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yr3 > cardio DPD > Flashcards

cardio DPD Flashcards

1
Q

Acute rheumatic fever (AI disease)

5 major criteria

A 
Arthritis 
Chorea (st vitus dance) 
Carditis (endocarditis/myocarditis) 
Subcutaneous nodules 
Erythema marginatum
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2
Q

AVRT

A

Type of SVT
Wolff-parkinson white syndrome
Bundle of Kent accessory pathway

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3
Q

Mitral valve prolapse

Barlow syndrome/click murmur syndrome

A

Occurs when one or two leaflets of mitral valve are pushed back into L atrium during systole. Causes a mid-systolic click, with late systolic murmur at apex (can radiate to axilla). May develop into MR and complications of bacterial endocarditis may occur

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4
Q

Austin Flint murmur

A

Occurs in aortic regurgitation
Low-pitched, mid-diastolic rumble at apex
causes a physiological mitral stenosis-like murmur.

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5
Q

Graham Steell murmur

A

Pulmonary regurg/HTN
High-pitched
Early diastolic murmur
Louder on inspiration

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6
Q

Carey Coombs murmur

A 
Mitral stenosis (in rheu fever)
Short, mid-diastolic rumble at apex
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7
Q

Dopamine agonists

used to treat prolactinomas

A

Bromocriptine

Cabergoline

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8
Q

Dopamine antagonists

anti-emetics

A

Metoclopramide

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9
Q

ACEi’s effect on plasma creatinine initially

A

Increases

this is abnormal but continue to administer the drug

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10
Q

Hypoglycaemic collapse causes

A

T1DM (insulin OD?)

Insulinoma (very rare)

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11
Q

Swollen leg DDx

A
  1. DVT (any risk factors?)
  2. Cellulitis
  3. Ruptured baker’s cyst
  4. CCF (usually bilateral leg swelling)
  5. Liver failure
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12
Q

Dressler’s syndrome

A

Autoimmune pericarditis

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13
Q

Sodium nitroprusside indications

A

Rapid BP lowering

Most effective and reliable drug

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14
Q

Secondary hypertension causes

90% are primary

A 
Phaeochromocytoma
Cushings
Conns
Acromegaly
Renal artery stenosis
Aortic co-arctation
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15
Q

Loud S1 with opening snap

Mid-diastolic murmur

A

Mitral stenosis

apex beat is tapping, heave: RV hypertrophy and pulmonary HTN, malar flush, AF, orthopnoea, thready pulse

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16
Q

Commonest cause of mitral stenosis (obstructed blood flow from LA to LV)

A

Rheumatic fever

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17
Q

Water-hammer pulse

A

Collapsing pulse, wide PP

= aortic regurg

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18
Q

Aortic regurg causes

A

Abnormalities (bicuspid valve, IE, rheumatic fever)

Dilation (hypertension -> LVH)

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19
Q

Aortic regurg (reflux of blood from aorta to LV in diastole) signs and symptoms

A 
Symptoms of HF (S3, S4, orthopnoea, palpitations)
Displaced apex beat
Early diastolic murmur
Wide PP, collapsing pulse
CXR = cardiomegaly
ECG = LVH
Echocardiogram
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20
Q

Aortic stenosis (obstruction from LV) signs and symptoms

A 
Angina, syncope
ESM radiates to carotids
Narrow PP, slow rising pulse
CXR = calcified aortic valve
ECG = LVH
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21
Q

Aortic stenosis causes

A

Rheumatic heart disease
Calcification of bicuspid aortic valve
Calcification of tricuspid valve in elderly

22
Q

Cardiac arrest O/E

A

Unconscious
Not breathing
No carotid pulse

23
Q

Cardiac arrest Rx

A

ABCDE
CPR + defibrillator
IV adrenaline
(Amiodarone and atropine)

24
Q

HTN classification
Normal
Normal high

A

Normal: <130, <85

Normal high: 130-39, 85-89

25
Q 
HTN classifcation
Stage I (mild)
Stage II (moderate)
Stage III (severe)
Stage IV (very severe)
A 
Stage I (mild): 140-159, 90-99
Stage II (moderate): 160-79, 100-109
Stage III (severe): 180-209, 110-120
Stage IV (very severe): ≥210, ≥120
26
Q

HTN classifcation
Isolated systolic Class I
Isolated sytolic Class II

A

Isolated systolic Class I: 140-159, <90

Isolated sytolic Class II: ≥160, <90

27
Q

Hypertensive retinopathy grades

A

Grade 1 - silver wiring
Grade 2 - AV nipping
Grade 3 - flame haemorrhage, cotton wool spots (ischaemia)
Grade 4 - all features and papilloedema

28
Q

Chronic HTN other signs

A 
LVH
Heave
S4 (ventricular hypertrophy)
Bruits
ECGs: deep S wave V1/2, tall R wave V5/6. Together >7large sqares
29
Q

High renin and aldosterone levels suggest…

A

Renal artery stenosis

30
Q

Low renin and high aldosterone levels suggests..

A

Hyperaldosteronism (Conn’s)

31
Q

de Musset’s sign

seen in aortic regurg, associated with hyperdynamic pulse.

A

Head nods in time with pulse

32
Q

Becker’s sign
Muller’s sign
Corrigan’s sign
Quincke’s sign

seen in aortic regurg, associated with hyperdynamic pulse.

A

Visible pulsations of:

  1. becker’s - pupils and retinal arteries
  2. muller’s - uvula
  3. corrigan’s - in neck
  4. quincke’s - on nail bed
33
Q

Traube’s sign

seen in aortic regurg, associated with hyperdynamic pulse.

A

Pistol shot (systolic and diastolic sounds) on auscultation of femoral arteries

34
Q

Duroziez’s sign

seen in aortic regurg, associated with hyperdynamic pulse.

A

Systolic and diastolic bruit on partial compression of femoral artery

35
Q

Rosenbach’s sign
Gerhard’s sign

seen in aortic regurg, associated with hyperdynamic pulse.

A

Systolic pulsations of:

  1. rosenbach’s - liver
  2. gerhard’s - spleen
36
Q

Hill’s sign

seen in aortic regurg, associated with hyperdynamic pulse.

A

Popliteal cuff SBP exceeding brachial pressure by >60mmHg

37
Q

Acute malignant HTN Rx

A

IV b-blocker e.g. labetolol
± sodium nitroprusside

Avoid very rapid lowering which can cause cerebral infarction

38
Q

When is CABG indicated in ischaemic heart disease

A

Left main stem or three-vessel disease involvement

39
Q

MI complications (DARTH VADER)

A 
Death
Arrhythmias
Rupture (papillary muscles - acute MR)
Tamponade
Heart failure
Valve disease
Aneurysm
Dressler's syndrome
Embolism
Re-infarction
40
Q

Causes of mitral regurg

A 
Rheumatic heart disease
IE
Mitral valve proplapse
Papillary muscle rupture
Floppy mitral valve/CTDs
41
Q

Coxsackie B virus and Chagas disease are infectious causes of

A

myocarditis

42
Q

Investigations for hypertension

A 
Bloods: FBC (polycythaemia), U+Es (hypoK+ and renal function)
Fasting glucose (DM risk)
Lipids
ECG (LVH)
Urinalysis (nephritis or renal disease)
43
Q

Phaeochromocytoma Rx

A 
(Rehydrate if dehydrated)
Alpha blockade
Beta blockade
Localise the lesion
surgery
44
Q

A 65 year old patient with a previous MI has a BP of 140/80 on atenolol. What is should be the next step in his treatment?

A

Add a thiazide diuretic

45
Q

D-dimer is useless in pregnancy because it will be raised anyway. Pregnant women with DVT risk investigation should be…

A

Doppler USS of the leg

46
Q

Polymorphic VT
Haemodynamically stable patient
Treatment?

A

IV amiodarone/magnesium

then DC cardioversion or if haemodynamically unstable

47
Q

Left main stem branches

A

left anterior descending artery

left circumflex artery

48
Q

HOCM cardiac signs + symptoms

A

Regular, jerky pulse
Hyperdynamic cardiac impulse (not displaced)
(Mid-systolic murmur with no ejection fraction)
S4

49
Q

STEMI Rx

A

MONABASH
<12hours: PCI/fibrinolysis in same 120mins
>12hours: consider CABG

50
Q

Unstable angina/NSTEMI Rx

A

Analgesia: morphine
Anti-ischaemia: GTN spray
Immediate aspirin + anti-thrombin therapy:
fondaparinux or LMWH

Long term: DASH diet, stop smoking, ACEi, dual antiplatelet therapy (aspirin + 2nd agent), statins, b-blockers

51
Q

Patient with NSTEMI diagnosed will be having a coronary angiogram soon. They have been given aspirin, morphine and GTN spray already so far. What other medication should be given?

A

Anti-thrombin therapy is indicated here
i.e. LMWH or fondaparinux
However this patient is having a coronary angiogram soon so LWMH is the choice and not fondaparinux.

yr3 (19 decks)

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