DPD Amir Sam 2 Flashcards
Cardio 2 Resp
Which limb leads show ST elevation in an anterior MI?
V3-4
Which limb leads show ST elevation in an lateral MI?
I, aVL, V5-6
Which limb leads show ST elevation in an inferior MI?
II, III, aVF
What are the types of tachycardia?
Sinus tachycardia SVT VT AF Atrial flutter
What is the pattern of atrial flutter?
Sawtooth
What is the treatment for atrial flutter?
Similar to AF
What is the distinct characteristic of VT?
Broad QRS complexes
What is 1st degree HB?
Prolonged P-R interval
What is 2nd degree HB?
P wave not followed by a QRS complex
What is 3rd degree HB?
Complete dissociation between P and QRS complexes
What is LVH by voltage criteria?
Deep S in V1 or 2
Tall R in V5 or 6
Total is greater than 7 large squares
How do you manage a Pt with pulseless VT?
Defibrillate
How do you manage a Pt with VT and no haemodynamic compromise?
IV amiodarone
Treat underlying cause
ICD (implantable cardioverter defibrillator)
What are the causes of LVH?
Hypertension
Aortic stenosis
65F SOB for a few hrs
Orthopnoea
Hx 2x MIs
DH- aspirin, simvastatin, ramipril, bisoprolol
Temp 36.5, raised JVP, HS 1+2+3, fine crackles on auscultation, peripheral oedema
What is the diagnosis?
Congestive heart failure
What is a third heart sound?
Rapid ventricular filling
What can cause a third heart sound?
Congestive heart failure
What is the characteristic sound heard in atrial septal defects?
Splitting of the heart sounds
What is a fourth heart sound?
Ventricular hypertrophy
What is the most appropriate management for a Pt with cHF?
A. Sit them up + 60-100% O2 B. BiPAP C. CPAP D. 24% O2 E. Intubate and ventilate
A. Sit them up + 60-100% O2
What is the management of acute HF?
Sit up
Oxygen
Frusemide (IV)
Treat the underlying cause
SOFT
When would you give a Pt BiPAP in an acute presentation?
When the Pt has respiratory acidosis
When would you give a Pt CPAP in an acute presentation?
When the Pt has pulmonary oedema
Why shouldn’t you give oral frusemide to a Pt with peripheral oedema?
They will also have gut oedema
Absorption of the diuretic will be poor
78M Unconscious Not breathing No carotid pulse Temp 29 ECG shows VF
What should you do first to treat the Pt?
Warm them up
What is the ALS algorithm for a Pt with VF/pulseless VT?
Shock them CPR (2 mins) Assess rhythm Give adrenaline every 3-5 mins Amiodarone after 3 shocks Correct reversible causes
What is the ALS algorithm for a Pt with asystole/pulseless electrical activity?
CPR (2 mins)
Give adrenaline every 3-5 mins
Correct reversible causes
What are the causes of
HHHHTTTT
Hypothermia Hypoxia Hypovolaemia Hypo/hyperkalaemia Tamponade Tension PT Thromboembolic Toxic/metabolic
30F URTI
Pleuritic chest pain
Better when leaning forwards
Widespread ST elevation (saddle shape)
What is the diagnosis?
Pericarditis
What are the causes of pleuritic chest pain?
Pericarditis Pneumothorax Pulmonary embolism Pneumonia Pleural pathology 5xP Sub-diaphragmatic pathology (eg SD abscess)
