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Final Year - Passmed > Difficult Cardio > Flashcards

Difficult Cardio Flashcards

1
Q

Complications Post MI

ventricular septal defect presents with?

A

pansystolic murmur
acute HF signs
within 1 week

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2
Q

Left ventricular free wall rupture?

A

2 weeks post MI
cardiac tamponade features

blood is leaking into pericardial space

Becks: hypotension, raised JVP, muffled heart sounds

ECG: electrical alternans

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3
Q

left ventricular aneurysm

A

2 weeks post MI
persistent St elevation

lack of other MI features

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4
Q

Dressler’s syndrome

A

acute-onset pleuritic pain
ST elevation would be saddle shaped with PR depression
global across all leads

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5
Q

Ventricular septal defects in Downs

A

Hole in septum which separates R/L ventricles

blood flows from Left >Right
pan systolic murmur

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6
Q

why is warfarin INR target higher for a mitral valves

A

Mechanical heart valves have a high propensity for clot formation, particularly mitral valves

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7
Q

GRACE - poor prognostic factors?

A

HF
Age
reduced systolic BP

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8
Q

what drugs have shown to reduce mortality in patients with left ventricular failure?

A

ACEi
Beta-Block
ARB
aldosterone antagonist - spironolactone
hydralazine and nitrates

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9
Q

Holter monitor :
what is it?
what does it monitor?

A

continuous ECG for a period of 24, 48 or 72 hours
to assess for Atrial fibrillation

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10
Q

NICE recommends ___________ for someone presenting with non-cardiac chest pain with signs of ischaemia

A

NICE recommends contrast-enhanced CT coronary angiogram for someone presenting with non-cardiac chest pain but whose resting ECG shows signs of ischaemia

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11
Q

hypothermia ECG changes?

A

j waves
qt is long
irregular rhythm
bradycardia
first degree heart block

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12
Q

How to exclude valvular pathology?

A

transthoracic echocardiography

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13
Q

What is the normal range for a P-R interval?

A

120-200ms

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14
Q

PR interval of 200ms would be how many small boxes?

A

5 small sqaures

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15
Q

Takayasu is a vasculitis that affects the ?

A

aorta and its main branches
causes occlusion

absent limb pulse

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16
Q

how to investigate takayasu?

A

vascular imaging
magnetic resonance angiography

CT angiography

17
Q

how long does Troponin remain elevated post MI?

18
Q

creatine kinase CK-MB ?

A

3-4 so usrful when assessing reinfarction

19
Q

cardiac enzymes and protein markers

A

myoglobin (1st(

CK-MB

Trop T - peaks at 12

AST
LDH

20
Q

immediate treatment for bradycardia with adverse features

A

500 micrograms atropine IV

repeat upto 3mg

21
Q

mitral stenosis

what suggests mobility of leaflets?

length of murmur suggests?

A

opening snap - pressure in left atrium is greater than the pressure in left ventricle

severity

loud S1

22
Q

causes of mitral stenosis?

A

Rheumatic fever

mucopolysaccharidoses, carcinoid and endocardial fibroelastosis

23
Q

Posterior MI
territory?

A

V1-V3 ST depression
tall borad R waves
uptight t waves
dominant r in V2

> circumflex or right coronary

24
Q

Inferior MI
coronary artery?
territory?

A

Right coronary artery

II,II, aVF

25
Q

Anterolateral MI

A

V1-V6, I aVL

proximal left anterior descending

26
Q

lateral MI

A

I, aVL, +/-V5,V6

left circumflex

27
Q

Arrhythmogenic right ventricular cardiomyopathy

A

right ventricular myocardium replaced with fatty and fibrofatty tissue

28
Q

Arrythmogenic right ventricular hypertrophy

IX?
Mx?

A

V1-V3
t wave inversion

sotalol
catheter ablation
implantable cardioverter defribillator

29
Q

Infective endocarditis cause associated with valve transplants?

A

coagulase negative staphylococcus epidermis

2 month tho

30
Q

why does Omeprazole affect clopidogrel?

A

pro-drug activated by the enzyme CYP2C19

omeprazole is an inhibitor of this enzyme

31
Q

Cardiac Resynchronisation Therapy?

A

Heart failure patients taking maximum triple therapy with widened QRS complexes

Biventricular pacemaker would improve cardiac function

32
Q

what does a wide QRS indicate in HF?

A

electrical signals between left and right sides of heart are not working well

33
Q

symptomatic bradycardia

A

Isoprenaline/adrenaline infusion is an alternative treatment to atropine/transcutaneous pacing

34
Q

Major bleed on warfarin?

A

stop warfarin

give IV vitamin K 5mg
prothrombin complex concentrate

35
Q

Buerger’s disease

A

raynaud

intermittent claudication

finger ulcerations

36
Q

Why do ACEi cause a cough as a side effect?

A

build up of bradykinin in the lungs which acts as an irritant

37
Q

Thiazide diuretics work by?

A

inhibiting sodium absorption in the distal convulated tubule

  • hyponatraemia
38
Q

A patient with AF + an acute stroke - not haemorrhagic when to start anticoagulation?

A

2 weeks after

but if this pt had a TIA then immediately after exculding haemorrhage

Final Year - Passmed (47 decks)

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