IF TIME :D Flashcards

1
Q

Acute Pericarditis

  1. Cause
  2. Symptoms
  3. Gold standard test
A
  1. Enterovirus - coxsackie
    - Dressler’s & AMI
    - RA/SLE
    - Uric acid –> gout & CKD & tumour lysis
    - Malignancy & radiotherapy
    - RHD
  • Pleuritic chest pain worse lying, better leaning forward
  • Neck and shoulder pain
  • Fever
  • Friction rub
  • ECG –> wide spread STEMI
  • Colchicine & NSAID
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2
Q

Becks Triad

A

CARDIAC TAMPONADE!

  1. Hypotension (obstructive shock)
  2. Muffled heart sounds
  3. Elevated JVP (Kussmal’s - increased with inspiration)
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3
Q

Cardiac tamponade investigation findings

A

Exam

  • Becks triad
  • Pulsus paradoxus
  • Dyspnoea
  • Dysphagia

ECG

  • Low voltages
  • Electrical alternans
  • Pulseless electrical activity

CXR
- Water bottle sign

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4
Q

JVP - Deep and sharp Y waves

A

Constrictive pericarditis

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5
Q

Pericardial effusion investigation findings & management

A

Exam
- Displaced apex beat

TTE
- Heart dancing in pericardium

CXR
- Enlarged cardiac silhouette

Management
- Pericardial window

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6
Q

Tricuspid regurgitation murmur

A
  • Pansystolic increased on inspiration and leg-raising
  • Large J-waves
  • Pulsatile liver
  • S3 and parasternal heave
  • P-pulmonale from RAE
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7
Q

Pulmonary stenosis murmur

A
  • Late ejection systolic murmur
  • S2 splitting
  • S4
  • Parasternal heave
  • Predominant A wave
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8
Q

JONES criteria

A

Major criteria for diagnosing RHD
J -joints –> migratory polyarthritis
O - heart –> pancarditis
N - nodules –> subcutaneous nodules, extensors, painless
E - erythema marginatum –> smoke ring rash, worse with heat
S - Sydenham’s chorea –> face, tongue and ULs

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9
Q

Rheumatic fever treatment

A
IM Benzylpenicillin (G)
or PO phenoxymethylpenicillin (V)

NSAID - pain

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10
Q

HOCM signs, symptoms & mutation

A
  • Sudden cardiac arrest in otherwise healthy individual
  • Beta-myosin heavy light chain (sarcomere) mutation
  • Exertion SOB, angina, syncope
  • Jerky pulse/pulsus bisferiens - sudden deacceleration
  • Ejection systolic loudest at the sternal edge
  • S4
  • Triple impulse apex, pressure loaded and displaced
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11
Q

Dilated cardiomyopathy aetiology

A
  • Alcohol
  • Myocarditis
  • AMI
  • Autoimmune
  • Chemotherapy
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12
Q

Myocarditis aetiology

A
  1. Coxsackie virus (enterovirus)
    - Bacteria
    - Fungi
    - Autoimmune
    - Pregnancy
    - Drugs and toxins
    - Trauma
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13
Q

Idiopathic pulmonary fibrosis (IPF)

A
  • Most common ILD
  • > 60yrs
  • Smoking
  • UIP pattern –> honey combing, subpleural, apical-basal
  • Fibrinolytic and oxygen therapy
  • Men > women
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14
Q

Pneumoconiosis

A

Silicosis

  • Diffuse pulmonary nodules
  • Egg-shell calcifications
  • Acute –> Massive exposure –> lavage
  • Accelerative –> ongoing high dose –> poor prognosis
  • Chronic –> chronic low dose –> fibrosis over many years
  • Stone mason’s and concreters
  • Calcified LNs

Berylliosis

Coal-workers lung

  • Long wall mining –> very high exposure
  • Anthracnosis –> black lung pigment
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15
Q

Hypersensitivity pneumonitis

A
  • Non-caseating granulomatous fibrosis
  • Repeated exposure to an allergen
  • Bird financiers lung
  • Farmer’s lung –> aspergillus mouldy grain/hay
  • Fever, cough and dyspnoea
  • Allergen avoidance and corticosteroids
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16
Q

Sarcoidosis

A
  • Young African women
  • Bilateral hilar lymphadenopathy
  • Non-caseating granulomas
  • Hypercalcaemia
  • Elevated vitamin D & ACE
  • Vitamin deficiency
  • 90% pulmonary fibrosis
  • Erythema nodosum
  • Kveim test - skin prick
  • Corticosteroid and immunosuppressants
17
Q

Pulmonary HTN

A

Type I

  • PAH
  • Intimal thickening
  • Primary –> BMRP-2 autosomal dominant
  • Secondary –> scleroderma
  • PWAP <15 mmHg
  • Vasodilators & anticoagulation & lung transplant

Type II

  • LVHF
  • Most common
  • PAWP >15 mmHg
  • Treat heart failure
  • Venous arterialization

Type III

  • COPD and ILD
  • Hypoxia –> V/Q mismatch –> vasoconstriction

Type IV

  • Chronic PE
  • Plexiform lesions
  • Pulmonary endarterectomy & anticoagulation
  • Anti-phospholipid syndrome

Type V
- Multifactorial

Symptoms
- Cor-pulmonale –> RHF signs
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