Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MBChB Phase 3 > Week 5: Cardiology > Flashcards

Week 5: Cardiology Flashcards

1
Q

What is a 12 lead ECG?

A

A recording of the electrical activity made from the heart on the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the P wave mean?

A

The heart beat is generated in the SA node, the impulse then spreads down through the atria triggering atrial contraction.
The atrial depolarisation produces the P wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the PR interval mean?

A

The impulse reaches the AV node where it is delayed to allow time for ventricular filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the QRS complex?

A

The impulse is conducted to the ventricles through the bundle branches and purkinje fibres. Ventricular depolarisation is the trigger for ventricular contraction and produces the QRS complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the ST segment?

A

Delay as ventricular action potentials are in their plateau phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the T wave?

A

Ventricular cell repolarisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Summarise the meaning of each wave on the ECG

A 
P = Atrial Depolarisation 
PR = AV nodal delay
QRS = Ventricular depolarisation
ST = ventricular plateau 
T = Ventricular repolarisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do chest leads V1-4 show?

A

Electrical activity recorded from the anterior surface of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What shows the lateral aspect of the heart?

A

V5, V6, limb leads 1, aVL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What shows the inferior surface of the heart?

A

Limb leads 2/3, aVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the QRS axis?

A

The average direction of depolarisation of the ventricles. Determines by looking at the QRS polarity in the limb leads. Normal = -30 to +90 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should the paper speed and gain of an ECG usually be?

A

Paper speed = 25mm/s

Gain = 10mV/mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a clinical trial?

A

Evaluation of new therapeutic intervention in human volunteers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some types of trial?

A

RCT double blind placebo controlled, cluster randomised, factorial, cross over, adaptive trial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is heart failure?

A

Failure of the heart to pump blood at a rate sufficient to meet metabolic requirements of the tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some clinical effects of heart failure?

A

breathlessness, effort intolerance, fluid retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some common causes of heart failure?

A

Coronary artery disease, MI, idiopathic, toxins, genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the main types of heart failure?

A

HF-REF, HF-PEF, chronic (congestive), acute (decompensated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the patho-physiology of heart failure?

A

Myocardial injury - left ventricular systolic dysfunction - perceived reduction in circulating volume and pressure - neurohumoral activation - systemic vasoconstriction renal sodium and water retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the stages of the New York Heart Association Functional Classification?

A

1: no symptoms or limitation in ordinary activity
2: mild symptoms and slight limitation
3: marked limitation (even during less than ordinary activity)
4: severe limitations even at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some investigations for heart failure?

A

ECG, CXR, echo, bloods (UEs, Cr, urea, LFT, urate), haematology, natriuretic peptides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the treatment for heart failure?

A

Beta blocker + ACE inhibitor (or ARB if pt is intolerant due to cough), digoxin, diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is acute heart failure classified?

A 
Warm-Dry = no congestion, hypoperfusion
Cold-Dry = no congestion, hypoperfusion
Warm-Wet = congestion, no hyperperfusion
Cold-Wet = congestion, hypoperfusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the main radiographic stages of congestive heart failure?

A 
1 = redistribution of pulmonary vessels, cardiomegaly
2 = Kerley Lines, peribronchial cuffing, hazy contours of vessels
3 = consolidation, air bronchogram, pleural effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are some signs and symptoms of myocardial infarctions?
Symptoms: chest pain, jaw pain, sweaty, short of breath Signs: tachycardia, heart failure, arrhythmia
26
What is troponin?
Part of cardiac myocyte, release into blood is marker of cardiac necrosis
27
What is an MI?
Elevation in troponin in clinical setting consistent with myocardial ischaemia
28
What are the 6 types of MI?
``` 1 = spontaneous due to primary coronary event 2 = inc O2 demand, sec O2 supply 3 = sudden cardiac death 4a = MI w/ percutaneous coronary intervenion 4b = MI stent thrombosis 4 = MI w/ CABG ```
29
What are some causes of chronic troponin elevation?
renal failure, chronic heart failure, infiltrative cardiomyopathes (eg amyloidosis, haemochromatosis, sarcoidosis)
30
What is unstable angina?
An acute coronary event without a rise in troponin
31
What are the different ECG patterns in a STEMI?
``` ST elevation (occlusion of coronary artery) Posterior infarct (location means ST elevation not seen) Left bundle branch block (new - infarction; old - obscures ST elevation) ```
32
What drugs are used for secondary prevention of an MI?
ACE inhibitors, beta blockers, statins, eplerenone (only for diabetes and LVSD or clinical HF)
33
What are some complications of MI?
Arrhythmias, heart failure, cardiogenic shock, myocardial rupture, psychological
34
What is the difference between stenosis and regurgitation?
``` Stenosis = pressure overload Regurgitation = volume overload ```
35
How does cardiac injury occur in rheumatic valve disease?
recurrent inflammation, fibrinous repair, scarring
36
What are some symptoms of aortic stenosis?
Shortness of breath, presyncope, syncope, chest pain, reduced exercise capacity
37
What are some causes of mitral stenosis?
``` rheumatic valve disease pressure overload dilated LA atrial fibrillation pulmonary hypertension secondary right heart dilatation ```
38
What is endocarditis?
Infection of the endocardium. It is the formation of a vegetation and results in damage to the cusp of valves
39
What are 3 types of endocarditis?
Endocarditis in IVDUs PVE: Prosthetic Valve Endocarditis NVE: native valve endocarditis
40
what are the 2 main signs of endocarditis?
Fever with a murmur
41
What are some long term effects of endocarditis?
Immunological reaction - splenomegaly, nephritis, vasculitic lesions, clubbing Tissue damage - valve destruction/abscess
42
What is the difference between a STEMI and NSTEMI?
STEMI: ST elevation, coronary blocked, no flow NSTEMI: coronary arteries partially blocked, persistent flow
43
What are the pros and cons of echocardiography?
Pros: cheap, available, portable, no radiation Cons: requires good acoustic window, user dependent
44
What are the indications for nuclear perfusion imaging?
Assess ischaemia, assess ejection fraction
45
What are the pros and cons of nuclear perfusion imaging?
Pros: availability Cons: radiation, no structural assessment
46
What are some pros and cons for cardiac CT?
Pros: good rule out for CAD, low risk Cons: radiation, requires low heart rate, no functional assessment of ischaemia
47
What are some indications for invasive angiography?
Ischaemia, primary PCI, valve assessment
48
What are pros and cons for invasive angiography?
Pros: gold standard, option for intervention during same procedure, availability Cons; radiation, risks (CVA, MI, contrast reaction, bleeding, death)
49
What is the ASA score for?
To assess the physical status of a patient before surgery
50
What are the stages in the ASA score?
1: healthy 2: mild systemic disease 3: severe systemic disease 4: severe disease/ constant threat to life 5: moribund 6: organ donor E: emergency
51
What is the METs scale?
MET = metabolic equivalent of task 1 MET: basal metabolic (tv) 3 METs: walking 100m flat 4 METs: walking up 1 flight of stairs/gardening 7 METs: jogging 10 METs: strenuous sport <4 METs associated with increased peri-operative risk
52
What are some peri-operative pitfalls?
Maintain hydration, avoid PONV, early mobilisation, give medication as appropriate, give appropriate analgesia
53
What is atrial fibrillation?
The commonest sustained cardiac arrhythmia
54
What are some symptoms of atrial fibrillation?
palpitation, dyspnoea, stroke (complication), pain, syncope
55
What are 3 types of atrial fibrillation?
Paroxysmal: intermittent, starting & stopping Persistent: needs intervention to stop arrhythmia Permanent
56
What score is used to calculate risk of stroke?
``` CHA2DS2-VASc Congestive heart failure Hypertension Age >75 Diabetes Mellitus Stroke Vascular disease Age 65-74 Sex (female) ```
57
What are the new oral anticoagulants
dabigatran (thrombin inhibitor), rivaroxaban, apixaban, edoxaban (Factor Xa inhibitors)
58
What is systemic hypertension?
Persistent elevation in arterial blood pressure >140/90
59
What is primary hyperension?
Hypertension with no identifiable cause. It is associated with certain risk factors: age, gender, ethnicity, smoking, obesity, alcohol
60
What is secondary hypertension?
A raised blood pressure with an aunderlying cause. Eg Cushing's, NSAIDs, renal artery stenosis
61
What end organ damage can be a result of sustained hypertension?
IHD, CHD, PVD, CVA
62
How would you manage hypertension?
lifestyle measures, pharmacological management (diuretics, ARB, vasodilator), device based therapy
63
What are the differences between the left and right ventricle?
``` RV = trabeculated endocardium, chordae, moderator band LV = smooth endocardium, ellipsoid cavity ```
64
What is secundum atrial septal defect?
The shunt goes left to right (no cyanosis). So may lead to RV failure, tricuspid regurgitation, atrial arrhythmia
65
What happens in transposition of the great arteries?
Rhe aorta and pulmonary arteries switch. This means the aorta is now connected to the right ventricle and the pulmonary artery is connected to the left ventricle
66
What are the components of tetralogy of fallot?
1. Ventricular septal defect 2. Overriding aorta 3. ROVT obstruction 4. Right ventricular hypertrophy
67
What is a univentricular heart?
A term for a congenital heart defect where there is only one effective pumping ventricle
68
What is a Fontan circulation?
The one functioning ventricle supports systemic circulation by being disconnected from the pulmonary vein and arteries. The IVC and SVC directly connect to the pulmonary artery and is then oxygenated by the lungs
69
What is part of the immediate treatment for MI?
``` Oxygen Morphine 10mg IV Antiemetics (odansetron 4mg) Clopidogrel 300mg Aspirin 300mg orally ```
70
What is a STEMI?
Thrombus formation on a ruptured athermatous plaque in a coronary artery
71
What is a primary PCI?
Primary Percutaneous Intervention | Treat by opening affected artery and removing plaque by balloon angioplasty and stent
72
What does thrombolytic therapy involve?
Tenecteplase: a tissue plasminogen activator. Fibrinolytic therapy to break up thrombus in coronary artery Heparin: anticoagulant to prevent further thrombosis
73
What is the first line drug for bradycardia?
Atropine 600ug IV bolus
74
What is the purpose of a coronary angioraphy?
To identify coronary artery stenoses with a view to revascularisation
75
What is cardiogenic shock?
Severe LV damage with hypotension, heart failure and poor cardiac output
76
What are some complications of acute MI?
arrhythmia, cardiogenic shock, LV mural thrombus, heart failure, myocardial rupture, pericarditis
77
What drugs are used in secondary prevention of MI?
Aspirin, Ticagrelor, Statin, Beta Blocker, ACE inhibitor
78
What is the immediate treatment for arterial occlusion?
analgesic, thrombolysis, angioplasty, stent
79
What is the long term management of vascular disease?
statin, antihypertensives, aspirin 75mg, lifestyle changes
80
What are the risk factors for peripheral vascular disease?
male, age over 40, smoking, hypertension, diabetes
81
How do statins work?
They are lipid lowering drugs. They inhibit the enzyme HMG-CoA reductase so reduce cholesterol production
82
How do fibrates work?
They reduce triglyceride levels and increase HDL cholesterol
83
What are resins and how do they work?
They are bile acid sequestrants which lower LDL cholesterol by sequestering the cholesterol-containing bile acids into the intestine and prevent their reabsorption
84
What is intermittent claudication?
Pain in leg brought on by walking and relieved by rest
85
What is intermittent claudication?
Pain in leg brought on by walking and relieved by rest
86
What are the signs of critical ischaemia?
6 P's: | Pale, pain, pulseless, paretic, perishingly cold, paraesthetic

MBChB Phase 3 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions