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medicine year 3 > cardiovascular > Flashcards

cardiovascular Flashcards

1
Q

what are the 3 main symptoms of aortic stenosis?

A

SOB, chest pain, syncope
on exertion

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2
Q

what can happen to heart rate post MI?

A

bradycardia

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3
Q

how do you measure central cap refill?

A

press on sternum for 5s, should reperfuse <2s.

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4
Q

what does left axis deviation in an ecg usually mean?

A

LVH

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5
Q

what does right axis deviation in an ecg usually mean?

A

RVH

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6
Q

what are some examples of blood tests that go in the gold bottle?

A

U and Es
CRP
troponin
LFTs
bone profile
thyroid function

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7
Q

what is shock?

A

state of cellular and tissue hypoxia due to mismatch between o2 supply and demand.

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8
Q

how do you treat hyperkalaemia?

A

calcium glucanate-stabilises myocardium
insulin and dextrose
salbutamol nebs

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9
Q

what does the chadsvasc score do?

A

stroke risk in AF

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10
Q

what does the hasbled score do?

A

bleeding risk in AF

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11
Q

what are the 2 important causes of irregularly irregular rhythm?

A

atrial flutter with variable block
AF

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12
Q

what are 2 things you can temporarily do to slow someone’s heart rate?

A

give drug called adenosine (reduces conduction time in the atrioventricular node of the heart)
carotid massage

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13
Q

what is Beck’s triad?

A

cardiac tamponade:
low BP
muffled heart sounds
raised JVP

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14
Q

how can you treat hyperkalaemia?

A

calcium gucanate-stabilises myocardium
insulin and dextrose
salbutamol nebs

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15
Q

why does long lie cause hyperkalaemia?

A

rhabdomyolysis-muscles release potassium.

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16
Q

what is the significance of Marfan’s in chest pain?

A

it affects big vessels and valves. can cause aortic aneurysms and aortic dissections.

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17
Q

what is cardiac tamponade?

A

blood or fluid fills the sac around the heart, compressing the heart.

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18
Q

what is a potential complication of myocarditis?

A

arrythmias like VF, VT

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19
Q

what is the affect of oestrogen on the cardiovascular system?

A

it decreases plaque formation bc it stops LDL deposition in tunica intima.
however it increases production of coagulation factors in liver so makes your blood more prone to clot .

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20
Q

what big change should happen to someone’s bloods post infusion?

A

increased haemoglobin

21
Q

what is a boot shaped heart classically associated with?

A

tetralogy of fallot

22
Q

what additional blood tests should look at/do if patient has a low Hb?

A

MCV
B12
folate
ferritin

23
Q

what is the difference between pericardial effusion and cardiac tamponade?

A

pericardial effusion can cause cardiac tamponade. becomes cardiac tamponade when heart stops being able to expand properly due to blood present in the sac.

24
Q

what blood vessel supplies the AVN and the effect of this?

A

right coronary artery
means if you see heart block it can be due to a RCA infarct

25
Q

what is prinzmetal angina?

A

just another word for unstable angina

26
Q

what leads are supplied by the right coronary artery?

A

inferior -II, III, aVF

27
Q

what is first line treatment for bradycardia with adverse outcomes like syncope and shock?

A

IV atropine

28
Q

what does widespread saddle shaped ST elevation suggest?

A

acute pericarditis

29
Q

what is the preferred first line treatment for acute pericarditis?

A

naproxen, colchine has also been used in some cases, can also use other NSAIDs

29
Q

what is the preferred first line treatment for acute pericarditis?

A

naproxen, colchine has also been used in some cases, can also use other NSAIDs

30
Q

what cardiac issue is adenosine used for?

A

narrow complex tachycardias

31
Q

what is dressler’s syndrome and why does it happen?

A

pericarditis post MI-can be with or without pericardial effusion
antibodies from damaged heart tissue trigger immune response

32
Q

what are the classic findings of pericarditis?

A

chest pain, fever
raised ESR
ECG findings: widespread concave st-elevation, pr depression, reciprocal st depression and pr elevation in avr

33
Q

what is the nice guideline target for BP control in diabetes?

A

target <130/80

34
Q

what is the treatment for torsades de pointes?

A

IV magnesium sulfate

35
Q

what are the causes of raised BNP?

A

heart failure
age over 70
LVH
renal dysfunction (egfr<60)
ischaemia
hypoxia (eg PE)
sepsis
COPD
diabetes
liver cirrhosis

36
Q

what are the rules post MI and driving?

A

driving may resume 1 week after ACS if successful PCI and EF>40%
if not treated successfully driving may resume after 4 weeks provided no other disqualifying condition

37
Q

what are the ECG changes that are considered normal variants in athletes?

A

sinus bradycardia
junctional rhythm
first degree heart block
Mobitz type 1 (Wenckebach phenomenon)

38
Q

what would haemolytic anaemia look like on bloods?

A

normocytic anaemia
high reticulocyte count

39
Q

what happens in DIC?

A

a disease process messes up your clotting pathways so you get a tendency to both bleed and clot at the same time.

40
Q

which arteritis causes an absent limb pulse and unequal BP in upper limbs due to aortic occlusion?`

A

takayasu’s arteritis

41
Q

what are the symptoms of pericarditis?

A

chest pain -may be pleuritic or relieved sitting forwards
nonproductive cough, dyspnoea, flu-like symptoms, tachycardia, tachypnoea

42
Q

what are some important things that increase the QT interval?

A

hypokalaemia
hypomagnesaemia
lithium
TCAs
citalopram+escitalopram
antipsychotics

43
Q

what is the most appropriate initial management of intermittent claudication?

A

supervised exercise and cardiovascular risk management

44
Q

what is an ecg finding sensitive to cardiac tamponade?

A

electrical alternans -beat to beat variation of QRS
this is due to heart ‘swinging’ in pericardial fluid.

45
Q

how does antiphospholipid syndrome present?

A

venous +arterial thromboses
recurrent foetal loss
thrombocytopaenia
paradoxical rise in APTT

46
Q

what is fat embolism syndrome?

A

trauma leads to release of fat emboli
causes cascade leading to sx of:
resp -high RR, low 02, high temp, high HR
derm -non blanching petechial rash
CNS -confusion, agitation

47
Q

if a patient is allergic to aspirin which medication may they also react to?

A

sulfasalazine

medicine year 3 (21 decks)

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