OSCEs Flashcards
causes of AF
THE ATRIAL FIBS
thyroid disease (hyperthyroidism) hypertension/hypothermia electrolyte imbalance alcohol thromboembolic disease (PE) rheumatic heart disease IHD atrial dilatation/myxoma lone (idiopathic) fever (endocarditis, chest infection) infarct/ischaemia bad valves stimulants
investigations for SVT
FBC, U&E, Mg, TFT, Glc
ECG
CXR, echo
24 hr cardiac tape
management of acute MI
ABCDE
ROMANCE
reassurance oxygen - high flow morphine + antiemetic aspirin 300mg (antiplatelet) nitrates (GTN spray/infusion) clopidogrel 300mg (antiplatelet) enoxaparin (anticoagulant)
consider: angioplasty
monitor: on CCU
investigations for ACS
FBC, U&E, lipids, Glc, cardiac enzymes (CK and trop)
ECG
CXR/echo
consider coronary angiography
causes of hypertension
primary (essential)
secondary:
- renal
- endocrine
- drugs
- CVS
- other
renal causes of hypertension
renal artery stenosis
polycystic kidneys
glomerulonephritis
endocrine causes of hypertension
Cushing’s
Conn’s
phaeochromocytoma
examples of drugs that may cause hypertension
steroids
OCP
CVS causes of hypertension
coarctation of aorta
other causes of hypertension
pre-eclampsia
white coat syndrome
investigations for hypertension
FBC, U&E, lipids, Glc
ECG
CXR, consider echo and renal US
consider 24hr BP monitoring
drug choice for hypertension for under 55s
- ACEi
- ACEi + CCB
- ACEi + CCB + thiazide diuretic
- consider further diuretic, alpha/beta blocker + specialist advice
drugs choice for hypertension for over 55s/afrocaribbeans of any age
- CCB
- ACEi + CCB
- ACEi + CCB + thiazide diuretic
- consider further diuretic, alpha/beta blocker + specialist advice
Hx and exam of MI
Hx: central crushing chest pain radiation to arms/jaw nausea, vomiting sweating unwell risk factors
Ex: sweaty cold clammy tachycardia signs of shock/cardiac failure
Hx and exam of angina
Hx: central chest pain \+/- radiation known precipitant alleviated by nitrates/rest
Ex:
tachycardia
Hx and exam of PE
Hx: sudden onset SOB pleuritic chest pain haemoptysis risk factors
Ex: non-specific tachycardia increased RR signs of shock pleural rub
Hx and exam of pleurisy
Hx:
sharp, pleuritic chest pain
recent chest infection
systemic symptoms
Ex:
fever
signs of consolidation
pleural rub
Hx and exam of pneumothorax
Hx:
sudden onset SOB
localised pleuritic chest pain
risk factors
Ex: decreased air entry increased RR tracheal deviation (late sign) signs of shock
Hx and exam of aortic dissection
Hx: central tearing chest pain radiation to back nausea, vomiting unwell dizziness risk factors
Ex: BP variation between arms radio-radial delay absent pulses signs of shock neurological deficits aortic regurgitation
Hx and exam of pericarditis
Hx: sharp central chest pain relieved by sitting forward systemic symptoms recent viral illness
Ex: fever tachycardia pericardial rub signs of vasculitic disease
Hx and exam of dyspepsia
Hx: burning central chest/epigastric pain may radiate to back food associations exacerbated by lying flat
Ex:
epigastric tenderness
Hx and exam of MSK chest pain
Hx:
injury
pain exacerbated by movement
Ex: reproducible tenderness (not MSK cause specific)
common cardiology investigations
bloods: FBC U&E lipids Glc CRP cardiac enzymes (CK and trop)
ECG
imaging:
CXR
echo
TOE
Micro:
blood cultures
other:
24hr tape
exercise tolerance test
coronary angiography
malar flush is a sign of…
mitral stenosis
myotonic facies is a sign of…
cardiomyopathy
marfanoid is a sign of…
aortic regurgitation
splinter haemorrhages are a sign of…
endocarditis
ankylosing spondylitis is a sign of…
aortic regurgitation
