Brainscape's Knowledge GenomeTM

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


See full index

MLA content map > MLA: Cardiology > Flashcards

MLA: Cardiology Flashcards

1
Q

which investigation should all patients with suspected acute pericarditis have?

A

transthoracic echocardiography

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

what is acute pericarditis?

A

a condition referring to inflammation of the pericardial sac, lasting less than 4-6 weeks

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

what are some of the causes of acute pericarditis?

A
  1. viral infections (Coxsackie)
  2. TB
  3. uraemia
  4. post MI
  5. radiotherapy
  6. connective tissue disease -> SLE and RA
  7. hypothyroidism
  8. malignancy - lung and breast
  9. trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the features of acute pericarditis?

A
  1. chest pain: may be pleuritic - often relieved by sitting forwards
  2. non-productive cough, dyspnoea and flu-like Sx
  3. pericardial rub
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the ECG changes seen in acute pericarditis?

A
  1. global/widespread
  2. saddle-shaped ST elevation
  3. PR depression = most specific ECG marker for pericarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the first line treatment of acute idiopathic/viral pericarditis?

A

a combination of NSAIDs and colchicine

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

which criteria is used to diagnosed infection endocarditis?

A

if:
1. pathological criteria positive OR
2. 2 major OR
3. 1 major and 3 minor criteria OR
4. 5 minor criteria

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

what is the pathological criteria for infective endocarditis?

A

positive histology or microbiology of pathological material obtained at autopsy or cardiac surgery (valve tissue, vegetations, embolic fragments or intracardiac abscess content)

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

what are the major criteria in the Duke’s criteria for infective endocarditis?

A
  1. two positive blood cultures showing typical organisms consistent with infective endo e.g. streptococcus viridans
  2. persistent bacteraemia from two blood cultures taken >12 hours apart or 3/+ positive blood cultures where the pathogen is less specific such as staph aureus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what make up the minor criteria in the Duke’s criteria for infective endocarditis?

A
  1. predisposing heart condition or IV drug use
  2. microbiological evidence does not meet major criteria
  3. fever >38
  4. vascular phenomena: major emboli, splenomegaly, clubbing, splinter haemorrhages, Janeway lesions, petechiae or purpura
  5. immunological phenomena: glomerulonephritis, Osler’s nodes, Roth spots
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the components of the CHADVASc score?

A

C = congestive HF
H = HTN
A2 = aged >75 (2)/aged 65-74 (1)
D = diabetes
S2 = prior stroke, TI or VTE
V = vascular disease (IHD and PAD)
S = sex (female)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

if someone scores 2 or more on their CHADVASc, what is the management?

A

offer anticoagulation

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

what is the ORBIT score?

A

replacing the HAS-BLED scoring system, which works out the risk of a patient bleeding - and helps evaluate the risk vs benefit of anticoagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

which DOACs are recommended by NICE for reducing stroke risk in AF?

A

apixaban, dabigatran, edoxaban and rivaroxaban

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

a lateral MI is generally caused by a lesion in which artery?

A

left circumflex artery lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which valvular defect has a holosystolic murmur, which is high-pitched and ‘blowing’ in character?

A

mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

which valvular defects have an ejection systolic murmur, loudest on expiration?

A

aortic stenosis and HOCM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

which defects have an ejection systolic murmur, louder on inspiration

A

pulmonary stenosis, atrial septal defect and TOF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

gram positive cocci cause the majority of cases in which pathology?

A

infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the echo findings for HOCM?

A

MR SAM ASH
Mitral regurgitation
Systolic anterior motion of the anterior mitral valve leaflet
Asymmetric hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the signs and symptoms of malignant HTN?

A
  1. papilloedema
  2. retinal bleeding
  3. increased cranial pressure causing headache and nausea
  4. chest pain due to increased workload on the heart
  5. haematuria due to kidney failure
  6. nosebleeds which are difficult to stop
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

which investigations also need to be done in a patient with newly diagnosed HTN to ensure they do not have end-organ damage?

A
  1. fundoscopy = check for hypertensive retinopathy
  2. urine dipstick = to check for renal disease, either as a cause or consequence of HTN
  3. ECG: to check for left ventricular hypertrophy or IHD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

which tests need to also be done for newly diagnosed HTN?

A
  1. U&E = check for renal disease
  2. HbA1c = co-existing DM
  3. lipids = hyperlipidaemia
  4. ECG
  5. urine dipstick
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the common side effects of ACE-i?

A

cough, angioedema, hyperkalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how do calcium channel blockers work?

A

they block voltage-gated calcium channels, relaxing vascular smooth muscle and the force of myocardial infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are some of the common side effects of CCBs?

A

flushing, ankle swelling and headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the mechanism of action of thiazide type diuretics?

A

inhibit sodium absorption at the beginning of the distal convoluted tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the common side effects of thiazide like diuretics?

A

hyponatremia, hypokalaemia, dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the mechanism of action of A2RB?

A

block effects of angiotensin II at the AT1 receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

when are ARBs generally used?

A

in situations where patients have not tolerated ACE inhibitors, usually due to the development of a cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is an established side effect of A2RBs?

A

hyperkalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

how is rheumatic fever diagnosed?

A

evidence of recent streptococcal infection and either 2 major criteria, or 1 major with 2 minor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

which components make up the major criteria for rheumatic fever?

A
  1. erythema marginatum
  2. Syndenham’s chorea (late)
  3. polyarthritis
  4. carditis and valvulitis
  5. subcutaneous nodules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

which components make up the minor criteria for rheumatic fever?

A
  1. raised ESR and CRP
  2. pyrexia
  3. arthralgia
  4. prolonged PR interval
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

as well as dual antiplatelet therapy, which other drug should be offered to non-ST elevation MI for patients not at a high risk of bleeding and who are not having angiography immediately?

A

Fondaparinux

36
Q

what is the most common ECG change in PE?

A

sinus tachycardia

37
Q

what is atrial flutter?

A

a form of supra ventricular tachycardia characterised by a succession of rapid atrial depolarisation waves

38
Q

what are the common ECG findings for atrial flutter?

A
  1. sawtooth appearance
  2. 2:1 block - atrial to ventricular
  3. flutter waves may be visible following carotid sinus massage or adenosine
39
Q

which new ECG feature is of great concern?

A

LBBB = always pathological and never normal

40
Q

what are the causes of LBBB?

A
  1. MI
  2. HTN
  3. aortic stenosis
  4. cardiomyopathy
  5. rare: idiopathic fibrosis, digoxin, toxicity and hyperkalaemia
41
Q

what are the ECG features of hypokalaemia?

A
  1. small or absent T waves (occasionally inversion)
  2. prolonged PR interval
  3. ST depression
  4. long QT
42
Q

what are the normal ECG variants in an athlete?

A
  1. sinus bradycardia
  2. junctional rhythm
  3. first degree heart block
  4. Mobitz type 1 (Wenckebach)
43
Q

which type of antihypertensives cause erectile dysfunction?

A

Beta-blockers

44
Q

which drug should be offered to a patient, in addition to an ACE-i/BB, who has HF with reduced ejection fraction if they are continuing to have Sx of HF?

A

mineralocorticoid receptor antagonist e.g. Spironolactone

45
Q

what are the 4 H’s of reversible causes of cardiac arrest

A

hypoxia, hypvolaemia, metabolic disorders (hyper/hypokalaemia etc), hypothermia

46
Q

what are the 4 T’s of reversible causes of cardiac arrest?

A

thrombosis (coronary or pulmonary), tension pneumothorax, tamponade, toxins

47
Q

when should amiodarone be administered?

A

amiodarone 300mg should be given to patients who are in VF/pulseless VT after 3 shocks have been administered

48
Q

how does pulmonary oedema occur in chronic heart failure?

A

impaired LVF results in a chronic backlog of blood waiting to flow into and through the left side of the heart. The left atrium, pulmonary veins and lungs experience an increase volume and pressure of blood. They then start to leak fluid

49
Q

what is ejection fraction?

A

the percentage of blood in the left ventricle squeezed out with each ventricular contraction - one above 50% is considered normal

50
Q

what is HF with preserved ejection fraction?

A

when someone has the clinical features of HF with an EJ greater than 50%. This is the result of diastolic dysfunction, where there is an issue with the left ventricle filling with blood during diastole (the left ventricle relaxing)

51
Q

what are the NYHA classes of severity of HF symptoms?

A

Class I = no limitation on activity
Class II = comfortable at rest but Sx with ordinary activities
Class III = comfortable at rest but Sx with any activity
Class IV = symptomatic at rest

52
Q

what are the five principles of management for HF?

A

RAMPS
Refer to cardiology
Advise them about the condition
Medical Rx
Procedural or surgical interventions
Specialist HF MDT

53
Q

what is the urgency of referral to cardiology for someone presenting with HF?

A

dependent on the NT-proBNP result:
From 400-2000ng/litre - echo within 6 weeks
Above 2000ng/litre = seen and echo within 2 weeks

54
Q

what is the first line medical Rx of chronic HF?

A

ABAL:
ACE-inhibitor
Beta-blocker
Aldosterone antagonists when Sx are not controlled with A and B
Loop diuretics (furosemide and bumetanide)

55
Q

blood supply to the brain can be disrupted by what?

A

thrombus/embolus, atherosclerosis, shock, vasculitis

56
Q

what is a TIA?

A

involves temporary neurological dysfunction (lasting less than 24 hours) caused by ischaemia but without infarction. Sx have a rapid onset and often resolve before the patient is seen

57
Q

what are crescendo TIAs?

A

two or more TIAs within a week and indicate a high risk of stroke

58
Q

what are the common symptoms of stroke?

A

limb weakness, facial weakness, dysphasia (speech disturbance), visual field defects, sensory loss and ataxia + vertigo (posterior circulation infarct)

59
Q

what is the ROSIER tool for stroke?

A

Recognition of stroke in the emergency room = gives a score based on the clinical features and duration. Stroke is possible in patients scoring one or more

60
Q

what is involved in the initial management of stroke?

A
  1. exclude hypoglycaemia
  2. immediate CT brain (non-contrast) to exclude haemorrhage
  3. Aspirin 300mg daily for 2 weeks (start after haemorrhage is excluded with a CT)
  4. admission to a specialist stroke centre
61
Q

when is thrombectomy considered?

A

in patients with a confirmed blockage of the proximal anterior circulation or proximal posterior circulation - it may be considered within 24 hours of the Sx onset and alongside IV thrombolysis

62
Q

patients with TIA or stroke are investigated for which conditions?

A

carotid artery stenosis and AF with carotid imaging and ECG or ambulatory ECG monitoring

63
Q

what are the associated effects of anterior cerebral artery stroke?

A

contralateral hemiparesis and sensory loss, lower extremity > upper

64
Q

what are the associated effects of a stroke in the middle cerebral artery?

A

contralateral hemiparesis and sensory loss, upper extremity > lower.
Contralateral homonymous hemianopia and aphasia

65
Q

what are the associated effects of a posterior cerebral artery stroke?

A

contralateral homonymous hemianopia with macular sparing and visual agnosia

66
Q

what is an embolic stroke?

A

embolic stroke occurs when a blood clot or other debris (embolus) from another part of the body travels through the bloodstream and becomes lodged in an artery supplying blood to the brain

67
Q

what is an intracerebral haemorrhage causing stroke?

A

caused by a blood vessel within the brain parenchyma, often due to HTN, cerebral amyloid angiopathy, or vascular malformations

68
Q

what is the pathophysiology of ischaemic stroke?

A

the reduction in blood flow to the affected brain region leads to inadequate oxygen and glucose delivery, resulting in energy failure and the disruption of cellular ion homeostasis.

69
Q

what is the pathophysiology of cerebral haemorrhage?

A

in haemorrhagic stroke, the rupture of a blood vessel causes blood to accumulate within the brain tissue or subarachnoid space. This can lead to ICP, compression of brain tissue, and disruption of cerebral blood flow + can trigger a local inflammatory response, resulting in further neuronal injury

70
Q

what is the criteria assessed in the Oxford Stroke Classification?

A
  1. unilateral hemiparesis and/or hemisensory loss of the face, arm and leg
  2. homonymous hemianopia
  3. higher cognitive dysfunction e.g. dysphasia
71
Q

total anterior circulation infarcts involve which arteries?

A

middle and anterior cerebral arteries

72
Q

which arteries are involved in partial anterior circulation infarcts

A

smaller arteries of anterior circulation e.g. upper division of middle cerebral artery

73
Q

which arteries are involved in lacunar infarcts?

A

involves perforating arteries around the internal capsule, thalamus and basal ganglia

74
Q

lacunar infarcts present with 1 of the following…?

A
  1. unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three
  2. pure sensory stroke
  3. ataxic hemiparesis
75
Q

which arteries are involved in posterior circulation infarcts?

A

vertebrobasilar arteries

76
Q

in the ROSIER score, new onset of which symptoms score one point each?

A
  1. asymmetric facial weakness
  2. asymmetric arm weakness
  3. asymmetric leg weakness
  4. speech disturbance
  5. visual field defect
77
Q

how should you immediately manage blood pressure in stroke?

A

do not lower the BP in the acute phase unless there are complications e.g. hypertensive encephalopathy

78
Q

regarding AF causing stroke, when should anticoagulation be commenced?

A

they should not be started until brain imaging has excluded haemorrhage, and usually not until 14 days post ischaemic stroke

79
Q

what are the absolute contraindications to thrombolysis?

A
  1. previous intracranial haemorrhage
  2. seizure at the onset of stroke
  3. intracranial neoplasm
  4. suspected SAH
  5. stroke/traumatic brain injury in the preceding 3 months
  6. LP in preceding 7 days
  7. GI haemorrhage in preceding 3 weeks
  8. active bleeding
  9. pregnancy
  10. oesophageal varices
  11. uncontrolled HTN >200/120mmHg
80
Q

what is the characteristic iron study profile in haemochromatosis?

A

raised transferrin saturation and ferritin, with low TIBC

81
Q

what is the first line for myoclonic seizures in females?

A

Levetiracetam

82
Q

what is the immediate treatment of patients with bradycardia and signs of shock?

A

500mcg of atropine (repeated up to max 3mg)

83
Q

which drug is used in the immediate management of tachycardias?

A

amiodarone

84
Q

which drug is used in rate control of longstanding tachycardias?

A

bisoprolol

85
Q

what is the immediate action of patients with suspected viral meningitis whilst waiting for LP result?

A

start IV abx and antivirals, particularly if immunocompromised or elderly

86
Q
A

MLA content map (7 decks)

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