Cardio Flashcards
(56 cards)
1
Q
- What operations might a midline sternotomy scar indicate ?
A
- Coronary artery bypass graft
- Aortic valve replacement
- Mitral valve replacement
2
Q
- What scars may indicate a CABG surgery ?
A
- Midline sternotomy
- Saphenous vein harvesting scar on the inner calf
3
Q
- What is the gold standard investigation for stable angina ?
A
- CT coronary angiography
4
Q
- What medications are given for long term symptoms control of stable angina ?
A
- Beta blockers e.g. bisoprolol
- CCBs e.g. amlodipine
5
Q
- What medication can be given for secondary prevention of stable angina ?
A
- Aspirin 75 mg OD
- Atorvastatin 80 mg OD
- ACE-I e.g. ramipril
- Beta blocker e.g. bisoprolol
6
Q
- What procedures or surgical options can be given for stable angina ?
A
- Percutaneous coronary intervention (PCI)
- Coronary artery bypass graft
7
Q
- Which ECG leads are anterolateral ?
A
- I, aVL and V3-V6
8
Q
- Which ECG leads are anterior ?
A
- V1-V4
9
Q
- Which ECG leads are lateral ?
A
- I, aVL, V5-V6
10
Q
- Which ECG leads are inferior ?
A
- II, III and aVF
11
Q
- How is a NSTEMI treated ?
A
- Aspirin
- Then calculate GRACE score (6 month mortality)
- Low risk = ticagrelor
- High risk = Prasugrel or ticagrelor + un-fractionated heparin + PCI (drug-eluting stents should be sued in preference)
12
Q
- What are complications of an MI ?
A
- DREAD
- Death
- Rupture
- Edema
- Arrhythmia
- Dressler’s syndrome
13
Q
- Which coronary artery supplies the anterolateral area ?
A
- LCA
- (leads I, aVL, V3-V6)
14
Q
- Which coronary artery supplies the anterior area ?
A
- LAD
- (Leads V1-V4)
15
Q
- Which coronary artery supplies the lateral area ?
A
- Circumflex
- (I, aVL, V5-V6)
16
Q
- Which coronary artery supplies the inferior area ?
A
- RCA
- (Leads II, III and aVF )
17
Q
- 83 yo with acute SOB and low sats. Pt has had 3L of fluid in the last 24 hours. What is the diagnosis ?
A
- Acute left ventricular failure with pulmonary oedema
18
Q
- What are potential triggers for acute left ventricular failure ?
A
- Iatrogenic e.g. IV fluids
- Sepsis
- MI
- Arrhythmias
19
Q
- What are X-ray findings for heart failure ?
A
- Alveolar oedema
- Kerley B lines
- Cardiomegaly
- Dilated upper lobe vessels
- Effusion
20
Q
- What is acute management of heart failure ?
A
- Treat cause e.g. stop IV fluids
- Sit up
- Oxygen
- Diuretics e.g. Furosemide
21
Q
- What is the name for pts with heart failure waking up breathless ?
A
- Paroxysmal nocturnal dyspnoea
22
Q
- What are HF causes ?
A
- Ischemic heart disease
- Valvular heart disease
- Hypertension
- Arrhythmias
23
Q
- What BNP level would prompt referral ?
A
- BNP > 2000
24
Q
- What are HF treatments ?
A
- ACE-I e.g. ramipril
- Beta blockers e.g. bisoprolol
- Aldosterone antagonist e.g. spiralactone
- Loop diuretic e.g. furosemide
25
25. Secondary causes of HTN ?
- Renal disease
- Obesity
- Pregnancy
- Endocrine
26
26. What would be first line in a 52yo white man ?
- Ramipril
27
27. What would it be in an over 55 or Afro-Caribbean man ?
- Amlodipine
28
28. What is a BP treatment target in under 80 ?
- 140/90
29
29. What valve pathology would cause left atrial hypertrophy ?
- Mitral stenosis
30
30. What valve pathology would cause left ventricular dilatation ?
- Aortic regurgitation
31
31. What valve pathology would cause Malar Flush ?
- Mitral stenosis
32
32. What valve pathology would cause a slow rising pulse ?
- Aortic stenosis
33
33. What valve would cause a collapsing pulse ?
- Aortic regurgitation
34
34. What valve would cause a mid-diastolic, low pitch rumbling murmur ?
- Mitral stenosis
35
35. What valve would cause a pan-systolic high pitched whistling murmur ?
- Mitral regurgitation
36
36. What valve would cause an early diastolic soft murmur ?
- Aortic regurgitation
37
37. What valve would cause AF ?
- Mitral stenosis
38
38. What would an aortic stenotic murmur sound like ?
- Ejection systolic, high pitched, crescendo-decrescendo murmur heard loudest over the aortic area (radiating into the neck)
39
39. What kind of pulse is associated with aortic stenosis ?
- Narrow pulse pressure
40
40. What are the causes of aortic stenosis ?
- Idiopathic
- Age related calcification
- Rheumatic heart disease
41
41. What management options are available for aortic valvular pathology ?
- Transcatheter aortic valve replacement
- Open heart valve replacement
42
42. What are shockable rhythms ?
- VF and Ventricular tachycardia
43
43. What are unshockable rhythms ?
- Asystole + pulseless electrical activity
44
44. What are the most common causes of AF ?
- Mitral valve pathology
- Ischemic heart disease
- Sepsis
- Thyrotoxicosis
- Hypertension
45
45. What are options for pharmacological cardioversion in AF?
- Flecainide
- Amiodarone
46
46. Scoring system for risk of stroke in AF ?
- CHA2 DS2 VASc
47
47. Options for anticoagulation in AF ?
- Warfarin
- DOAC e.g. apixaban
48
48. Initial Non-pharmacological managed of supraventricular tachycardia
- Valsalva manoeuvre
- Carotid sinus massage
49
49. Contraindications for adenosine
- Asthma/COPD
- HF
- Heart block
- Severe HTN
50
50. Common side effects of adenosine
- Flushing
- Feeling of impending doom
51
51. Doses of Adenosine
- 6mg 12 mg 18 mg
52
52. Procedure to prevent recurrent episodes of SVT ?
- Radiofrequency ablation
53
53. Types of pacemaker ?
- Single chamber
- Dual chamber
- Biventricular chamber (triple chamber)
- Implantable cardioverter defibrillators
54
54. Indications for a pacemaker ?
- Symptomatic bradycardias
- Mobitz type 2 AV block
- 3rd degree heart block
- Severe heart failure
- Hypertrophic obstructive cardiomyopathy
55
What scoring system can be used to calculate the risk of a major bleed in a patient who is anticoagulated ?
- HAS-BLED
56
For NSTEMI treatment what should be given pre-PCI if there is a high risk of bleeding ?
- Give ticgrelor instead of prasugrel
- Swap Ticagrelor for clopidogrel
- If patient is taking oral anticoagulants swap praugrel/ticagrelor for clopidogrel
