reivsion Flashcards
revision
slow rising pulse
aortic stenosis
collapsing pulse
aortic regurg
irregular pulse
AF
jerky pulse
hocm
pulsus alterans
left ventricular systole failure
pulsus pardoxus- fading on insipiration
cardiac tamponade/pericarditis
raised JVP fixed
lung tumour- SVC obstruction
jvp raised on inspiration- kussmal sign
constrictive pericarditis/ cardiac tamponade
large V waves
tricuspid regugrg
cannon waves
complete heart block
absent a waves
AF
prominent a waves
tricuspid stenosis/ pulmonary stenosis/ pulmonary HT causing right v hypertrophy
infective endocarditis diagnosis criteria?
Duke’s (2,1+ 3, 5) major= +ve blood culture 2x certain time apart, sign of endocardial involvement
organism in IE?
group a haemolytic strep viridans, staph aureus in IVD users
criteria for rheumatic heart disease? + organism?
duckett jones- arthiritis carditis, carey coombs murmur- mid diastolic murmur. sydenham chorea, erythema marginatum strep b haemolytic- strep pyogenes
signs of aortic stenosis?
narrow pulse pressure, heaving displaced apex beat, ejection systolic crescendo murmur- aortic area radiate to axilla + carotids
signs of aortic regurg?
wide pulse pressure, crescendo decrescendo early diastolic murmur, collapsing pulse severe = austin flint murmur volume overload displaced apex beat
signs of mitral regurg?
overloaded apex beat + displaced, pansystolic murmur
signs of mitral stenosis?
tapping apex beat, rumbling mid diastolic murmur
graham steel murmur?
pulmonary hypertension due to mitral stenosis causing pulmonary valve regurg
atrial septal defect murmur?
ejection systolic murmur
VSD murmur?
pansystolic murmur
malar flush sign=?
mitral stenosis
Aortic regurg corrigan sign? De mussets? quinckes? traube's?
Carotid pulsation (Corrigan’s sign)
Head nodding (De Musset’s sign)
Capillary pulsations in nail bed (Quincke’s sign)
Pistol-shot heard over femorals (Traube’s sign
what are roth’s spots
infective endocardidtis- boat shaped retinal haemorrhage with a white centre
what is beck’s triad?
criteria for cardiac tamponade signs = (Low BP + Increased JVP + Muffled heart sounds)
causes of absent p waves?
sinoatrial block, af
cause of peaked p waves?
right ventricle hypertrophy
pericarditis ecg changes?
saddle shaped st segment + PR depression
PE ECG sign?
S1Q3T3
hyperkalaemia ecg signs?
tented t waves, sine wave- QRS
hypokalaemia ecg signs?
flattened t waves, u waves present
side effect of b blocker
impotence, SOB, cold peripheries
ACEi side effect?
persistent dry cough
simvastatin side effect?
hepatotoxicity- LFTs every 12 months, myositis
GTN SE?
hypotension, tachycardia, flushing, headaches, worsening GORD
frusemide SE?
hypokalaemia
digoxin SE?
hypokalaemia, hypercalcaemia, hypo Mg
amiodarone SE?
lung liver fibrosis, thyroid issues as iodine
verapamil se?
LV failure
anaphylaxis treatment?
0.5mg IM (1:1000) adrenaline + 200mg Hydrocortisone + 10mg chlorphenamine
pemberton’s sign?
facial congestion when lifting arm
pleural effusion dx?
light’s criteria- Pleural aspiration with ultrasound recommended to reduce the complication rate
Fluid should be sent for pH, protein, lactate dehydrogenase (LDH), cytology and microbiology
• Exudates have a protein level of >30 g/L, transudates have a protein level of <30 g/L
Diagnostic criteria of ARDS
Bilateral infiltrates on CXR, Pulmonary capillary wedge pressure <18 (no clinical evidence
of increased left atrial pressure) , Refractory hypoxaemia (PaO2:FiO2 <200), lack of clinical congestive heart failure,
acute onset
leigonella treatment?
ciprofloxaxin- flucoxacillin
CF pneumonia?
Pseudomonas Aeruginosum
Positive cold agglutinins, low grade fever
Eyrthema nodosum. Younger adolescents and adults
Headache, malaise which preceded chest Sx, dry cough
mycoplasma pneumonia- treat using clarithromycin
most common hospital acquired pneumonia?
kliebsiella pneumonia
copd pneumonia?
haemophilus
CURB 65 criteria?
AMTS <8, Urea >7, RR >30/min, SBP<90 or DBP<60mmHg,
Age >65
Mx of aspiration pneumonia
IV cefuroxime and metronidazole (need to
cover anaerobic bacteria)
Longstanding COPD, SOB, cough with coloured sputum MX
28% O2 blue venturi mask, nebulised salbutamol +
ipratropium, PO prednisolone, amoxicillin (in that
order)
when is magnesium sulphate used in asthma
life threatining situation
how is hiatus hernia managed?
nissen fundoplication
Signs of chron’s?
cobble stone + rose thorn ulcers, barium swallow
toxic mega colon dx?
12cm dilation of transverse colon with colonic wall thickening
dx + mx of haemachromotosis
pearl stain liver biopsy show haemosiderin deposits. MX = dexoferoxamine
portal HTN criteria
10mmhg