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Phase 2A (HV) > Miscellaneous- Cardio > Flashcards

Miscellaneous- Cardio Flashcards

1
Q

What is becks triad, and where is it implicated

A

In cardiac tamponade

Hypotension
Raised JVP
Muffled heart sounds

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2
Q

Causes of pericardial effusion

A 
Bacterial infection
Viral
Trauma 
Malignancy 
MI
CHF
aortic dissections
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3
Q

Tx for cardiac tamponade

A

Pericardiocentesis (5th ics close to sternum)

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4
Q

Complication of cardiac tamponade

A

Pneumothorax
Damage to myocardium
Damage to coronary vessels

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5
Q

Criteria for IE

A

Dukes (2 major or 1 major and 3 minor)

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6
Q

Gs investigation for IE

A

Echocardiography
TTE- 1st line imaging
TOE- most sensitive diagnostic test

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7
Q

Name 5 causes of acute pericarditis

A 
Idiopathic 
Viral 
Autoimmune conditions- ra
Malignancy 
Trauma 
Post mi 
Dressler’s syndrome
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8
Q

Describe the nature of chest pain in acute pericarditis

A

Sharp pleuritic unilateral chest pain
Relief on leaning forward/sitting up
Worse on inspiration

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9
Q

ECG changes seen in acute pericarditis

A

St saddle shape

Pr segment depression

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10
Q

Tx for acute pericarditis

A

1st line- NSAIDs + ppi + colchicine

Give glucocorticoids if contraindicated

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11
Q

Complications of acute pericarditis

A

Chronic pericarditis
Cardiac tamponade
Pleural effusion

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12
Q

What is constrictive pericarditis

A

Chronic inflammation of pericardium results in fibrotic thickened pericardium that impedes diastolic filing

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13
Q

Causes of constrictive pericarditis

A

Idiopathic
Viral (cksackie)
Tb
Post mi

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14
Q

Signs and Sx of constrictive pericarditis

A

Signs- kausmmal sign, raised jvp, pericardial knock

Sx- chest pain, dyspnoea, oedema, fever

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15
Q

Tx for constrictive pericarditis

A

Diuretics to relieve oedema
NSAIDs ppi and colchicine
Pericardiectomy in severe cases

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16
Q

1st line Ix for pad

A

Ankle brachial index >0.9

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17
Q

Moa of apaixaban/rivaroxaban

A

Direct factor 10a inhibitor

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18
Q

Moa of dabigatran

A

Direct thrombin inhibitor

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19
Q

Gs Ix and tx for PE in
A) normal person
B) pregnant or renal impairment

A

A) CTPA and DOAC- apixaban

B) v/a scan and LMWH

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20
Q

Moa of lmwh

A

Activates antithrombin 3

And forms complex that inhibits factor 10a

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21
Q

What criteria is used to stratify the risk of a DVT/PE

A

Wells scrore

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22
Q

2ndry causes of HTN

A 
ROPES
Renal artery stenosis 
Obesity
Pregnancy
Endocrine- conns, cushings, phaechromocytoma 
Sleep disorders
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23
Q

What is atrial fibrillation

A

A SVT with uncoordinated atrial electrical activation and consequently ineffective atrial contraction

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24
Q

List 5 causes of a fib

A

MRS SMITH (sepsis, mitral valve pathology, IHD, thyrotoxicosis, HTN)

HTN 
Valvular disease 
Thyroid disorders 
CAD
diabetes 
Cardiomyopathy
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25
Q

What is atrial flutter

A

A SVT characterised by rapid atrial depolarisation

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26
Q

What score determines anticoagulantion in a fib

A

CHA2DS2-VASc

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27
Q

What score determines the risk of bleeding on anticoagulants

A

HASBLED

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28
Q

Key findings of a fib

A

Absent p waves
Iregularly irregular rhythm
Narrow QRS complex

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29
Q

List 5 causes of atrial flutter

A 
Idiopathic fibrosis 
Atrial dilation 
Thyrotoxicosis 
Amiadorone 
Congenital 
Pericarditis
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30
Q

What is WPW

A

Causes by congenital accessory pathway which connects the atria to the ventricles bypassing AV node

This accessory pathway leads to the potential for re-enterant circuits to form leading to SVT

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31
Q

Features on ECG in WPW

A

Delta waves
Short PR interval
Broad QRS
if re-enter at circuit has developed the ECG will show narrow complex tachycardia

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32
Q

Tx for WFW

A

1st- radio frequency ablation of accessory pathway

2nd- drug tx beta blocker (sotalol) of amaiadorone

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33
Q

Mx of WFW syndrome in SVT

A

Valsalva monouvere
IV adenosine
Dc cardioverison (1st line in unstable)

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34
Q

What is 1st degree HB and list 3 causes

A

Prolonged PR interval >200ms

Hyperkalaemia
Ccb/bb
High Vagal tone (professional athletes)

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35
Q

What is mobitz type 1 and list 3 causes

A

PR Interval gets progressively longer, eventually resulting in dropped beat

MI
Ccb/bb/digoxin
High vagal tone

36
Q

What is mobitz ii and list 3 causes

A

PR interval is constant but p waves not followed by QRS complex

Mi
Ccb/bb
Fibrosis
SLE/RA

37
Q

What is third degree HB and list 3 causes

A

Complete signal block

Mi
Bb/ Ccb
Idiopathic fibrosis

38
Q

Ecg changes in LBBB

A

(WILLIAM)

V1- S wave
V6- notched R. wave

39
Q

ECG changes in RBBB

A

(MARROW)

V1- r wave
V6- S wave

40
Q

List 3 causes of LBBB

A

IHD
MI
hyperkalaemia
Aortic stenosis

41
Q

List 3 causes of RBBB

A

Righ ventricular hypertrophic
PE
IHD
ASD

42
Q

What is a AAA

A

A permanent dilatation of the abdominal aorta diameter >3cm

43
Q

Who is offered screening for AAA

A

Men in England over 65

If small AAA (3-4.4cm) – offered yearly repeat ultrasound
If medium AAA (4.5-5.4cm) – offered repeat ultrasound every 3 months
If large AAA (>5.5cm) – surgery generally recommended.

44
Q

Rf for AAA

A

HTN, hyperlipidemia, diabetes, obesity, smoking, CT disorder, increased age, infections (staph and salmonella)

45
Q

Most common site for AAA

A

BETWEEN RENAL AND INFERIOR MESENTERIC ARTERIES

46
Q

tx for AAA

A

Open repair via laparotomy

EVAR- Endovascular aneurysm repair

47
Q

What is a aortic dissection

A

Tear in the tunica intima of the aorta

48
Q

Rf of aortic dissection

A 
Ct disorders
Aortic vale replacement
Co-arctation of aorta
HTN 
Bicuspid aortic valve
49
Q

Classification of aortic dissections

A

Type a Stanford- ascending aorta before braciocephalic trunk

Type b Stanford- descending aorta after left subclavian artery

50
Q

Gold standard Ix of aortic dissection

A

Ct angiogram

51
Q

1st line tx for aortic dissection

A

Beta blockers- control hr and bp, manage stress and analgesia

52
Q

List 3 complications of aortic dissection

A

Stroke
Cardiac tamponade
MESENTERIC ischameia
Death

53
Q

What is RHD

A

An autoimmune disease that occurs following a group A beta haemolytic strep throat infection

54
Q

Sx of RHD

A

Murmurs- mitral valve most common (MR- Pansystolic)
Joint pain
Fever
Recent throat infection
Subcut nodules
Erythematous marginatum rash (pink rings)

55
Q

What is the name for granulomatous nodules found in rheumatic fever

A

Aschoff bodies

56
Q

What criteria is used to make a diagnosis of RHD

A

Jones criteria

2 major or 1 major and 2 minor

57
Q

Ix for rheumatic fever

A

Throat swab
ASO antibody titres
Echo/ech/CXR

58
Q

Tx for rheumatic fever

A

Treat strep infection- benzoyl penicillin for 10 days
NSAIDS for joint pain]
Aspirin/steroids treat carditis

59
Q

What is long QT syndrome

A

Prolonged ventricular repolarisation

60
Q

What causes long qt

A

Inherited- mutations in sodium and potassium channels

Acquired- drugs, electrolyte imbalances

61
Q

What is a complocation of long qt

A

Tosarde de pointes

62
Q

What is the tx for tosardes de pointes in
A) stable pt
B)unstable pt

A

A- IV magnesium sulphate

B- Dc cardio version

63
Q

Tx for ventricular tachycardia

A

Stable- amiadoarone (300mg)

Unstable- Dc cardioverison (3 attempts),
amaiadorone

64
Q

What are the 4 features in tetralogy of fallout

A

Over-riding aorta
RV hypertrophy
VSD
Pulmonary stenosis

65
Q

Most common congenital defect

A

VSD

66
Q

Name the 4 categories of shock

A

Hypovolaemic
Cardiogenic
Neurogenic
Obstructive

67
Q

What blood test confirms the diagnosis of anaphylaxis

A

Serum tryptase

68
Q

What is the management of anaphylaxis

A 
Remove precipitating cause
DR ABCDE
IM adrenaline (500 micro grams)-breadminister after 5. In’s if no changes
IV Fluid bolus
\+/-Chloramphenamine- antihistamine 
Measure serum tryptase
69
Q

What is sepsis 6

A 
Give O2
Take cultures
Give broad spectrum antibiotics
Give IV fluids
Measure lactate
Measure urine output
70
Q

Name a cyanosis heart defect

A

TOF

71
Q

What is eisenmengers syndrome

A

When the shunt reverses thus R>L

72
Q

What is the GS Ix for TOF

A

Echocardiography

73
Q

CXR finding of TOF

A

Boot shaped heart

74
Q

What is co-arctation of the aorta

A

Congenital narrowing of the aorta

75
Q

What are the 2 forms of coarctation of the aorta

A

1) infant form
patent ductus arteriosus (PA>aorta)
lower extremity cyanosis
-70%

2) adult form
no patent ductus arteriosus
coarctation happens distal to aortic arch
upstream issues- cerebral aneurysm due to high bf
downstream issues- decrease bp in lower extremities, activation of RAAS, HTN

76
Q

Associations of VSD

A

Foetal alcohol syndrome

Down’s syndrome

77
Q

Symptoms of VSD

A 
Failure to thrive
Sob 
Poor feeding 
Finger clubbing
Holosytolic murmur 
High pulmonary blood flow
78
Q

Sx of ASD

A 
Pulmonary flow murmur
Right heart dilatation 
SOBOE
increase chest infections
S-pitting S2
79
Q

During development what substance keeps the Ductus arteriosus open

A

Prostaglandin E2

80
Q

What is the tx for PDA

A

Indomethacin to babies in post natal period

81
Q

Gibson murmur associated with what disease

A

PDA

82
Q

Causes of HCM

A 
Inherited autosomal dominant
Frederichs ataxia (autosomal recessive)
83
Q

What is dilated cm

A

Heart muscle becomes weakened and enlarged

84
Q

Causes of DCM

A 
Idiopathic
Viral infection
Alcohol abuse
Haemochromotosis 
Duchenne muscular dystrophy 
Cocksackie
85
Q

List the Sx of all SVT

A 
Palpitations 
Sob
Chest pains
Dizziness
Syncope

Phase 2A (HV) (13 decks)

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