Clinical very good :) :) Flashcards
Harsh pan-systolic murmur, loudest at the lower left sternal edge and inaudible at the apex. The apex is not displaced. It does not intensify on inspiration
Ventricular septal defect
Soft late systolic murmur at the apex, radiating to the axilla
Mitral valve prolapse
(late systolic murmurs resemble mitral incompetence)
There may also be a systolic click
Possible reason for systolic click?
Mitral incompetence
Slow-rising pulse and heaving apex (apex not displaced)
Ejection systolic murmur best hears at the right second interspace that does not radiate
Aortic stenosis
The pulse is regular and jerky in character. The cardiac impulse is hyperdynamic and not displaced.
There is a mid-systolic murmur with no ejection click, loudest at the left sternal edge
Hypertrophic cardiomyopathy
Constant “machinery-like” murmur throughout systole and diastole
Patent ductus arteriosus
Tented T waves on ECG?
Hyperkaelemia
hyperkaelemia impairs cardiac conduction
You can investigate arrhythmias with an electrophysiological study, what is this?
This is when you induce a clinical arrhythmia to study mechanism and map pathway
-Also gives the opportunity to treat the arrhythmia by radiofrequency ablation
Why would you carry out an exercise ECG?
To assess for ischemia
Exercise induced arrhythmia
How would you check for paroxysmal arrhythmia?
To assess for paroxysmal arrhythmia
Side effects of statins?
Myalgias, myositis and deranged liver function tests
Side effects of amiodarone?
Hepatic/pulmonary fibrosis
Hypo/hyperthyroidism
Blue-grey photosensitivity rash
Side effects of GTN?
Headaches and hypotension
Loud S1 with opening snap
Palpable S1
Rumbling low pitched diastolic murmur
Mitral stenosis
A 72 year old woman with an acute ischaemic stroke has ST elevation on her electrocardiogram. There is a past medical history of MI
Left ventricular aneurysm
Retinal haemorrhages that are usually caused by an immune complex vasculitis and are most commonly seen in bacterial endocarditis
Roth’s spots
ECG yellow electrode
Left arm
Which ECG electrode should be put on bony prominence on left side of abdomen or left leg?
Green
Which ECG electrode should be placed on bony prominence on the right arm/shoulder?
Red
Risks of RIPE aneurysm
Rupture
Infection (of thrombus)
Pressure effects on neighbouring structures
Emboli of thrombi to lower limb
Cardiac abnormalities Thymoma Cleft palate Hypocalcemia/hypoparathyroidism 22nd chromosome
DiGeorge syndrome
Raised J waves
Hypothermia
Loud P2
Pulmonary hypertension
Congenital rubella syndrome is associated with
PDA
Atrial septal defect
Pulmonary stenosis
Marfan syndrome is associated with
Aortic root dilaration (causing aortic regurgitation)
Mitral valve proplapse
Mitral regurgitation
Turner syndrome is associated with
Coarction of the aorta
When and how does Tetralogy of Fallot usually present?
Prevents with cyanotic episodes usually at 1-2 months
Why should you not use rate-limiting Ca channel blockers and beta blockers together?
May cause severe AV block and hypotension
Opens into the left posterior aortic sinus
Left coronary artery
Opens into the right atrium
Coronary sinus
Commonly associated with the atrioventricular groove
Right coronary artery
Supplies the AV node
Posterior interventricular artery
Supplies the apex of the heart
Anterior interventricular artery
Most common cause of aortic stenosis
Calcification of congenital bicuspid valve
