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Year 3 DPD > DPD Amir Sam 1 > Flashcards

DPD Amir Sam 1 Flashcards

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1
Q

60M
Tight chest pain 2hrs
Nausea and sweating
Hx HTN, on amlodipene

What are your cardio differentials?

A

Ischaemic heart disease
Aortic dissection
Pericarditis

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2
Q

60M
Tight chest pain 2hrs
Nausea and sweating
Hx HTN, on amlodipene

What is the most appropriate investigation?

A

ECG

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3
Q

What are you looking for in an ECG of a Pt with chest pain?

A

STEMI/NSTEMI

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4
Q

What investigation would you do after the ECG of a Pt with chest pain?

A

Troponin levels

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5
Q

What investigation would you do if the troponin levels were positive?

A

Angiography

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6
Q

What investigation would you do if the troponin levels were negative?

A

ETT

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7
Q

What investigation would you do after the troponins of a Pt with chest pain?

A

Echocardiogram

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8
Q

What would the echo show in a Pt with an MI?

A

Regional wall motion abnormality (RWMA)

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9
Q

What would you do in a Pt with a STEMI?

A

Percutaneous coronary intervention

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10
Q

What would you do in a Pt with a NSTEMI?

A

Aspirin, clopidogrel, LMWH etc

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11
Q

How would a Pt present with aortic dissection?

A

Tearing pain, radiating to the back

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12
Q

What would you note on examination of a Pt with aortic dissection?

A

Aortic regurgitation
Radio-radial relay
Difference in BP in right and left upper limbs

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13
Q

How would a Pt present with pericarditis?

A

Pleuritic pain
Worse on inspiration
Relieved when leaning forwards
Flu-like symptoms

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14
Q

How would you treat a Pt with pericarditis?

A

Give NSAIDs

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15
Q

Why could a Pt w/ a brain tumour on high dose dexamethasone to reduce inflammation around the lesion present with chest pain?

A

Dexamethasone- steroid
Steroid- immunosuppressant
Immunosuppressed- susceptible to candidiasis

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16
Q

An occlusion of the LAD coronary artery would lead to what type of MI?

A

Anterior MI

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17
Q

An occlusion of the circumflex coronary artery would lead to what type of MI?

A

Lateral MI

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18
Q

An occlusion of the right coronary artery would lead to what type of MI?

A

Inferior MI

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19
Q

Where would you expect to see ST elevation in an anterior MI?

A

V1-V4

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20
Q

Where would you expect to see ST elevation in a lateral MI?

A

V5-6, I, aVL

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21
Q

Where would you expect to see ST elevation in an inferior MI?

A

II, III, aVF

22
Q

What do you ask a Pt/witness seeing someone collapse?

A

What happened before?
What happened during?
What happened after?

23
Q

What can happen before the collapse and what does it signify?

A

Aura- likely seizure

Nothing- likely cardiovascular involvement

24
Q

What can happen during the collapse and what does it signify?

A

Tongue biting/incontinence- likely seizure

25
What are the causes of collapse?
``` Hypoglycaemia Vasovagal syncope Outflow obstruction Arrhythmia Postural hypotension Seizure ```
26
What are the types of left/right sided outflow obstructions?
L- aortic stenosis, HOCM | R- pulmonary embolus
27
What would you request for in a Pt suspected of postural hypotension?
Standing and lying BP
28
What would you request for in a Pt suspected of an arrhythmia?
ECG Cardiac monitor bed 24hr tape
29
What are the causes of a long QT?
Congenital- K+ channel mutation [Pts may recall a FHx of sudden death] Acquired- low K+/Mg++; drugs
30
``` 45M fever and malaise Known IVDU Raised JVP to ear Pan-systolic murmur Louder on inspiration Hepatomegaly Diagnosis? ```
Tricuspid regurgitation IVDU- infective endocarditis V raised JVP PSM -> RILE Louder on inspiration therefore right-sided
31
What are the causes of a raised JVP?
Right sided HF Tricuspid regurgitation Constrictive pericarditis
32
What are the causes of RHF?
``` 2" to LHF (CCF) Pulmonary hypertension (PE, COPD etc) ```
33
What are the causes of tricuspid regurgitation?
Valve leaflet damage (endocarditis) | Right ventricular dilation
34
What are the causes of constrictive pericarditis?
Infection (eg. TB) Inflammation (eg. connective tissue disorder) Malignancy
35
What are the causes of a systolic murmur?
AS MR TR VSD
36
What are the characteristics of an aortic stenosis?
2nd intercostal @ R sternal border Radiates to carotids Slow rising pulse
37
What are the characteristics of a mitral regurgitation?
5th intercostal L mid-clavicular | Radiates to axilla
38
What are the characteristics of a tricuspid regurgitation?
5th intercostal @ L sternal border | V high JVP
39
What type of murmur will you hear in someone with a VSD?
Pan-systolic murmur
40
What are the types of tachycardia?
Sinus Supraventricular AF Ventricular
41
What are the causes of a sinus tachycardia?
Sepsis Hypovolaemia Endocrine (thyrotoxicosis, phaeo)
42
What are the causes of a supraventricular tachycardia?
Re-entry circuit | Via accessory pathway
43
What are the causes of AF?
``` Thyrotoxicosis Alcohol Pericarditis (peri) Muscle (myo) Valvular (endo) Pneumonia/PE/cancer ```
44
What are the causes of a ventricular tachycardia?
Ischaemia Electrolyte imbalance Long QT syndrome
45
What could you see on an ECG of a Pt with AVRT?
Delta wave (WPW syndrome)
46
How would you treat a patient in SVT?
Valsalva/carotid massage (vasovagal manouvre) Adenosine IV amiodarone if haemodynamically stable DC cardioversion if not HDS (drop in BP)
47
What two types of medication should you give a Pt with AF?
Rate controlling | Rhythm controlling
48
Why would you give anticoagulants for 3-4 weeks before cardioverting in a Pt with an onset of AF >48hrs?
Risk of thromboembolus
49
What rate controlling drugs could you give a Pt with AF?
Beta blocker | Digoxin
50
What would you see in a Pt with LVH by voltage criteria?
``` Deep S (V1-2) Tall R (V5-6) Total is greater than 7 large squares ```

Year 3 DPD (5 decks)

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