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Cardio Module 2 > Medicine (CVS) > Flashcards

Medicine (CVS) Flashcards

1
Q

ECG leads

A

12 leads in total
6 limb leads
6 chest leads

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2
Q

Limb lead placement in ECG

A 
6 limb leads
3 bipolar (1,2,3)
3 unipolar (aVL, aVR, aVF)
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3
Q

Chest leads placement in ECG

A

V1,V2,V3,V4,V5,V6

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4
Q

ECG leads with relation to cardiac wall and blood vessel.

A

V1-V4 = anterior wall, LAD
V5-V6 = anterolateral wall, LAD + LCA
Lead 1 and aVL = laterla wall, LCA
lead 2,3 and aVF = inferior wall , RCA

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5
Q

Causes of + upward detection of current in aVR

A

By mistake of operator

Dextrocardia

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6
Q

Cause of vibrations and thrills in ECG?

A

Anxiety

Parkinson’s disease

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7
Q

Low voltage i.e. less than 15mm occurs in?

A 
Obese pt.
CCF
pleural effusion
Percardial effusion
Primary hypothyroidism
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8
Q

Heart rate is checked in which lead?

A

Lead 2

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9
Q

Method of calculating heart rate

A

R-R wave is the key
2 methods
1. Calculate big boxes between R-R interval and divide that number from 300

Ex, 3 boxes between R-R interval
300/3 =100 beats per minute

  1. Calculate small boxes between R-R interval and devide that number from 1500
    Ex. 10 small boxes between R-R interval
    1500/10 = 150 beats per minute
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10
Q

Normal cardiac axis is between what degrees?

A

-30 to +90 degrees

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11
Q

Axis deviation in ECG is checked by which leads?

A

Lead 1 and 2
Or
Lead 1 and aVF

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12
Q

Normal axis in ecg is shown by?

A

+ or upward deflection in lead 1 and 2 or in lead 1 and aVF

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13
Q

LAD i.e. left axis deviation in ECG.

A

Lead 1 upward
Lead 2 or aVF downward
Current is more towards left axis

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14
Q

Causes of Left axis deviation?

A

Chronic HTN
Left ventricular hypertrophy
Inferior wall MI
Wolf-parkinson-white syndrome (extra electrical pathway in left ventricle)
Ventricular tachycardia
Ostium primum ASD (the defect is near atrio-ventricular valve i.e. very near to left ventricle.
LBBB

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15
Q

RAD i.e. right axis deviation in ECG

A

Lead 1 downward

Lead 2 or aVF upward

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16
Q

Causes of right axis deviation?

A 
COPD
Left sided pneumothorax
Right ventricular hypertrophy
Anterolateral MI
Pulmonary embolism
RBBB
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17
Q

Extreme right axis deviation in ECG?

A

Both leads downward or negative

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18
Q

Boxes distribution in ECG for time and lenght

A

1 small box = 0.04sec = 1mm

1 large box = 5 small boxes= 0.2s =5mm

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19
Q

How to check Left ventricular hypertrophy in ECG?

A

Vertical small boxes aVL lead should be checked

If R wave is taller than 11mm , it is ventricular hypertrophy

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20
Q

MCC of left axis deviation?

A

Left ventricular hypertrophy

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21
Q

MCC of right axis deviation?

A

Pulmonary hypertension

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22
Q

Sokolow-LyonCriteria is used to detect which heart pathology?

A

Left ventricular hypertrophy

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23
Q

Explain sokolow-LyonCriteria

A

Calculate hight of S wave in V1 and of R wave in V5 or V6. Then add them, if the sum is greater than 35 mm, LVH is present

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24
Q

What is J point in ECG

A

Junction between S and T wave

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25
Q

ST elevation and depression are seen by which part of ECG?

A

By J point

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26
Q

ST elecation indicates MI in which heart wall?

A

Ant.wall MI

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27
Q

ST depression MI indicates MI in which heart wall?

A

Lateral / Inferior wall MI

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28
Q

How to check ST elevation and depression in ECG?

A

ST elevation = J point more than 2small boxes

ST depression= J point depress more than 1 small box

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29
Q

Phases of cardiac contraction

A

Phase 0, rapid depolarization by Na influx
Phase 1, sodium channel closses resulting in sudden small drop
Phase 2, Ca2+ influx and K+ efflux causes a platue formation
Phase 3, K+ efflux only causes a rapid drop and repolarization
Phase 4, resting membrane potential.

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30
Q

Diagnosis of hypertensive pt.

A

Systolic BP morethan 140mmHg
Diastolic BP more than 90mmHg

Morning occipetal pain
Dizziness
Fatigue
Epistaxis and blurred vission in severe hypertension.

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31
Q

Drug group i.e. treatment of choice in most healthy pt. With only hypertension.

A

No#1 rule, life style modification

No#2 drug, MC thiazide diuretics

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32
Q

Diuretics contraindications.

A

Gout (due to hyperurecemia effect)
DM (due to hyperglycemia effect)
Not safe in renal and hepatic impairement pt.

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33
Q

Mnemonics for drugs

A

CCB, dipine and diltiazem
ARB, losartan, sartan
B-Blockers, olol
ACEI, opril

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34
Q

Drug of choice in pt. With co-existing coronary artery disease.

A

B-Blockers

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35
Q

Drug of choice for hypertension in pt. With DM and heart failure.

A

ACEI

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36
Q

Drug of choice in elderly pt. With asthma?

A

CCB, dipine

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37
Q

Drug of choice in hypertensive pt. With stroke?

A

ACEI or ARB

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38
Q

Drugs for aggressive treatment if HTN in stroke?

A

All should be given IV
Labetolol
Nicardipine
Hydralazine

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39
Q

Ca2+ channel blockers work on which phase of cardiac contratility?

A

Phase 4

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40
Q

Endogenous lipid function.

A 
Chylomicrons, carry dietry lipids
VLDL, TAGs to adipocytes
IDL, both TAGS n cholesterol
VLDL, cholesterol only
HDL, removes cholesterol from blood.
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41
Q

Types of hyperlipidemia.

A

Type 1, chylomicrons (one word)
Type 2-A, LDL (2 L)
Type 2-B, LDL n VLDL (2 L in both)
Type 3, IDL (3 digits)
Type 4, VLDL (4 Digits)
Type 5, VLDL + Chylomicron (4 digits + one word)
Full Names:
Type 1 familial hyperchylomicronemia
Type 2-A familial hypercholesterolemia
Type 2-B Familial combines mixed hyperlipidemia
Type 3 familial dysbetalipoproteinemia (also known as beta lipoprotien)
Type 4 familial hypertriglyceridemia
Type 5 familial mixed hypertriglyceridemia

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42
Q

Most common type of familial hyperlipidemia

A

Type 2-B, familial combined hyperlipidemia.

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43
Q

Type of hyperlipidemia which is a genetic effect.

A

Type 5 i.e. raised VLDL n chylomicrons

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44
Q

Type of hyperlipidemia that has highest chances of inchemic heart disease?

A

Type 2-A ,becz LDL has cholesterol which is main culprit.

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45
Q

Type of hyperlipidemia with no risk of coronary heart disease?

A

Type 1 by chylomicrons, becz dietry lipid is useless in causing disease.

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46
Q

Xanthomas occurs in which type of dyslipidemia?

Skin nodule like irregular lesion filled with lipid

A

Type 3, IDL raised one, becz of their both lipid and cholesterol content.

47
Q

Classification of dyslipidemia.

A

Primary or familial dyslipidemia.

Secondary or acquired dyslipidemia.

48
Q

Causes of secondary / acquired dyslipidemia.

A 
Body related:
Pregnancy
Alcohol abuse
DM
Cushing syndrome
Chronic kidney disease
Nephrotic syndrome
Obstructive jaundice
Hypothyroidism
Drug induced:
Oral contraceptives
Thiazide diuretics
Beta Blockers
Glucocorticoids
49
Q

3 classic clinical features of dyslipidemia

A

Premature acrus senilis: opaque ring in the corneal margin
Tendon Xanthomata: hard-non tender nodular enlargment of tendons
Xanthelasmas: Fatty deposits in eye lids

50
Q

Most widely used diagnostic criteria for familial hypercholesterolemia.

A

Simmon Broome Diagnostic Criteria

51
Q

What DNA evidence is found in simmon broome criteria?

A

Mutation of LDL receptors
Defective apo-B-100
Defective PCSK 9

52
Q

Desired HDL levels in blood.

A

40mg/dL or more

53
Q

Most important enzyme ascardiac marker for MI?

A

Troponin i

54
Q

What is PCI or angioplasty and when it is indicated?

A

PCI(Percutaneous Coronary Intervention) or angioplasty is a non surgical procedure in which catheter is used to place a stent in blocked artery of heart.

And it is indicated when one vessel of heart is blocked.

55
Q

Indication for CABG or Corronary artery bypass graft.

A

When 2-3 arteries of heart are blocked.

56
Q

Time period when thrombolytic agents are most effective?

A

During First hour of MI

57
Q

O2 therapy should be monitored in which type of pt.

A

In COPD, as it may cause hypercapnia or raised CO2 level in blood

58
Q

Brand name of nitroglycerine i.e. used as initial home remedy for MI.

A

Angised

59
Q

ECG findings in unstable angina and NSTEMI

A

ST-depression +or- T-wave inversion

60
Q

Cardiac enzyme findings in unstable angina?

A

Cardiac enzymes are always negative in unstable angine as uptill now no cardiac injury has occured.

61
Q

S-3 sound is heard in which pathology?

A

Heart failure

62
Q

S-4 sound in which condition?

A

Sign of ichemia

63
Q

MC cause of death within 1 hour of MI?

A

By arrhythmias

64
Q

MC cause of death after few hours of MI?

A

Heart failure

65
Q

Best initial test for confirming MI?

A

Repitive ECG

66
Q

Q wave in ECG indicates which condition?

A

Prior infarct

67
Q

Cardiac marker which is enzyme of choice to check re-infarct with in few days of MI

A

CK-MB marker

68
Q

ST elevation in ECG indicates which type of MI

A

Transmural MI

69
Q

Non ST elevation ECG indicates which type of MI?

A

Subendocardial injury

70
Q

Arteries involved in MI.

A

Inferior wall MI: right coronary artery
Anterior wall MI: left anterior descending
Anteroseptal MI: left anterior descending artery
Posterior wall MI: posterior descending
Anterolateral wall MI: LAD and left circumflex artery.

71
Q

MC overall cause of infective endocarditis.

A

Strep. viridians

72
Q

MC organism causing infective endocarditis in IV drug users.

A

Staph.Aureus

73
Q

MC cause of acute Infective endocarditis.

A

Staph. Aureus

74
Q

MC cause of infective endocarditis in prothetic valve

A

Staph.epidermidis.

75
Q

MC valve involved in IE.

A

mitral valve (becz of rich O2 blood)

76
Q

2nd MC valve involved in IE.

A

Aortic valve.

77
Q

MC Valve involved in IV drug users in IE.

A

Tricuspid valve.

78
Q

types of IE

A

Acute n sub-acute
Acute: is more dangerous, causing more damage, and attacking a normal valve.
sub-acute: less dangerous, causing less damage and attacking already damaged valve.

79
Q

MC organism causing acute IE.

A

Staph.Aureus

80
Q

MC organism causing sub-acute IE.

A

Strep.viridians i.e. S.sangius and s.mitis

81
Q

Abscesses in echocardiography is found in which type of IE?

A

Acute (becz of staph i.e. pyogenic bacteria)

82
Q

some Imp findings in sub acute IE.

A 
Roth spots (hemorrhage in ratina)
Oslers nodes (painful, red, raised lesions found on the hands and feet)
splinter hemorrhages (in fingers)
Janeway's lesions (painless lesions on palms and feet)
83
Q

most accurate investigation for confirming IE.

A

Blood culture.

84
Q

MC surgical indication in IE.

A

Heart failure due to valve damage.

85
Q

treatment of penicilin (methicilin) resistant s.aureus MRSA?

A

vancomycin

86
Q

treatment of penicilin (methicilin) sensitive s.aureus?

A

Nafcilin, oxacilin and benzyl penicilin,

penicilin working, use it

87
Q

Diagnostic methodology or criteria used for IE?

A

Duke’s criteria

88
Q

Types of EEG.

A 
transthoracic echocardiograms (TTE)
transesophageal echocardiograms (TEE)
89
Q

which type of EEG is more specific and sensitive in IE.

A

TEE i.e. tranesophageal echocardiograms

90
Q

MC type of heart failure?

A

Left sided heart failure (HF)

91
Q

Key clinical features of left sided HF.

A

Dyspnea (difficulty in breathing)
Orthopnea (difficulty in bleeding while lying flat)
Paroxysmal nocturnal dysnea (PND) i.e. dysnea while sleeping.

92
Q

First cardiac sign of Left sided HF.

A

S3 heart sound

93
Q

Murmur in Left sided HF.

A

pansystolic murmur

94
Q

MC cause of right sided HF,

A

Left sided HF

corpulmonale

95
Q

Heart sound in left sided heart failure.

A

S3 heart sound.

96
Q

Heart sound in right sided heart failure.

A

right sided S3 and S4 heart sound

97
Q

Hall mark sign of right sided HF.

A

Pitting pedal and peritibial edema.

98
Q

what is high-output heart failure.

A

Congestive heart failure with high cardiac output.

99
Q

Causes of high-output heart failure.

A

severe anemia
wet beri beri (effects heart and circulatory sys)
mitral regurgitation
aortic regurgitation (becz blood always comes back)
pregnancy.

100
Q

most common symptom of congestive heart failure.

A

Dyspnea on exertion.

101
Q

best initial test for CHF

A

transthoracic EEG

becz it shows the size of heart from all angels

102
Q

cardiac neuro hormone which is marker of CHF

A

(BNP) brain natriuretic peptide
if elevated i.e. CHF confirm
if normal than no CHF

103
Q

MC indication for heart transplantation

A

coronary artery disease and dilated cardiomyopathy.

104
Q

MC cause of death in CHF pt.

A

sudden cardiac death due to ventricular arrhythmia.

105
Q

Worst and most serious menifestation of CHF.

A

Acute pulmonary edema

106
Q

loud S1 is heard in which pahology.

A

mitral stenosis

107
Q

soft S1 is heard in which pahology.

A

heart failure and mitral regurgitation.

108
Q

Fixed Splitting of S2 sound is heard in

A

ASD

109
Q

low-pitched, early diastolic sound is heard in which condition S3

A

mitral regurgitation
tricuspid regurgitation
acute aortic regurgitation
becz blood comes back

110
Q

low-pitched, late diastolic sound is heard in

S4

A

LV hypertrophy
RV hypertrophy
2 hypertrophy= 4 guna taqat

111
Q

MC cause of death in acute attack of rheumatic fever.

A

myocarditis

112
Q

MC initial presentation of acute RF.

A

migratory polyarthritis.

113
Q

murmur in RHD

A

carey coombs murmur

114
Q

sydenham chorea is also known as

A

st.vitus dance

Cardio Module 2 (2 decks)

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