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MRCP Flashcards > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Acute Coronary Syndrome

A

Spectrum of presentations caused by myocardial ischaemia ranging from unstable angina to STEMI. There is a common pathophysiology of impaired myocardial blood supply secondary to atheromatous plaque disruption and thrombus formation.

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2
Q

Causes of obesity

A

Primary elevated energy intake

Secondary to: 
Hypothyroidism
Cushing’s syndrome 
PCOS 
Insulinoma 
Hypothalamic or pituitary disease 
Drugs 
Generic syndromes such as Laurence-Moon-Biedl syndrome 
Leptin deficiency
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3
Q

Causes of AF

A 
5 most common causes:
Coronary artery disease
Hypertension
Valvular heart disease
Thyroid dysfunction 
Alcohol 
Age
Symptomatic heart failure 
Cardiomyopathies 
ASD and congenital heart defect 
Obesity 
Diabetes 
Chronic respiratory disease 
Infection
High caffeine supplements
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4
Q

Prosthetic valves

A

All cause ESM as narrow outflow (aortic) and interfere with stream (mitral)

Tilting disc - Bjorn-Shiley
Bileaflet- St Jude

Above two has diastolic murmur (aortic and mitral, for different reasons)

Ball and cage - Starr Edwards

Close completely. If diastolic murmur in aorta heard then failure.

If loud systolic murmur, implies valve failure

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5
Q

Causes of Pericarditis

A 
Viral (coxsackie, adenovirus, echovirus)
Bacterial (mycoplasma, haemophilus, TB) 
Connective Tissue Disease (SLE, RA) 
Drugs (hydralazine, procainamide) 
Dresser’s syndrome (MI, post op) 
Uraemia
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6
Q

Collapsing pulse

A 
Aortic regurgitation 
Anaemia 
Fever 
Pregnancy 
Thyrotoxicosis
Patent ductus arteriosus 
AV fistula 
Severe bradycardia 
Severe MR
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7
Q

Duke’s criteria

A

Major:
Typical organism in BC
Echo showing vegetation, access, dehiscence

Minor:
Atypical organism in BC
Suggestive echo
Risk factor such as prosthetic valve 
Pyrexial 
Vasculitic phenomena such as raised ESR 
Embolic phenomena

2M, 1M 2m, or 5m

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8
Q

Causes of Aortic Stenosis

A

Age
Biscuspid valve
Congenital
Rheumatic fever

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9
Q

Causes of Aortic Regurgitation

A

Congenital:
Bicuspid valve
Perimembranous VSD

Acquired:
Acute:
Endocarditis
Dissection

Chronic
Rheumatic fever
Connective tissue disease such as RA/ Ank Spond
Inherited disorders such as Marfan’s
Chronic aortitis - syphillis and Ank Spond

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10
Q

Causes of collapsing pulse

A 
Pregnancy
Patent ductus arteriosus 
Paget’s disease 
Anaemia 
Thyrotoxicosis
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11
Q

Causes of Mitral Stenosis

A

Congenital:
Cleft mitral valve

Acquired:
Rheumatic fever
Age
Endocarditis

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12
Q

Differential diagnosis of mid-diastolic murmur

A

Mitral stenosis
Austin-Flint murmur
Atrial myxoma

Early diastolic murmur - aortic regurgitation

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13
Q

Rheumatic Fever

A

Immunological cross reactivity between Group A Haemolytic Streptococcus and the valve tissue

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14
Q

Duckett-Jones diagnostic criteria

A

Rheumatic fever

Proven beta haemolytic strep diagnosis via throat swab, antigen test, titre test, or clinical scarlet fever AND

Major
Chorea
Erythema marginatum
Subcutaneous nodules 
Polyarthritis 
Carditis 
Minor 
Raised ESR
Raised WCC 
Arthralgia 
Previous rheumatic fever 
Pyrexia 
Prolonged PR interval

2M or 1M 2m

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15
Q

Causes of Mitral Regurgitation

A

Congenital:
Secundum ASD

Acquired:
Acute:
Endocarditis
Rupture

Chronic:
Myxomatous degeneration
Rheumatic
Connective tissue disease

Fibrosis secondary to drugs such as fenfluramine and pergolide
Dilated LV
Calcification

Infiltrative disorders such as amyloid
Fibrosis of papillae post MI

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16
Q

Causes of tricuspid regurgitation

A 
Congenital:
Ebstein anomaly (atrialisation of the right ventricle and tricuspid regurgitation)

Acquired:
Acute: infective endocarditis
Chronic: functional, rheumatic, carcinoid

17
Q

Indication for ICD

A

Primary prevention:
MI more than 4 weeks ago with
1. LVEF less than 35% and non-sustained VT and positive EP study
2. LVEF less than 35% and QRS more than 120ms
Familial condition with high risk SCD
LQTS, Brugada, HCM, CHD

Secondary prevention:

  1. Previous cardiac arrest
  2. Haemodynamically compromised VT
  3. VT with LVEF less than 35%

And only if NYHA three and below

18
Q

Indication for CRT

A

Optimal medical therapy
LVEF less than 35%

NYHA I only if QRS more than 150

NYHA II to III if QRS more than 120 and LBBB

NYHA IV is QRS more than 120 alone

19
Q

Causes of pericardial disease

A 
TB and infection
Trauma
Tumour 
Therapy (radio) 
Tissue disease (RA, SLE)
Thrombus (MI)
20
Q

Causes of absent radial pulse

A 
Acute:
Embolism
Dissection
Catheterisation 
Death
Chronic:
Blalock-Taussig shunt 
Atheroma 
Coarctation
Takayatsu’s arteritis
21
Q

Apex beat descriptions:

A

Aortic stenosis - sustained
Aortic regurgitation - hyperkinetic displaced
Mitral stenosis - tapping
Mitral regurgitation - volume loaded displaced
Coarctation - heaving
Patent ductus arteriosus - thrusting
HCM - double apical impulse

22
Q

Tetralogy of Fallot

A

Overriding aorta
Pulmonary stenosis
VSD
Right ventricular hypertrophy

MRCP Flashcards (7 decks)

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