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Phase 4 > Cardio > Flashcards

Cardio Flashcards

1
Q

What is an abdominal aortic aneurysm?

A

a permanent pathological dilation of the aorta (>1.5 times the expected)

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2
Q

Are heart conditions generally more common in men or women?

A

men

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3
Q

where are AAAs most common?

A

90% below the renal arteries

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4
Q

What are 5 risk factors for AAA?

A 
smoking 
genetics/FHx 
connective tissue disorders 
Atherosclerosis 
hypertension
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5
Q

what are 3 presentations of AAA?

A

Usually asymptomatic until rupture/near rupture

palpable pulsate abdominal mass
tachycardia + hypotension
flank/back/abdominal pain

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6
Q

What is the 1st line investigation of AAA?

A

abdominal ultrasound

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7
Q

what are 3 differentials for AAA?

A

diverticulitis
IBS
appendicitis

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8
Q

what is the management for AAA?

A

urgent surgical repair - EVAR

surveillance - if <5.5cm

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9
Q

what are 3 complications of AAA?

A

AAA rupture
thromboembolism
ureteric obstruction

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10
Q

What is acute coronary syndrome?

A

a spectrum of conditions that includes unstable angina (UA), non-ST-elevation myocardial infarction (non-STEMI), and ST-elevation myocardial infarction (STEMI)

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11
Q

what is the number one cause of death globally?

A

cardiovascular disease

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12
Q

what is the underlying cause of most acute coronary syndromes?

A

coronary artery disease

rare - coronary artery spasm

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13
Q

what are the 3 pathophysiological origins of ischaemic heart disease?

A

increased myocardial O2 demand (exercise, infection)

reduced coronary blood flow (atherosclerosis)

Reduced myocardial oxygen delivery (anaemia, hypoxaemia)

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14
Q

What alleviates stable angina?

A

rest

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15
Q

What are 3 differentials for angina?

A

prinzmetal angina
STEMI/NSTEMI
aortic dissection

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16
Q

what is the symptomatic relief for angina?

A

GTN spray/tablet - vasodilator

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17
Q

what are 3 complications of angina?

A

MI
Chronic HF
Stroke

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18
Q

What is aortic dissection?

A

a separation in the aortic wall intima, causing blood flow into a new false channel composed of the tunica intima and media

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19
Q

what is the peak age range for aortic dissection?

A

50-70 years

rare <40

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20
Q

what are 5 risk factors for aortic dissection?

A 
connective tissue disorders 
bicuspid aortic valve 
smoking 
FHx
hypertension
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21
Q

What is the pathophysiology for aortic dissection?

A

There is a tear in the intimal lining of the aorta => blood to enters the aortic wall under pressure forming a haematoma which separates intima from adventitia and creates a false lumen

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22
Q

What are 6 manifestations of aortic dissection?

A

tearing pain in chest from front to back or inter scapular pain
L/R BP differential
pulse deficit
syncope
hypertension/tachycardia and hypotension later on

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23
Q

What are 3 investigations that can be done for aortic dissection?

A

ECG
CXR - widened mediasteinem
contrast enhanced CT angiogram - GOLD

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24
Q

what are 3 differentials for aortic dissection?

A

ACS
pericarditis
aortic aneurysm

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25
Q

What is the management of aortic dissection?

A

Beta blocker - IV labetalol

urgent surgical repair

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26
Q

what are 3 complications of aortic dissection?

A

cardiac tamponade
aortic regurgitation
MI

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27
Q

what is aortic regurgitation?

A

the diastolic leakage of blood from the aorta into the left ventricle due to inadequate coaptation of valve leaflets

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28
Q

when does aortic regurgitation usually become symptomatic?

A

when the ejection fraction <50%

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29
Q

what are 5 risk factors for aortic regurgitation?

A 
bicuspid aortic valves
rheumatic fever
endocarditis 
connective tissue disorders
Aortic dissection/anyeurysm
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30
Q

what is the pathophysiology of aortic regurgitation?

A

There is reflux of blood from the aorta to the L ventricle in diastole => increased LV preload => LV hypertrophy and dilation => eventual heart failure

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31
Q

what are 4 signs of aortic regurgitation?

A 
early diastolic decrescendo murmur 
displaced apex beat 
wide pulse pressure
bounding pulse 
de Musset's head bobbing with pulse 
Quincke's sign - nail capillaries pulsing 
Traube's pistol shot femoral pulse 
raised JVP
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32
Q

what are 4 investigations of aortic regurgitation?

A

ECHO - gold
ECG
CXR (pos cardiomegaly)
colour flow/pulsed wave doppler

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33
Q

what ECG changes can be seen with aortic regurgitation?

A

LV hypertrophy
tall R waves
deep inverted T waves in L side chest leads and deep S waves in R sides chest leads
L axis deviation

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34
Q

what are 3 differentials for aortic regurgitation?

A

mitral regurgitation
mitral stenosis
aortic stenosis

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35
Q

what is the management for aortic regurgitation?

A

acute - ianotropes (digoxin), vasodilators (nifedipine), aortic valve replacement

chronic - reassurance, nifedipine, ACEi, transcatheter aortic valve implantation

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36
Q

what is the most common valvular disease?

A

Aortic stenosis

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37
Q

what are 6 risk factors for aortic stenosis?

A 
smoking
60+
bicuspid aortic valve 
rheumatic heart disease
hypertension/lipidaemia
CKD
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38
Q

what are 6 manifestations of aortic stenosis?

A 
crescendo derescendo systolic murmur 
chest pain 
fatigue 
carotid parvus et tardes (slow rising carotid pulse)
S2 diminished and single, S4 sound
SOB
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39
Q

what are 4 investigations for aortic stenosis?

A

Transthoracic ECHO - GOLD
ECG
CXR
Doppler ECHO

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40
Q

what are 3 differentials for aortic stenosis?

A

Aortic sclerosis
ischaemic heart disease
hypertrophic cardiomyopathy

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41
Q

what are 3 management options for aortic stenosis?

A

aortic valcoplasty/valvotomy
valve replacement
transcutaneous aortic valve implantation

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42
Q

what are 3 complications of aortic stenosis?

A

LV outflow tract obstruction
Heart failure
Infective endocarditis

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43
Q

What is atrial fibrillation?

A

a supraventricular tachyarrhythmia with uncoordinated atrial electrical activation and consequently ineffective atrial contraction

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44
Q

what is the most common cardiac arrhythmias?

A

atrial fibrillation

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45
Q

what are 7 causes of atrial fibrillation?

A

PIRATES

Pulmonary - COPD
Rheumatic HD (valvular disease)
Anaemia, alcohol
Thyroid disease
Electrolyte disturbance
Sepsis/Sleep apnoea
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46
Q

What are 6 risk factors for atrial fibrillation?

A 
increasing age
DM 
hyperthyroidism
Hypertension
valvular heart disease 
diet and lifestyle factors (caffeine, alcohol, etc)
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47
Q

What are 5 presentations of atrial fibrillation?

A 
irregularly irregular pulse 
Palpitations
SOB
hypotension/dizziness/fainting - RED FLAG 
chest pain - RED FLAG
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48
Q

what are 3 investigations for atrial fibrillation?

A

ECG - irregularly irregular QRS complexes with absent P waves and chaotic baseline
serum electrolytes
Thyroid function tests

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49
Q

what are 3 differentials for atrial fibrillation?

A

atrial flutter
wolff-pankinson-white syndrome
atrial tachycardia

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50
Q

what are the 1st line rhythm control treatments for atrial fibrillation?

A

beta blocker - bisoprolol
OR
rate limiting CCB - verapamil

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51
Q

what are 3 complications for atrial fibrillation?

A

acute stroke, MI, congestive HF

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52
Q

what are the ECG characteristics of Atrial fibrillation?

A

regularly irregular R-R interval
absence of distinctive repeating P waves
irregular atrial activations

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53
Q

What is cardia tamponade?

A

raised intra-pericardial pressure due to pericardial effusion which restricts cardiac filling and decreasing cardiac output.

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54
Q

what are 5 causes of cardiac tamponade?

A 
iatrogenic (surgery/trauma)
pericarditis 
malignancy
trauma 
aortic dissection
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55
Q

What are 6 manifestations of cardiac tamponade?

A 
dyspnoea and chest pain
elevated jugular venous pressure
pulses paradoxus 
hypotension
tachycardia 
pericardial rub
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56
Q

what are 6 investigations of cardiac tamponade?

A 
ECG - electrical alternans 
Transthoracic ECHO (gold)
CXR
FBC - raised WBCs, low Hb 
ESR - elevated
Troponin - elevated
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57
Q

what are 3 differentials of cardiac tamponade?

A

constrictive pericarditis, pericardiocentesis, fluid for culture and cytology

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58
Q

what are 3 treatments for cardiac tamponade?

A

effusion only - anti-inflammatories - ibuprofen, aspirin, colchicine

acute - urgent pericardiocentesis or surgical drain

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59
Q

what are 2 complications of cardiac tamponade?

A

constrictive pericarditis

cardiac arrest

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60
Q

what is congestive heart failure?

A

when cardiac output cannot meet metabolic demands

L and R ventricular failure

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61
Q

what can cause congestive heart failure?

A 
Ischaemic heart disease
cardiomyopathy
valvular heart disease
Cor pulmonale
hypertension
alcohol excess
anaemia
arrythmias
hyperthyroidism
pregnancy
obesity
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62
Q

what are 5 risk factors of heart failure?

A 
65+
African descent
male 
obesity 
MI
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63
Q

what are 4 investigations for heart failure?

A

NT-proBNP
ECG - broad QRS complexes
CXR
Transthoracic ECHO

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64
Q

what is the gold standard for heart failure?

A

B-type natriuretic peptide

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65
Q

what are 3 differentials for heart failure?

A

angina
COPD
pulmonary embolism

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66
Q

what is the 1st line treatment for heart failure?

A

Beta blocker - Bisoprolol
AND
ACEi - Ramipril

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67
Q

what are 3 complications of heart failure?

A

pleural effusion
acute renal failure (due to reduced CO)
acute decompensation of chronic heart failure

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68
Q

What is hypertension?

A

Persistent elevation of arterial blood pressure

BP ≥140/90 mmHg

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69
Q

what are 4 causes of hypertension?

A

excess sodium intake
renal sodium retention
RAAS dysfunction
increased peripheral resistance

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70
Q

what are 4 risk factors for hypertension?

A

obesity
sedentary lifestyle
high alcohol intake
DM

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71
Q

BP =

A

CO X TPR

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72
Q

what are 3 presentations of hypertension?

A

dyspnoea
retinopathy
headaches

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73
Q

what are 5 causes of hypertension?

A 
drug induced 
renal artery stenosis/kidney disease
pregnancy
Conn's syndrome 
Cushing's syndrome
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74
Q

what is the management of hypertension?

A

55+/black - CCB - amlodipine
<55 - ACEi or ARB (ramipril or cadesartan)

CCB + ACEI
+ thiazide diuretics

Resistant hypertension not controllable by 3 drugs

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75
Q

what are some side effects of calcium channel blockers?

A 
Constipation
Dizziness
Fast heartbeat (palpitations)
Fatigue
Flushing
Headache
Nausea
Rash
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76
Q

what are some side effects of ACEi?

A

Dry cough.
Increased potassium levels in the blood (hyperkalemia)
Fatigue.
Dizziness from blood pressure going too low.
Headaches.
Loss of taste.

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77
Q

what are 3 complications of hypertension?

A

coronary artery disease
stroke
CKD

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78
Q

what is infective endocarditis?

A

an infection involving the endocardial surface of the heart (valves, Chordae tendonae, septal defects etc)

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79
Q

why is IE more common in developing countries?

A

increased prevalence of rheumatic fever

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80
Q

what are 5 risk factors for IE?

A 
Hx of endocarditis 
prosthetic valves
congenital heart diseases 
IVDU
poor dental hygiene
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81
Q

what are 5 manifestations for IE?

A 
fever/chills
new cardiac murmur 
night sweats, fatigue, weightloss
headaches
joint pain (can be caused by septic emboli)
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82
Q

what are 3 clinical signs for IE?

A

Roth spots - retina
Janeway lesions - palms and soles
Osler nodes - painful nodules on fingertips

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83
Q

what are 3 investigations for IE?

A

blood cultures X3 SETS
ECHO - vegetations
CRP/ESR - raised

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84
Q

how should blood cultures for IE be taken?

A

BEFORE antibiotics

3 x at 30min intervals

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85
Q

what are 3 differentials for IE?

A

rheumatic feer
atrial myxoma
non-bacterial thrombotic endocarditis

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86
Q

what criteria is used to diagnose IE?

A

Duke’s criteria

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87
Q

what are the major criteria for dukes criteria?

A

2 positive blood cultures of typical organisms

ECHO

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88
Q

What is ischaemic heart disease?

A

Ischaemic heart disease, an inability to provide adequate blood supply to the myocardium

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89
Q

what is the primary cause of ischaemic heart disease?

A

atherosclerosis

90
Q

what are 4 risk factors for ischaemic heart disease?

A

smoking
hypertension
hyperlipidaemia
diabetes

91
Q

what is the pathophysiology of atherosclerosis?

A

Endothelial cell injury due to change in Virchow’s triad causes sticky endothelial cells => fatty streak => macrophages ingest lipids and become foam cells => collagen, fibrin, smooth muscle, LDLs and WBCs make up plaque => plaque grows and obstructs lumen

92
Q

what is a manifestations of ischaemic heart disease?

A

chest pressure/squeezing provoked by exercise/emotional stress

93
Q

what are 3 investigations for IHD?

A

ECG
FBC
lipid profile

94
Q

what are 3 differentials for IHD?

A

aortic dissection
pericarditis
pulmonary embolism

95
Q

what is the management of IHD?

A 
lifestyle management 
antiplatelet therapy (clopidogrel) 
statin (atorvastatin)
GTN spray
beta blocker
calcium channel blocker
96
Q

what are 3 complications of IHD?

A

heart failure
MI
sudden cardiac death

97
Q

What is mitral regurgitation?

A

Backflow from the left ventricle to the left atrium in systole due to dysfunctios of the mitral valve apparatus

98
Q

what are 4 causes of mitral regurgitation?

A

IE
ischaemic papillary dysfunction
acute rheumatic fever
L ventricular dilation

99
Q

what are 3 risk factors for mitral regurgitation?

A

Hx MI/IE
congenital heart disease
mitral valve prolapse

100
Q

what are 5 signs of mitral regurgitation?

A

mid-systolic click and pan systolic murmur
soft S1
additional S3
displaced apex beat laterally

101
Q

what are 3 investigations of mitral regurgitation?

A

Transthoracic ECHO
ECG - underlying arrythmias
CXR - LA enlargement

102
Q

what are 3 differentials of mitral valve regurgitation?

A

acute coronary syndrome
IE
mitral stenosis

103
Q

what is the management of mitral valve regurgitation?

A

surgery (valvulopathy)
ACEi - ramipril
beta blockers
diuretics - furosemide

104
Q

what are 3 complications of mitral valve regurgitation?

A

atrial fibrillation
pulmonary hypertension
cardiogenic shock

105
Q

what is mitral stenosis?

A

narrowing of the mitral valve orifice preventing proper filling of the LV during diastole

106
Q

what historically is the most common causes of mitral stenosis?

A

rheumatic fever

107
Q

what are 4 risk factors for mitral stenosis?

A

streptococcal infection
female
SLE
amyloidosis

108
Q

What are 5 presentations of mitral stenosis?

A 
loud S1 snap
mid-diastolic murmur
AF
malar flush 
Dysphagia if dilated atria press on oesophagus
109
Q

what are 3 investigations for mitral stenosis?

A

ECG - AF, LA enlargement, RV hypertrophy
CXR
Transthoracic ECHO - GOLD

110
Q

what are 2 differentials of mitral stenosis?

A

L atrial myxoma

unexplained AF

111
Q

what is the management of mitral stenosis?

A

beta blockers - atenolol and digoxin
valve replacement/repair
diuretics
anticoagulants

112
Q

what are 3 complications of mitral stenosis?

A

AF
stroke
thrombus formation

113
Q

What is pericardial effusion?

A

when the fluid in the pericardial space exceeds its physiological amount (>50 mL).

114
Q

what are 3 causes of pericardial effusion?

A

malignancy
infection - EBV. CMV, S.aurea
TB

115
Q

what is the investigation for pericardial effusion?

A

chest imaging

116
Q

what are 3 differentials for pericardial effusion?

A

malignancy
viral pericarditis
congestive heart failure

117
Q

how long does acute pericarditis last?

A

<6 weeks

118
Q

what are the most common causes of pericarditis?

A

90% idiopathic or viral - coxsackie virus, mumps, EBV, CMV, VZV, HV
rare - fungi and drugs

119
Q

what are 5 risk factors for pericarditis?

A 
male 
20-50 years 
previous MI
neoplasm
infection
120
Q

what are 4 presentations of pericarditis?

A

sharp, severe retrosternal chest pain, worse with inspiration, relieved leaning forward
low grade fever
pericardial rub
hiccups (phrenic involvement)

121
Q

what are 4 investigations for pericarditis?

A

ECG - saddle shaped upward ST elevation and PR depression, T wave flattening
TT ECHO
CXR - water bottle heart
ESR and CRP

122
Q

what are 3 differentials for pericarditis?

A

pulmonary embolism
MI
Pneumonia

123
Q

what is the 1st line treatment for pericarditis?

A

NSAIDs and colchicine

+ prednisolone (2nd line)

124
Q

what are 3 complications of pericarditis?

A

pericardial effusion with/without tamponade
chronic constructive pericarditis
myocarditis

125
Q

what is peripheral arterial disease?

A

a range of arterial syndromes that are caused by atherosclerotic obstruction of the lower-extremity arteries.

126
Q

what is the most common cause of PAD?

A

atherosclerosis - most common

127
Q

what are 4 risk factors for PAD?

A

smoking
DM
hypertension
male

128
Q

what are 7 presentations of PAD?

A

most asymptomatic

intermittent claudication
paleness/cold legs
gangrene 
muscle atrophy 
loss of dorsal foot hair
erectile dysfunction
non-healing wound
129
Q

what are 3 investigations for PAD?

A

ankle-brachial pressure index
doppler ultrasound
CT angiography

130
Q

What are 3 differentials for PAD?

A

spinal stenosis
arthritis
venous claudication

131
Q

what is the treatment of PAD?

A

exercise therapy
surgery - stents, angioplasty, bypass
vasodilators - nadtidrofuryl oxalate

132
Q

what are 3 complications of PAD?

A

critical limb ischaemia
gangrene and ulceration
amputation

133
Q

what is the 1st step of atherogenesis?

A

endothelial dysfunction

134
Q

what is the 2nd step of atherogenesis?

A

formation of lipid layer of fatty streak within intima

135
Q

what is the 3rd step of atherogenesis?

A

migration of leukocyte and smooth muscle cells into the vessel wall

136
Q

what is the 4th step of atherogenesis?

A

foam cell formation

137
Q

what is the 5th step of atherogenesis?

A

degradation of the extracellular matrix

138
Q

what is the 1st line anti-anginal medication?

A

B blocker - Bisoprolol
OR
CCB - verapamil

2nd line - BB AND CCB (nifedipine!!!)

139
Q

what is the preventative treatment for angina?

A

Lifestyle changes
aspirin
statin
ACEI

140
Q

what are the primary investigations for angina?

A

ECG - 1st line
functional imaging - stress echo
transcatheter angiography

141
Q

what are 4 signs of L sided HF?

A

cool peripheries and cyanosis
bibasal crackles
S3
Displaced Apex beat

142
Q

what are 4 symptoms of LSHF?

A

SOB
Orthopnoea (SOB lying down)
Weakness and fatigue
cough with pink frothy sputum

143
Q

what are 4 signs of RSHF?

A

raised JVP
peripheral pitting oedema
hepatospleomegaly
Ascites

144
Q

what are 3 symptoms of RSHF?

A

fatigue and weakness
oedema in legs
distended abdomen (ascites)

145
Q

what are 5 signs of heart failure of CXR?

A 
A - alveolar oedema
B - Kelley B lines
C - cardiomegaly 
D - Dilated upper lobe vesels 
E - pleural Effusion
146
Q

what is the second line management for heart failure?

A

Potassium sparing diuretic - spironolactone (aldosterone antagonist)

147
Q

what is the management of decompensated heart failure?

A

fluid restriction
IV diuretics
Inotropes or vasopressors
NIV

148
Q

what is stage 1 hypertension?

A

clinical - >140/90

ambulatory - >135/85

149
Q

what is stage 2 hypertension?

A

clinical - >160/100

ambulatory - >150/95

150
Q

what is stage 3 hypertension?

A

> 180/120

151
Q

what are the 2 shockable pulseless arrythmias?

A

ventricular tachycardia
ventricular fibrillation

152
Q

what are 2 non-shockable rhythms?

A

pulseless electrical activity
asystole

153
Q

what is the 1st line treatment for AF with HF?

A

digoxin

154
Q

what is the treatment for haemodynamically unstable AF?

A

DC cardioversion

155
Q

what does CHA2DS2-VASc calculate?

A

stroke risk for AF when considering anticoagulation

156
Q

what does HAS-BLED calculate?

A

the risk of major bleeding for patients on anticoagulants

157
Q

what does CHA2DS2-VASc stand for?

A 
Congestive HF 
Hypertension
Age >75 = 2 points 
Diabetes 
Stroke/TIA/thromboembolism
Vascular disease
Age <65 = 1 point 
Sc - Sex category (+2 women)
158
Q

what does HAS-BLED stand for?

A 
Hypertension 
Abnormal liver/renal function
Stroke 
Bleeding 
Labile INRs 
Elderly >65 
Drugs + Alcohol
159
Q

what are 3 causes of atrial flutter?

A

idiopathic - 30%
CHD
obesity

160
Q

what is bradycardia?

A

HR < 50 BPM

161
Q

what is 1st degree heart block?

A

delay in AV conduction but every atrial impulse leads to a ventricular contraction

162
Q

what is Mobitz type 1 2nd degree heart block?

A

AV conductions get longer (PR interval) until there is no ventricular contraction then are a normal length again in a cycle

163
Q

what is Mobitz type II 2nd degree heart block?

A

intermittent failure of AV conduction resulting in a ratio of missing to normal QRS complexes

164
Q

what is 3rd degree heart block?

A

complete heart block - no relationship between P waves and QRS complexes

165
Q

what are cannon A waves seen in?

A

JVP in complete heart block

166
Q

what is the 1st line management of unstable heart block?

A

IV atropine

167
Q

what are 3 causes of RBBB?

A

pulmonary embolism
cor Pulmonale
ischaemic heart disease

168
Q

what are 3 causes of LBBB?

A

ischaemic heart disease
hypertension
cardiomyopathy

169
Q

what sound is there in RBBB?

A

wide splitting of second heart sound

170
Q

what sound is there is LBBB?

A

reverse splitting of second heart sound

171
Q

what does the ECG look like in RBBB?

A

MaRRoW

V1 - R wave looks like an M
V6 - Slurred S wave looks like a W

172
Q

what does the ECG look like in LBBB?

A

WiLLiaM

V1 - slurred S wave looks like a W
V6 - R wave looks like an M

173
Q

what sex if AF more common in?

A

women

174
Q

What is Wolff Parkinson White syndrome?

A

extra connections between the atria and ventricles causing tachycardia

175
Q

what does the ECG look like in Wolff parkinson white?

A 
short PR interval 
slurred upstroke (DELTA WAVES)
wide QRS
176
Q

what are 2 complications of Wolff Parkinson White?

A

prone to AF

sudden death

177
Q

what are 2 eponymous signs for AAA?

A

Grey-Turner’s sign - flank bruising secondary to rupture

Cullen’s sign - peri-umbilical bruising

178
Q

what are the 2 Stanford types of Aortic dissection?

A

A - ascending aorta involved

B - descending aorta only

179
Q

what are the DeBakey Aortic dissection types?

A

I - ascending aorta + arch
II - just ascending aorta
III - descending aorta

180
Q

what is the overall most common causative organism for IE?

A

S. Aureus

181
Q

what demographics are staph epidermis IE infections associated with?

A

indwelling lines and prosthetic valves

182
Q

what is the second most common causative pathogen in IE?

A

Viridans (group B) strep

183
Q

what is the most common pathogen in IE after dental work?

A

veridans (group B) strep

184
Q

what kind of strep is veridans group strep?

A

Alpha haemolytic on BA, optochin resistant => group B

185
Q

what is the treatment for veridans group IE?

A

IV Benzylpenicillin +/- gentamicin (veridans group)

4-6 weeks

186
Q

what kind of bacteria is gentamicin useful against?

A

gram negs

187
Q

what does S. Aureus look like on blood agar?

A

coagulase +ve, gram +ve cocci in clusters growing golden colonies on BA

188
Q

is S. Aureus coagular +ve or -ve?

A

NAME?

189
Q

is S. epidermis gram +ve or -ve?

A

NAME?

190
Q

what pathogens can cause IE in immunosuppressed people?

A

FUNGAl IE

191
Q

what is the treatment for enterococci IE?

A

amoxicillin + gentamicin

4-6 weeks

192
Q

what is the treatment for S. aureus/epidermis IE?

A

flucloxacillin + gentamicin
(or vancomycin if MRSA)
4-6 weeks

193
Q

what are 2 risk factors for atrial septal defects?

A

foetal alcohol syndrome

Down syndrome

194
Q

what is the most common congenital heart defect?

A

ventral septal defect

195
Q

what is patent ductus arteriosus?

A

when the ductus arteriosus (the shunt to avoid the lungs in foetal circulation) fails to close upon birth

196
Q

what is the most common form of congenital cyanotic heart disease?

A

tetralogy of Fallot

197
Q

what are 3 risk factors for tetralogy of Fallot?

A

FHx
Rubella infection
increased maternal age

198
Q

what are the 4 malformations in tetralogy of Fallot?

A

pulmonary stenosis
RV hypertrophy
Ventricular septal defect
overriding aorta

199
Q

what are 6 signs of tetralogy of fallot?

A 
ejection systolic murmur 
reduced SpO2
respiratory distress
cyanosis
clubbing
failure to thrive
200
Q

what is the most common cause of sudden cardiac death in young people?

A

hypertrophic cardiomyopathy

201
Q

what is the inheritance pattern for hypertrophic cardiomyopathy?

A

autosomal dominant

202
Q

what is rheumatic fever?

A

autoimmune condition triggered by streptococcus bacteria

203
Q

what bacteria is in rheumatic fever?

A

group A beta-haemolytic strep - Strep pyogenes

usually follows strep throat

204
Q

what criteria is used to diagnose rheumatic fever?

A

Jones criteria

205
Q

what does jones criteria stand for?

A 
Joint arthritis
Organ inflammation
Nodules
Erythema marginatum rash
Sydenham chorea
206
Q

what are 5 X-ray indications of heart failure?

A

ABCDE

Alveolar Oedema 
Kerley B lines 
cardiomegaly 
Dilation of upper lobe vessels 
pleural effusion
207
Q

what are the 5 types of shock?

A 
anaphylactic 
septic
cariogenic 
haemoragic 
neurogenic
208
Q

is ascites a feature of R heart failure?

A

NO

209
Q

where is BNP released from?

A

the ventricles of the brain

210
Q

what are delta waves on an ECG?

A

slurred upstroke in the QRS complex

seen in Wolff Parkinson white syndrome => due to accessory conduction pathways

211
Q

what is the 1st line investigation in stable angina?

A

CT coronary angiography

212
Q

what is an embolism?

A

a blocked vessel caused by a foreign body

213
Q

what is a thrombosis?

A

the formation of a solid mass of blood constituents within an intact vessel is the living

214
Q

are there B lymphocytes in atherosclerosis/

A

NO ONLY T

215
Q

what is the MRC scale for?

A

Dyspnoea

216
Q

what is the MRC scale?

A

0 - not breathless unless strenuous exercise
1 - SOB hurrying/up slight hill
2 - has to walk slower then normal or stop
3 - stops walking after 100m/few mins
4 - too breathless to leave house/gets breathless doing normal tasks

217
Q

what does the ECG look like in pericarditis?

A

PeRicariTiS

Saddle shaped upward ST elevation
PR depression
T wave flattening
Low QRS amplitude

218
Q

what is the gold standard investigation for unstable angina?

A

angiography

219
Q

what are the 3 features of a total anterior circulation stroke?

A 
Unilateral weakness (and/or sensory deficit) of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfunction
220
Q

what score is used for stroke risk after a TIA?

A

ABCD2

221
Q

what is the ABCD2 score?

A 
Age > 60 
BP > 140/90
Clinical features - sensory (1), weakness (2)
Diabetes
Duration - <1 hour (1), >1 hour (2)
222
Q

what is the CHA2DS2-VASC score?

A 
Congestive Heart failure
Hypertension 
Age >75 (2)
Age >65 (1)
Diabetes 
Stroke/TIA (2)

Vascular disease
Sex category - Female (+1)

Phase 4 (19 decks)

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