Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Final year actually useful flashcrads > General cardio > Flashcards

General cardio Flashcards

1
Q

Normal T -wave inversion?

A

V1 and lead III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

inversion of T waves LBBB?

A

V4-V6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

inserversion T waves RBBB?

A

V1-V3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is stoke adams attack?

A

Cardiac syncope or bradycardic syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Distributive shock?

A

Decrease in BP due to peripheral vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can cause distributive shock?

A

Rewarming in hypothermia causing peripheral vasodilation and hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Unprovoked PE anticoagulation?

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Provoked PE anticoagulation?

A

3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Part of QRS complex used for synchronisation?

A

R wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is it important to synchronise the DC cardioversion?

A

Reduce the risk of ventricular fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

uses of DC cardioversion?

A

AF, Atrial fibrillation, Supraventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When is synchronised DC cardioversion used?

A

This is defibrillation and only in cardiac arrest for shockable rhythms
-Ventricular fibrillation
-pulseless ventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does QT interval represnet?

A

ventricle contraction and relaxation (depolarisation and repolarisation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is classed as a prolonged QT interval?

A

QT>450ms men
QT>460ms women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What causes prolonged QT?

A

-Genetic
-Medications (those affect potassium channels - antipsychotics, antiarrhythmics, antibiotics, antihistamines)
-Electrolyte imbalance (low potassim, magnesium and calcium)
-Bradycardia
-MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Symptoms of long QT syndrome?

A

-Syncope
-Seizures
-Sudden cardiac death
-ALWAYS ASK FAMILY HISTORY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What arrhythmias can prolonged QT cause?

A

-Torsades de pointes (ventricular tachycardia)
-Sudden cardiac death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Antibiotics to avoid with QT prolongation?

A

-Macrolides (erythromycin, clarithromycin, azithromycin)
-Fluroquinolones (ending in floxacin)
-Clindamycin
-Fluconazole
-Chloroquine and Hydroxychloroquine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is pulseless electrical activity?

A

-Electrical activity seen on the electrocardiogram (ECG) but there is no palpable pulse and the patient is clinically in cardiac arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management of PEA?

A
  1. CPR
  2. Check for reversible causes (H’s and T’s)
  3. 1mg adrenaline ASAP
    -1mg every 3-5 minutes
  4. Thrombolytics drugs (ATEPLASE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What anti-anginal medication can patients develop a tolerance to?

A

Nitrates
-Standard-release isosorbide mononitrate - nitrate free time of 10-14 hours (asymmetric dosing interval)
-Not seen in patients who take onse-daily modified release isosorbide mononitrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can cause shortened QT interval on ECG?

A

Hypocalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Aortic reguritation?

A

-Leaking aortic valve causing blood to flow through back through aortic valve during ventricular diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Murmurs in aortic regurgitation?

A

-Early diastolic soft murmur
-Austin flint heard at apex in severe AS - rumbling murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Causes of chronic presentation of AR VALVE disease?
-Rheumatic fever (most common developing worlds) -Calcific valve disease -Connective tissue disease (RA, SLE) -Bicuspid aortic valve (should be tricuspid)
26
Causes of acute presentation AR due to valve disease?
Infective endocarditis
27
Causes of chronic presentation AR due to aortic root disease?
-Bicupsid aortic valve -Spondylarthropathies -Hypertension -Syphillis -Marfnans, Ehler Danlos
28
Causes of acute AR aortic root disease?
Aortic dissection
29
Features of aortic regurgaition?
-Collapsing pulse (forcefully appearing and rapidly disappearing pulse) -Wide pulse pressure -Quincke's sign - nailbedpulsation -De Musset's sign (head bobbing) -Heart failure and pulmonary oedema
30
AR investigation?
Echocardiogroahy
31
Management of AR?
-Medical management of heart failure -Surgery if : 1. Severe AR with symptoms 2. Severe AR asymptomatic with LV systolic dysfucntion
32
1at line tretament for patients with acute idiopathic or viral pericarditis?
NSAIDS and colchicine until symptoms resolution and normalisation of inflammatory markers - tapper dose
33
Buerger's disease ?
small/medium vasculitis strongly associated with smoking
34
Features of buerger's disease?
-Extremity ischemia (intermittent claudication, ischaemic ulcer) -Superficial thrombophlebitis -Raynauds phenomenon
35
Initial management for MI?
CPAIN Call ambulance Perfrom ECG Aspirin 300mg IV morphine for pain (with antiemetic) Nitrate (GTN0
36
Management STEMI?
Call local cardiac centre -PCI if available within 2 hours -Thrombolysis (if PCI not available within 2 hours) -PCI should be done within 12 hours -ECG should be repeated in 90mins with thrombolysis is given - if no resolution still PCI
37
What is PCI and how is it carried out?
Percutaneous coronary intervention -Feeding catheter into coronary arteries to identify areas of blockage -It is an angiography (contrast) that is used to identify the blockage -An angioplasty (balloon) can be used to widen the lumen - A stent can be inserted to keep artery open -Devices can be used used to remove or aspirate the blockage
38
Where is catheter inserted to access coronary arteries?
-Radial artery -Femoral artery -Brachial artery
39
What does thrombolysis involve (STEMI)?
Injecting fibrinolytic agent - alteplase, streptokinase, tenecteplase
40
Management of NSTEMI?
BATMAN -Base decision of angiography and PCI based on GRACE score -Aspirin 300mg -Ticagrelor 180mg stat dose (clopigogrel and prasugrel can also be used) -Morphine -Antithrombin therapy with fondaparinux -N Nitrates GTN spray
41
How to decide which antiplatelet medication in NSTEMI?
-180mg ticagrelor -Clopidogrel if high bleeding risk -Prasugrel if angiogrpahy
42
Side effects of ACEi?
ACE i Angioedema Cough Elevated potassium i - 1st dose hypotension: more common with diuretics
43
Hypovolemic shock values of Pulmonary artery occlusion pressure, cardiac output and systemic vascular resistance?
-Pulmonary artery occlusion pressure - LOW -Cardiac output - LOW -Systemic vascular resistance - HIGH
44
Cardiogenic shock values of Pulmonary artery occlusion pressure, cardiac output and systemic vascular resistance?
-PAOP - HIGH -CO - LOW -SVR - HIGH NOTE - venodilators are usefulk
45
Septic shock pulmonary artery occlusion pressures, cardiac output and systemic vascular resistance?
POAP - LOW CO - HIGH SVR - LOW NOTE decreased SVR is major feature Use of vasoconstricotrs
46
How should adenosine bve administered?
-Large cannula (16G) in antecubital vein -Central route
47
What medications can worsen glucose tolerance?
Thiazdies
48
What is cardiac tamponade?
Accumulation of peridcarial fluid
49
What are the features of cardaic tamponade?
-Hypotension - despite fluid resuscitation -Raised JVP -Muffled heart sounds
50
What is the management of pericardiocentesis?
-Urgent pericardiocentesis
51
How is pericardiocentesis performed?
-US needle insertion, aspirate fluid, catheter may be needed, CXR to check for complications such as pneumothorax
52
ECG findings of cardiac tamponade?
Electrical alterans, alternation of QRS com ples amplitude between wuetsiosn
53
Pulse findings in cardiac tamponade?
Pulsus paradoxus - abnormally large drop in BP during inspiration
54
Borad complex tahcycardia with new LBBB?
High sensitivity troponin - ACS
55
Management for orthostatic hypotenison?
-Education and lifestyle suhc as adequate hydration and salt intake -Discontinuation of vasoactive drugs -If symptoms persist, compression, manoeuvers and head-up tilt sleeping, medication such as fludrocortisone and midodrine
56
Medication prescribed for orthostatic hypotension?
-Fludrocortisone -Midodrine
57
Prolonged PR interval with bradycardia and syncope intial tretament?
IV Atropine
58
What medication can make clopidogrel less affective?
PPIs, omeprazole and/esomeprazole
59
Most common cause of mitral stenosis?
Rheumatic fever
60
What is mitral stenosis
Obstruction blood flow across mitral valve from left atrium to left ventricle - increased pressures in left atrium, pulmonary vasculature and right side of heart
61
Causes of mitral stenosis?
-Rheumatic fever, RF, RF!!! -Mucopolysaccharidoses, carninoid and endocardial firbtoelastosis -Infective endocarditis
62
Murmur in mitral stenosis?
mide-diastolic, low pitched and rumbling -Loud S1 - thick valves -Opening snap after S2
63
Features of mitral stenosis?
-Dyspnea -Hemoptysis (pink frothy or sudden haemorrhage due to vascular congestion) -Tapping apex beat, prominet in s1 -Atrial fibrillation (increase pressure in LA) -Malar flush (pressure in pulmonary system causing co2 retention and vasodilation)
64
Features of severe MS
-Opening snap is closer to S2 -Length of murmur increases
65
CXR findings of MS?
-Left atrial enlargement
66
Echo of MS?
Normal cross-sectional area of mitral valve is 4-6sq cm -Mitral stenosis 1sqcm
67
Management of MS in patients with AF?
-Anticoagulation - Warfarin for patients with moderate/severe MS -DOACs may be suitable if patients have mild MS
68
Asymptomatic MS management?
-Monitor regular echos
69
Symptomatic MS management?
Percutaneous mitral ballon valvotomy -Mitral valve surgery - valve replacement or commissurotomy
70
ACE inhibitors and monitoring?
Urea, creatinine , sodium, potassium and bicarbonate should be checked -can cause hyperkalemia -Rise in K and creatine may be expected
71
What are acceptable changes in serum creatinine and potassium after starting an ACE inhibtor?
-up to 30% from baseline in serum creatinine -K of upto 5.5mmol/l
72
Patients who develop significant renal impairment after starting ACE inhibitors may have what?
Bilateral artery stenosis
73
Third heart sound?
-Diastolic filling of the ventricle -Normally <30 and up to 50 in women -Heard left ventricular failure, constrictive pericarditis
74
Acute mitral regurgitation post MI caused by?
-Papillary muscle rupture or ischemia
75
Symptoms and features of acute mitral regurgitation caused post MI?
-Acute hypotension -Pulmonary edema
76
Murmur present in acute mitral regurg post MI (ischemia/rupture of papillary muscle)?
Early-to-mid systolic murmur
77
Management of acute MR?
-Vasodilator therapy but often require emergency surgical repair
78
Left ventricular aneursym?
-Ischemic damage from MI weakens myocardium resulting aneurysm formation -thrombus can form
79
ECG changes left ventricular aneursym?
-Persistent ST elevation -Left ventricular failure
80
Management for patients left ventricular failure?
Must be anticoagulated because of risk of stroke
81
Pericarditis post MI?
Pericarditis in first 48 hours is common ECG: ST saddle shaped and T wave inversion
82
Dresslers syndrome?
-2-6 weeks post MI -Fever, pleuritic chest pain, pericardial effusion -Raised ESR
83
Cardiac arrest post MI?
Ventricular febrillation is most common cause post MI
84
Ventricular septal defect post MI?
-Rupture of interventiruclar septum -Occurs first week 1-2%
85
What are the features of ventricular septal defect?
-Acute heart failure and pansystolic murmur
86
Ventricular septal defect vs acute mitral regurg?
Echo to exclude mitral regurg -present in similar fashion
87
Management of ventricular septal defect?
Urgent surgical correction
88
Left ventricular free wall rupture?
There is a tear in left ventricular wall which can lead to cardiac tamponade
89
When and how common is left ventricular free wall tear?
3% MIs 1-2 weeks after
90
Features of left ventricular free wall rupture?
-Acute heart failure secondary to cardiac tamponade -raised JVP -Pulsus paradoxus -Diminsihed heart sounds
91
Management of left ventricular free wall rupture?
Urgent pericardiocentesis and thoracotomy are required
92
Assessing bleeding risk in patient requiring anticoagulation ?
ORBIT score (Hb, >74, bleeding hisotry, renal impairment, antiplateelt agents_
93
Surgical interventions for chronic heart failure?
-Implantable cardioverter defibrillators (IDC) -Cardiac resynchronisation therapy (CRT)
94
What are implantable cardioverter defibrillators?
-Monitor heart and apply defibrillator shock to cardiovert patient back into sinus rhythm -Used in patients with previous ventricular tachycardia or ventricular fibrillation -Preferred with QRS between 120-149
95
What is cardiac resynchronisation therapy?
-biventricular pacemaker, allowing left and right side to beat simultaneously - this improves cardiac fucntion
96
When is cardiac resynchronisation therapy indicated?
In severe heart fialure with EF <35% -Widened QRS >149 as this indicated electrical signal between left and right side of heart are not working properly
97
What classification is used for chronic heart failure?
new york heart association classificaton (NYHA) Class I: no limitation on acitvity Class II: comfortable at rest but symptomatic with ordinary activites Class III: comfortable at rest but symptoms with any activity Class IV: symptomatic at rest
98
Management of chronci heart fialure?
-Specialist heart failure MDT with heart failure specialty nurses
99
NT-pro BNP result?
-Urgency of referral and specialist assessment -400-2000ng/l echo within 6 weeks -> 2000ng/l echo 2 weeks
100
AF - post stroke long term stroke prevention?
Warfarin or factor Xa inhibitor (apixaban)
101
Regualr broad complex tachycardia treatment?
Loading dose of amiodarone and 24 hour infusion
102
Medication contraindicated in ventricular tachycardia?
Verapamil - IV calcium blocker can cause cardiac arrest
103
Subclavian steal syndrome symptoms?
Posterior circulation symptoms - dizziness and vertigo during exertion of arm
104
What is subclavian steal syndrome?
Subclavian artery steno-occlusive disease proximal to vertebral artery
105
What is management of subclavian steal syndrome?
-Percutaneous transluminal angioplasty -Stent
106
Verapamil and beta blockers?
Absolute contraindictaion -Heart block and fatal arrest

Final year actually useful flashcrads (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions