DPD Cases Flashcards
1
Q
60 yo, chest pain, tight, 4hrs, nausea, sweating, breathlessness, THTN, amlodipine Temp: 37.0C HS: S1 + S2 BP: 120/80 (L), 118/75 (R) Chest: clear Abdomen is soft, non-tender
Diagnosis?
A
MI
2
Q
Investigations for a suspected MI
A
Investigations:
- ECG
- Cardiac Biomarkers = troponin; if + coronary angiography, if - ETT (exercise tolerance tests)
- echocardiography
IF ST ELEVATION = give aspirin and clopidrogel and send them to cathetirization
3
Q
Collapse of 30 yo without warning no tongue biting and not confused afterwards FMHx = brother dying at young age HS: S1 + S2 + 0 BP: 120/80 (lying), 115/75 (standing) Vesicular breath sounds Abdomen: soft, non-tender
A
Diagnosis: Tachyarrythmia
Other possible diagnosis: Cardiac causes such as
4
Q
45 yo man fever malaise IV drug use temp of 38 ^ JVP to earlobes HS: S1+S2+PSM (louder on Inspiration) Hepatomegaly
A
Tricuspid Regurgitation
5
Q
65 yo SOB palpitations HTN bendroflumethiazide 38C PR:160 irregular BP: 110/80 Dull percussion note + coarse crackles L base
A
AF
underlying cause pneumonia
6
Q
Management plan for a patient with SVT & BP 120/80
A
- cardioversion (= you give the shock at a specific time to sync with the QRS)
- vagal maneuvers
- adenosine
7
Q
Management of a patient with ACUTE fast AF & BP of 120/80
A
RHYTHM CONTROL
if onset>48hours, anticoagulate for 3-4 weeks before cardioversion
RATE CONTROL
beta blocker
digoxin
always think of Cause and Complications (anticoagulation)
8
Q
Management of VT
A
- IV amiodarone
- look and treat underlying cause
- ICD (implantable cardio-verter defib)
If pulseless VT = do defib
9
Q
65yo SOB onset of few hours orthopnoea 2xMIs aspirin, simvastatin, ramipril, bisprolol temp 36.5 ^JVP HS: S1+S2+S3 Chest: fine crackels peripheral oedema
Diagnosis?
Management?
A
HF
Management of acute HF: Sit up O2 (60-100%) GTN infusion (venodilator) Diamorphine (venodilator) Furosemide (IV) (venodilator) Treat underlying cause
10
Q
S1? S2? fixed wide splitting of S2? S3? S4?
A
s1 = MV closure s2 = AV closure wide split s2 (non physiological) = Atrial septal defect S3 = ventricular filling s4 = ventricular hypertrophy
11
Q
78 yo brought in by ambulance unconscious not breathing absence carotid pulse temp 29
A
VF Management: 1.Shock 2.CPR (2min) 3.Assess rhytm adrenaline every 3-5min 4.correct reversible causes
12
Q
30 yo woman upper resp tract infection pleuritic chest pain better when leaning forward ECG shows widespread ST-Elevation (diffuse)
Diagnosis?
A
pericarditis
