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YR6: CARDIAC > DPD: AMIR SAM 1 > Flashcards

DPD: AMIR SAM 1 Flashcards

1
Q

Which investigations must be performed in acute chest pain presentation ?

A
  1. ECG
  2. Troponin
    +ve: coronary angiography
    ‐ve: ETT
  3. Echocardiography
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2
Q

How can you differentiatially diagnose chest pain?

A

Cardiac: IHD, aortic dissection, pericarditis
Resp: PE, Pneumonia, Pneumothorax
GI: Oesophageal spasm, oesophagitis, gastritis
MSK: Costochondritis

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3
Q

Which artery is involved in an anterior MI? Which ECG leads will show this?

A

LAD

V1 - V4

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4
Q

Which artery is involved in a lateral MI? Which ECG leads will show this?

A

Circumflex

V5, V6, I, aVL

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5
Q

Which artery is involved in an inferior MI? Which ECG leads will show this?

A

RCA

II, III, aVF

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6
Q

How can you differentiatially diagnose collapse?

A
  1. Hypoglycaemia: DNEFG
  2. Cardiac: Vasovagal, Arrhythmia, Outflow obstruction, Postural hypotension
  3. Neuro: Seizure
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7
Q

What will you look for on an ECG if you suspect arrythmia as cause of collapse? Why?

A

Long QT

Predisposes to tachyarrythmia

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8
Q

What may cause outflow obstruction leading to collapse?

A

Aortic stenosis (low volume, slow rising carotid pulse, ESM)
HOCM
PE

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9
Q

What is long QT syndrome? What are the causes of it?

A

Abnormal ventricular repolarisation
Congenital: mutation in K+ channels
Acquired: low K+/ Mg2+, drugs

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10
Q

List 3 differentials for raised JVP

A

RHF
Tricuspid regurgitation
Constrictive pericarditis

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11
Q

What characterises a neurological cause for loss of consciousness, with respects to before, during and after the episode?

A

Before: Aura
During: Tongue biting
After: Confusion

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12
Q

What characterises a cardiac cause for loss of consciousness, with respects to before, during and after the episode?

A

Before: no warning
During: no tongue biting
After: no confusion

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13
Q

What 2 differentials should you consider in a patient with sinus tachycardia?

A

Sepsis

Hypovolaemia

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14
Q

What causes a supra ventricular tachycardia? What does this look like on an ECG?

A

Re-entry circuit

No P waves before QRS

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15
Q

What are the 2 types of re-entry circuits?

A

AVNRT: reentry at the level of the AVN
AVRT: reentry along accessory pathway

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16
Q

What is seen in a ECG of a patient with an accessory pathway? (not in tachycardia)

A

Delta wave

Short PR interval + slurred upstroke due to presence of accessory pathway

17
Q

What is your differential diagnosis for atrial fibrillation?

A

Alcohol excess, thyrotoxicosis
Heart: muscle, valve, pericardium
Lungs: pneumonia, PE, cancer

18
Q

List 3 causes of ventricular tachycardia

A

Ischaemia
Electrolyte imbalance
Long QT syndrome

19
Q

How do you manage a SVT

A

Vagal manœuvres
If ineffective, give adenosine with a cardiac monitor
If in haemo-dynamic compromise consider DC cardioversion

20
Q

What does management of AF consist of?

A

Rhythm control: cardio version in <48 hrs
Rate control: B blocker/ Digoxin
Anticoagulate (if appropriate)

21
Q

How do you manage VT with no haemodynamic compromise?

A

IV Amiodarone
Treat underlying cause
Consider ICD

22
Q

How would you manage pulseless VT?

A

Defibrillate

23
Q

What are the ECG characteristics of left ventricular hypertrophy?

A

Deep S in V1/2

Tall R in V5/6

24
Q

What evidence of ischaemia can be seen on an ECG?

A

ST elevation
T inversion
Q waves indicating old MI’s

25
Q

How do you assess an ECG for arrhythmia or conduction defects?

A 
Rate slow or fast?
Rhythm sinus or AF?
PR interval: first degree heart block?
Broad QRS: bundle branch block
Prolonged QT interval predisposes to VT
26
Q

How do you assess an ECG for ventricular strain or hypertrophy?

A

Look at R + S

Is there evidence of strain on left side of heart possible due to HTN

27
Q

What is the 3rd heart sound associated with?

A

Ventricular filling

28
Q

What is the 4th heart sound associated with?

A

Ventricular hypertrophy

29
Q

What is indicated by a fixed wide splitting of S2?

A

Atrial septal defect

30
Q

What treatment is suitable for type 2 respiratory failure?

A

BiPAP

31
Q

What treatment is required for acute HF?

A

Sit up
O2
Furosemide IV
GTN infusion if in pain

32
Q

What is the differential diagnosis for pleuritic chest pain?

A 
Pericarditis
PE
Pneumonia
Pneumothorax
Pleural pathology

YR6: CARDIAC (41 decks)

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