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Progress Test Study > GP cardiology > Flashcards

GP cardiology Flashcards

1
Q

What are the Major Criteria of the Jones Scoring?

A
  • Migratory polyarthritis
  • Pancarditis
  • Subcutaneous Nodules
  • Erythema Marginatum
  • Sydenham Chorea
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2
Q

What are the minor criteria of the Jones Scoring?

A
  • Fever
  • Arthralgia
  • Raised Acute Phase Proteins
  • Prolonged PR Interval
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3
Q

What is often involved in Rheumatic Carditis?

A
  • Endocarditis
    • Valvular involvement: Mitral +/- aortic
      • HF and severe left ventricular dilitation
    • Pericarditis
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4
Q

Describe Sydenham Chorea and signs of this

A
  • uncontrollable, erratic, unrhythmic movement or twitching.
  • Often worse on one side
  • Stops with sleep, worsens on purposeful movement
  • Emotional Change: crying, restless
  • Milk-maids sign: ssqueeze and release when holding someones hand
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5
Q

When we say ‘pancarditis’ as a result of Acute rheumatic fever, what do we mean by this ?

A
  • Endocarditis: valvular disease (mainly of Mitral valve +/- aortic)
  • Myocarditis: main cause of mortality in these patients!
  • Pericarditis: associated pericardial rub may be auscultated
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6
Q

Causes and features of mitral stenosis

A
  • Rheumatic fever, rheumatic fever, rheumatic fever!
  • mid-late diastolic murmur (best heard in expiration)
  • loud S1, opening snap
  • low volume pulse
  • malar flush
  • atrial fibrillation
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7
Q

What would you see of CXR in a patient with Mitral Stenosis?

A
  • Left Atrial Enlargement may be seen
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8
Q

Describe the Pathophysiology of Aortic Dissection

A

A tear in the Tunica Intima of the aortic wall, causing blood pooling and tearing .

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9
Q

Causes of Aortic Dissection

A

Either

  • Too much pressure
    • Chronic HTN
    • Pregnancy (increased blood volume)
    • Coarctation (narrowing)
  • Weakened wall
    • Connective Tissue Disorders: Marfans
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10
Q

Features of Aortic Dissection?

A
  • Chest Pain that radiates to the back and is tearing in nature
  • Aortic Regurgitation
  • Hypertension
  • other features may result from the involvement of specific arteries. For example coronary arteries → angina, spinal arteries → paraplegia, distal aorta → limb ischaemia
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11
Q

What is the Stanford Classificationof Aortic Dissection?

How does this change treatment?

A

Type A: First 10cm from the heart (2/3’s of cases)

  • Surgery treament (removal of blood + graft placement)
  • BP control whilst waiting

Type B: >10cm and below

  • conservative management
  • bed rest
  • reduce blood pressure IV labetalol to prevent progression
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12
Q

Complications of a backward (to the heart) aortic dissection?

A
  • Cardiac tamponade
  • Aortic Regurgitation
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13
Q

Complications of a forward (down the aorta) tear?

A
  • Unequal and weak Pulses
  • Renal failure
  • Stroke
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14
Q

Aneurysms typically represent dilitation of what layers of the artery?

What is the primary event of this dilitation?

A

All three layers!

  • 1o: Loss of tunica intima + loss of elastic fibres in the media
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15
Q

What are the major Risk factors of developing an AAA

A
  • Smoking
  • HTN
  • Connective Tissue Disease (Marfans)
  • Syphillus
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16
Q

What is the normal diameter of an abdominal aorta in a patient aged 50 years, and when is this considered aneurysmal?

A
  • F: 1.5cm
  • M: 1.7cm
  • Aneurysmal: >3cm
17
Q

AAA with low risk versus AAA that’s high risk?

Treatment?

A

Low Risk AAA:

  • Asymptomatic, <5.5cm
  • Treat with surveillance

High RIsk AAA:

  • symptomatic, aortic diameter >=5.5cm or rapidly enlarging (>1cm/year)
  • Elective endovascular repair (EVAR) or open repair if unsuitable
18
Q

Two different types of Atrial Fibrillation

A
  • Paroxysmal AF: < 7 days, typically <24hrs and self-terminating
  • Persistent AF: >7 days, cannot be cardioverted
19
Q

The two main strategies for treating AF is in?

A
  1. Rate Control: accept that the pulse will be irregular, but slow the rate down to avoid negative effects on cardiac function
  2. Rhythm Control: try to get the patient back into, and maintain, normal sinus rhythm. This is termed cardioversion. Drugs or DC electrical shocks

Nowadays rate-control is the preffered method

20
Q

What is used to rate control AF?

A

Either a Beta-blocker or a calcium channel blocker (eg diltiazem)

Combination Therapy of:

  • B-blocker
  • Diltiazem
  • Digoxin

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