Cardio Flashcards
(139 cards)
1
Q
What does RAAS do in relation to HTN
A
It causes vasoconstriction and
2
Q
Causes of secondary HTN
A
Renovascular disease
Hyperaldosteronism
Adrenal adenoma (Conns syndrome)
Pheochromocytoma
Obstructive sleep apnea
Hyperthyroidism
Cushings syndrome
Steroids. OCPs, cocaine , NSAIDs
3
Q
HTN with sweating, headache and palpitations
A
Pheochromocytoma
4
Q
HTN with heat intolerance and weight loss
A
hyperthyroidism
5
Q
HTN with daytime sleeping
A
Obstructive sleep apnea
6
Q
180/20
A
Hypertensive urgency
7
Q
HTN with Diabetic
A
ACEI/ARB regardless
8
Q
Complication of ACEI
A
Cough
9
Q
patients >= 55-years-old or of black African or African-Caribbean origin: drug of choice in HTN
A
Calcium channel blocker (C)
10
Q
Auscultation finding of pulmonary HTN
A
Pericardial heave
Loud P2
Tricuspid regurgitation
Raised JVP with a waves
11
Q
Physical findings in Pulmonary HTN
A
Progressive exertional dyspnea
Exertional syncope
Peripheral edema
Exertional chest pain
Cyanosis
12
Q
intravenous epoprostenol or inhaled nitric oxide.
A
Vasodilators given for acute vasodilator therapy in PHTN
13
Q
Vave commonly affected in infective endocarditis
A
Mitral valve
Aortic
14
Q
Criteria for diagnosis of infective endocarditis
A
Dukes criteria
2 major
1 major 3 minor
5 minor
15
Q
now the most common cause of infective endocarditis
particularly common in acute presentation and IVDUs
A
Staphylococcus aureus
16
Q
endocarditis caused by these organisms is linked with poor dental hygiene or following a dental procedure
A
Strep Viridans
17
Q
most cause of endocarditis in patients following prosthetic valve surgery,
A
Staph epidermidis
18
Q
non infective causes of infective endocarditis
A
systemic lupus erythematosus (Libman-Sacks)
malignancy: marantic endocarditis
19
Q
IE associated with colorectal cancer
A
Strep bovis
(now called Streptococcus gallolyticus)
20
Q
vascular phenomena: major emboli, splenomegaly, clubbing, splinter haemorrhages, Janeway lesions, petechiae or purpura
A
minor criteria of duke
21
Q
immunological phenomena: glomerulonephritis, Osler’s nodes, Roth spots
A
minor criteria for duke
22
Q
ECG finding of stable and unstable angine
A
ST segment depression
23
Q
ECG finding of prinzmetal angina
A
ST segment elevation
24
Q
Treatment for angina
A
Nitroglycerine (vasodilator) and for prinzmetal add CCB
25
Gold standard for assessing coronary arteries
CT coronary angiography
26
Types of lipids
Cholestrol
Triglycerides
Phospholipids
27
Side effects of niacin
Flushing
Gout
Liver toxicity
28
Side effect of fibrates
Rhabdomyolysis
Myopathy
GI disturbances
29
side effects of bile acid sequestrans
GI upset
30
Labs to check with statins?
LFTs for raised transaminases
31
Contraindication of statins
Patient with a history of intracerebral haemorrhage
macrolides (e.g. erythromycin, clarithromycin) are an important interaction. Statins should be stopped until patients complete the course
pregnancy
32
Target INR for metallic prosthetic valve
aortic: 3.0
mitral: 3.5
with lifelong warfarin
33
Side effects of B blockers
* Bronchospasm (especially in asthmatics)
* Fatigue
* Cold peripheries
* Sleep disturbances
34
Side effect of CCB
* Headache
* Flushing
* Ankle oedema
Verapamil also commonly causes constipation
35
Side effect of nitrates
* Headache
* Postural hypotension
* Tachycardia
36
side effect of nicorandil(anti anginal)
* Headache
* Flushing
* Anal ulceration
37
Dyspnea on exertion
Syncope on exertion
Exertional dyspnea
Aortic stenosis
38
ECG finding of aortic stenosis
Left ventricular hypertrophy
39
GOld standard for valvular heart disease
Transthoracic echo
40
ejection systolic murmur (ESM) is classically seen in
aortic stenosis
41
Atrial fibrillation patients are at high risk for what
Stroke
42
Sign of Afib
an irregularly irregular pulse
43
There are two key parts of managing patients with AF:
1. Rate/rhythm control
2. Reducing stroke risk
44
Absent P waves
A Fib
45
Diagnostic for afib
Holter monitoring
ECG
46
ALternate to cardioversion in afib is
beta blockers
CCB
Digoxin
47
used first-line to control the rate in AF.
A beta-blocker or a rate-limiting calcium channel blocker (e.g. diltiazem)
48
CCBs given with beta blockers
diltiazem and verapamil
49
first-line anticoagulant for patients with AF.
DOACS
50
What's the target INR for patients on Warfarin?
2-3
51
Rate control is done by
cardioversion
52
pharmacological cardioversion
amiodarone if structural heart disease, flecainide or amiodarone in those without structural heart disease
53
a common contraindication for beta-blockers is
asthma
54
What echocardiographic finding is often associated with atrial fibrillation?
Left atrial enlargement.
55
LHF results in
pulmonary edema
56
First line labs for HF
NTproBNP
57
Effects of BNP
vasodilator
diuretic and natriuretic
suppresses both sympathetic tone and the renin-angiotensin-aldosterone system
58
Kaussmal sign positive in
Constrictive pericarditis
59
Pericardial knock loud S3 seen in
Constricitve pericarditis
60
Pulsus paradoxicus present in
Cardiac tamponade
61
CXR finding of constrictive pericarditis
Pericardial calcification
62
Hypotension
Raised JVP
Muffled heart sound
(Becks Triad)
Cardiac tamponade
63
ECG finding of cardiac tamponade?
electrical alternans
64
Leading cause of sudden cardiac death in young athletes
HOCM
65
Echo findings of HOCM
include MR, systolic anterior motion (SAM) of the anterior mitral valve and asymmetric septal hypertrophy
66
Endocrine causes of cardiomyopathy
Diabetes mellitus
Thyrotoxicosis
Acromegaly
67
Infective causes of cardiomyopathy
68
Autoimmune causes of cardiomyopathy
SLE
69
Neurologica causes of cardiomyopathy
Friedreich's ataxia
Duchenne-Becker muscular dystrophy
Myotonic dystrophy
70
Infective causes of cardiomyopathy
Coxsackie B virus
Chagas disease
71
Nutritional causes of cardiomyopathy
wet beri beri
72
Storage causes of cardiomyopathy
Haemochromatosis
73
Dilated cardiomyopathy is what defect
Systolic defect
74
Balloon appearance of heart on CXR
Dilated cardiomyopathy
75
Octopus trap
Takotsubo cardiomyopathy
76
Genetic mutatuions associated with dilated cardiomyopathy
Duchenne muscuar dystrophy
Haemochromatosis
77
Drugs causing DCM
Doxurubicin (chemo drug)
Coacaine
ALcohol
78
Cause of peripartum DCM
Pregnancy induced hypertension
79
Imaging findings in Takotsubo cardiomyopathy
Echocardiography in Takotsubo reveals apical hypokinesis with basal hypercontractility (apical ballooning), unlike regional wall motion abnormalities correlating with coronary anatomy in MI. Cardiac MRI shows no late gadolinium enhancement in Takotsubo.
80
Broken heart syndrome
Takotsubo cardiomyopathy
81
ECG finding of takotsubo cardiomyopathy
ST-elevation
82
chest pain
features of heart failure
ECG: ST-elevation
normal coronary angiogram
takotsubo cardiomyopathy
83
prominent apical pulse
absence of pericardial calcification on CXR
the heart may be enlarged
ECG abnormalities e.g. bundle branch block, Q waves
Restrictive cardiomyopathy
84
ECG finding of restrictive cardiomyopathy
low amplitude QRS
85
Drug contraindicated in HOCM
Digoxin, nitrates, ACEI, inotropes as in increase force of contraction causing more obstruction
86
Disarray fibrocytes is a characteristic feature of
HOCM
87
jerky pulse, large 'a' waves, double apex beat
HOCM
88
Neurodegenerative associations of HOCM
Friedreich's ataxia
Wolff-Parkinson White
89
an autosomal recessive variant of ARVC
a triad of ARVC, palmoplantar keratosis, and woolly hair
Naxos disease
90
SCN5A gene mutation
Burguada syndrome
91
Lightheadedness
Syncope
SOB
Palpitations
Headache
Chest pain
Burguada syndrome
92
Arrythmias after meal or during fever or alcohol abuse
Burguada syndrome
93
investigation of choice in suspected cases of Brugada syndrome
the ECG changes may be more apparent following the administration of flecainide or ajmaline
94
downsloping ST segment and an inverted T wave
Brugada syndrome
95
Autosomal dominant, SCN5A, downsloping ST into negative T (V1-3), ICD
Burguada syndrome
96
Murmur in HOCM
Pansysytolic murmur
97
Deep Q waves specially in inf and lateral leads
LVH
seen on ecg of
HOCM
98
Severe complication of eclampsia
AKI
99
condition seen after 20 weeks gestation
pregnancy-induced hypertension (new onset)
proteinuria
edema
pre eclampsia
100
Hemolysis
Elevated liver enzymes
low plateletes (<100)
HELLP syndrome
101
cardinal feature of severe pre eclampsia
upper epigastric pain
102
Fetal complications of Pre eclampsia
IUGR
Prematurity
103
Anti hypertensive used in pregnancy
beta blocker (labetolol)
104
avoiding _______ in patients with a history of intracerebral haemorrhage
statins
105
Myopathies common with what kind of statins
lipophilic statins (atorvastatin, simvastatin)
106
Osmotic diuretics act on
PCT
Loop of Henle
107
Loop diuretics (Bumedonide, Furosemide) act on
Thick ascending limb
108
Gout is a complication of ____ diuretic
Thiazide
109
Major complication of thiazide diuretic
Gout
110
Indications for loop diuretics
heart failure: both acute (usually intravenously) and chronic (usually orally)
resistant hypertension, particularly in patients with renal impairment
111
They should be used with caution in patients taking ACE inhibitors as they precipitate hyperkalaemia.
K sparing diuretics
112
Indications of Amiadrione
Ventricular tachycardia
Ventricular fibrillation
Atrial flutter
In Afib for cardioversion for rhythm control
113
D/D of MI
Pericarditis
Aortix aneurysm
Infective endocarditis
Pericardial effusion
Cardiac tamponade
Anxiety
Pulmonary embolism
Esophageal rupture
114
Arteries involved in MI
LAD
LCX
RCA
115
The two most important investigations when assessing a patient with chest pain are:
ECG
cardiac markers e.g. troponin
116
First line in STEMI
PCI (within 12 hours of attack)
117
Second line for STEMI
Fibrinolysis (within 120 minutes of fibrinolysis PCI can be done)
118
Gold standard treatment for STEMI
PCI
119
most common cause of death following a MI
Ventricular fibrillation
120
A non-pulsatile JVP is seen in
superior vena caval obstruction.
121
Kussmaul's sign describes a paradoxical rise in JVP during inspiration seen in
constrictive pericarditis.
122
a wave absent in
Afib
123
seen in complete heart block, ventricular tachycardia/ectopics, nodal rhythm, single chamber ventricular pacing
Cannon a waves
124
Giant v waves in
tricuspid regurgitation
125
PDA is common in
Premature babies
Babies born at high altitude
Mlother having rubella infection
126
Continuous machinery murmue
Left subclavicular thrill
large volume, bounding, collapsing pulse
wide pulse pressure
heaving apex beat
PDA
127
Drugs for PDA closure in preterm infants
Ibuprofen
Indomethacin (rare)
Paracetamol
128
PDA closure in term infants
Transcatheter PDA closure and never pharmacological in term babies
129
Drug to keep PDA patent
Prostaglandin E1
130
PDA and aortic regurd murmur diff
this is holosystolic, aortic regurg is early diastolic
131
aortic regurgitation
patent ductus arteriosus
hyperkinetic states (anaemia, thyrotoxic, fever, exercise/pregnancy
Collapsing pulse seen in
132
Severe LVF pulse
Pulsus alternans
133
Drug that should not be used in VT
Verapamil
134
Drug therapy for VT
amiodarone: ideally administered through a central line
lidocaine: use with caution in severe left ventricular impairment
procainamide
135
Congenital defect caused by exposure to Lithium in utero
Ebstiens anomaly
136
tachycardia with rate of 150 b/m
atrial flutter
137
management for torsades pointes
IV MgSO4
138
commonly used to treat MRSA and Clostridium difficile.
vancomycin
139
