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Cardiology > Disorders > Flashcards

Disorders Flashcards

1
Q

Mc known cause of acute pericarditis

A

Coxackie

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2
Q

Kussmaul absent in CP or CT

A

CT Strength-(fluid

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3
Q

Y descent in CP and CT

A

Rapid Absent

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4
Q

Earliest ECHO sign of ct

A

E RV D C

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5
Q

Becks triad (CT)

A

Shock

Engorged neck veins

Muffled heart sounds

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6
Q

Earliest symptoms of CT CP

A

Dyspnoea. Swelling.

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7
Q

Broadbent sign

A

CP fibrous pericardium pulls AB downwards

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8
Q

Normal pericardial fluid

A

15-20

pEff- >200

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9
Q

Is E:A (early:atrial kick) normal in CP

A

Yes

Normal = >1

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10
Q

Relief of Acute pericarditis pain

Aggravation?

A

Leaning forwards
(Heart away from mediastinal pleura)

Supine
(Inc VR—- heart engorges—— pain)

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11
Q

Cp heart sound

A

Pericardial Knock

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12
Q

AP heart sound

A

Pericardial rub

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13
Q

Most specific ecg sign of AP

A

Downsloping of TP segment

SPODICK SIGN

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14
Q

Mcc MS

A

Rhd

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15
Q

Mcc MS (non rheumatic)

A

Lutembacher

ASD primum + MS

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16
Q

D/D MS

A

Atrial clot

Atrial myxoma

Cor triatum

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17
Q

LAE seen in

A

MS — Double density sign

VSD

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18
Q

Hoarseness of voice d/t LRLN compression d/t LAE

A

ORTNERS SYNDROME

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19
Q

Mc vein to rupture in Ms

A

Bronchial vein (not pulmonary vein)

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20
Q

Murmurs of MS (all)

A

1° = MDM

2° = TR (High pulmonary pressures cause destruction of pulmonary valve)

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21
Q

ECG MS

A

P mitrale (bifid)—- due to LAE

RAD— due to RVH

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22
Q

Rx Uncomplicated MS

A

Diuretics

ACE (prevent remodelling of heart)

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23
Q

Rx Complicated MS

A

Balloon Mitral valvotomy OR replacement

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24
Q

Severity of Ms criteria

A

S2-OS gap

Pulsatile Liver

Afib

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25
Q

Type of LVH in AR

A

Eccentric

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26
Q

Classic symptom of AR

A

Palpitation

Increased FOC

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27
Q

Pulses in AR

A

Bisferiens

Water Hammer

Bounding

Dancing carotids

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28
Q

Murmurs in AR

A

1° Early Diastolic

2° Austin Flint (MDM) - due to blood in LA

 ESM- due to inc blood in LV

DUROZIEZ SIGN : Continuous murmur over FEMORAL ARTERY

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29
Q

Causes of AR

A

Valvular. Aortic root : marfan/syp

RHD (mc)
IE
Congenital

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30
Q

Type of LVH in AS

A

Concentric

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31
Q

Mcc of AS

A

Degeneration (mc)

Biscuspid valve

Rhd (rare)

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32
Q

Cardinal symptoms of AS (SAD)

A

Syncope (earliest)

Angina (lvh = inc demand)

Dyspnea (most dreaded)

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33
Q

Murmurs in AS

A

ESM with radiation to carotids

                  \+

With GALLAVERDIN PHENOMENON
(Radiation to apex)

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34
Q

Drugs C/I AS

A

Nitrates (dec afterload) - diastolic hypot

Diuretics (dec preload) - systolic hypot

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35
Q

Most common valvular HD a/w SCD

A

AS

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36
Q

Regurgitant blood volume for severe AR and MR

A

> 60ml

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37
Q

Competence of Mitral valve

Derive pathogenesis

A

Healthy leaflets (RHd=mcc)

Normal position (iatrogenic/dehiscence)

Papillary muscles (necrosed in MI)

Chordae tendinae (trauma/cpr/marfan)

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38
Q

Murmurs in MR

A

1° Early Systolic (Acute)

 Pan systolic chronic (as atria enlarged)

2° MDM (dt more blood in left atrium)

LVS3 (same reason)

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39
Q

Rx Acute and Chronic MR

A

Emergency MR Rep. MV Repair>rep

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40
Q

MS criteria in pregnancy

A

URGENT valvotomy/replacement (mortality high)

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41
Q

Barlow’s Syndrome?

A

MVP

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42
Q

Early sign of MR

A

Palpitations

43
Q

Late MR c/f

A

Hypotension and hf

44
Q

Mc CHD with MVp

A

ASD secundum

45
Q

MVP syndrome?

A

Click Murmur Syndrome
(Non ejection click + MR)

NEC always in late systole

46
Q

Most common symptom of MvP

A

Palpitations

Chordae stretch—ventricle fibre stretch—ventricle ectopics —palpitations

47
Q

Complications of MvP

A

TIA

Arrythmia

Sudden death

48
Q

Mcc chd IE

A

VSD

49
Q

Mc valvular cause IE

A

MR

50
Q

Lowest risk of IE

A

Small ASD&raquo_space;> MVP+MR

51
Q

Community acquired IE organisms

A

Strep viridans (mc)

H A C E K (hemophilus aggragatobacter cardiobacterium eikenella kingella)

52
Q

Hospita acquired IE mcc

A

MSSA&raquo_space; enterococci

53
Q

Prosthetic valve IE mcc

A

Within 1 yr = CONS > S. Epidermidis

After 1 year ~ Normal valve

54
Q

Mc organism in IVDA

A

S. Aureus

@ tricuspid valve

55
Q

Bacteremia mc in IE dt which procedure

A

Dental surgery

56
Q

Complications of IE vegetations

A

Direct spread : valve damage/paraval abs

Vascu embo : janeway/infarcts/cer hge

Im cx rxn : Roth/osler/GN/arthritis

57
Q

Fastidious organism for IE

A

Coxiella

58
Q

Major Duke criteria

A

Blood culture evidence

Echo evidence

59
Q

Minor duke criteria

A

1) Fever
2) Vascular Phenomenon
3) Immunological phenomenon (RROG)
4) Blood culture positive
5) Pre disposing condition

60
Q

Blood culture evidence criteria (duke)

A

> 2 blood cultures positive 24 hr typical

2 blood culture positive persistently 12 hr atypical

> 1 positive for fastidious organisms

> 1:800 titre for coxiella

61
Q

Echo evidences (duke)

A

Osclillating mass

Paravalvular abscess

Partial dehiscence of prosthesis

New onset regurgitant lesion

62
Q

Vascular involvement (minor dukes)

A

Major Arterial emboli (mcs brain»spleen)

Septic pulmonary infarct

Mycotic aneurysm

Hge stroke

63
Q

Immunological involvement dukes

RROG

A

Roth spots
Rheumatoid factor +
Osler nodes (palms soles)
GN

64
Q

Rx IE Native

A

Iv penicillin/ 3g ceph

65
Q

Rx IE healthcare exposed

A

Iv nafacillin/gentamicin

66
Q

Prophylactic abx in IE for which condition?

A

Co arctation of aorta

67
Q

Elective sx IE conditions

A

> 10mm vegetation

Mycotic vegetation (mcc candida— lifelong rx—poor px)

68
Q

Emergency surgery in IE?

A

MR/AR

Intracardiac fistula

Unstable prosthesis

69
Q

Vegetations in SLE

A

Liebman sacks

70
Q

Dcmp causes

A 
Alcohol
Myocarditis
Beri beri
Peripartum
Untreated psvt
71
Q

Rcmp causes

Diastolic fn disturbed

A

Amyloidosis
Sarcoidosis
hemochromatosis

72
Q

Doc for hcm

A

Beta blockers

73
Q

Greatest risk of hocm

A

SCD (~AS)

AS murmur radiates to carotids***

74
Q

Best rx for SCD

A

ICD intracardia defibrillator&raquo_space; AMIODARONE

75
Q

ECG dcmp rcmp hocm

A

V.ectopics. AV blocks. Giant T in (V5-v6)

76
Q

Murmurs in dcmp rcmp hocm

A

MR. MR/TR. ESM(~AS)

77
Q

Heart sounds in cmp

A

S3 (dcmp)

S4 (rcmp hocm)

78
Q

Pointed finger pulse

A

HOCM

79
Q

BERNHEIMS EFFECT

A

Compression of RV in HCM

Leads to increased JVP

80
Q

Drugs not allowed in hocm

A

Contractility increasers (digoxin)

Hypotensives( nitrates diuretics)

81
Q

ARVD genetics and ecg

A

PKP2 gene

Epsilon wave

Mc arrythmia is PSVT
most dreaded Vtach

82
Q

Takutsubo(DCMP) pathology

A

Apical akinesia (octopus heart)

83
Q

Yamaguchi (HOCM) pathology

A

Apical Septal hypertrophy

SPADE SHAPED HEART

Both yama and takut are d/d coronary syndromes

84
Q

Symptoms of HF

FED-PP-CT

A 
Fatigue
Edema
Dyspnoea on exertion
PND
Palpitations
Cheyne stokes
Trepopnea
85
Q

Signs of Hf

HIP-SEC

A 
Hypotension
Insp crepts
Pedal Edema
S3-S4
Elevated JVP
Congestive hepatomegaly (ascites)
86
Q

Cardiomarkers of Hf

A

BNp
Soluble ST2
Galectin

87
Q

Mc secondary cause of htn

A

Reno Parenchymal (ckd gn)

88
Q

Mcc renal artery stenosis

A

<30 FMD

>50 atherosclerosis

89
Q

Renal causes of htn

A

Reno parenchymal
RAStenosis
Gordon syndrome (gof nacl ch in dct)
Liddle syndrome (gof enac ch in CD)

Gordon = M acidosis
Liddle = M alkalosis
90
Q

Endocrine causes of HTN

A

Hypothyroidism (DBP)
Hyperthyroidism (SBP)
CONS Syndrome (DBP)—aldo=BV fibrosis
Phaeochromocytoma (TBP)

91
Q

Miscellaneous causes of HtN

A

Co arctation of aorta (mcc congenital)

Obstructive sleep apnoea (OSA)- hypoxia—pulm vasoconstriction—symp+ due to repeated awakening

92
Q

Doc angina + htn

A

Beta blockers

93
Q

Doc Htn with RENAL ARTERY STENOSIS

A 
UL = ACE
BL= CCB
94
Q

Doc elderly c htn

A

Diuretics

If BPH then alpha blockers

95
Q

MI with bradycardia-suspect?

A

Inferior wall MI

RCA = SAN+ inferior wall

96
Q

MI with tachycardia-suspect?

A

Anterior wall MI

Thoracic nerve is sympathetic and gets stimulated

97
Q

Dressler syndrome in CP

4p

A

Pericarditis
Pneumonitis
Pleuritis
Pyrexia

98
Q

ECG changes in MI sequence

A

1) T wave inversion / TALL T WAVE
(Dt k+ release from infarcted myocyte)

2) Tombstone (ST elevation)
(Infarcted myocytes repolarise early)

3) Pardees sign- STE + T inv
(S/o evolving MI)

4) Pathological Q wave
(S/o evolved MI)

99
Q

Ixoc to detect REVERSIBLE MI

A

Thallium scan

100
Q

Localization of MI

A 
Anterior wall/septum :  v2- v3 (LAD)
Posterior wall : v7-v8-v9 (LCX)
Inferior wall : (II) (RCA)
Lateral wall : v4-v5-v6 (LCX)
High lateral : avL (I) 
Right wall : Rv4- (III) (RMA)
101
Q

Cardiac biomarkers and time

A

HTFAB- 30-24h

Ckmb- 5hrs-72hrs

Troponin I&T- 5hrs-14d

102
Q

DOC NSTEMI and UNSTABLE ANGINA

Aanb

A

Antiplatelet (asp+clop)

Antithrombotics (enoxaparin). (NOT THROMBOLYTICS)

Nitrates

Beta blockers

103
Q

DOC STEMI

MOdAC NBS

A 
Morphine
O2
ACE
Aspirin
Clopidogrel
Nitrates
Beta blockers
Statins high dose

C/I = CCB (hypotension)

104
Q

DOC Prinzmetal Angina

A 
Nitrates (acute)
Alpha blockers (maintainence)
Ccb (maintainence)

C/I = Beta blockers (unapposed alpha)
Aspirin (xPG—> vasoconstriction)

Cardiology (3 decks)

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