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cardiac Flashcards

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1
Q

palpable pulsatile abdominal mass, abdo/back pain, HTN

A

AAA

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2
Q

central crushing chest pain that radiates to arms/neck/jaw, pallor + sweating

A

ACS (unstable angina, STEMI, NSTEMI)

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3
Q

unexplained weight loss, fatigue, oedema that is resistant to diuretic therapy, periorbital purpura, neuropathy, waxy skin, easy bruising

A

amyloidosis

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4
Q

punched out, elliptical ulcer with defined edges and grey base on feet / legs. night pain relieved by dangling legs off bed

A

Arterial ulcer

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5
Q

cetral tearing chest pain that may radiate to between shoulder blades. BP difference between arms of >20mmHg

A

aortic dissection

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6
Q

end-diastolic soft murmur, louder at sternal border or when pt sits forward, louder at end of expiration,
water hammer pulse (rapidly appearing and disappearing pulse at corotid)
visible pulsation on nail bed/in eyes/neck
head nodding in time with pulse

A

aortic regurgitation

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7
Q

worsening SOB (esp on exertion), high pitched ejection systolic murmur, heaving apex beat, slow rising pulse, narrow pulse pressure, exertion syncope, leg swelling

A

aortic stenosis

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8
Q

irregularity irregular tachycardia with no p waves

A

AF

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9
Q

young athletes with no PMH presenting with syncopal episodes

angina, palp, jerky carotid pulse, double apex beat but not displaced, ejection systolic murmur

A

hypertrophic cardiomyopathy

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10
Q

tricuspid +mitral regurge murmur, apex beat displaced

association with alcohol

A

dilated cardiomyopathy

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11
Q

painless swollen leg, erythema, skin colour changes. calf pain when forced dorsiflexion of ankle
RF - recent surgery, immobile, obese

A

DVT

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12
Q

area of oedema/erythema, blisters, extreme out of proportion pain, signs of sepsis/systemic inflam

A

necrotising fascitis

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13
Q

orthopnoea, exertion dyspnoea, paroxysmal nocturnal dyspnea, fatigue, nocturnal cough (w/ pink frothy sputum), wheeze, displaced apex beat, S3 gallop rhythm

A

LHF

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14
Q

oedema, weight gain, nocturia, dec exercise tolerance, inc JVP, facial swelling

A

RHF

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15
Q

fever with sweats and chills, malaise, arthralgia, confusion, signs of anaemia, pyrexia, tachycardia, vasculitis, rheumatoid factor in blood

A

infective endocarditis

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16
Q

high pitched pan-systolic murmur louder in inspiration, S3, displaced apex beat

A

Mitral regurg

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17
Q

mid diastolic, low-pitched rumbling murmur at apex, louder when pt lies on left side, loud S1, opening snap
associated with AF and malar flush

A

mitral stenosis

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18
Q

flu like prodrome, SOB, palp, positional chest pain (worse when lying down)
bloods - raised CK and troponins

A

myocarditis

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19
Q

sharp, central pleuritic chest pain relieved by sitting forward , pericardial friction rub, tamponade
widespread saddle shaped ST elevation

A

pericarditis

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20
Q

painfull, pulseless, paralysed, perishingly cold, pale limb with paraesthesia

A

acute limb ischaemia

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21
Q

progressive SOB, weakness, dizziness, angina, RV heave, tricuspid regurg, raised JVP

A

pulmo HTN

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22
Q

fever, joint pain, malaise, SOB, chest pain, palp, recent sore throat, chorea, small painless SC nodules seen on joints/tendons, erythematous rash with raised edges

A

rheumatic fever

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23
Q

regular, narrow complex tachycardia with no p waves,

A

SVT

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24
Q

slurred upstroke QRS on ECG

A

WPW syndro

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25
pan systolic murmur heard at lower left sternal border, louder on inspiration, inc JVP, pulsatile liver
tricuspid regurg
26
large, shallow painless ulcers with an ire margin situated above the medial malleoli, swelling and itching
venous ulcers
27
irreg, broad complex tachycardia that can cause cardiac arrest and SCD, pulseless
vent fibrilation
28
regular broad complex tachycardia, symptoms of heart failure
vent tachycardia
29
Whats the management for STEMI
MONA BASH | morphine, oxygen, nitrates, anti-platelets (aspirin + clopidogrel), BB, ACEi, statins, heparin
30
Management for NSTEMI/unstable angina
1 - aspirin + clopidogrel 2 - fondapurinux if low bleeding risk 3 - unfractionated heparin if coronary angiogram plannned
31
What is the investigation of choice for an arterial ulcer
Duplex USS of lower limbs
32
what CXR changes would you see with an aortic dissection
widened mediastinum
33
what is an austin-flint murmur`
mid-diastolic rumbling murmur heard at apex. associated with aortic regurg
34
what is the management plan for AF
If haemodynamically unstable - DC cardioversion 1 rhythm control - DC or chemical cardioversion 2 - rate control - verapamil, BB, digoxin 3 - check stroke risk, high - warfarin
35
What drugs can be used for a chemical cardioversion
flecainide (contraindicated if prev Hx of IHD) or amialdarone
36
What ECG changes would you see with atrial flutter
SAW tooth
37
What would you use to check the risk of stroke in AF
CHAD2 score CHF (+1), HTN (+1), Age >75 (+2), DM (+1), prev stroke/TIA (+2) If 0 or 1 - aspirin, if >2 then warfarin
38
What are the 8 main causes of cardiac arrest
4H - hypothermia, hypoxia, hypovolaemia, hypokalaemia | 4T - toxins, thromboembolic, tamponade, tension pneumothorax
39
what is homan's sign
forced dorsiflexion of ankle -> calf pain | indicates DVT
40
what is the most common cause of recurrent DVTs at a young age
inherited disorer | Factor V lieden - mut of factor 5 makes it resistance to degradation by protein C -> inc F5 -> procoagulant state -> DVT
41
What JVP signs can be seen with complete heart block
Cannon A waves - large volume pulses
42
What is the first step of management fo acute heart block
IV atropine
43
what are the steps of management for chronic heart failure
``` 1 - ACEi (enalapril) 2 - BB (bisoprolol) 3 - duretics - if evidence of fluid retention 4 - Digoxin 5 - treat cause ```
44
what 5 CXR changes can be seen with chromic heart failure
Alv oedema, B-lines, Cardiomegaly, Dilated upper lobe vessels, pleural Effusion
45
what is cor pulmonale
enlargement and failure of RV due to inc lung pressure/vasc resistance
46
What are the management steps for acute HF
``` Sit Pt up and give high flow O2 furosemide (loop diuretic) GTN infusion CPAP treat cariogenic shock if hypotensive ```
47
how would you manage HTN if <55 and not afro-caribbean
1 - ACEi (switch to ARB if develop cough) 2 - ACEi/ARB + CCB 3 - + thiazide diuretic
48
how would you manage HTN if >55 or AC
1 - CCB 2 - CCB + ACEi/ARB 3 - + thiazide diuretics
49
what type of drugs end in -pril
ACEi
50
what type of drugs end in -tan
ARB
51
what type of drugs end in -dipine
CCB
52
what type of drugs end in -ide
thiazide diuretic
53
what type of drugs end in -olol
BB
54
what type of drugs end in -osin
Alpha B
55
what are the complications of ACEi
cough, inc potassium/creatinine
56
what are the complications of CCB
swelling +angiooedema
57
what level is considered level 3 HTN and a medical emergency
180/120
58
what's the target BP for someone <80
140/90
59
what's the target BP for someone >80
150/90
60
what are the most common causes of infective endocarditis
strep (40%) staph (35%) enterococci (20%)
61
what autoantibody is found in the blood with inf endocarditis
rheumatoid factor
62
what murmur is often associated with AF
mitral stenosis - mid diastolic low pitched murmur
63
how can you tell the difference between myocarditis and pericarditis
cardiac biomarkers raised in myocarditis but not pericarditis (CK and troponins)
64
pain in calf on exercise
PVD - intermittent claudation of femoral a.
65
pain in buttock on exercise
PVD - intermittent laudation of iliac a
66
what inv would confirm pulmo HTN
R H catheterisation
67
what causes rheumatic fever
Group A strep throat inf
68
what is the management of SVT
if haemo unstable - DCC 1 - vagal manœuvres + chemical cardioversion 2 - adenosine
69
when is adenosine contraindicated
in asthma - use verapamil
70
what murmur is associated with infective endocarditis
Tricuspid regurg - pan-systolic
71
what is the management of VF
urgent defib and cardioversion
72
what ECG change is seen in WPW syndro
delta wave

Y3 symptoms (15 decks)

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