4th Year Cardio Flashcards Preview

Cardiovascular > 4th Year Cardio > Flashcards

Flashcards in 4th Year Cardio Deck (84):
1

Mitral regurgitation - systolic or diastolic?

Systolic

2

Aortic stenosis - systolic or diastolic?

Systolic - ejection systolic

3

BNP is marker of?

heart failure

4

First line drug treatment for heart failure?

ACE inhibitor and Beta blocker

5

Second line drug treatment for heart failure?

Spironolactone, ARB or hydralazine

6

Third line treatment for heart failure?

Digoxin

7

Slurred upstroke on ECG?

Wolff Parkinson white syndrome (delta wave)

8

When should a bradycardia be treated?

If <40 or symptomatic

9

What is the drug treatment for a bradycardia?

Atropine

10

What kind of arrhythmia does sick sinus syndrome cause?

Brady cardia

11

SVT - what kind of tachycardia? What is the treatment?

Narrow complex tachycardia
Vagotonic manoeuvres
IV adenosine or Verapamil (asthma)

12

VT - what kind of tachycardia cardia and treatment?

Broad complex
IV amiodarone or IV lidocaine
DC shock if no response or unstable

13

What is 1st degree heart block?

Fixed prolongation of the PR interval

14

What is 2nd degree heart block - mobitz 1?

Progressive PR prolongation followed by missing QRS

15

What is 2nd degree heart block - mobitz 2?

P wave without QRS

16

What is complete heart block?

No relationship between P and QRS waves

17

What is the rate of atrial flutter usually?

A division of 300

18

Which type of arrhythmias are always pathological?

Ventricular

19

Which is rhythm is always shockable?

Ventricular fibrillation

20

What is bruggada syndrome?

QRS goes into T wave inversion - risk of sudden cardiac death

21

Which leads are lateral territory?

I, aVL, V5, V6

22

Which leads are inferior territory?

II, III, aVF

23

Which leads are anterior territory?

V1, V2, V3, V4

24

Name 2 ECG markers of ischaemia?

T wave -tall, biphasic, inverted
ST depression
ST elevation

25

What are the criteria for thrombosis in ischaemia?

>1mm in 2 contiguous limb leads
>2mm in 2 contiguous chest leads

26

3 features of RBBB?

Broad M shaped V1
QRS >0.12 seconds
RSR complex in V1
Delayed S wave

27

Name the 4 heart valves in order?

Ticuspid
Pulmonary
Mitral (bicuspid)
Aortic

28

What causes the P wave on ECG?

Atrial depolarisation

29

What causes the QRS complex on ECG?

Contraction of L and R ventricles

30

What causes the 1st heart sound?

Closure of mitral and tricuspid valves

31

What causes the second heart sound?

Closure of the aortic and pulmonary valve

32

What is the ejection fraction?

Proportion of end diastolic volume ejected in each cardiac cycle

33

What is the after load?

Resistance against which heart is pumping

34

What causes wollf Parkinson white syndrome?

Congenital accessory pathway between atria and ventricle

35

treatment of WPW syndrome?

Radio frequency ablation of accessory pathway

36

Drugs for cardio version in AF?

Amiodarone or Flecainide

37

When should DC cardioversion be used in AF?

If the patient is unstable

38

Two signs of aortic stenosis?

Narrow pulse pressure
Slow rising pulse

39

Most common causes of aortic stenosis in older and younger patients?

>65 - degenerative calcification
<65 - bi cuspid aortic valve

40

When should you replace a the valve in a patient with aortic stenosis?

If they are symptomatic or valvular gradient is >40mmHg

41

What two cardiac drugs should you never prescribe together and why?

Verapamil and a beta blocker - risk of complete heart block

42

Drug management of angina?

Statin and aspirin for all
GTN for symptoms
B blocker or Ca channel blocker - first line - both if uncontrolled
If uncontrolled or cannot tolerate - long acting nitrate (ivabradine, nicorandil)

43

Which anti biotic should you avoid in long QT syndrome?

Erythromycin

44

What ECG sign is seen in hypokalaemia?

U waves

45

In what condition will a patient with VF be?

Unconscious - not compatible with cardiac output

46

What drugs are used for rate control in AF?

Bisoprolol or Ca channel blockers (diltiazem)

47

If BP between 135/85 and 150/95 when should you treat?

If <80 or 10 year risk >20%

48

First line hypertensive for someone under 55?

ACE inhibitor

49

First line hypertensive for someone over 55?

Calcium channel blocker

50

Step 2 of hypertension management?

ACE and Ca blocker

51

3rd drug to add in hypertension?

Thiazide

52

Which 3 drugs can be added if control is not achieved on first line treatment?

Spironolactone if K <4.5
Alpha blocker
Beta blocker

53

Splitting of which heart sound is normal?

S2 during inspiration

54

When is S3 normal?

If under 30

55

Causes of a 4th heart sound?

AS, hypertension

56

What type of arrhythmia is torsades des points?

VT

57

What kind of drug is diltiazem?

Calcium channel blocker

58

Anti coagulation in actue AF?

Heparin

59

What is systolic heart failure?

Failure of the ventricles to contract

60

What is diastolic heart failure?

Failure of the ventricles of relax

61

Symptoms of left ventricular failure?

Dyspnora, paroxysmal bought, nocturnal dyspnoea, pink frothy sputum

62

Symptoms of right ventricular failure?

Peripheral oedema, ascities

63

CXR features of LVF?

A - alveolar oedema
B - Kelley B lines
C - cardiomegaly
D - dilated prominent upper lobe vessels
E - effusion

64

First line management of heart failure?

ACE inhibitor and beta blocker

65

2nd line treatment for heart failure?

Spironolactone, ARB, hydralazine

66

3rd line treatment for heart failure?

Digoxin

67

Diuretics used in heart failure and when?

Furosemide and bumetenide
When signs of fluid overload

68

In what time frame should PCI be performed for an MI?

Within 120 minutes, if not possible then thrombolyse

69

W and M in LBBB and RBBB?

Left - W in V1, M in V6
Right - M in V1, W in V6

70

Which type of BBB can be a normal variant?

RBBB

71

Acute drug management of anaphylaxis?

0.5mg IM adrenaline
10mg IV chlorphenamine

72

When should you treat AF according to CHADVASC score?

1 - for males
2 - for everyone

73

What arrhythmia has absent P waves?

AF

74

Typical symptoms of pericarditis?

Chest pain relieved on sitting forward, non productive cought

75

ECG changes in pericarditis?

Saddle shaped ST elevation
PR depression

76

What is the commonest ECG change in PE?

Sinus tachycardia

77

Treatment of torsades des points?

IV magnesium

78

What other arrhytmia is torsades des points associated with and what drugs can cause this?

Long QT syndrome
Anti psychotics and anti depressants

79

What type of murmur Is head in hypertrophic obstructive cardiomyopathy?

Ejection systolic

80

What ECG changes are seen in a recovering MI?

Inverted T waves, Q waves

81

What is a complication of pericarditis?

Pericardial effusion

82

Name 3 causes of pericarditis?

Virus - coxsackie
Post MI -dressler syndrome
Uraemic pericarditis - renal
Autoimmune
Idiopathic

83

Risk in pericardial effusion?

Cardiac tamponade

84

Treatment of pericardial effusion?

Pericardiocentesis
Analgesia
Treat cause