + >250 bpm

Asynchronous ventricular contraction, no filling

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6
Q

Describe ventricular tachycardia

A

Rate regular + fast

p waves hidden- dissociated atrial rhythm

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7
Q

What characterises ST elevation? What is it caused by?

A

ST segment >2mm above isoelectric line

Infarction

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8
Q

What characterises ST depression? What is it caused by?

A

ST segment >2mm below isoelectric line

Ischaemia

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9
Q

What 4 features are seen in the hands of a patient with infective endocarditis?

A

Janeway lesions: haemorrhagic lesions on thenar eminence
Clubbing
Osler’s nodes: painful, raised lesions
Splinter haemorrhages

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10
Q

List 4 defining features of clubbing

A

Loss of Lovibonds angle
Increased longitudinal curvature of nail
Boggy nail bed
Drumsticking of finger nails

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11
Q

Give 4 CVS causes of clubbing

A

Congenital cyanotic heart disease e.g. teratology of fallot
Atrial myxoma
Infective endocarditis
Malignancy

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12
Q

What stigmata may be present in the hands of a patient with hypercholesterolaemia?

A

Tendon xanthomata

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13
Q

Name a condition that can cause radio-radial delay

A

Aortic dissection

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14
Q

Name a condition that can cause a collapsing pulse. What other hyper kinetic states may this arise in?

A

Aortic regurgitation
Thyrotoxicosis
Fever
Anaemia

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15
Q

What is Quincke’s pulse? What causes it?

A

Visible capillary pulsations on compression to fingernail bed
Aortic regurgitation

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16
Q

What causes an irregularly irregular pulse?

A

Atrial fibrillation

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17
Q

What causes a slow rising pulse?

A

Aortic stenosis

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18
Q

What causes a bounding pulse?

A

CO2 retention

19
Q

Give 2 features of a CO2 retention flap. What causes this?

A

Bilateral
Symmetrically timed
Hypercapnia: COPD/ T2 respiratory failure

20
Q

Describe the abnormality of a collapsing pulse

A

On lifting their arm, pulse gets REALLY strong (like hammer hitting arm)

21
Q

State 2 causes of a collapsing pulse

A

Aortic regurgitation

Patent ductus arteriosis

22
Q

Give 3 causes of a narrow pulse pressure

A

HF
Blood loss
Aortic stenosis

23
Q

Give 3 causes of a wide pulse pressure

A

Aortic regurgitation
PDA
Aortic coarctation

24
Q

What is pulsus paradoxus? Give 2 causes

A

varied pulse strength with each inspiration + expiration
Sever asthma
Cardiac tamponade

25
Q

What is pulsus alternans? Name a cause

A

regular alterations in force of pulse (not varying with respiration)
Severe LVF

26
Q

When may a jerky pulse be felt?

A

HOCM

27
Q

Give 3 causes of a molar flush

A

Mitral stenosis (CO2 retention causes vasodilation)
SLE
Polycythaemia rubra vera

28
Q

What causes corneal arcus in under 50s?

A

Hypercholesteralaemia

29
Q

What causes xanthelasma?

A

Hypercholesteralaemia

30
Q

In which syndrome may you see a high arched palate?

A

Marfan’s

31
Q

List 4 causes of raised JVP

A

Fluid overload
Cardiac tamponade
RHF + Cor pulmonale
Constrictive pericarditis

32
Q

What should happen to the JVP on inspiration?

A

Fall due to reduced intrathoracic pressure

33
Q

What are cannon A waves in the JVP? What causes these?

A

Large A waves from simultaneous contraction of RA + RV

3rd degree heart block

34
Q

What causes large V waves in the JVP?

A

Tricuspid regurgitation

35
Q

What is Kussmaul’s sign? What causes this?

A

JVP rise on inspiration
Impaired RV function
Cardiac tamponade, constrictive pericarditis, restrictive cardiomyopathy

36
Q

What can cause displacement of the apex beat?

A

Left/ Right ventricular hypertrophy

37
Q

What causes a heaving apex beat?

A

Pressure overload in Aortic stenosis

38
Q

What causes a tapping apex beat?

A

Mitral stenosis

39
Q

What causes S4?

A

Atrial contraction against a stiff ventricle

40
Q

What causes S3?

A

Turbulent ventricular filling

41
Q

What manoeuvre is recommended for hearing aortic regurgitation? Where?

A

Lean forward

Left 3rd ICS parasternal

42
Q

What manoeuvre is recommended for hearing mitral stenosis? Where?

A

Roll onto left side

5th ICS MCL with bell

43
Q

Which heart murmur radiates to the cartoids?

A

Aortic stenosis

YR3: OSCE (6 decks)

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