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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
What is atrial flutter
A SVT characterised by rapid atrial depolarisation
26
What score determines anticoagulantion in a fib
CHA2DS2-VASc
27
What score determines the risk of bleeding on anticoagulants
HASBLED
28
Key findings of a fib
Absent p waves Iregularly irregular rhythm Narrow QRS complex
29
List 5 causes of atrial flutter
``` Idiopathic fibrosis Atrial dilation Thyrotoxicosis Amiadorone Congenital Pericarditis ```
30
What is WPW
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
31
Features on ECG in WPW
Delta waves Short PR interval Broad QRS if re-enter at circuit has developed the ECG will show narrow complex tachycardia
32
Tx for WFW
1st- radio frequency ablation of accessory pathway | 2nd- drug tx beta blocker (sotalol) of amaiadorone
33
Mx of WFW syndrome in SVT
Valsalva monouvere IV adenosine Dc cardioverison (1st line in unstable)
34
What is 1st degree HB and list 3 causes
Prolonged PR interval >200ms Hyperkalaemia Ccb/bb High Vagal tone (professional athletes)
35
What is mobitz type 1 and list 3 causes
PR Interval gets progressively longer, eventually resulting in dropped beat MI Ccb/bb/digoxin High vagal tone
36
What is mobitz ii and list 3 causes
PR interval is constant but p waves not followed by QRS complex Mi Ccb/bb Fibrosis SLE/RA
37
What is third degree HB and list 3 causes
Complete signal block Mi Bb/ Ccb Idiopathic fibrosis
38
Ecg changes in LBBB
(WILLIAM) V1- S wave V6- notched R. wave
39
ECG changes in RBBB
(MARROW) V1- r wave V6- S wave
40
List 3 causes of LBBB
IHD MI hyperkalaemia Aortic stenosis
41
List 3 causes of RBBB
Righ ventricular hypertrophic PE IHD ASD
42
What is a AAA
A permanent dilatation of the abdominal aorta diameter >3cm
43
Who is offered screening for AAA
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
Rf for AAA
HTN, hyperlipidemia, diabetes, obesity, smoking, CT disorder, increased age, infections (staph and salmonella)
45
Most common site for AAA
BETWEEN RENAL AND INFERIOR MESENTERIC ARTERIES
46
tx for AAA
Open repair via laparotomy | EVAR- Endovascular aneurysm repair
47
What is a aortic dissection
Tear in the tunica intima of the aorta
48
Rf of aortic dissection
``` Ct disorders Aortic vale replacement Co-arctation of aorta HTN Bicuspid aortic valve ```
49
Classification of aortic dissections
Type a Stanford- ascending aorta before braciocephalic trunk | Type b Stanford- descending aorta after left subclavian artery
50
Gold standard Ix of aortic dissection
Ct angiogram
51
1st line tx for aortic dissection
Beta blockers- control hr and bp, manage stress and analgesia
52
List 3 complications of aortic dissection
Stroke Cardiac tamponade MESENTERIC ischameia Death
53
What is RHD
An autoimmune disease that occurs following a group A beta haemolytic strep throat infection
54
Sx of RHD
Murmurs- mitral valve most common (MR- Pansystolic) Joint pain Fever Recent throat infection Subcut nodules Erythematous marginatum rash (pink rings)
55
What is the name for granulomatous nodules found in rheumatic fever
Aschoff bodies
56
What criteria is used to make a diagnosis of RHD
Jones criteria 2 major or 1 major and 2 minor
57
Ix for rheumatic fever
Throat swab ASO antibody titres Echo/ech/CXR
58
Tx for rheumatic fever
Treat strep infection- benzoyl penicillin for 10 days NSAIDS for joint pain] Aspirin/steroids treat carditis
59
What is long QT syndrome
Prolonged ventricular repolarisation
60
What causes long qt
Inherited- mutations in sodium and potassium channels | Acquired- drugs, electrolyte imbalances
61
What is a complocation of long qt
Tosarde de pointes
62
What is the tx for tosardes de pointes in A) stable pt B)unstable pt
A- IV magnesium sulphate | B- Dc cardio version
63
Tx for ventricular tachycardia
Stable- amiadoarone (300mg) Unstable- Dc cardioverison (3 attempts), amaiadorone
64
What are the 4 features in tetralogy of fallout
Over-riding aorta RV hypertrophy VSD Pulmonary stenosis
65
Most common congenital defect
VSD
66
Name the 4 categories of shock
Hypovolaemic Cardiogenic Neurogenic Obstructive
67
What blood test confirms the diagnosis of anaphylaxis
Serum tryptase
68
What is the management of anaphylaxis
``` 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
What is sepsis 6
``` Give O2 Take cultures Give broad spectrum antibiotics Give IV fluids Measure lactate Measure urine output ```
70
Name a cyanosis heart defect
TOF
71
What is eisenmengers syndrome
When the shunt reverses thus R>L
72
What is the GS Ix for TOF
Echocardiography
73
CXR finding of TOF
Boot shaped heart
74
What is co-arctation of the aorta
Congenital narrowing of the aorta
75
What are the 2 forms of coarctation of the aorta
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
Associations of VSD
Foetal alcohol syndrome | Down’s syndrome
77
Symptoms of VSD
``` Failure to thrive Sob Poor feeding Finger clubbing Holosytolic murmur High pulmonary blood flow ```
78
Sx of ASD
``` Pulmonary flow murmur Right heart dilatation SOBOE increase chest infections S-pitting S2 ```
79
During development what substance keeps the Ductus arteriosus open
Prostaglandin E2
80
What is the tx for PDA
Indomethacin to babies in post natal period
81
Gibson murmur associated with what disease
PDA
82
Causes of HCM
``` Inherited autosomal dominant Frederichs ataxia (autosomal recessive) ```
83
What is dilated cm
Heart muscle becomes weakened and enlarged
84
Causes of DCM
``` Idiopathic Viral infection Alcohol abuse Haemochromotosis Duchenne muscular dystrophy Cocksackie ```
85
List the Sx of all SVT
``` Palpitations Sob Chest pains Dizziness Syncope ```

Phase 2A (HV) (13 decks)

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