General Flashcards
What signs on an ECG would you expect to see with acute pericarditis?
PT segment depression
ST elevation
What type of MI is associated with bradycardia?
Which vessel is occluded?
Inferior
RAD
How would you accentuate aortic stenosis?
Ask the patient to squat down
What does adenosine do?
Decreases heart rate and reduces conduction velocity at the the AV node
What type of hypertension is of ‘unknown cause’?
Essential hypertension
What type of hypertension can damage other organs?
Essential hypertension
What is the clinical definition of hypertension?
Bp of over 140/90
How is hypertension diagnosed?
If clinic bp is over 140/90, ambulatory bp monitoring (ABPM) is a way to confirm diagnosis
If over 135/85 during daytime, type 1 hypertension
If a patient is under 55, what is the first line treatment for hypertension?
ACEi or low cost ARB
If a patient is African or Caribbean, what is the first line treatment for their hypertension?
Calcium-channel blocker
What is the 2nd line treatment of hypertension?
ACEi/ARB + calcium channel blocker
What is the 3rd line treatment of hypertension?
ACE-i/ARB + calcium channel blocker + thiazide like diuretic
When are loop diuretics used?
Heart failure, oedema etc
What is spironolactone
Potassium sparing diuretic
What is secondary hypertension?
Hypertension that is caused by another bodily problem e.g. renal disease, hyperaldosteronism
What is the primary treatment for a STEMI?
PCI (90 mins)
Thrombolysis if PCI not available
What is the primary treatment for an NSTEMI?
Fundaparinux or heparin (anticoagulants)
High risk or recurrent: coronary angiography
What is the initial treatment for an MI?
Analgesia - diamorphine IV Anti-emetic - IV Aspirin and Ticagrelor GTN if BP > 90mmHg Oxygen - if hypoxic
If a patient has presented with a STEMI that has lasted more than 12hrs, what is the management?
Same as NSTEMI
anticoagulants
If you see a change in leads II, III, AVF, what type of MI is it?
Inferior
I, IVF V1-6 is what type of MI?
Anterolateral
If a patient has narrow complex QRS waves with an irregular heart beat, what do they have?
AF
If a patient has broad complex tachycardia and a regular rhythm, what do they have?
Ventricular tachycardia
If a patient has a narrow complex tachycardia and regular rhythm that is not helped by vagal manouvres, what do they have?
Atrial flutter
What organisms commonly cause endocarditis
Staph. aureus
Viridans streptococci
Inverted P waves in the inferior leads are suggestive of what?
Retrograde atrial conduction
Problem probably orignates at the AV node
Bradycardic inferior MI is usually due to an occlusion of what vessel?
RCA
What heart murmur will be detected on a patient who has recurrent bronchitis and a hoarse voice?
Mitral stenosis
Enlarged left atrium struggling to clear bronchial secretions (hence bronchitis)
Hoarse voice due to effects on recurrent laryngeal nerve
When a patient is asked to sit up and lean forwards, what murmur is the Dr listening for?
Aortic regurgitation
When a patient is asked to lie on their left side, what murmur is the Dr listening for?
Mitral stenosis
What type of people die from hypertrophic cardiomyopathy?
Young athletes
What is the main tool used to diagnose hypertrophic cardiomyopathy?
Echo
What disease is an anacrotic pulse associated with?
Aortic stenosis
What type of pulse is associated with hypertrophic cardiomyopathy?
Jerky pulse
What disease is a bisferiens pulse associated with?
Mixed aortic stenosis and regurgitation
What disease is a bounding pulse associated with?
CO2 narcosis
Sepsis
Liver failure
What disease causes a collapsing pulse?
Aortic regurgitation
What pulse would you expect to find on a patient with liver failure?
Bounding
What type of pulse would you expect to find on a patient with aortic regurgitation?
Collapsing pulse
What type of pulse would you expect to find on a patient with aortic stenosis and regurgitation?
Bisferiens
What type of pulse would you expect to find on a patient with aortic stenosis?
Anacrotic
What condition typically causes a slurred upstroke of the R-wave on an ECG?
Wolff-Parkinson-White syndrome
What heart murmur is associated with a slow rising pulse?
Aortic stenosis
What does corneal arcus show?
hyperlipidaemia
What tests need to be done if a patient is found to have hyperlipidaemia?
Renal, liver and thyroid function tests
What does warfarin actually do?
It is an inhibitor of the formation of vitamin K-dependent coagulation factors
What does clopidogrel do?
Inhibits ADP on platelet cell membranes
What does aspirin do?
Inhibits cyclo-oxygenase enzyme
What drug inhibits ADP on platelet cell membranes?
Clopidogrel
What drug is an inhibitor of the formation of vitamin-K dependent coagulation factors?
Warfarin
What drug inhibits cyclo-oxygenase enzyme?
Aspirin
What causes a raised JVP?
Raised right atrial pressure
Cor pulmonale is more commonly found in patients with what lung condition?
COPD
What does adenosine do?
It blocks the AV node, thus unmasking flutter waves
