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Zero to finals > Cardio 2 > Flashcards

Cardio 2 Flashcards

(71 cards)

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1
Q

which valves close to cause S1

A

mitral and tricuspid

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2
Q

which valves close to cause s2

A

aortic and pulmonary

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3
Q

when is the 4th heart sound heart

A

just before s1

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4
Q

what causes the 4th heart sound

A

hypertrophic ventricle

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5
Q

the 2 special manoeuvres in cardio exam assess for what valve abnormality

A

left hand side= mitral stenosis
leaning forward= aortic regurg

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6
Q

how to grade murmurs

A

grade 2= quiet
grade 3= easy to hear

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7
Q

how to present a murmur

A

the patient has a

  1. harsh/soft/blowing
  2. grade x
  3. systolic/diastolic
    murmur

it is heard loudest in the
4.aortic/pulmonary/mitral/tricuspid area
5. does/doesnt radiate to xyz

this suggests a diagnosis of

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8
Q

stenosis/regurg affects which chamber in relation to the valve

A

the chamber before

stenosis causes hypertrophy
regurg causes dilatation

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9
Q

aortic stenosis murmur

A

ejection systolic, crescendo decrescendo

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10
Q

how does aortic stenosis affect pulse

A

slow rising
narrow pulse pressure

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11
Q

aortic regurg murmur

A

early diastolic

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12
Q

how does aortic regurg affect the pulse

A

collapsing pulse- think if it as the blood flowing back because of regurg
wide pulse pressure

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13
Q

mitral stenosis murmur

A

early diastolic

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14
Q

signs of mitral stenosis

A

malar flush- due to back pressure into pulmonary system

AF- left atrium struggling to push can disrupt electrical activity

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15
Q

marfans syndrome common murmur

A

aortic regurg

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16
Q

mitral regurg murmur

A

pan systolic

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17
Q

causes of murmurs

A

infective endocarditis
rheumatic heart disease
ischaemic heart disease
connective tissue disorder eg marfans, ehlers danlos

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18
Q

tricuspid regurg murmur

A

pansystolic

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19
Q

signs of tricuspid regurg

A

raised JVP
pulsatile liver
peripheral oedema
ascites

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20
Q

pulmonary stenosis murmur

A

ejection systolic

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21
Q

signs of pulmonary stenosis

A

raised JVP
oedema
ascites

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22
Q

causes of pulmonary stenosis

A

congential: ToF and noonan syndrome

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23
Q

what valve pathology most commonly requires replacement

A

aortic stenosis

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24
Q

what scar indicates valve replacement

A

midline sternotomy

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25
INR traget AF
2-3
26
INR target mechanical valve
2.5-3.5
27
complications of valve replacement
thrombus formation infective endocarditis haemolysis
28
what valve replacements need warfarin
only metallic
29
what surgeries can be done for valve replacement
TAVI- bioprosthetic replacement open surgery- bioprosthetic or metallic replacement
30
most common causative organism for infective endocarditis
staphylococcus aureus
31
what do janeway lesions and oslers nodes look like
janeway lesions= flat red macules on palms and soles of feet oslers nodes= red/purple nodules on pads of fingers/toes
32
how should blood cultures be taken in infective endocarditis
3 times different sites 6 hrs apart
33
what is better out of TOE and trans thoracic echo
TOE- more sensitive and specific
34
how long does abx therapy in infective endocarditis last
4 weeks= native valves 6 weeks= prosthetic valves
35
criteria for infective endocarditis
dukes
36
major criteria dukes
1. positive culture 2. imaging findings eg on echo
37
HOCM inheritance
autosomal dominant
38
how is blood flow disrupted in HOCM
left ventricular outflow tract obstruction
39
what pathologies cause irregularly irregular heart rate
AF ventricular ectopics
40
how to differentiate between causes of irregularly irregualr heart rate
if ventricular ectopics they will disappear once heart rate is over a certain threshold
41
what valve abnormality causes valvular AF
mitral stenosis
42
first line rate control in AF
beta blocker
43
flecanide vs amiodarone for rhythmn control in AF
amiodarone for structural heart disease
44
how long should a patient be anticoagulated for before delayed cardioversion in AF
3 weeks
45
what drug is used for pill in pocket management of AF
flecanide
46
what investigation do you need to do for everyone on anticoagulation who has a fall
CT head
47
reversal agent for apixaban/rivaroxaban
adenexat alpha
48
reversal agent for dabigatran
idarucizumab
49
moa warfarin
vitamin K antagonist prolongs PT
50
what enzyme metabolises warfarin and where is it found
cytochrome p450 in liver
51
reversal agent for warfarin
vitamin K
52
what score is used to assess bleeding risk in those with AF
ORBIT
53
what is left atrial appendage occlusion
used when someone with AG cant be anticoagulated due to bleeding risk the left atrial appendage is where clots are most likely to form so it is occluded
54
SVT pathophysiology
there is a reentry circuit from ventricles to atria so the electrical signal goes back to atria, travels to AVN and causes a loop
55
narrow QRS complex length
<0.12 secs <3 small squares
56
SVT mx
1. vagal manoeuvres 2. adenosine 3. verapamil or beta blocker 4. synchronised DC cardioversion
57
what part of the nervous system do vagal manoeuvres affect
parasympathetic
58
what should you not give in wolff parkinson white
beta blocker or adenosine (blocks the AV node and encourages use of the accessory pathway)
59
avoid adenosine in
asthma COPD heart failure heart block wolff parkinson white
60
adenosine dosage
6mg then 12mg then 18mg
61
4 main narrow complex tachycardias
SVT sinus tachycardia AF atrial flutter
62
atrial flutter mx
same as AF- anticoagulation based on chadsvasc radiofrequency ablation of re-entrant circuit
63
QT interval prolonged when
>440 milliseconds in men >460 milliseconds in women
64
normal PR interval
0.2 secs 5 small squares
65
first degree heart block on ECG
prolonges PR interval
66
second degree heart block on ECG
mobitz type 1= increasing PR interval until one p wave is not followed by a QRS complex mobitz type 2= regularly dropped QRS complex
67
3rd degree heart block on ECG
no association between p waves and QRS complexes
68
mx for unstable patients at risk of asystole
1. atropine 2. inotropes 3. transcutaneous pacing 4. transvenous pacing 5. permanent pacemaker when possible
69
when is a single chamber pacemaker placed in right atrium vs right ventricle
right atrium if issue with SA node right ventricle if issue with AV node
70
risk of what is an indication for implantable cardiac defibrillators
going into v tach or v fib
71
how do you identify pacemaker on ECG
a single sharp vertical line before p waves/ qrs complexes

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