Cardio

Question 1

Hypertrophic obstructive cardiomyopathy symptoms and echo + gene

Answer 1

Sudden cardiac death in athletes
Beta myosin heavy chain mutation
Mitral regurg, systolic anterior motion of mitral valve and asymetric septal hypertrophy

Question 2

Arrythmogenic RV dysplasia pathogenesis, ECG

Answer 2

RV myocardium replaced by fatty and fibrous tissue

V1-3 abnormalities (t wave inversion) and epsilon wave (notch in QRS)

Question 3

Causes of dilated cardiomyopathy

Answer 3

Alcohol
Coxswckie B virus
Wet beri beri
Docorubicin

Question 4

Causes of restrictive cardiomyopathy

Answer 4

Amyloidosid
Post RT
Loefflers endocarditis

Question 5

Peripartum cardiomyopathy

Answer 5

Between final month of pregnancy and 5 months post

Older women multiparous multigravid

Question 6

Takotsubo cardiomyopathy

Answer 6

Stress induced

Question 7

Secondary cardiomyopathies (types)

Answer 7

Infective (coxsackie B, Chagas)
Infiltrative (amyloidosis)
Storage (haemochromatosis)
Toxic (doxorubicin, alcoholic) 
Inflamm (sarcoid granulomas)
Endocrine (DM, thyrotoxicosis, acromegaly)
NM (Friedrichs, DMD, myotonic dystrophy)
Nutrition (beri beri = thiamine)
AI (SLE)

Question 8

Reversible causes of cardiac arrest

Answer 8

Hypoxia
Hypovolaemia 
Hypothermia 
Hypo- kal/ glycaemia/ calc 
Hyperkalaemia 

Toxin
Thrombus
Tension PT
Tamponade

Question 9

Types of calcium antagonist and what to use/not use with them

Answer 9

Dihydropyridines (nicedipine amlodopine). Peripheral vasodilators. Use with beta blocker as they cause reflex tachy. Treat HT and angina.

Non digydropyridines
Verapamil diltiazam. Slow conduction through AV and SA. DO NOT USE BB risk of Brady.

Question 10

Hypetkalaenia

Answer 10

Tall tended T
Flat P
Tachy

Sinusoidal

Question 11

NSTEMI

Answer 11

RMANCE / ticag 180mg

Look atT wave inversion (where is it) ie lateral circumflex
Inferior RCA
Anterior LAD

Angiography

Secondary PCI

Question 12

Ccx of septal anterior infarct

Answer 12

Papillary rupture

Mitral regurgitation

Question 13

Score for Nstemi

Answer 13

GRACE score

Question 14

2ary cardiac prevention

Answer 14

dapt

Statin

Question 15

Losartan

Answer 15

AT2 block

Question 16

Brady andST depress

Answer 16

Posterior stemj/ STEMI

Septal ischaemia

Question 17

When to not give GTN

Answer 17

Low BP

Question 18

Posterior

Answer 18

RCA

Branches of L circumflex

Question 19

PE ecg

Answer 19

Tachycardia 
Right axis
RBBB
T wave inversion 
S wave in lead 1 
Deep Q S1Q3T3

Question 20

Broad QRS

Answer 20

> 120ms or 3 small

Question 21

S1Q3T3

Answer 21

Cor pulmonale

Question 22

Provoked PE prevention post

Answer 22

Disc

Question 23

ThromboLYs PE

Answer 23

Haemodtnamically unstable

Question 24

New LBBB and chest pain

Answer 24

Treat for STEMI

Check old ECGs

Question 25

NSTEMI

Answer 25

Raised trop with chest pain | Not another reason ie CKD chronic hypertensive

Question 26

Scarbossa criteria

Answer 26

For LBBB

Question 27

Left main stem partial block

Answer 27

Global ST and AVR

Question 28

CT angio before intervention

Answer 28

Unfit

Question 29

Ix before CABG

Answer 29

``` Cxr Ecg Echo (EF >55 normal) Bloods Angiogram for stenosis ```

Question 30

CABG vs stent

Answer 30

cabg if multiple vessels triple vessel Already stented (diabetics get stent failure) >50% stenosis of left main steno = critical main stem disease LV failure

Question 31

CP bypass

Answer 31

Heparinise 1 venous (SVC/RA) 1 arterial (aortic arch) Oxygenate warm filter cool blood Reverse heparin with protamine

Question 32

Cardioplegia

Answer 32

Stop heart K+ rich crystaloid Arrest and prevent ischaemia

Question 33

CABG scar

Answer 33

Saphenous graft and midline sternotomy L Internal mammary Internal thoracic

Question 34

Post op CCX CABG

Answer 34

``` Infection. (Wound) Bleed Poor cardiac function Stroke Mortality 2-3% ``` Hook to telemetry for AF / VT / tachy Cautious for fluid so inotropic support ie dobutamine and NA

Question 35

Triad for Aortic stenosis

Answer 35

Chest pain Syncope Breathless

Question 36

Aortic stenosis findings

Answer 36

Brady Pulse changes eg slow rising Ejection systolic to carotid Echo showing trileaflet calcified valve stenosis.

Question 37

Classify aortic stenosis

Answer 37

Area Gradient Velocity

Question 38

Causes of valve disease

Answer 38

``` Bicuspid/unileaflet aortic Calcified Infective (rheumatic/BE) Connective tissue Ischaemia Degenerative ```

Question 39

Indication for aortic valve replacement

Answer 39

Severe Symptomatic / reduced exercise tolerance | EF <50%

Question 40

Replacement of aortic valve choice

Answer 40

TAVI- life expectancy over a year OPen - fit Lifelong anticoag

Question 41

Metal vs tissue valve

Answer 41

Metal vs tissue Mechanical with warfarin as INR needs to be higher as higher risk of vegetation’s. Hear it. Lifelong? Tissue 10-15y, degeneration, risk of reop. No lifelong anti coagulation (ie could get pregnant).

Question 42

Pan systolic murmur

Answer 42

Mitral regurgitation

Question 43

Indication for mitral valve

Answer 43

Severity of MR | Symptoms

Question 44

Repair vs replacement mitral valve

Answer 44

Repair- reduce systolic dysfunction. Annuloplasty.

Question 45

Common valves needing replacement

Answer 45

Mitral and aortic ie left heart

Question 46

Symptoms of constructive pericarditis

Answer 46

``` Dyspnoea JVP that doesn’t fall on inspiration = Kussmalls sign Peripheral oedema Pericardial knock (S3) RH failure (JVP ascites oedema hepatomeg) ``` CXR- pericardial calcification

Question 47

Common valve defect following rheumatic disease

Answer 47

Mitral stenosis heard as diastolic murmur with opening snap and low pitch rumble

Question 48

ECG changes in trifascicular block

Answer 48

RBBB | Left anterior or posterior HEMi block + first degree heart block

Question 49

ECG in wpw

Answer 49

Short PR Delta wave QRS prolongation