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Year 3 DPD > DPD Amir Sam 1 > Flashcards

DPD Amir Sam 1 Flashcards

Cardio

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
Q

What are the causes of collapse?

A 
Hypoglycaemia
Vasovagal syncope
Outflow obstruction
Arrhythmia
Postural hypotension
Seizure
26
Q

What are the types of left/right sided outflow obstructions?

A

L- aortic stenosis, HOCM

R- pulmonary embolus

27
Q

What would you request for in a Pt suspected of postural hypotension?

A

Standing and lying BP

28
Q

What would you request for in a Pt suspected of an arrhythmia?

A

ECG
Cardiac monitor bed
24hr tape

29
Q

What are the causes of a long QT?

A

Congenital- K+ channel mutation
[Pts may recall a FHx of sudden death]
Acquired- low K+/Mg++; drugs

30
Q 
45M fever and malaise
Known IVDU
Raised JVP to ear
Pan-systolic murmur
Louder on inspiration
Hepatomegaly
Diagnosis?
A

Tricuspid regurgitation

IVDU- infective endocarditis
V raised JVP
PSM -> RILE
Louder on inspiration therefore right-sided

31
Q

What are the causes of a raised JVP?

A

Right sided HF
Tricuspid regurgitation
Constrictive pericarditis

32
Q

What are the causes of RHF?

A 
2" to LHF (CCF)
Pulmonary hypertension (PE, COPD etc)
33
Q

What are the causes of tricuspid regurgitation?

A

Valve leaflet damage (endocarditis)

Right ventricular dilation

34
Q

What are the causes of constrictive pericarditis?

A

Infection (eg. TB)
Inflammation (eg. connective tissue disorder)
Malignancy

35
Q

What are the causes of a systolic murmur?

A

AS MR TR VSD

36
Q

What are the characteristics of an aortic stenosis?

A

2nd intercostal @ R sternal border
Radiates to carotids
Slow rising pulse

37
Q

What are the characteristics of a mitral regurgitation?

A

5th intercostal L mid-clavicular

Radiates to axilla

38
Q

What are the characteristics of a tricuspid regurgitation?

A

5th intercostal @ L sternal border

V high JVP

39
Q

What type of murmur will you hear in someone with a VSD?

A

Pan-systolic murmur

40
Q

What are the types of tachycardia?

A

Sinus
Supraventricular
AF
Ventricular

41
Q

What are the causes of a sinus tachycardia?

A

Sepsis
Hypovolaemia
Endocrine (thyrotoxicosis, phaeo)

42
Q

What are the causes of a supraventricular tachycardia?

A

Re-entry circuit

Via accessory pathway

43
Q

What are the causes of AF?

A 
Thyrotoxicosis
Alcohol
Pericarditis (peri)
Muscle (myo)
Valvular (endo)
Pneumonia/PE/cancer
44
Q

What are the causes of a ventricular tachycardia?

A

Ischaemia
Electrolyte imbalance
Long QT syndrome

45
Q

What could you see on an ECG of a Pt with AVRT?

A

Delta wave (WPW syndrome)

46
Q

How would you treat a patient in SVT?

A

Valsalva/carotid massage (vasovagal manouvre)
Adenosine
IV amiodarone if haemodynamically stable
DC cardioversion if not HDS (drop in BP)

47
Q

What two types of medication should you give a Pt with AF?

A

Rate controlling

Rhythm controlling

48
Q

Why would you give anticoagulants for 3-4 weeks before cardioverting in a Pt with an onset of AF >48hrs?

A

Risk of thromboembolus

49
Q

What rate controlling drugs could you give a Pt with AF?

A

Beta blocker

Digoxin

50
Q

What would you see in a Pt with LVH by voltage criteria?

A 
Deep S (V1-2)
Tall R (V5-6)
Total is greater than 7 large squares

Year 3 DPD (5 decks)

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