Disease Factfiles

Question 1

Aetiology Acute Heart Failure

Answer 1

Ischaemic Heart Disease
Valvular Heart Disease
Hypertension
Acute and Chronic Kidney Disease
Atrial Fibrillation

Question 2

Acute HF features

Answer 2

Dyspnoea/ PND
Pulmonary oedema
Tachypnoea
Pulmonary Congestion
Low Co output

Question 3

Acute HF Diagnosis

Answer 3

Gold: Transthoracic Echo

12-lead ECG
CXR
Bloods: creatinine and electrolytes, FBC, glucose, cardiac enzymes, troponin, CRP an D-dimer
BNP

Question 4

Acute HF Management

Answer 4

Initial
- Oxygen, Diuretic (furosemide), CPAP, vasodilator (GTN)

Morphine
Antithrombin (LMWH)

Question 5

Acute Mesenteric Ischaemia Aetiology

Answer 5

Thrombus-in situ
Embolis
Non-occlusive
Venous occlusion and congestion

Question 6

Acute Mesenteric Ischaemia Features

Answer 6

Abdo pain (out of proportion to findings)
Nausea & vomiting

Abdo exam
- Non-specific tenderness
-Late: Global peritoneum

Question 7

Acute mesenteric Ischaemia Investigations

Answer 7

ABG, Bloods

Imaging: CT scan with IV contrast

Question 8

Acute mesenteric Ischaemia Management

Answer 8

Surgical emergency
Excision of necrotic or non-viable bowel

Question 9

Angina Features

Answer 9

Classical
- heavy, tight, gripping
-central/retrosternal
- occurs with exercise/ emotional stress

Stable
- Occurs with activity

Unstable
- angina of recent onset
-occurs at rest

Question 10

Angina management

Answer 10

Vasodilator: GTN, isosorbide mononitrate

Betablocker

Calcium Channel Blocker (verapamil. dilimiazem, amlodipine)

Other anti-anginals: Ivabradine, nicorandil. ranolazine

Event reducing: Aspirin, clopidogrel, atorvastatin

Question 11

Thoracic Aortic Aneurysm Aetiology

Answer 11

Connective tissue disease
Bicuspid Aortic valve
Trauma
aortic dissection
aortic arteritis (Takayasu)
Tertiary syphilis

Question 12

Thoracic Aortic Aneurysm aetiology

Answer 12

Chest pain
back pain
hoarse voice
Features of HF

Question 13

Thoracic aortic aneurysm investigations

Answer 13

Routine bloods
ECG
Plain CXR

1st Line: CT angiogram

Transoesophageal echo

Question 14

Acute limb Ischaemia features

Answer 14

Pain
Pallor
Pulseless
Paraesthesia
Perishingly cold
Paralysis

Question 15

Acute limb Ischaemia investigation

Answer 15

Doppler US
CT angiography

Question 16

Acute limb Ischaemia management

Answer 16

Surgical emergency

Therapeutic dose heparin

Intervention
-Embolic: Embolectomy via Fogarty catheter
Bypass surgery
-Thrombotic: Local intra-arterial thrombolysis, angioplasty

Question 17

Acute Aortic Syndrome

Answer 17

Aortic dissection
penetrating aortic ulcer
Intramural haemartoma

Question 18

Aortic Dissection Classification

Answer 18

Acute <14 days
Chronic >14 days

Stanford
A- involves ascending aorta
B- doesn’t involve ascending aorta

Question 19

Aortic dissection clinical features

Answer 19

Tearing chest pain (radiates to back)
tachycardia
hypotension
new aortic regurgitation
end organ hypo perfusion

Question 20

Aortic dissection investigations

Answer 20

First: CT angiogram

Transoesophageal echo

Question 21

Aortic dissection management

Answer 21

type A: Surgical

Uncomplicated Type B : Labetalol

Question 22

Narrow Complex Tachycardia Ddx

Answer 22

Sinus tachycardia
SVT
AF
Atrial flutter

Question 23

SVT management

Answer 23

Vagal Manœuvres
Adenosine

Question 24

Broad complex tachycardia DDx

Answer 24

QRS >0.12

Ventricular tachycardia
Polymorphic VT
AF with BBB
SVT with BBB

Question 25

VT management

Answer 25

Amiodarone

Question 26

Polymorphic VT management

Answer 26

IV magnesium

Question 27

Prolonged QT Interval aetiology

Answer 27

Long QT syndrome
Medications
- antipsychotics, citalopram, flecainide, stall, amiodarone & macrolide ABx
Electrolyte Imbalances
- Hypokalaemia, hypomagnesaemia, hypocalcaemia

Question 28

Prolonged QT management

Answer 28

Correct electrolyte disturbances
BB (not sotalol)