random Flashcards
if someone has an NSTEMI and <3% GRACE score what medications should they receive? what if they have bleeding risk
ASPIRIN 300mg +Ticagrelor
Clopidogrel if bleeding risk
ECG findings in posterior MI
horizontal ST depression
tall, broad R waves
upright T waves
dominant R wave in V1/2
how does a left ventriuclar aneurysm presetn post MI and ehat are ECG findings
NO PAIN
signs of HF eg dyspnoea, bibasal crackles rasied JVP
ECG - persistent ST elevation
treatment of neurogenic shock
vasoconstrictors - spinal cord transection casues peripheral vasodilaion
prophylaxis of variceal rebleed
propanolol
what drug is used in hypercholesterolaemia in people who dont tolerate statins
ezetimibe
features of takayasu arteritis
headache malaise, unequal BP in arms, aortic regurgitation, claudication on exertion
what is pulsus paradoxus and when is it seen
decrease in pulse pressure during insp
asthmas
what is romano ward syndrome ?
auto dom congenital long QT syndrome
Pericarditis ECG findings
st elevation and pr depression
what antibiotic can prolong the QT
tetrayclines
does warfarin affect the PT or APTT
PT
ank spond x-ray findings
subchondral erosions, sclerosis
and squaring of lumbar vertebrae
maagement ofpancreatic pseudo cyst
conservatively - 50% reslove in 3 months
what type of colostomy is placed in an emergency sigmoid persoration
end colostomy - hartmanns procedure
treatment of intrapartum GABHS
IV benpen
what is osteomalacia
softening of the bones secondary to low vitamin D levels
MI of what region causes AV nodal block
inferior
biochemical findings in osteomalacia
low calcium
low phosphate
high ALP
high PTH
what is th emost reliable test to confirm ovulation
day 21 progesterone
treatmet of pneumothorax< 2cm
if SOB > need asp
if aymp - discahrge
biochemistry in oesteogenesis imperfecta
normal CA, P04, ALP and PTH
what medication is used for people wiht systemic scleorsis with renal crisis
ACEI
tx of torsades
iv magnesium sulphate
what size of aorta is classed an aneurysmal
> 3cm
management of AAA depending on size
3cm- 4.5 = rescan every 12 month
4.5-5.5cm - -rescan every 3month
.5.5cm or rapidly enlarging eg> 1cm/ yr- refer urgent 2 week referral
diagnosis of AAA rupture
theatre straight away if unstable
CTA if stable
types of arotic dissection
type A -ascending
`type b - descending
investigations in arotci dissection and when used
CXR - widened mediastinum
CT -stable
TOE - unstable
mangemenet of differeretn arotic dissections
type A Ascending - emergecny Surgical (TEVAR)
TyPE B - Iv labetalol and conservative
STEMI ECG changes
increase in 1mm on limb leads
increase of 2mm on chest
new LBBB
what classically precipitates digoxin toxicity
hypokalaemia
classical causes fo SVT
AVNRT - most common
AVRT eg WPW
what to give in SVT if allergic to adenosine
verapamil
what is PR prolongation classed as
> 0.2
mobitzII
P’s not always followed by QRS
after TIA or Stroke folllowign AF when should anticoagulation begine
TIA - immediately
Stroke - 2 weeks
options for chemical cardioversion
flecanide and amiodarone (if structural heart disease)
what should be given alongside cardioversion if presenting <48 hours
heparin
how long shoud a patient be anticoaged for prior to cardioversion
3weeks
how long shoudl a patient be anticoaged for prior to ablation
4 weeks
what electrolyte disturbances cause long QT
hypokalaemia
hypocalcaemia
hypomagnesium
difference between paroxysmal and persistent AF
paroxsymal <48 hours
peristenet >48hrs and can be cardioverted
what must be done in AF if CHADVASC says no anticoag
must do echo to exclude valvular disease
when is S3 heard
left ventricular failure (e.g. dilated cardiomyopathy, HF), constrictive pericarditis
mitral regurg
are innocent murmurs sys or diastolic
always systolic
regurgitation murmurs tend to have what sound
blowing
management of mitral stenosis
aymp - monitor
symp -perc balloom valvotomy
management of mitra regurg
medical - nitrates diuretics Hf meds
severe - pig/artificial valve replacement
management of aaortic stenosis
aymp - monitor if >40mmhg then replace
symp - AVR
aortic regurg mangeemnt
medical
aymp with LV dys or symp = AVR
most common endocarditis organism forllowin gsurgery/indwellign lines
staph epidermidis
enodcarditis organims assoc with colorectal cancer
strep bovis
how far apart do cultures need to be in infective endocarditis and how many
2 >12 hrs apart
3 cultures fi less specific organism eg staph aureus/epidermidis
how to diagnse brugada syndrome
give flecanide if ECG gets worse then brugada (ST elevation in leads V1-3 and t wave inversion )
treatment of brugadas
ICD
ECG changes seen in brugada
TS elevation and RBBB in V1,2,3
mutation in HOCM
β-myosin heavy chain protein or myosin-binding protein C
characteristic biopsy findings in HOCM
myofibrillar hypertrophy with chaotic and disorganized fashion myocytes (‘disarray’) and fibrosis on biopsy
what movements alter murmur in HOCM
decrease with squatting increase with valsalva
echo findings in HOCM
MR SAM ASH
mitral regurg
sys anterior mitral valve leaflet
asyym hypertrophy
cancer assoc with Acanthosis nigricans
gastrointestinal cancer
what overdose causes tinnitus
aspirin
mist common casue of neutropenic sepsis
staph epidermidis
what size of DCIS warrants mastectoym
> 4cm
symptoms of myocarditis
chest pain , SOB, arrhythmia
what test must all pericarditis patients have
TTE
what test is used to monitor LMWH
anti-Xa activity
