Cardio Flashcards
(129 cards)
1
Q
How is a paroxysmal SVT treated first and second line?
A
Carotid sinus massage then adenosine
2
Q
When is primary pulmonary hypertension common?
A
Post-partum
3
Q
In patients with what conditions is temporary pacing during PCI indicated?
A
Type II or complete heart block
4
Q
What is a side effect of amiodarone?
A
Slate grey rash
5
Q
What ECG changes are caused by digoxin-overdose?
A
Reversed-tick ST segment depression
6
Q
rSR pattern in V1 indicates what?
A
RBBB
7
Q
Name 3 causes of QT prolongation
A
Antibiotics
Hypokalaemia
Bradycardia
8
Q
What heart murmur is associated with an opening snap?
A
Mitral stenosis
9
Q
Name 4 causes of palpitations
A
Alcohol
Caffeine
Heavy metals
Cigarettes
10
Q
Apart from AS, what murmur may cause an ejection systolic murmur?
A
Severe AR
11
Q
VSDs can cause what heart murmur?
A
AR
12
Q
What arrhythmia may be caused by hyperthyroidism?
A
AF
13
Q
Occlusion of which coronary vessel cannot be treated safely with PCI?
A
Left main stem
14
Q
Define pulsus paradoxus
A
A decrease of >10mmHg (systolic) upon inspiration
15
Q
What are 3 characteristics of an ASD?
A
- Fixed splitting of S2
- Dilation of RA and RV
- Ejection systolic murmur
16
Q
In what condition are cannon a waves seen in JVP?
A
Complete heart block
17
Q
Which heart murmur leads to an elevated JVP?
A
Tricuspid regurgitation
18
Q
With which valve is a defect in the ostium priumum associated?
A
Mitral valve
19
Q
Name a condition which can cause pulsus paradoxus
A
Cardiac tamponade
20
Q
What is Takayasu’s arteritis?
A
Absent pulses
21
Q
Head bobbing and visible capillary pulsations are associated with which murmur?
A
AR
22
Q
Which kind of inheritance is HOCM?
A
Autosomal dominant
23
Q
Does the valsalva manoeuvre increase/decrease preload/afterload?
A
Decreases preload
24
Q
Pericarditis may cause which heart sound?
A
3rd
25
A LV aneurysm may present how on an ECG?
Persistent ST elevation
26
What is Tietze's disease?
Inflammation around the costosternal junctions (painful to touch)
27
Coronary artery vasospasms are common in patients with a history of what medical condition?
Migraines
28
Having AF increases your risk of stroke by how much?
5x
29
What % of EDV is ejected during systole?
50-70%
30
Which is worse prognostically (post-MI) - high or low BP?
Low
31
Do inferior or anterior infarcts have a worse prognosis?
Anterior
32
When do large VSDs usually present?
Within the first month of life
33
In which lead may T wave inversion be normal?
V1
34
What is the maximum time for normal QRS duration?
120ms (3 small boxes)
35
Which is better post-MI for revascularisation - tPA or streptokinase?
tPA
36
When is streptokinase contraindicated (4 reasons)?
Peptic ulcer disease
Previous hypertensive stroke
History of hypersensitivity
Extensive cardiac massage
37
Which type of endocarditis is related to SLE?
Liebmann Sacks
38
In under 70s, what is the most common cause of AS?
Bicuspid aortic valve
39
What % of hypertension cases are secondary?
10%
40
What types of diseases most commonly cause secondary hypertension?
Renal diseases
41
Describe characteristics of Turner's syndrome
```
Coarctation
Aortic dissection
Congenital bicuspid aortic valve
Mitral valve prolapse
Non-development of secondary sexual characteristics
```
42
What causes fixed splitting of the second heart sound?
ASDs
43
Is streptokinase given in NSTEMI?
No - only in the presence of ECG changes
44
Which murmur are UC, ankylosing spondylitis and rheumatoid arthritis associated?
AR
45
What is De Mussett's sign?
Bobbing of the head
46
What is Durosiez's sign?
Bruit in the femoral artery
47
How is alcoholic dilative cardiomyopathy treated?
```
Bed rest
Fluid restriction
Cautious diuresis
ACE inhibitors
Spironolactone
```
48
When is a wide pulse pressure seen?
When there is a low peripheral vascular resistance eg due to vasodilation
49
What does renal artery stenosis result in?
Inequal sized kidneys
50
What does Kartagener's syndrome effect?
Cilia in respiratory and reproductive tracts
51
Cushing syndrome is associated with what physical appearance?
Moon face
52
Acute pericarditis may present how on an ECG?
ST elevation in leads I and II
53
In which population is Brugada syndrome most common?
Asian males
54
What ECG changes does Brugada syndrome involve?
RBBB and ST elevation
55
What are the limits for stage 1 hypertension?
140/90mmHg
or
135/85mmHg (ABPM/HBPM)
56
What are the limits for stage 2 hypertension?
160/100mmHg
or
155/95mmHg (ABPM/HBPM)
57
What are the limits for severe hypertension?
>180mmHg systolic
or
>110mmHg diastolic
58
What two drugs may be used prophylactically in AF?
Amiodarone or flecainide
59
What is the most common cause of endocarditis in the developing world?
Strep viridans
60
When is PCI indicated (ECG changes)?
>2mm elevation in 2 or more consecutive anterior leads
61
What type of genetic inheritance does catecholaminergic polymoprhic VT show?
Autosomal dominant
62
How is Torsades de Pointes treated?
MgSO4
63
What effect do beta-blockers have in heart failure?
Decrease mortality
64
How does LVH present on an ECG?
R wave in aVL >12mm
or
S wave in V1 or V2 + R wave in V5 or V6 >35mm
65
Which layer of the heart is most vulnerable to ischaemia?
Endocardium
66
Which fraction of stroke volume is ejected in the first 1/3 of diastole?
2/3
67
What does a bifid P wave indicate?
LA hypertrophy
68
Which murmur is associated with LA hypertrophy?
Mitral stenosis
69
What are the HACEK organisms associated with endocarditis?
```
Haemophilus
Aggregatibacter
Cardiobacterium
Eikenella
Kingella
```
70
What usually causes restrictive cardiomyopathy?
Substance deposition
71
What is the mechanism of arrhythmogenic RV dysplasia?
It affects desmosomes, which causes cardiac muscle to be replaced by fat (which may lead to arrhythmias)
72
What are four causes of dilated caridomyopathy?
Genetics
Alcohol
Chemotherapy
Pregnancy
73
What are the normal durations of systole and disatole?
```
Systole = 0.3s
Diastole = 0.5s
```
74
What are the four aspects of the tetralogy of Fallot?
Over-riding aorta
Pulmonary stenosis
RV outflow obstruction and hypertrophy
VSD
75
What medications should be continued post-MI?
Dual antiplatelet therapy (clopidogrel + aspirin)
ACE inhibitors
Beta blockers
Statins
76
In what condition is IV adenosine contraindicated?
Asthma
77
Which heart murmur is associated with S4?
Aortic stenosis
78
Is Torsades de Pointes mono- or polymorphic?
Polymorphic
79
What is Frank-Starling law?
The more the ventricles are filled, the greater the systolic contractions
80
What effect will sympathetic stimulation have on the Frank-Starling curve?
Shift to the right
81
Pulmonary conditions eg PE cause which type of axis deviation?
Right
82
Which two ECG leads should be used to determine axis deviation?
I and aVF
83
Tall QRS complexes in V4,5,6 indicate what?
LVH
84
Which drug directly inhibits thrombin?
Dabigatran
85
What are three catecholamines?
Adrenaline
Dobutamine
Noradrenaline
86
What is first line management of SVT?
Valsalva manouevre or carotid massage
87
What is second line management of SVT?
Adenosine and cardioversion
88
What is the most common cause of endocarditis?
Staph aureus
89
What is the most common anti-emetic given with diamorphine during a STEMI?
Metoclopramide
90
Where is the ectopic focus usually located in AF?
The ostia of pulmonary veins
91
When should CCBs not be used for rate control in AF?
When there is co-existing heart failure
92
When should beta blockers not be used to treat AF?
Asthmatics
93
Is electrical or pharmacological cardioversion superior?
Electrical
94
After what period of time of AF should anti-coagulation be carried out for before cardioversion? How long should anti-coagulation be continued for?
AF for >48hours
| Anti-coagulation for 3 weeks
95
What is second line AF therapy?
2/3 from beta blockers, rate limiting CCBs and digoxin
96
Which two drugs should never be used together to treat AF?
Verapamil and beta-blockers
97
Which two murmurs are associated with low volume pulses?
AS and MS
98
What is the resting potential of a myocardial cell?
-90mV
99
Give an example of an a1 receptor antagonist
Adenosine
100
Which drug can be used in VTs and SVTs?
Amiodarone
101
How long is the action of adenosine?
8-10 seconds
102
Which heart murmur is associated with S3?
MR
103
Via which method of signalling does adenosine work?
GPCR
104
Which two drug classes work on supraventricular arrhythmias in the atria?
IC and III
105
How does amiodarone decrease heart rate?
Prolongs the action potential
106
Which group is most likely to develop SVTs?
Young women
107
Which pattern of inheritance does Brugada syndrome show?
Autosomal dominant
108
Which 3 conditions does Brugada increase the risk of?
VT, VF and AF
109
Which type of heart block isknown as Wenckbach phenomenon?
Mobitz Type I
110
Which condition contraindicates the use of diamorphine in heart failure?
COPD
111
What is the treatment for chronic heart failure?
```
ACEi
Beta blocker
Diuretics
Digoxin
Spironolactone
```
112
What is the treatment for DVT?
LMWH
| Warfarin
113
When is warfarin use contraindicated?
Pregnancy
114
What is the treatment for limb ischaemia?
```
ALPS:
Antiplatelets
Lifestyle change
PCI or vascular bypass
Statins
```
115
What is the treatment for acute pulmonary oedema?
Furosemide
116
What is the treatment for varicose veins?
Foam scleropathy
Endovenous ablation
Compression stockings
117
What is the treatment for an ischaemic stroke?
Statins
Aspirin
Thrombolysis
Supportive
118
What is the treatment for a haemorrhagic stroke?
Supportive
119
How is phlegmasia dolens treated?
IVC filter through the femoral artery
120
What is the purpose of treatment in phlegmasia dolens?
Prophylaxis for PE
121
What is the treatment for cardiac tamponade?
Pericardiocentesis
122
What is the treatment for co-arctation of the aorta?
Stent and balloon dilation
123
What is the treatment for Tetralogy of Fallot?
Oxygen
Beta blockers
Endocarditis prophylaxis
Surgery
124
What is the treatment for AAA?
Endovascular aneurysm repair
125
What is the treatment for stable angina?
```
ABC BAGS P
ACEi
Beta blockers
CCBs
Bypass
Aspirin
GTN
Statins
Potassium channel openers
```
126
What is the treatment for unstable angina?
HAG
Heparin
Aspirin
GTN (IV)
127
What is the treatment for coronary artery vasospasm?
CCBs
| Isosorbide mononitrate
128
What condition is the Bundle of Kent associated with?
WPW
129
Which congenital defect will cause splitting of the second heart sound?
ASD
