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Z Year 3 Misc > CCC - Cardiology > Flashcards

CCC - Cardiology Flashcards

1
Q

What investigations do you do for a MI?

A
  1. ECG
  2. Troponin
  3. Echocardiography
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2
Q

What do you do if the troponin is positive?

A

coronary angiography

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3
Q

What do you do if the troponin is negative?

A

ETT

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4
Q

What are the cardiac differential diagnosis of chest pain?

A
  1. IHD
  2. Aortic dissection: sudden onset
  3. Pericarditis: worse on breathing in and leaning forward
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5
Q

What are the respiratory differential diagnosis of chest pain?

A
  1. PE
  2. Pneumonia: temp recently?
  3. Pneumothorax: sudden onset, SOB, sharp pain, pain worse breathing in
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6
Q

What are GI differential diagnosis of chest pain?

A
  1. oesophageal spasm

2. oesophagitis, gastritis

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7
Q

What are the musculoskeletal differential diagnosis of chest pain?

A

costochrondritis: pain on movement

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8
Q

What is first line investigation for chest pain?

A

ECG - if ST elevation or not

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9
Q

If it is an anterior MI which coronary artery is affected and in which leads will there be ECG changes?

A
  1. LAD

2. V1-V4

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10
Q

If it is a lateral MI which coronary artery is affected and in which leads will there be ECG changes?

A
  1. circumflex

2. V5, V6, I, aVL

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11
Q

If it is an inferior MI which coronary artery is affected and in which leads will there be ECG changes?

A
  1. RCA

2. II, III, aVF

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12
Q

What does the different in BP need to be for postural hypotension?

A

20mmHg

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13
Q

If there is a FHx of sudden cardiac collapse should vasovagal be high sus?

A

no

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14
Q

What are the 3 categories for differential diagnosis of collapse?

A
  1. hypoglycaemia
  2. cardio
  3. brain
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15
Q

What are the different cardio reasons for collapse?

A
  1. Vasovagal
  2. Arrhythmia
  3. Outflow obstruction
  4. Postural hypotension
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16
Q

Which arrhythmia can cause collapse and how would you manage?

A
  1. tachycardia, bradycardia

2. ECG (long QT predisposes you to VT), cardiac monitor, 24hr tape

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17
Q

What could a left outflow obstruction lead to collapse be due to?

A
  1. HOCM

2. Aortic stenosis

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18
Q

What could a right outflow obstruction lead to collapse be due to?

A

PE - low volume/slow rising pulse, ESM (ejection systolic murmur), echocardiogram

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19
Q

How do you determine if postural hypotension causes collapse?

A

lying/standing BP

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20
Q

What are the brain causes of sudden collapse?

A

seizure

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21
Q

What does a long QT mean?

A

abnormal ventricular reporlarization

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22
Q

What are the congenital causes of long QT syndrome?

A
  • mutations in K+ channels

- FH of sudden death

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23
Q

What are the acquired causes of long QT syndrome?

A

low K+/Mg2+, drugs

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24
Q

How do you know if it is a long QT?

A

red line in between QRS and T waves should have finished by red line

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25
Q

Which valves are affected in infective endocarditis?

A

right sided valves get affected (as inject into veins) and right sided murmurs are louder on inspiration

26
Q

When would mitral regurgitations have a high JVP?

A

only with heart failure

27
Q

What is tricuspid regurgitation associated with?

A

raised JVP and hepatomegaly

28
Q

Which type of murmurs are louder on inspiration?

A

right

29
Q

What are the differential diagnosis of a raised JVP?

A
  1. Right sided heart failure
  2. Tricuspid regurgitation
  3. Constrictive pericarditis
30
Q

What is right sided heart failure caused by?

A
  1. Secondary to L heart failure (CCF)
  2. Caused by pulmonary HTN (secondary to PE, COPD etc) leads to
    - Left parasternal heave is a sign of right ventricular hypertrophy
31
Q

What is tricuspid regurgitation caused by?

A
  1. Valve leaflets

2. Right ventricle dilation

32
Q

What is constrictive pericarditis caused by?

A
  1. Infection e.g. TB
  2. Inflammation: Connective tissue disease
  3. Malignancy
33
Q

What are the DDx for a systolic murmur?

A
  1. aortic stenosis
  2. mitral regurg
  3. tricuspid regu
  4. VSD
34
Q

How can you tell if the systolic murmur is aortic stenosis?

A

loudest is aortic area and radiates to neck - associated with slow rising pulse

35
Q

How can you tell if the systolic murmur is mitral regurgitation?

A

loudest in apex and radiates to axilla - associated with displaced apex beat

36
Q

How can you tell if the systolic murmur is tricuspid regurgitation?

A

loudest in tricuspid area and loudest on inspiration and associated with high JVP

37
Q

How can you tell if systolic murmur is due to VSD?

A

systolic murmur not associated with anything - hole between two ventricles

38
Q

What does SVT stand for?

A

supraventircular tachycardia

39
Q

What are the DDx for sinus tachycardia on an ECG?

A
  1. sepsis
  2. hypovolemia
  3. endocrine (thyrotoixosis, phaemochromocytoma)
  4. Anxious, stressed
40
Q

What are the DDx for SVT on an ECG?

A

re-entry cirucit: AVNRT and AVRT (after treatment would have a delta wave AVRT)

41
Q

Which ECGs have absent p waves?

A
  1. SVT

2. AF

42
Q

What are the differential diagnosis for Atrial Fibrillation on ECCG?

A
  1. thyrotoxicosis
  2. alcohol
  3. Heart: muscles, valve, pericardium
  4. Lungs: pneumonia, PE, cancer
43
Q

What are the DDx for ventricular tachycardia on ECG?

A
  1. ischaemia
  2. electrolyte abnormality
  3. Long QT (congenital)
    - Broad complexes
44
Q

How do you treat a patient with SVT and BP of 120/80?

A
  1. vagal maneuvers
  2. adenosine (cardiac monitor)
  3. DC cardioversion if evidence of haemodynamic compromise
45
Q

How do you treat a patient with acute fast AF and BP 120/80?

A
  1. Rhythm control
    If onset >48hours, anticoagulate for 3-4 weeks before cardioversion
  2. Rate control:
    -beta blocker
    -digoxin
  3. Think of underlying cause
  4. Think of complications (anticoagulation)
46
Q

What is the management of VT?

A
  1. If no haemodynamic compromise: IV amidarone
  2. Look for and treat underlying cause
  3. ICD
47
Q

What is the management of pulseless VT?

A

defibrillate

48
Q

How can you tell left ventricular hypertrophy by voltage criteria?

A
  1. Deep S waves and tall R waves

2. S in V1 + R in V5 or V6 (whichever is larger) > 7 large squares

49
Q

How is ischaemia suggested on an ECG?

A

ST, T, Q waves

50
Q

How is arrhythmia or conduction defects suggested by ECG?

A
  1. Rate, rhythm

2. PR, QRS, QT

51
Q

How is ventricular strain or hypertrophy suggested by ECG?

A
  1. Axis
  2. R
  3. S
52
Q

What is the S3 sound associated with?

A

ventricular filling

53
Q

What is the S4 sounds associated with?

A

ventricular hypertrophy

54
Q

How could you tell atrial septal defect in a heart sound?

A

fixed wide splitting of S2

55
Q

When do you give BiPaP?

A

if COPD with high CO2 and low pH

56
Q

When do you give CPAP?

A

improve oxygen

57
Q

What is the management of acute heart failure?

A
  1. Sit up
  2. Oxygen
  3. Furosemide (IV)
    - GTN infusion
    - Treat underlying cause
58
Q

When do you not give adrenaline in Vfib?

A

temp below 30 degrees

59
Q

What is the ALS algorithim for VF/pulseless VT?

A
  1. Shock
  2. CPR (2min)
  3. Assess rhythm
  4. Adrenaline every 3-5min
  5. Amiodarone after 3 shocks
  6. Treat reversible causes
60
Q

What is the ALS algorithm for asystole/PEA?

A
  1. CPR (2min)
  2. Adrenaline every 3-5min
  3. Correct reversible causes
61
Q

What are the DDx of pleuritic chest pain?

A
  1. Pericarditis
  2. PE
  3. Pneumonia
  4. Pnuermothroax
  5. Plueral pathology
    - Sub diaphragmatic pathology

Z Year 3 Misc (11 decks)

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