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cardio + resp > questions i got wrong > Flashcards

questions i got wrong Flashcards

1
Q

what is a pericardial knock and what is it indicative of?

A
  • commonly caused by constrictive pericarditis
  • high pitched sound made by heart during early diastole
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2
Q

murmurs on which side of the heart get louder on expiration

A
  • left side + vice versa
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3
Q

which murmurs are louder with valsalva manouvre?

A

HOCM + mitral valve regurg

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4
Q

acute management for a patient in AF who is haemodynamically unstable

A

DC cardioversion

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5
Q

ECG changes in pericarditis

A
  • PR depression
  • saddle ST elevation
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6
Q

management of VT with pulse

A
  • amiodarone 300mg IV over 20-60 mins
  • 900mg over 24 hours
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7
Q

management SVT in stable patients with a regular rhythm

A
  • vagal manouvres
  • IV adenosine 6mg
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8
Q

rheumatic fever management

A
  • oral benzylpenicillin
  • NSAIDs
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9
Q

management of STEMI if PCI not available within 2 hours

A
  • fibrinolysis - with tPA
  • give a heparin at same time
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10
Q

management of patient if ECG still shows ST-elevation 90 mins after fibrinolysis

A

PCI - persisting ischaemia on ECG following fibrinolysis demonstrates failure of intervention

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11
Q

what cha2ds2-vasc score indicates anticoagulation?

A

1 - men
2 - women

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12
Q

what do each of the letters mean in cha2ds2vasc

A

c - congestive heart failure
h - hypertension
a2 - age>75 =2, age>65 = 1
d - diabetes
s2- stroke, TIA, thromboembolism
v - vascular disease
s - sex (female)

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13
Q

features of aortic regurgitation

A
  • early diastolic murmur
  • intensity increased by handgrip manoeuvre
  • intensity increased with exhalation
  • widened pulse pressure
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14
Q

management 3 vessel disease

A

CABG

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15
Q

management type A and B aortic dissection

A

type A - surgery
type B - conservative + bed rest - reduce blood pressure with IV labetalol

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16
Q

signs aortic stenosis

A

narrow pulse pressure
ejection systolic murmur - transmitted to carotids
soft s2
ejection click

17
Q

ecg findings aortic stenosis

A

increased QRS
LAD
LBBB
poor R wave progression

18
Q

definition severe aortic stenosis

A
  • peak gradient > 40 mmHg
  • aortic jet velocity >4m/s
19
Q

when to give SAVR vs TAVI in aortic stenosis

A

SAVR = surgical aortic valve replacement - if patient low risk and <75
TAVI = trans-catheter aortic valve implantation - if patient has co-morbidities, >75

20
Q

causes LAD

A

shortness
obesity
inferior MI
LBBB

21
Q

causes RAD

A

tall + lean
PE
RBBB

22
Q

features aortic regurg

A

early diastolic murmur, best heard on exhalation
wide pulse pressure
head bobbing (de musset’s sign)
nailbed pulsation
collapsing pulse

23
Q

features left ventricular free wall rupture post-MI

A
  • acute heart failure secondary to cardiac tamponade-raised JVP
  • pulsus paradoxus (drop in blood pressure >10mmHg on inspiration)
  • diminished heart sounds
24
Q

features left ventricular aneurysm post-MI

A
  • persistent ST elevation
  • risk of thrombus, must be anti-coagulated
25
Q

features ventricular septal defect

A

acute heart failure + pan-systolic murmur

26
Q

features acute mitral regurg post-MI

A
  • due to ischaemia of papillary muscle
  • hypotension and pulmonary oedema
  • pan-systolic murmur
27
Q

acceptable blood changes after commencing ACE-inhibitor

A

<30% increase in creatinine
<25% decrease in eGFR
- don’t modify dose, recheck levels in 1-2 weeks

28
Q

which hypertensive medication causes ototoxicity

A

loop diuretics

29
Q

‘non-shockable’ rhythms

A

asystole/pulseless-electrical activity (asystole/PEA)

30
Q

target INR for patient with aortic metallic heart valve

A

INR 3.0

31
Q

target INR for patient with mitral metallic valve

A

3.5

32
Q

ECG findings posterior MI

A

V1-V3
Reciprocal changes of STEMI are typically seen:
horizontal ST depression
tall, broad R waves
upright T waves
dominant R wave in V2

Posterior infarction is confirmed by ST elevation and Q waves in posterior leads (V7-9)

33
Q

medication to avoid in ventricular tachycardia

A

verapamil

cardio + resp (8 decks)

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