Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DPD 2020 > interactive cases i > Flashcards

interactive cases i Flashcards

1
Q

What are the ix for chest pain?

A

1) ECG
2) Troponin
+ve: coronary angiography
-ve: ETT
3) Echocardiography

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

What are cardiac ddx of chest pain?

A

IHD
Aortic dissection
Pericarditis

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

What are resp ddx of chest pain?

A

PE
Pneumonia
Pneumothorax

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

What are GI ddx of chest pain?

A

Oesophageal spasm

Oesphagitis, gastritis

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

What is a musc ddx of chest pain?

A

Costochondritis

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

If pt has a drug hx of dexamethasone with a pc of chest pain, what does this point towards?

A

Dexamethasone is an immunosuppresant thus increased risk of inflammation/infection => GI => oesophagitis

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

Which leads would you see a STEMI for:

a) anteriolateral STEMI,
b) inferior STEMI?

A

a) V2-6, I, VL

b) II, III, VF (with reciprocal changes in I + VL)

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

What’s the treatment once identifed an anteriolateral STEMI?

A

Percutaneous coronary intervention

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

Name the coronary artery and leads affected for the following:

a) anterior MI
b) lateral MI
c) inferior MI

A

a) LAD, V1-4
b) Circumflex, V5-6, I, VL
c) RCA, II, III, VF

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

What in a collapse hx points towards a cardiac cause?

A

Before - no warning
During - no tongue biting
After - not confused

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

What are ddx of collapse?

A 
Hypoglycaemia 
- do not ever forget glucose
Heart
- Vasovagal
- Arrhythmia: unexplained death in FH
- Outflow obstruction: dizziness, exertional chest pain
- Postural hypotension: lying + standing BP different
Brain
- Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name left and right-sided causes of outflow obstruction to the heart

A

Left: aortic stenosis, HOCM
Right: PE

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

Causes of long QT syndrome

A 
Congenital
- K+ channel mutations
- sudden death in FH
Acquired
- low K+/Mg2+, drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cardiac causes of increased JVP

A 
RHF
- secondary to LHF
- pulmonary HTN
Tricuspid regurg
- valve leaflets
- R ventricle dilatation
Constrictive pericarditis
- infection; TB
- inflammation; connective tissue disease, i.e. lupus
- malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Name four systolic murmurs (whooshing sound) and how to differentiate them

A 
Aortic stenosis
- loudest at aorta
- radiates to carotids
Mitral regurg
- loudest at mitral v
- radiates to axilla
Tricuspid regurg
- loudest at tricuspid v
VSD (ventricular septal defect)
- occurs in young person w/o features of cardiac disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name fours palpitations/tachycardia and their possible causes

A

Sinus tachycardia
- sepsis, hypovalaemia, endocrine (thyrotoxicosis, phaeochromacytoma)
SVT
- AVRT, AVRNT (re-entry circuits that keep depolarisation going)
AF
- thyrotoxicosis, alcohol
- heart: pericardium, muscle, valve
- lungs: PE, cancer, pneumonia
VT
- long QT, ischaemia, electrolyte imbalance

17
Q

How do you treat SVT?

A

Vagal manoeuvres

Adenosine

18
Q

How do you treat AF?

A 
Rhythm control
- onsent >48hrs, anticoagulate 3-4 weeks before cardioversion
Rate control
- beta blockers
- digoxin

Treat underlying cause + complications (thromboembolism therefore anticoaulgate)

19
Q

How do you treat VT?

A

If no haemodynamic compromise => IV amiodarone
ICD
Look for underlying cause
Pulseless VT => defibrillate

20
Q

What would an ECG of LVH show?

A

Deep S in V1/2
Tall R in V5/6
S in V1 + R in V5/6 = Larger/equal to 7 squares

21
Q

Distinguish the three heart blocks in an ECG

A

1st: long PR interval (>1 square)
2nd: P waves not followed by QRS complex
3rd: no association between P waves and QRS complexes and broad QRS complex

22
Q

What would indicate ischaemia in an ECG?

A

ST elevation
T inversion
Q waves present (old MI)

23
Q

What does a prominent R- wave indicate?

A

in V1 => tall R wave => strain on right-side of heart => PE

24
Q

What are the possible heart sounds you may hear?

A

S1 => closure of mitral valve
S2 => closure of aortic valve
S3 => associated w/ ventricular filling
S4 => associated w/ ventricular hypertrophy
fixed wide splitting of S2 => atrial septal defect

25
Q

Rx of acute heart failure

A

1) sit up
2) O2
3) Furosemide (iv)
4) GTN infusion
5) treat underlying cause

26
Q

Ddx of pleuritic chest pain

A 
Pericarditis; flu sx recently?
PE; immobile/travel?
Pneumonia; fever?
Pneumothorax; sudden onset?
Pleural pathology; weight loss/malignancy?
27
Q

ALS algorithm for VF/pulseless VT

A 
Shock
CPR (2 mins)
Assess rhythm
Adrenaline every 3-5 mins
Amiodarone after 3 shocks
Correct reversible causes
28
Q

ALS algorithm for asystole/PEA

A

CPR (2 mins)
Adrenaline every 3-5 mins
Correct reversible causes

DPD 2020 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions