Cardio

Question 1

Symptoms of left heart failure

Answer 1

paroxysmal nocturnal dyspnoea
wheeze
nocturnal cough

Question 2

Symptoms of right heart failure

Answer 2

usually caused by LVF or lung disease

peripheral oedema
ascites

Question 3

Investigations for heart failure

Answer 3

FBC
Us and Es
LFTs
TFTs
lipid profile
brain natriuretic peptide
CXR
Echo
ECG

Question 4

Treatment for heart failure

Answer 4

ACE Inhibitor
Beta blocker
Candesartan
Digoxin
Diuretics
Spironolactone

Conservative; weight loss, healthy diet and exercise

Question 5

symptoms of MI

Answer 5

nausea
sweating
palpitations
crushing chest pain

Question 6

Signs of MI

Answer 6

Raised JVP
Increased pulse, bp changes
Pallor, anxiety

Question 7

Investigations in MI

Answer 7

ECG; ST elevation/depression, inverted T waves, pathological Q waves

CXR
Bloods; cardiac troponin
angiography

Question 8

Treatment for MI

Answer 8

Morphine
Oxygen
Nitrate
Anticoagulants and antiemetics
Betablockers

On discharge; aspirin, ACEI, bb, statin

Question 9

Describe angina

Answer 9

substernal discomfort precipitated by exercise

Includes stable and unstable

Stable; relieved by rest
Unstable; not relieved by rest

Question 10

Investigations for angina

Answer 10

ECG
CT scan
coronary arteriography
thallium scan

Question 11

Treatment of angina

Answer 11

Nitrates; GTN spray
Aspirin
Beta blocker
Ca antagonists

K channel activator

Surgical; percutaenous translumenal coronary angioplasty, coronary artery bypass graft

Question 12

Define stage 1 hypertension

Answer 12

140/90

Question 13

Define stage 2 hypertension

Answer 13

160/100

Question 14

Define stage 3 hypertension

Answer 14

≥180 systolic

≥110 diastolic

Question 15

Investigations in hypertension

Answer 15

ECG
LFTs
creatinine
urea
lipid levels
glucose 
FBC
urine dipstick

Question 16

Treatment of hypertension in <55yo

Answer 16

Step 1; A
Step 2; A + C
Step 3; A + C + D
Step 4 = refer for add-on therapy

Question 17

Treatment of hypertension >55yo/black patients

Answer 17

Step 1; C or D
Step 2; A and D
Step 3; A + C + D
Step 4 = refer for add-on therapy

Question 18

symptoms of atrial fibrillation

Answer 18

none
palpitations
dyspnoea
syncope
exercise intolerance
fatigue
heart failure
irregularly irregular pulse

Question 19

Investigations for atrial fibrillation

Answer 19

ECG; absent P waves, irreg RR intervals, narrow QRS

ECHO
Holter monitoring
TFTs
CXR

Question 20

Treatment of atrial fibrillation

Answer 20

Treat cause
Restore rate; bb, ca antagonist, digoxin, amiodarone
Restore rhythm; bb, cardioversion, amiodarone
Anticoagulation

Question 21

Symptoms of aortic stenosis

Answer 21

syncope
dyspnoea
angina

Question 22

Signs of aortic stenosis

Answer 22

narrow pulse pressure

slow rising pulse

Question 23

Murmur in aortic stenosis

Answer 23

ejection systolic murmur radiating to carotids

Question 24

Investigations in aortic stenosis

Answer 24

ECG
ECHO
CXR

Question 25

Treatment for aortic stenosis

Answer 25

control bp | valve replacement

Question 26

symptoms of aortic regurgitation

Answer 26

dyspnoea angina heart failure

Question 27

Signs of aortic regurgitation

Answer 27

waterhammer pulse aka collapsing pulse | wide pulse pressure

Question 28

Murmur in aortic regurgitation

Answer 28

early diastolic murmur

Question 29

Investigations in aortic regurgitation

Answer 29

ECG CXR ECHO

Question 30

Treatment for aortic regurgitation

Answer 30

manage heart failure | valve replacement

Question 31

symptoms of mitral stenosis

Answer 31

dyspnoea palpitations heart failure haemoptysis

Question 32

signs of mitral stenosis

Answer 32

malar flush tapping apex beat hoarse voice

Question 33

murmur in mitral stenosis

Answer 33

low pitch mid-diastolic

Question 34

Investigations in mitral stenosis

Answer 34

ECG CXR ECHO

Question 35

Treatment for mitral stenosis

Answer 35

manage AF and heart failure | valve replacement

Question 36

symptoms of mitral regurgitation

Answer 36

dyspnoea heart failure palpitations

Question 37

signs of mitral regurgitation

Answer 37

displaced apex beat

Question 38

Murmur in mitral regurgitation

Answer 38

harsh pansystolic to axilla

Question 39

Investigations for mitral regurgitation

Answer 39

ECG ECHO CXR

Question 40

Treatment for mitral regurgitation

Answer 40

Treat heart failure and AF | valve repair

Question 41

Symptoms of DVT

Answer 41

calf swelling localised pain along deep venous system asymmetric oedema

Question 42

Investigations for DVT

Answer 42

Well's score leg vein ultrasound d-dimer level

Question 43

Treatment for DVT

Answer 43

anticoag + physical activity = low mol weight heparin + physical activity may be followed by warfarin to prevent further clotting