a little bit more of the cardiovascular

Question 1

pathology of peripheral vascular disease

Answer 1

atherosclerotic blockages leading to arterial insufficiency

Question 2

signs of peripheral vascular disease

Answer 2

pallor
pulses decreased
perishing cold
pain
paraesthesia
paralysis

Question 3

symptoms of peripheral vascular disease

Answer 3

impairment in walking
pain 
discomfort
numbness
tiredness in legs that is relieved by rest

Question 4

treatment of peripheral vascular disease

Answer 4

exercise
revascularisation 
stenting
ACEi 
BB
antiplatelets

Question 5

diagnosis of peripheral vascular disease

Answer 5

pt with a history of leg pain relieved by rest
MRI angiography
duplex US

Question 6

what is critical limb ischaemia?

Answer 6

Fontaine classification 4 peripheral arterial disease

Question 7

signs of critical limb ischaemia

Answer 7

ulceration
gangrene
intermittent claudication

Question 8

symptoms of critical limb ischaemia

Answer 8

burning pain at night, relieved by hanging legs over the bed

Question 9

complications of critical limb ischaemia

Answer 9

gangrene

mass tissue loss

Question 10

diagnosis of critical limb ischaemia

Answer 10

triad of rest pain, arterial insufficiency, gangrene & ulcers

Question 11

pathology of pericarditis

Answer 11

inflammation of the pericardium

Question 12

signs of pericarditis

Answer 12

central chest pain relived by leaning forward
fever
pericardial rub (like crunching snow)
tachypnoea
tachycardia
cough 
dyspnoea
pulsus paradoxus
Beck's triad
hiccups

Question 13

what is Beck’s triad? (cardiac tamponade)

Answer 13

distant heart sounds
distended jugular veins
decreased arterial pressure

Question 14

what causes constrictive pericarditis?

Answer 14

build up of calcium around heart

Question 15

complications of pericarditis

Answer 15

tamponade - compression upon atria (and later the ventricles)

Question 16

treatment of pericarditis

Answer 16

analgesia
steroids/immunosuppressants
treat primary pathology

Question 17

ECG diagnosis of pericarditis

Answer 17

diffuse ST elevation
PR depression
sinus tachycardia
concave ST segment with no reciprocal ST depression

Question 18

how to distinguish STEMI from pericarditis on ECG

Answer 18

for pericarditis, everything above the isoelectric line looks normal

Question 19

pathology of aortic stenosis

Answer 19

orifice reduced to a quarter of normal size due to…

degenerative calcification
congenital
rheumatoid factors

Question 20

signs of aortic stenosis

Answer 20

murmur
pulsus trades et parvus (slow rising)
soft/absent 2nd heart sound

Question 21

symptoms of aortic stenosis

Answer 21

syncope
angina
dyspnoea

Question 22

treatment of aortic stenosis

Answer 22

surgery - TAVI - inflate balloon to open valve (don’t give vasodilators)

Question 23

ECG diagnosis of aortic stenosis

Answer 23

P mitrale (bifid P wave)

Question 24

diagnostic tests for aortic stenosis

Answer 24

ECG
LVH
LAD
CXR
echocardiogram

Question 25

pathology of mitral regurgitation

Answer 25

regurgitation causes left atrial dilation which causes pulmonary venous HTN --> pulmonary HTN regurgitation can also cause left ventricular dilation --> left ventricular hypertrophy -- left ventricular heart failure due to volume overload

Question 26

signs of mitral regurgitation

Answer 26

heart murmur displaced hyper dynamic apex atrial fibrillation pan systolic murmur at apex radiating to axilla

Question 27

symptoms of mitral regurgitation

Answer 27

fatigue | dyspnoea on exertion

Question 28

complications of mitral regurgitation

Answer 28

pulmonary hypertension (pressure can back up to lungs) LA and LV enlargement heart failure

Question 29

treatment of mitral regurgitation

Answer 29

``` surgery ACEi (vasodilation) BB (rate control) anticoagulation if AF present diuretics ```

Question 30

ECG diagnosis of mitral regurgitation

Answer 30

P mitrale in lead II | evidence of LA enlargement

Question 31

diagnostic tests for mitral regurgitation

Answer 31

ECG CXR echocardiogram (evidence of LA enlargement on all of the above)

Question 32

pathology of shock

Answer 32

circulatory failure - inadequate organ perfusion

Question 33

types of shock

Answer 33

``` haemorrhage/hypovolaemic anaphylactic septic cardiogenic neurogenic ```

Question 34

features of haemorrhage/hypovolaemic shock

Answer 34

bleeding diarrhoea ascites pancreatitis

Question 35

features of anaphylactic shock

Answer 35

vascular tone histamine urticaria oedema

Question 36

features of septic shock

Answer 36

SIRS + suspected infection + hypotension

Question 37

causes of cardiogenic shock

Answer 37

pump failure | inadequate lining

Question 38

causes of neurogenic/spinal shock

Answer 38

traumatic section | iatrogenic

Question 39

signs of shock

Answer 39

``` pallor rapid but weak pulse low bp decreased capillary refill time oliguria confusion chest pain ```

Question 40

treatment of shock

Answer 40

IV access fluids high flow oxygen

Question 41

pathology of Naxos disease

Answer 41

arrhythmogenic cardiomyopathy | woolly hair and predisposition to ventricular tachycardia --> likely to drop dead

Question 42

pathology of hypertrophic cardiomyopathy

Answer 42

sarcomeric gene mutations

Question 43

pathology of dilated cardiomyopathy

Answer 43

cytoskeletal mutations | LV/RV/4 chamber dysfunction and failure

Question 44

pathology of arrhythmic cardiomyopathy

Answer 44

desmosome gene mutation

Question 45

symptoms of hypertrophic cardiomyopathy

Answer 45

angina dyspnoea palpitations syncope

Question 46

symptoms of dilated cardiomyopathy

Answer 46

heart failure symptoms

Question 47

symptoms of arrhythmic cardiomyopathy

Answer 47

arrhythmia

Question 48

complications of hypertrophic cardiomyopathy

Answer 48

arrhythmias due to fibrosis | sudden death - more likely if little bursts of ventricular tachycardia

Question 49

complications of dilated cardiomyopathy

Answer 49

arrhythmias

Question 50

diagnosis of cardiomyopathy

Answer 50

ECG | genetic tests

Question 51

treatment of cardiomyopathy

Answer 51

beta blockers ACEi implantable defib dilated cardiomyopathy likely to get a heart transplant

Question 52

ECG sign of hypertrophic cardiomyopathy

Answer 52

deep T wave inversion

Question 53

what is brigada?

Answer 53

ST elevation in anterior leads