Cardiology Flashcards

(82 cards)

1
Q

ECG signs/causes

A

Pulmonary embolism displays classical ECG changes S1Q3T3, however the commonest finding on ECGs in PE is tachycardia.

  • Signs of Pericarditis
    • Widespread ST Elevation
    • Pericarditis is commonly caused by myocardial infarction and viruses such as Coxsackie B, which means there is frequently a history of flu-like illness.
  • Causes of AF

There are numerous causes of atrial fibrillation but the most common is usually ischaemic heart disease/MI.

Other causes include:

* Mitral stenosis (not aortic until much later in the disease process)
* Thyrotoxicosis
* Pneumonia
* Pulmonary embolism, and
* Sepsis.

COPD is a risk factor for atrial fibrillation and they are often associated.

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2
Q

Tetralogy of Fallot features

A

Pulmonary stenosis

Right ventricular hypertrophy

Overriding aorta

Ventricular septal defect

E

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3
Q

Tetralogy of Fallot commonly appears in which genetic condition?

A

Down’s Syndrome

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4
Q

Which anatomical abnormality in Tetralogy of Fallot determines the level of cyanosis?

A

Pulmonary stenosis

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5
Q

Most common infant cardiac abnormality?

A

Ventricular septal defects are the most common congenital cardiac lesions

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6
Q

Heart failure, syncope + angina are signs of what valvular disorder?

A

Aortic stenosis

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7
Q

Biggest cause of heart disease?

A

Rheumatic Heart Disease

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8
Q

Which valve is most commonly affected in valvular heart disease and is it stenosis or regurg?

A

Mitral Regurgitation (mild)

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9
Q

Gold standard for diagnosis of aortic stenosis?

A

Trans-thoracic echocardiogram

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10
Q

Most common causes of aortic stenosis

A

Aortic stenosis is a consequence of narrowing of the aortic valve causing outflow obstruction of the left ventricle. It may be caused by rheumatic fever but this is less common now with most cases due to degenerative changes and calcification.

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11
Q

Cardiogenic shock, tachycardia, cyanosis, pulmonary edema are all signs of what type of valvular disorder?

A

Aortic Regurgitations

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12
Q

What’s the name given to the short, loud, snapping noise associated with the pulse in someone with chronic aortic regurgitation?

A

Pistol shot pulse

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13
Q

What’s the informal name for Corrigan pulse and what valvular disorder does it indicate?

A

Water Hammer Pulse - Aortic Regurgitation

It will feel like a tapping impulse through the patient’s forearm due to the rapid emptying of blood from the arm during diastole.

https://www.youtube.com/watch?v=6mqJUU12POY

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14
Q

‘a low pitched rumbling mid-diastolic murmur heard best at the apex.’ indicates which valvular disorder?

A

Austin-Flint murmur: Acute Aortic Regurgitation

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15
Q

BP of 125/50 indicates what?

A

WIDE PULSE PRESSURE - Aortic Regurgitation

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16
Q

Acute AR treatment?

A

Ionotropes + SAVR/TAVI

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17
Q

Chronic AR asymptomatic treatment?

A

Reassurange + Medications

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18
Q

Chronic AR symptomatic treatment?

A

Vasodilator + SAVR/TAVI

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19
Q

Chronic MR asymptomatic treatment?

A

ACE inhibitor

if LVEF < 60%, β-blockers

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20
Q

Most common valvular disorders?

A

MR AS - systolic

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21
Q

In acute AR, what’s the cause of death?

A

A back up of lung blood

  1. Starts off with aortic valve weakening
  2. Blood regurges into the left ventricle from aorta during diastole
  3. Increased end-diastolic pressure
  4. Pushes back on pulmonary circulation
  5. Pulmonary oedema, dyspnoea, congestive heart failure, cardiogenic shock
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22
Q

In chronic AR, what’s the cause of death?

A

A problem with heart’s muscles

  1. Initially, a compensatory increase in stroke volume can maintain adequate cardiac output despite regurgitation (compensated heart failure)
  2. Over time, increased left ventricular end-diastolic volume
  3. LV enlargement and eccentric hypertrophy of myocardium
  4. left ventricular systolic dysfunction
  5. Lower coronary perfusion causing ischaemia, necrosis + apoptosis
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23
Q

Causes of dilated cardiomyopathy

A

Idiopathic, Alcoholism, After pregnancy, Autoimmune, Thyroid disease

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24
Q

In familial DCM, if at least 2 family members have the condition what’s the chance of a 1st degree relative getting it?

A

50%

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25
What are 2 things that should be covered in counselling a patient with DCM?
Diet (fluid/sodium restriction) Treating underlying conditions
26
Hypertrophic cardiomyopathy produces systolic/diastolic impairment?
Diastolic
27
Which electrodes make up...
* Lead 1 RA → LA * Lead 2 RA → LL * Lead 3 LA → LL
28
Placement of V1 - V6 on ECG
[![]()](Cardio%20f1b444e56b9d4fa19dee7f15aaf6e41c/Untitled%201.png)
29
Formula for MAP + Ejection Fraction?
MAP: DBP + 1/3 (SBP - DBP) EF: SV/**EDV** times 100
30
Signs of decompensation from infective endo?
[![]()](Cardio%20f1b444e56b9d4fa19dee7f15aaf6e41c/Untitled%202.png)
31
Some non-medical details that should be checked on an ECG?
1. Correct recording? 1. Signal quality and leads? 1. Voltage and Paper speed? 1. Patient background
32
Glanzmann’s Thrombasthenia
Deficiency in **GPIIb/IIIa - platelet aggregation issues**
33
Bernard-Soulier Syndrome
Deficiency in **GPIb**
34
Storage Pool Disease
## Footnote **Dense Granules deficiency - platelet activation issue**
35
Which drug commonly causes impaired platelet function?
Clopidogrel
36
Dense vs Alpha granules?
## Footnote **Dense: CASH - Calcium 2+, ADP, Serotonin + Histamine** **Alpha: Alfffa - ADP, Fibrinogen**
37
Clopidogrel function
Blocks ADP receptor - **P2Y12**
38
3 types of VWF disease?
Type 1: Mild - Moderate deficiency Type 2: Impaired function Type 3: Complete deficiency
39
Common abnormalities of vessel wall?
Senile purpura, Scurvy, Steroid Therapy + **Vasculitis** (VeSSSel 🐍)
40
Functions of ADP/Thromboxane A2
* Adenosine diphosphate ([ADP](https://next.amboss.com/us/article/L60wlS#Z9eba7a6f060d59488b4ba0245a0b3e0d)): promotes adhesion of [platelets](https://next.amboss.com/us/article/ln0vtg#Z53cb67a3181e33f55118053e63485c2e) to [endothelium](https://next.amboss.com/us/article/Io0YWS#Z5497a0f4058d523c955929ca6a14200a) * [Thromboxane A2](https://next.amboss.com/us/article/4p03pS#Zb00bcd679d7b7bb6a3262db12c70ec0f) ([TXA2](https://next.amboss.com/us/article/4p03pS#Zb00bcd679d7b7bb6a3262db12c70ec0f)): activates additional [platelets](https://next.amboss.com/us/article/ln0vtg#Z53cb67a3181e33f55118053e63485c2e) and promotes vasoconstriction
41
What’s petechiae
Thrombocytopenia
42
What’s purpura
Bleeding under the skin
43
Distinguish between purpura and petechiae
Purpura doesn’t blanch when pressure applied
44
Ranges for severe spontaneous bleeding, spontaneous bleeding, bleeding with trauma and normal bleeding?
10/40/100/400 [![]()](Cardio%20f1b444e56b9d4fa19dee7f15aaf6e41c/Untitled%204.png)
45
Purpose of coagulation?
Generate **Thrombin** (IIa)
46
What term is used for the hallmark of haemophilia?
Haemoarthrosis
47
Type of injection in haemophiliacs that is contraindicated?
DO NOT GIVE intramuscular injections **X**
48
Which haemophilias present with spontaneous bleeding?
VIII/IX (8 and 9)
49
Acquired haemophilias are more common in ..... ?
Clinical Practice - Liver disease, DOACs
50
Features of secondary haemostasis cogaulation disorders?
**Essentially deeper bleeding (not mucosal/spontaneous)** [![]()](Cardio%20f1b444e56b9d4fa19dee7f15aaf6e41c/Untitled%205.png)
51
Elongated PT & APTT time indicates what...
1. Liver disease 1. Anticoagulant drugs e.g. warfarin 1. DIC (platelets and D dimer) 1. Dilution following red cell transfusion
52
The only factor for which an isolated concentrate doesn’t exist?
Factor 5 (have to get from FFP or platelets)
53
When do we use Prothrombin complexes?
Reversal of Warfarin
54
Prothrombin concentrate factors
2 + 7 = 9, not 10
55
When do we use FFP?
Liver injury, DIC, vitamin K deficiencies
56
Emicizumab function?
Binds to 9a and 10 which stops procoagulant function of 8
57
RNA silencing knockouts which gene?
Antithrombin
58
Which VWF is desmopressin useful in?
Type 1 and maybe type 2 if moderate since it releases **endogenous** stores
59
Presents with Sudden-onset shortness of breath, pleuritic chest pain, and haemoptysis
## Footnote **Pulmonary Embolism**
60
Virchow’s Triad
## Footnote **Hypercoagulability (venous impact)** **Endothelial stress (arterial impact)** **Venous Stasis (arterial + venous impact)**
61
Factor 5 leiden
Resistant to protein C **Time to Play Counter Strike at Five to Eight**
62
Which deficiency has to most **profound** impact on inherited thrombophilic survival?
Antithrombin deficiencies
63
Patient’s who have had an embolism in hospital have prophylactic treatment for how long?
3 months
64
Two components of reducing risk of reoccurence?
Decreasing procoagulant factors Increasing anticoagulant factors
65
Which factors are required for the maintenance of **tissue homeostasis and organ regeneration**?
## Footnote **Angiocrine factors**
66
What process causes the cessation of endothelial cell growth in vessels?
Contact Inhibition
67
Most common arteries affected by atherosclerosis?
AA → Coronary → Popliteal → Carotid ACPC 🎶
68
What happens to leukocytes in atherosclerosis?
Migrate to **sub-endothelial** space of **major arteries**.
69
Four main components of atherosclerosis mechanism?
1. Leukocyte recruitment 1. Permeabiblity 1. Sheer stress 1. Angiogenesis
70
Name of the paradox that argues whether angiogenesis is good or not?
Janus Paradox [![]()](Cardio%20f1b444e56b9d4fa19dee7f15aaf6e41c/Untitled%206.png)
71
What term describes ‘loss of the normal antithrombotic and anti-inflammatory functions of endothelial cells causes thrombosis with associated inflammation’
Thromboinflammation
72
Which are the only vessels to not have a tunica intima, media + adventitia?
Capillaries + Post capillary venules
73
Increase in risk of atherosclerosis w/ smoking, hypertension + high cholesterol?
16 x
74
2 types of macrophages
Inflammatory + Resident
75
What’s the name for nodular lipid deposits in the skin and tendons in familial hyperlipidaemia?
Xanthoma
76
2 types of macrophage scavenger receptors?
A: also binds Staph + Strep B: also binds malaria
77
Name an oxidative pathway that macrophages activate in plaques?
NADPH oxidase / myleoperoxidase
78
Name a cytokine that macrophages can activate and a chemokine that attract monocytes?
Interleukin 1 (upregulates VCAM) Monocyte Chemotactic Protein 1
79
Main inflammatory cytokines in atherosclerosis that attract smooth muscle cells?
## Footnote **PDGF + TBF β - turns then from contractile SMCs to synthetic SMCs (less contractile elements)**
80
Main transcription factor that mediates regulation (activators send signals to [...], which turns on certain genes)
Nuclear Factor kappa b
81
What determines the phenotype of a blood vessel?
## Footnote **The location.**
82
Examples of Resident Macrophages
* Alveolar resident * Osteoclasts * Spleen