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Cardiovascular Disease > Passmedicine > Flashcards

Passmedicine Flashcards

1
Q

What vessel is affected in anterior MI

A

LAD

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2
Q

What vessel is affected in inferior MI

A

RCA

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3
Q

What vessel is affected in anterolateral MI

A

LAD or left circumflex

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4
Q

What vessel is affected in lateral MI

A

left circumflex

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5
Q

What vessel is affected in posterior MI

A

left circumflex or RCA

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6
Q

Angina pain, worse in morning, no CVS risk factors, normal exercise tolerance

A

Prinzmetal angina - due to coronary artery spasm

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7
Q

cardiac complication of TB

A

constrictive pericarditis

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8
Q

dose of adrenaline in anaphalaxis in adults

A

500mcgs (0.5ml of 1 unit in 1000)

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9
Q

what cardiac drug should be withheld in an MI

A

ACE/ARB

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10
Q

j waves on ecg

A

hypothermia

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11
Q

u waves on ecg

A

hypokalaemia

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12
Q

delta waves on wcg

A

WPW

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13
Q

what is bumetanide

A

loop diurectic

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14
Q

mechanism of action of amioderone

A

blocks potassium channels

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15
Q

post MI treatment

A

dual antiplatelet
ace
beta blocker
statin

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16
Q

slow rising pulse

A

aortic stenosis

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17
Q

most common cause of aortic stenosis

A

older - calcification

younger - bicuspid valve

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18
Q

common side effect/problem with amioderone

A

thrombophlebitis - should be given into central veins

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19
Q

what should you not prescribe with verapamil

A

beta blockers

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20
Q

what is an absolute contraindication to thrombolysis

A

intracranial neoplasm

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21
Q

ejection systolic murmur radiating to carotids

A

aortic stenosis

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22
Q

when would you give a mechanical heart valve vs bioprosthetic valve

A

mechanical valve given to younger patients as they last longer

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23
Q

What is the advantage if biiprosthetic valve replacement

A

do not need anticoagulated

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24
Q

how should type 2 diabetics glycemic control be managed post MI

A

stop all diabetic med

start iv insulin whilst in hospital

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25
Q

when can you offer statins to type 1 diabetics

A

older than 40
had diabetes for over 10 years
risk factor eg obese
nephropathy

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26
Q

what drug interacts with statin

A

clarythromycin - causes statin induced myopathy

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27
Q

side effects of GTN

A

headache, tachycardia, hypotension

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28
Q

early diastolic murmur

A

aortic regurg

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29
Q

most common complication of MI causing death

A

v fib

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30
Q

intial dose of amioderone during cardiac arrest

A

300mg

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31
Q

treatment of symptomatic bradycardia

A

IV atropine

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32
Q

treatment of symptomatic bradycardia if atropine fails

A

external pacing

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33
Q

how soon can you give a second adrenaline dose in analylaxis

A

five minutes

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34
Q

ECG features of WPW

A

short PR
slurred upstroke, wide QRS = delta wave
axis deviation

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35
Q

side effect of ivabradine

A

transient luminous phenominon

bright spots of light in vision

36
Q

occurs after sore throat, arthritis, rash (erythema marginatum), sydenhams chorea, can cause carditis

A

rheumatic fever

37
Q

dose of adrenaline in children 6-12 for analphylaxis

A

300mcgs

38
Q

how do u decide when to replace aortic valve in aortic stenosis

A

symptomatic

valvular gradient more than 40mmHg

39
Q

how long can you not drive post MI

A

4 weeks

40
Q

where do thiazide diuretics work

A

proximal part of distal convoluted tubule

41
Q

investigation of heartfailure

A

no MI - BNP naturietc peptides, if high echo in 2 weeks, if ‘raised’ echo in 6 weeks
if had previous MI - echo within 2 weeks

42
Q

absent limb pulse

A

Takayasu

43
Q

kussmauls’s sign

A

JVP increases on inspiration/fails to decrease

sign of constrictive pericarditis

44
Q

ejection systolic, radiating to carotids, aortic area

A

aortic stenosis

45
Q

Pansystolic, tricuspid area, radiating to 4th intercostal space

A

tricuspid regurg

46
Q

Pansystolic, mitral area, radiating to axilla

A

mitral regurge

47
Q

Mid diastolic, mitral area, radiating to axilla

A

mitral stenosis

48
Q

what is coartication of the aorta

A

congenital narrowing of the descending aorta

49
Q

what murmur is heard in coartication of the aorta

A

mid systolic maximal over back

50
Q

who is at risk of silent MI

A

diabetics

51
Q

pulsus paradoxicus

A

cardiac tamponade

52
Q

bifasicular block

A

RBBB and left axis deviation

53
Q

trifasicular block

A

bifasicular block + first degree heaet block

54
Q

what leads do you look at for axis deviation

A

I and avF

55
Q

third heart sound

A 
normal in under 40s
LVF - dilated cardiomyopathy
constrictive pericarditis
mitral regurg
caused by ventricle filling in diastole
56
Q

fourth heart sound

A

may be heard in aortic stenosis, HOCM, hypertension
caused by atrial contraction against a stiff ventricle
in HOCM a double apical impulse may be felt as a result of a palpable S$

57
Q

mechanism of action of thrombolytic drugs

A

activates plasminogen to form plasmin

58
Q

heart block and MI

A

RCA lesion - branch of RCA supplies AV node

59
Q

pharmacological cardioversion in AF in patient with structural heart disease

A

amioderone

60
Q

what should u be worried about if u see inferior MI on ECG + aortic regurg

A

aortic dissection

61
Q

name medications that can cause long QT

A

amiodarone, sotalol, class 1a antiarrhythmic drugs
tricyclic antidepressants, selective serotonin reuptake inhibitors (especially citalopram)
methadone
chloroquine
terfenadine**
erythromycin
haloperidol

62
Q

signs of heart failure on a chest x ray (pulmonary oedema)

A 
A -alveolar oedema (batswing)
B - Kerley B - interstitial oedema
C- cardiomegaly
D - dilated prominent upper lobe vessels
E - effusion
63
Q

trx of acute heart left venticular failure

A

sit up
oxygen
iv diuretic
iv diamorphine

64
Q

what is important finding on echo in heart failue

A

left ventricular ejection fraction - whether this is reduced or normal
normal is above 50 percent

65
Q

pulse in patients with heart failure

A

pulsus artenans - upstroke of pulse alternated between strong and weak

66
Q

most useful test to confirm if someone has had analphylaxis

A

tryptase - remains elevated for 12 hours after an attach

67
Q

becks triad

A

falling BP, enlarged neck veins/raised JVP, muffled heart sounds = cardiac tamponade

68
Q

what test to diagnose cardiac tamponade

A

echocardiogram

69
Q

adverse effects of amioderone

A 
thyroid dysfunction
corneal deposits
pulmonary fibrosis/pneumonitis
liver fibrosis/hepatitis
peripheral neuropathy, myopathy
photosensitivity
'slate-grey' appearance
thrombophlebitis and injection site reactions
bradycardia
70
Q

monitoring required on amioderone

A 
TFT
UE
LFT
chest x ray 
all prior to treatment
just TFTs and LFTs 6 monthly thereafter
71
Q

which is the ‘bad’ cholesterol

A

LDL

72
Q

murmur associated with rheumatic heart disease

A

mitral stenosis

73
Q

when is malar flush seen

A

seen in mitral stenosis

74
Q

blood transfusion threshold

A

70

75
Q

blood transfusion threshold in ACS

A

80

76
Q

wedge shaped opacification of cxr

A

PE

77
Q

threshold for platelets prior to surgery or invasive proceudre

A

more than 50 x10(9)

78
Q

what cardio drug needs to be stopped in pregnancy

A

statins

79
Q

signs associated with aortic regurg

A 
Corrigan's - exaggerated carotid pulse
Quinke's - nailed pulsation
De Musset's - head nodding
Duroziez's - diastolic femoral murmur
Traube's - 'pistol shot' femorals
80
Q

pericardial rub is a sign of

A

pericarditis

81
Q

collapsing pulse

A

aortic regurg

82
Q

rumbling mid diastolic murmur, opening snap

A

mitral stenosis

83
Q

slow rising pusle

A

aortic stenosis

84
Q

diagnostic test for cardiac tamponade

A

echocardiogram

85
Q

heyde’s sydnrome

A

triad of aortic stenosis, an acquired von Willebrand disease and anaemia due to angiodysplasia

86
Q

monitoring for statins

A

lfrs at baseline, at 3 months and 12 months

87
Q

ecg change in hypercalcaemia

A

shortening of the QT interval

Cardiovascular Disease (10 decks)

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