More Flashcards

1
Q

Diagnosis of accelerated hypertension

A

Severe hypertension - associated grade 2-3 retinopathy

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2
Q

Malignant hypertension

A

Severe hypertension associate with grade 4 retinopathy - therefore papilloedema

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3
Q

Reducing BP in severe hypertension

A
Maximum by 20% in first hour 
Use continuous infusion of short-acing titratable anti-hypertensive with constant arterial monitoring
- sodium nitroprusside 
- glyceryl trinitrate 
- labetalol
- hydralazine
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4
Q

Glyceryl trinitrate contraindication medication

A

Tadalafil - used for erectile dysfunction
Also sildenafil and vardenafil

Cause circulatory collapse and severe hypotension

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5
Q

Onion skimming on microscopy

A

Accelerated hypertension

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6
Q

Aschoff nodule on microscopy

A

Myocarditis

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7
Q

4 signs of haemodynamic compromise in arrhythmias

A

Heart failure

Blood pressure 150bpm

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8
Q

Infective endocarditis vasculitis test

A

Urine dip for microscopic haematuria due to vasculitis

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9
Q

Pulsus alternans

A

Heart failure

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10
Q

What is an atrial myxoma

A

Benign tumour that grows in the atrial wall/septum

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11
Q

Where do majority of atrial myxomas occur?

A

In the left atrium

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12
Q

What can atrial myxomas lead to/be linked with?

A

Atrial fibrillation and tricuspid stenosis

Can also lead to obstruction, pulmonary embolism, peripheral emboli

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13
Q

Prevalence of atrial myxoma

A

More common in women
1 in 10 are familial - familial myxoma - often occur in more than one location in the heart at one time and give symptoms younger

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14
Q

What do signs and symptoms of atrial myxoma resemble?

A

Mitral stenosis - pulmonary oedema symptoms, breathlessness, faintness

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15
Q

Rate of atrial flutter

A

Atrial fate of 300 per min and ventricular rate of 150 per min - 2:1 heart block as atria conducts every 2nd beat

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16
Q

Reversal of atrial flutter

A

Vagal manoeuvres, IV adenosine or chemical cardioversion

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17
Q

What increases the risk of digoxin toxicity when treating AF

A

Hypokalaemia, hypomagnesaemia and hypercalcaemia - therefore do a baseline investigation before initiating treatment

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18
Q

Prognosis of Chronic AF in a diseased heart

A

Doesn’t usually return to sinus rhythm

19
Q

3rd heart sound

A

dilated cardiomyopathy (left ventricular failure), MR and constrictive pericarditis

20
Q

Words to remember RBBB and LBBB

A

WiLLiaM MaRRoW

21
Q

Which BBB is never normal

22
Q

Can wenckebach phenomenon normal?

23
Q

Can RBBB be normal?

24
Q

Can LBBB be normal?

25
Can 1st degree AV block be normal?
Yes
26
Signs of ongoing acute MI vs past MI
Hyperacute T waves during acute MI whereas invert after 24hrs Pathological Q waves develop after several hours to days
27
Driving post angioplasty and pacemaker insertion
1 week
28
Driving post ACS
4 weeks unless successfully treated with angioplasty (1 week)
29
Driving post CABG
4 weeks
30
Arrythmia catheter ablation and driving
2 days
31
Pulse in PDA
large volume, bounding collapsing pulse
32
Closure of PDA
Indomethacin
33
Signs of PDA
Subclavicular thrill Heaving apex beat Wide pulse pressure
34
Most common cause of death post MI
Cardiac arrest due to VF
35
What type of MI is more commonly associated with AV block
Inferior MI
36
Murmur in coarctation of aorta
mid systolic murmur | Loudest over back
37
PR depression
Pericarditis
38
Signs of LV hypertrophy on ECG
``` Deep S wave in v1-2 Tall R wave in V5-6 Left axis deviation LBBB Inverted T waves in I, AvL and V5-6 ```
39
What are Stokes Adams attacks
Syncope caused by ventricular asystole eg. in heart block
40
Broad bifid p wave
p mitrale - mitral valve regurge causing left atria enlargement
41
Tall p wave
right atria hypertrophy due to triscupid regurge
42
QRS concordance with broad complex tachycardia
Ventricular tachycardia
43
Fixed splitting of second heart sound
Atrial septal defect