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Flashcards in Cardiovascular Deck (63)
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1
Q

Marfans syndrome associated with?

A

Aortic regurgitation

2
Q

Down’s syndrome associated with

A

Congenital heart disease

3
Q

What is turners syndrome ?

Associated with

A

Female who is partially or totally missing an X chromosome

Coarctation of the aorta

4
Q

Cardiovascular causes of clubbing

A

Cyanotic congenital heart disease

Subacute infective endocarditis

5
Q

Causes of sprinter haemorrhages

A

Infective endocarditis

Profound anaemia

6
Q

What are Olsers nodes

Why do you get them?

A

Painful lumps in fingers / Palms

Fragments of vegetation from an infected valve

7
Q

Most common cause of irregularly irregular pulse

A

Atrial fibrillation

8
Q

When do you get a collapsing pulse

A

Aortic regurgitation

Patent ductus arteriosus

9
Q

Radial radial delay

A

Arterial occlusion

Atherosclerotic plaque, aneurysm

10
Q

Radial femoral delay suggests ?

A

Coarctation of the aorta

11
Q

Why check blood pressure lying and standing

A

Postural hypotension

12
Q

Cardiac cause of jaundice

A

Prophetic heart valve induced haemolysis

13
Q

Malar flush is?

Cause ?

A

Rosy cheeks with bluish tinge
Dilation of malar capillaries -
pulmonary hypertension
Low cardiac output - mitral stenosis

14
Q

High arched palate seen in

A

Mar fans

15
Q

Ways to distinguish JVP from arterial

A

Double impulse
Varies with position and inspiration
Cannot be palpated
Rises if pressure applied to liver

16
Q
Carotid pulses 
Slow rising 
Collapsing 
Bisferiens (slow rising and collapsing) 
Small volume 
Pulses alternates (alternating weakens strong)
A

Slow rising - aortic stenosis
Collapsing - aortic regurgitation, patent ductus arteriosus
Bisferiens (slow rising and collapsing) - aortic stenosis and incompetence
Small volume - aortic stenosis, pericardial effusion
Pulses alternates (alternating weakens strong) - LV diseased

17
Q

Cardiac failure -> what heard in lungs

A

Pan-inspiriatory crackles

18
Q

Pitting oedema of sacrum occurs when

A

Severe right heart failure

19
Q

Unilateral lower limb oedema

A

DVT or compression of large veins by tumour/ lymph nodes

20
Q

Causes of raised JVP

A
HOLT 
Heart failure
Obstruction of vena cava 
Lymph node enlargement - supraclavicular 
Thoracic pressure increase
21
Q

What is cardiac tamponade ?

Becks triad?

A
Pericardial effusion -> slow / rapid compression of heart 
3 Ds
Distant heart sounds
Distended jugular veins 
Decreased arterial pressure
22
Q

Difference between valve replacement scar and cabg

A

Cabg always midline sternotomy

Valve may be on side

23
Q

When may apex best be decimated laterally

A

Mitral / aortic regurgitation (volume overload)

24
Q

When would you feel parasternal heaves

A

Rv / severe LA enlargement

25
Q

Right / left sided murmurs heard loudest when ?

A

Right - inspiration (venous return increased)

Left - expiration

26
Q

Causes of pericarditis

A
CARDIAC RIND 
Collagen vascular disease 
Aortic aneurysm 
Radiation 
Drugs eg. Hydralazine 
Infections 
Acute renal failure
Cardiac infarction 
Rheumatic fever 
Injury
Neoplasms 
Dressers syndrome
27
Q

Radial radial delay

A

Aortic coarctation

28
Q

Dental caries predispose to?

A

Infective endocarditis

29
Q

Pansystolic murmur

A

Mitral regurgitation

30
Q

Ejection systolic murmur

A

Aortic stenosis

Can be heard in carotids

31
Q

Basic management of MI

A
BOOMAR
bed rest
Oxygen
Opiate
Monitor
Anticoagulants
Reduce clot
32
Q

Causes of ST elevation

A
ELEVATION 
Electrolytes 
LBBB
Early repolarisation 
Ventricular hypertrophic 
Aneurysm 
Treatment 
Injury 
Osbourne waves (hypothermia) 
Non-occlusive vasospasm
33
Q

Causes of depressed ST

A
Dropping valve 
Enlargement of LV with strain 
Potassium loss 
Reciprocal ST 
Embolism in lungs
Subendocardial ischemia 
Encephalopathy haemorrhage (cranial)
Shock 
Toxicity (digitalis, quinidine)
34
Q

Causes of T wave inversion

A
INVERT
Ischemia 
Normal (young, black) 
Ventricular hyper trophy 
Ectopic foci 
RBBB, LBBB
Treatments (digoxin)
35
Q

How do you calculate ABPI

Arterial disease indicated by

A

Highest systolic in the ankle / highest in arms

ABPI

36
Q

Haemosidderin deposition looks like?

Indicative of ?

A

Purplish bruise just below skin

Venous insufficiency

37
Q

Malar flush indicative of

A

Mitral stenosis

38
Q

Splinter haemorrhages

A

Bacterial endocarditis

39
Q

2 causes of clubbing

A

Infective endocarditis

Cyanotic congenital heart disease

40
Q

Where are janeway lesions found

A

Palm pulp lesions

41
Q

Where are Olsers nodes found

A

Tender red nodules on finger pulps / thenar eminence

42
Q

What is xanthomata

A

Raised yellow lesions often in tendons of wrist

Hyperlipidaemia

43
Q

Radial radial delay suggests

A

Aortic coarctation

44
Q

Causes of water hammer pulse

A

Normal - fever , pregnancy
Cardiac - AR, PDA
High output - anaemia , AV fistula, thryrotoxicosis

45
Q

Narrow pulse pressure associated with

A

Aortic stenosis

46
Q

Wide pulse pressure associated with

A

Aortic regurgitation

47
Q

Causes of raised JVP

A

Fluid overload
Rv failure
Tricuspid regurgitation

48
Q

Where / when do you get heaves

A

Left steal edge

Rv hyper trophy

49
Q

What is a thrill

A

Palpable murmur over aortic valve and apex beat

50
Q

Lateral displacement of apex beat indicates

A

Cardiomegaly

51
Q

Lung base crackles could mean

A

LV failure

52
Q

Sacral / pedal oedema could mean

A

Rv failure

53
Q

Finish cv exam

A

Peripheral vascular examination
12 lead ECG
Dipstick urine (eg proteinuria caused by hypertension)
Capillary blood glucose
Fundoscopy ( malignant hypertension - papilloedema )

54
Q

Difference in BP across arms

A

Aortic aneurysm

55
Q

Hair loss in legs due to

A

PVD

56
Q

Discolouration of legs due to

A
Eg haemosiderin 
Venous disease (not PVD)
57
Q

Prolonged cap refil indicates

A

PVD

58
Q

Radial femoral delay

A

Coarctation of aorta

59
Q

Femoral Bruis indicates

A

Femoral / iliac stenosis

60
Q

What angle of positive buergers indicates severe limb ischemia

A

Less than 20 degrees

61
Q

What is reactive hyperaemia

A

When leg first goes pink and then Becomes red

Due to arteriolar dilatation to remove built up metabolic waste

62
Q

Finish peripheral vascular exam

A

Cv exam
ABPI
Lower limb neurological examination

63
Q

Usual cause of endocarditis

A

Strep viridans