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Cardiology > MRCP > Flashcards

MRCP Flashcards

1
Q

What is the dose of adrenaline given in cardiac arrest?

A

1mg of 1:10,000

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2
Q

What is the dose of adrenaline given in anaphylaxis?

A

<6 years: 150 mcg of 1:1,000
6-12 years: 300mch of 1:1,000
>12 years: 500mcg of 1:1,000

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3
Q

Causes of bradycardia

A 
Physiological
Hypothyroid
AV block
Sick sinus syndrome
Drugs
Vasovagal
Electrolyte abnormalities
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4
Q

How do you treat broad complex tachycardia?

A

Irregular - seek help
Regular - Amiodarone 300mg
If adverse features - Amiodarone plus synchronised shock 120J

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5
Q

How do you treat a narrow complex tachycardia?

A

Irregular - as AF
Regular - vagal manoeuvres, adenosine 6mg
If adverse features, Amiodarone 300mg and synchronised shock 120J

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6
Q

Inheritance of HOCM

A

Autosomal Dominant

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7
Q

What is the pathophysiology of HOCM?

A

There is thickening of the interventricular septum which bulges out asymmetrically which narrows the outflow of LV
There is decreased pre load and excessive afterload

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8
Q

What murmur is heard in HOCM?

A

Ejection Systolic - therefore AS as Ddx

HOCM murmur increases in intensity with valsalva

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9
Q

Complications of ACS?

A

Septal rupture - pansystolic murmur
Ventricular rupture - tamponade
Papillary muscle rupture - mitral regurg
LV aneurysm - persistent ST elevation
Arrythmias
Pericarditis - 2-3 days post MI, pleuritic type pain
Dressler’s Syndrome - weeks after MI, fever, pericarditis and pleurisy

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10
Q

What is a Stokes-Adams attack?

A

Someone with known heart block who has episodes of transient asystole which causes syncope
They go grey/deathly pale and collapse
As soon as the attack is over they regain colour and consciousness quickly

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11
Q

What is decubitus angina?

A

Angina precipitated by lying flat

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12
Q

What is Pritzmetal’s angina?

A

There is ST elevation on ECG with no elevation in troponin

There are sporadic cycles of angina at rest due to coronary artery spasm

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13
Q

What is syndrome X?

A

ST depression and angina pain on exercise with no coronary artery abnormalities on angiography
Microvascular disease

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14
Q

Pulse description in heart failure?

A

Pulsus Alternans (Severe LVF)

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15
Q

Causes of Pulsus Paradoxus?

A

Severe asthma, Cardiac tamponade

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16
Q

Pulse description in aortic stenosis?

A

Slow rising

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17
Q

Causes of collapsing pulse?

A

Aortic regurgitation, PDA, Hyperdynamic states

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18
Q

Pulse description in HOCM?

A

Jerky

19
Q

Causes of Bisferiens pulse?

A

Mixed aortic valve disease

20
Q

Peripheral stigmata of infective endocarditis

A 
Osler's Nodes
Janeway Lesions
Clubbing
Splinter haemorrhages
Fever
Roth spots
New murmur
21
Q

Treatment of Wolff Parkinson White?

A

Non-AV Nodal blocking drugs (NO Verapamil) - risk of VF
Flecainide or Sotalol (if no AF)
Definitive treatment is RFA of accessory pathway

22
Q

What is the pathophysiology of WPW?

A

Accessory conduction pathway - AVRT

As the conduction pathway doesn’t slow down conduction, if someone with WPW goes into AF they can rapidly go into VF

23
Q

Differentiating between Type A and Type B WPW?

A

Type A: Left sided. Dominant R wave in V1

Type B: Right sided

24
Q

What causes S2 heart sound?

A

Closure of aortic valve shortly followed by closure of the pulmonary valve

25
Q

Causes of a loud S2?

A

Hypertension

Hyperdynamic states

26
Q

Causes of a soft S2?

A

Aortic stenosis

27
Q

Causes of a fixed split S2?

A

ASD

28
Q

Causes of a widely split S2?

A

RBBB

Deep inspiration

29
Q

Causes of a reversed split S2?

A

LBBB

30
Q

Treatment for Prinzmetal’s Angina?

A

Calcium channel blockers, such as Felodipine

31
Q

Mechanism of action of Endothelin Receptor Antagonists?

A

Reduce pulmonary vascular resistance (in patients with primary pulmonary hypertension) therefore reducing strain on right ventricle

32
Q

Most common cause of death in patients with primary pulmonary hypertension?

A

Right ventricular failure

33
Q

Treatment plan for Pulmonary Hypertension?

A

Need to do acute vasodilator testing
Positive response: Oral Calcium channel blockers
Negative response: Prostacyclin analogues/endothelin receptor antagonists/Phosphodiesterase inhibitors
Progressive symptoms - Heart/lung transplant

34
Q

What does Trop-T bind to?

A

Tropomyosin

35
Q

First cardiac enzyme to rise in an acute cardiac event?

A

Myoglobin

36
Q

Heart sounds in complete heart block?

A

Variable intensity of S1

37
Q

Conditions which progress to Eisenmenger’s Syndrome?

A

VSD
ASD
PDA

38
Q

What is a cannon wave in JVP?

A

Right atrium contracting against a closed tricuspid valve
Regular: VT or AVNRT
Irregular: Complete heart block

39
Q

Signs of right ventricular hypertrophy?

A

Left parasternal heave

40
Q

Treatment of PDA?

A

Indomethacin is given to the newborn if PDA confirmed on echo 1 week after birth. Not given to the mother in the antenatal period
Ibuprofen can also be given to close the PDA

41
Q

ECG abnormality associated with hypercalcemia?

A

Shortening of the QT interval

42
Q

Pathophysiology of ARVC?

A

Fibrofatty infiltrates of the right ventricle

RV is thin walled

43
Q

First line management of acute pericarditis?

A

NSAID and Colchicine for 3/12

Adding Colchicine reduces recurrence and symptom duration

Cardiology (1 decks)

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