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Cardiovascular > Valvular, Genetic, Inflammation > Flashcards

Valvular, Genetic, Inflammation Flashcards

1
Q

Causes of mitral stenosis

A 
Rheumatic fever (majority of the time)
Congenital causes
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2
Q

Definition of mitral stenosis (size)

A

Orifice less than 2 square cm

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3
Q

What does severity of mitral stenosis depend on?

A

Trans-valvular pressure gradient

Trans-valvular flow rate

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4
Q

Treatment of mitral stenosis

A

Diuretics and restrict sodium intake

Anticoagulation

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5
Q

Is acute mitral regurgitation an emergency?

A

Yes

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6
Q

Most common valvular disease

A

Aortic stenosis

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7
Q

Treatment of aortic stenosis

A

Surgical

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8
Q

Aortic regurgitation causes

A

Aorta disease

Valve leaflet pathology

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9
Q

Is acute aortic regurgitation an emergency?

A

Yes

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10
Q

Treatment for aortic regurgitation

A

Surgical

Vasodilator therapy delays requirement of surgery

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11
Q

Conditions patients must meet before CABG

A 
Adequate lung function
Adequate mental function
Adequate hepatic function
Ascending aorta OK
Distal coronary targets OK
LVEF >20%
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12
Q

What vessels are used for a graft in CABG?

A

Reversed saphenous vein
Internal mammary vein
Radial arteries

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13
Q

What 2 valves are more commonly operated on in adults?

A

Aortic and mitral

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14
Q

What are the 3 most common valve conditions requiring surgery?

A

Senile tricuspid AS
Bicuspid AS
Degenerative MR

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15
Q

What sort of infection is rheumatic fever related to?

A

Streptococcal infections

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16
Q

What is the hallmark of pathology in rheumatic fever?

A

Pancarditis

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17
Q

Treatment of rheumatic fever

A

Aspirin and bed rest

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18
Q

Presentation of chronic rheumatic heart disease

A

Gradually progressive mitral valve disease and/or aortic valve disease

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19
Q

Commonest cause of endocarditis

A

Strep viridans

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20
Q

What sort of endocarditis does strep viridans lead to?

A

Subacute bacterial endocarditis

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21
Q

Second commonest cause of endocarditis

A

Staph aureus

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22
Q

What sort of endocarditis does staph aureus lead to?

A

Acute bacterial endocarditis

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23
Q

Is cure more likely with strep viridans or staph aureus endocarditis?

A

Strep viridans

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24
Q

What’s more likely to be cured with antibiotics alone, native valve or prosthetic valve enocarditis?

A

NVE. 90% chance vs 50%

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25
Q

How long are antibiotics given after op for endocarditis?

A

6 weeks IV antibiotics

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26
Q

Audibility of aortic stenosis

A

Murmur usually easily heard

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27
Q

Audibility of aortic regurgitation

A

Murmur usually difficult to hear. Louder the murmur, the more severe it is

28
Q

Audibility of mitral stenosis

A

Murmur usually difficult to hear. Louder the murmur, the more severe it is

29
Q

Audibility of mitral regurgitation

A

Murmur usually easy to hear. If murmur loud then MR usually severe

30
Q

Type of surgical procedure indicated if severe valve disease

A

Valve replacement

31
Q

What size indicates surgery for mitral stenosis?

A

Orifice <1.5cm squared

32
Q

Where is blood drained from and returned to in cardiopulmonary bypass?

A

Drained from RA, returned to ascending aorta

33
Q

Max time limit for patient to be on cardiopulmonary bypass

A

12 hours

34
Q

Type of embolism that can be involved as complication of open thoracic surgery?

A

Air embolism

35
Q

Pros and cons of biological and mechanical prosthetic valves

A

Biological: no warfarin, wears out after 15 years
Mechanical: warfarin required, lasts >40 years

36
Q

2 commonest signs/symptoms of infective endocarditis

A

Fever

Heart murmur

37
Q

What criteria is used for diagnosis of infective endocarditis?

A

Modified Duke criteria

38
Q

Indications for surgery in IE

A

Heart failure with valvular dysfunction or cardiac complications
Uncontrolled infection
Prevention of embolism

39
Q

Effect of rheumatic heart disease on valve leaflets

A

Leaflet thickening, calcification, restricted movement

40
Q

Pretest scoring system for DVT

A

Wells scoring system

41
Q

Pretest scoring system for PE

A

Wells scoring system

42
Q

Treatment for DVT and PE

A

Anticoagulation is main treatment
Vascular surgery for massive DVT
Thrombolysis for massive PE

43
Q

How long is anticoagulation given for provoked vs unprovoked DVT and PE?

A

Provoked: 3 months
Unprovoked: usually lifelong

44
Q

3 aims of treatment of DVT and PE

A

Prevent clot extension
Prevent clot embolisation
Prevent clot recurrence

45
Q

3 causes of congenital heart disease

A

Copy number variation
Single nucleotide variation
Teratogens

46
Q

How does genetics of down syndrome present?

3 ways

A

95% maternal non-disjunction
3% translocation
2% mosaic

47
Q

Common cardiac problem associated with down sydrome

A

Atrio-ventricular septal defects (in 12%)

48
Q

Percentage of Turner syndrome that are mosaic

A

30%

49
Q

Common cardiac problem associated with turner sydrome

A

Coarctation of aorta

50
Q

Mnemonic for 22q11 deletion syndrome

A 
Cardiac malformation
Abnormal face
Thymic hypoplasia
Cleft palate
Hypoparathyroidism
22q11 deletion
51
Q

Percentage of 22q11 deletion patients that have schizophrenia

A

22%

52
Q

What 2 syndromes does 22q11 deletion encompass?

A

DiGeorge and Shprintzen

53
Q

Common cardiac problem associated with Williams sydrome

A

Aortic stenosis

54
Q

What deficiency is ventricular septal defects associated with?

A

Folate deficiency

55
Q

Is marfans dominant or recessive?

A

Autosomal dominant

56
Q

Gene and chromosome mutated in marfans

A

Fibrillin 1 gene on chromosome 15

57
Q

Management of marfans

A

At least annual review

ECHO

58
Q

When is surgery offered for marfans?

A

Sinus of valsalva exceeds 5.5cm or 5% growth per year

59
Q

2 conditions that come under long QT syndrome

A

Romano-ward syndrome

Jervell Lange-Neilsen

60
Q

Effects of brugada syndrome

A

Sudden cardiac death, ventricular fibrillation/tachycardia

Enlarged LV/poor LV function

61
Q

Management of brugada syndrome

A

Avoid fever, excess alcohol, overeating

ICD

62
Q

Affect of hypertrophic cardiomyopathy on heart rhythm

A

Arrhythmia

63
Q

Screening system for genetic diseases

A

NICCS

64
Q

Most common cause of myocarditis

A

Viral infection

65
Q

Most common causes of pericardial disease

A

Viral or idiopathic

66
Q

Most important causes of pericardial disease to pick up

A

Bacterial, post-MI, perforation, neoplasia

Cardiovascular (4 decks)

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