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Yr 5 - CVS > Corrections > Flashcards

Corrections Flashcards

1
Q

1st line mx of acute pericarditis?

A

NSAIDs

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2
Q

Side effects of adenosine?

A
  • chest pain
  • bronchospasm
  • transient flushing
  • feeling of doom
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3
Q

Why should adenosine be avoided in asthmatics?

A

Due to possible bronchospasm

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4
Q

Most common bacterial cause of endocarditis:

a) normally
b) <2 months post valve surgery

A

a) Staph. aureus

b) Staph. epidermis

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5
Q

Conservative mx of NSTEMI:

a) high bleeding risk

b) not high bleeding risk

A

Aspirin plus:

a) clopidogrel
b) ticagrelor

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6
Q

The most common type of coarctation of the aorta seen in adults is the postductal variety, i.e. the aortic narrowing is distal to the ductus arteriosus.

How does this affect UL and LL BP?

A

Upper limb BP > lower limb BP as the narrowing occurs after the left subclavian artery branches from the aorta.

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7
Q

Can orthostatic hypotension be triggered by heavy meals?

A

Yes (postprandial hypotension)

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8
Q

Does a new early diastolic murmur indicate aortic dissection affecting the ascending or descending aorta?

A

Ascending –> aortic regurgitation

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9
Q

T wave inversion in which lead is a normal variant?

A

III

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10
Q

ECG features of hypokalaemia?

A
  • small or absent T waves (occasionally inversion)
  • prolong PR interval
  • ST depression
  • long QT
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11
Q

Mx of patients on warfarin with major bleeding (e.g. variceal haemorrhage, intracranial haemorrhage) no matter what the INR?

A

Stop warfarin
IV vitamin K 5mg
PCC

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12
Q

What is the definitive treatment of WPW?

A

radiofrequency ablation of the accessory pathway

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13
Q

Surgical options for aortic stenosis:

a) low/medium operative risk patients
b) high operative risk patients

A

a) surgical AVR
b) transcatheter AVR

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14
Q

If thrombolytic drugs are given during ALS, how long should CPR continue?

A

prolonged period of CPR (e.g. 60-90 mins) should be considered

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15
Q

A lateral MI is generally caused by a lesion in what artery?

A

Left circumflex artery

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16
Q

Mx of infective endocarditis causing congestive cardiac failure?

A

An indication for emergency valve replacement surgery

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17
Q

What is the main ECG abnormality seen with hypercalcaemia?

A

Shortening of the QT interval

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18
Q

Site of action of loop diuretics?

A

Ascending loop of Henle

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19
Q

Mx of patients on warfarin if their INR becomes <2?

A

They needs immediate anti-coagulation with rapid acting LMWH.

Warfarin dose should be increased.

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20
Q

Mx of angina in those with an inadequate response to verapamil (if beta blockers are contraindicated)?

A

Add a long acting nitrate e.g. isosorbide mononitrate

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21
Q

What is torsades de pointes?

A

A form of polymorphic VT that occurs due to prolonged QT interval.

22
Q

Mx of VF/pulseless VT?

A

1) A single shock followed by 2 minutes of CPR

2) Amiodarone 300 mg should be given 3 shocks have been administered

3) A further dose of amiodarone 150 mg should be given after 5 shocks have been administered

23
Q

If a cardiac arrest is witnessed in a monitored patient (e.g. in a coronary care unit), what is mx?

A

up to 3 quick successive (stacked) shocks, rather than 1 shock followed by CPR

24
Q

Mx of non-shockable rhythms?

A

adrenaline 1 mg as soon as possible

25
Q

How to measure QT interval on an ECG

A

Time between start of Q wave and end of T wave

26
Q

How can mitral stenosis cause haemoptysis?

A

Due to increased pressures causing rupture of pulmonary vessels.

27
Q

What murmur does an ASD vs VSD cause?

A

ASD - ejection systolic, louder on inspiration

VSD - pansystolic

28
Q

Target BP for T2D?

A

<14/90

29
Q

What is the main ECG abnormality seen with hypercalcaemia?

A

Shortening of the QT interval

30
Q

1st line mx of acute pericarditis?

A

Ibuprofen + colchicine

31
Q

When should ivabradine be considered in HF?

A

If the patient has sinus rhythm >75/min and a LV EF <35% and has not responded to triple therapy

32
Q

When should amiodarone be delivered in VF/pulseless VT?

A

300mg after 3 shocks

further 150mg dose after 5 shocks

33
Q

Mx of torsades de pointes?

A

IV magnesium

34
Q

For a patient with hypertension who is already taking an ACEi, a history of gout would favour the addition of what?

A

CCB > thiazide diuretic

35
Q

How can pulmonary HTN be heard?

A

Loud S2 (due to loud P2)

36
Q

How is dextrocardia seen on an ECG?

A

1) inverted P wave in lead I
2) right axis deviation
3) loss of R wave progression

37
Q

Signs of tricuspid regurgitation?

A
  • pansystolic murmur
  • prominent/giant V waves in JVP
  • pulsatile hepatomegaly
  • left parasternal heave
38
Q

Causes of tricuspid regurg?

A

1) RV infarction

2) pulmonary HTN e.g. COPD

3) rheumatic heart disease

4) infective endocarditis (especially IVDU)

5) Ebstein’s anomaly

6) carcinoid syndrome

39
Q

Infective endocarditis most commonly affects what valve?

A

Mitral

40
Q

Infective endocarditis most commonly affects what valve in IVDU?

A

Tricuspid valve leading to regurg

41
Q

What is the intensity of the murmur in AR increased by?

A

Handgrip manouevre

42
Q

Most common cause of mitral stenosis?

A

Rheumatic fever

43
Q

What causes malar flush in mitral stenosis?

A

It is due to the back pressure of blood into the pulmonary system, causing a rise in CO2 and vasodilation.

44
Q

Describe murmur heard in MS

A

Mid-diastolic, low-pitched “rumbling” murmur (due to a low blood flow velocity).

There is an opening snap after S2, which triggers the onset of the murmur.

45
Q

2 causes of mitral stenosis?

A

1) RHD

2) infective endocarditis

46
Q

Key complications of MS?

A

1) AF

2) Pulmonary HTN

3) Thromboembolism

4) Infective endocarditis

47
Q

How is infective endocarditis a complication of mitral stenosis?

A

Damaged mitral valve leaflets are more susceptible to infection.

48
Q

Where does the murmur radiate to in mitral regurgitation?

A

L axilla

49
Q

Long-term anticoagulation in biological valves?

A

Long-term anticoagulation not usually needed.

Warfarin may be given for the first 3 months depending on patient factors.

Low-dose aspirin is given long-term.

50
Q

What is the most common causative organism of infective endocarditis in patients following prosthetic valve surgery?

A

Coagulase-negative Staphylococci such as Staphylococcus epidermidis.

51
Q
A

Yr 5 - CVS (6 decks)

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