cardiology Flashcards
(211 cards)
1
Q
Dressler’s syndrome
A
post MI pericarditis
2
Q
ECG changes in pericarditis
A
global/widespread,
‘saddle-shaped’ ST elevation
PR depression: most specific ECG marker for pericarditis
3
Q
Mx pericarditis
A
acute pericarditis should have transthoracic echocardiography
treat the underlying cause
a combination of NSAIDs and colchicine
4
Q
ECG leads and territories
A
see screenshot
5
Q
when is adenosine used
A
terminate SVTs
6
Q
when is amiodarone used
A
Amiodarone is a class III antiarrhythmic agent used in the treatment of atrial, nodal and ventricular tachycardias
7
Q
eg rate limiting ca channel blockers
A
verapamil, diltiazem
8
Q
which 2 cardio meds can cause complete heart block if taken together
A
beta-blockers and verapamil
9
Q
ARB examples
A
candesartan
losartan
irbesartan
10
Q
causes of aortic dissection
A
hypertension: the most important risk factor
trauma
bicuspid aortic valve
collagens: Marfan’s syndrome, Ehlers-Danlos syndrome
Turner’s and Noonan’s syndrome
pregnancy
syphilis
11
Q
Aortic dissection symptoms
A
chest/back pain
pulse deficit
aortic regurgitation
hypertension
the majority of patients have no or non-specific ECG changes. In a minority of patients, ST-segment elevation may be seen in the inferior leads
12
Q
types aortic dissection
A
Stanford classification
type A - ascending aorta, 2/3 of cases
type B - descending aorta, distal to left subclavian origin, 1/3 of cases
13
Q
gold standard aortic dissection Ix
A
- CT angiography of the chest, abdomen and pelvis is the investigation of choice
suitable for stable patients and for planning surgery
a false lumen is a key finding in diagnosing aortic dissection - Transoesophageal echocardiography (TOE)
more suitable for unstable patients who are too risky to take to CT scanner - CXR can be also done- shows widened mediastinum (or loss of aortic knob)
14
Q
atrial flutter ecg findings
A
saw tooth
15
Q
management atrial flutter
A
Management
is similar to that of atrial fibrillation although medication may be less effective
atrial flutter is more sensitive to cardioversion however so lower energy levels may be used
radiofrequency ablation of the tricuspid valve isthmus is curative for most patients
16
Q
Atrial myxoma most common chamber
A
LA
17
Q
Atrial septal defects symptoms
which type more common?
A
Features
ejection systolic murmur, fixed splitting of S2
embolism may pass from venous system to left side of heart causing a stroke
ostium secundem more common
18
Q
types of heart block and symptoms and ecg
A
- first degree heart block: Prolonged PR >0.2secs, asymptomatic usually and o tx needed
- mobitz1 wenkebach: increasing pr interval until missed beat
mobitz 2: constant PR interval but P often not followed by QRS - complete heart block there is no association between the P waves and QRS complexes
19
Q
atropine use
A
bradycardia
20
Q
Bivalirudin
A
Bivalirudin is a reversible direct thrombin inhibitor used as an anticoagulant in the management of acute coronary syndrome.
21
Q
Brugada syndrome
CFs
Tx
A
inherited cardiovascular disease with may present with sudden cardiac death.
autosomal dominant fashion
mutation in the SCN5A gene
ECG shows convex ST elevation in V1-V3 with a partial right bundle branch block
Mx= ICD
22
Q
becks triad
A
cardiac tampondade:
- hypotension
- muffled heart sounds
- raised JVP
23
Q
other symptoms of cardiac tamponade (inc becks traid)
A
pulsus paradoxus - an extra large drop in BP during inspiration
Kussmaul’s sign - much debate about this
ECG: electrical alternans
24
Q
management cardiac tamponade
A
Management
urgent pericardiocentes
25
Leading cause of sudden cardiac death in young athletes
Hypertrophic obstructive cardiomyopathy
26
Right ventricular myocardium is replaced by fatty and fibrofatty tissue
Arrhythmogenic right ventricular dysplasia
Tx= ICD and sotalol , catheter ablation
27
Catecholaminergic polymorphic ventricular tachycardia
inherited cardiac disease associated with sudden cardiac death.
autosomal dominant fashion and has a prevalence of around 1:10,000.
- defect in the ryanodine receptor (RYR2)
Mx Management
beta-blockers
implantable cardioverter-defibrillator
28
Coarctation of the aorta
Coarctation of the aorta describes a congenital narrowing of the descending aorta.
29
Complete heart block symptoms
syncope
heart failure
regular bradycardia (30-50 bpm)
wide pulse pressure
JVP: cannon waves in neck
variable intensity of S1
30
systole or diastole when coronary arteries fill?
The coronary arteries fill during diastole.
31
prolonged QT interval on ECG?
hypocalcemia
32
causes L axis deviation
left anterior hemiblock
left bundle branch block
inferior myocardial infarction
Wolff-Parkinson-White syndrome* - right-sided accessory pathway
hyperkalaemia
congenital: ostium primum ASD, tricuspid atresia
minor LAD in obese people
33
causes RAD
right ventricular hypertrophy
left posterior hemiblock
lateral myocardial infarction
chronic lung disease → cor pulmonale
pulmonary embolism
ostium secundum ASD
Wolff-Parkinson-White syndrome* - left-sided accessory pathway
normal in infant < 1 years old
minor RAD in tall people
34
digoxin ecg changes
ECG features
down-sloping ST depression ('reverse tick', 'scooped out')
flattened/inverted T waves
short QT interval
arrhythmias e.g. AV block, bradycardia
35
ECG: hypokalaemia
ECG features of hypokalaemia
U waves
small or absent T waves (occasionally inversion)
prolong PR interval
ST depression
long QT
36
ECG: hypothermia
The following ECG changes may be seen in hypothermia
bradycardia
'J' wave (Osborne waves) - small hump at the end of the QRS complex
first degree heart block
long QT interval
atrial and ventricular arrhythmias
37
LBBB AND RBBB ECG
in LBBB there is a 'W' in V1 and a 'M' in V6
in RBBB there is a 'M' in V1 and a 'W' in V6
38
WHICH TYPe of BBB is always pathological
new LBBB always pathological
39
S1Q3T3')
PE
40
Inverted T waves CAUSES
myocardial ischaemia
digoxin toxicity
subarachnoid haemorrhage
arrhythmogenic right ventricular cardiomyopathy
pulmonary embolism ('S1Q3T3')
Brugada syndrome
41
Eisenmenger's syndrome
- which conditions cause it
reversal of a left-to-right shunt in a congenital heart defect due to pulmonary hypertension.
- ventricular septal defect
atrial septal defect
patent ductus arteriosus
42
symptoms eisenmengers syndrome
Tx
original murmur may disappear
cyanosis
clubbing
right ventricular failure
haemoptysis, embolism
Tx= heart and lung transplant
43
when are exercise tolerance tests used
1. suspected angina
2. risk stratifying patients post MI
3. risk stratifying pts with hypertrophic cardiomyopathy
44
Causes of a loud S1
mitral stenosis
left-to-right shunts
short PR interval, atrial premature beats
hyperdynamic states
45
Causes of a quiet S1
mitral regurgitation
46
Hypercalcaemia: features
'bones, stones, groans and psychic moans'
corneal calcification
shortened QT interval on ECG
hypertension
47
Hypertension in pregnancy in usually defined as:
systolic > 140 mmHg or diastolic > 90 mmHg
OR
48
Blood pressure classification
Stage 1 Clinic BP >= 140/90 mmHg and subsequent ABPM daytime average or HBPM average BP >= 135/85 mmHg
Stage 2 Clinic BP >= 160/100 mmHg and subsequent ABPM daytime average or HBPM average BP >= 150/95 mmHg
Severe hypertension Clinic systolic BP >= 180 mmHg, or clinic diastolic BP >= 120 mmHg
49
Infective endocarditis causes and organisms- which org most common?
Staphylococcus aureus
-most common cause
- IVDUs
Streptococcus viridans
-dental procedures
- streptococcus sanguinis and streptococcus mitis
coagulase-negative Staph such as Staphy epidermidis
- valve surgery
Strep bovis
- colorectal ca
50
Infective endocarditis- duke criteria - MAJOR criteria
- Positive blood cultures
- Echo signs (veg, abscess etc)
- new regurg murmur
51
Infective endocarditis treatment- initial blind therapy
Initial blind therapy
- NATIVE VALVE: amox
PEN allergic- vanc and gent
If prosthetic valve
vancomycin + rifampicin + low-dose gentamicin
52
JVP wave order
ACXVY
53
Kawasaki disease
Features
high-grade fever which lasts for > 5 days. Fever is characteristically resistant to antipyretics
conjunctival injection
bright red, cracked lips
strawberry tongue
cervical lymphadenopathy
red palms of the hands and the soles of the feet which later peel
54
Mx kawasaki disease
- high-dose aspirin
- IV immunoglobulin
- echocardiogram -is used as the initial screening test for coronary artery aneurysms
55
What type of murmurs are benign
systolic
56
AORTIC STENOSIS
57
is the aortic valve usually tri or bileaflet
tricuspid
58
Aortic stenosis
causes
symptoms
signs
treatment
causes: age related calficication, congential bicuspid valve, post rheumatic
SYMPTOMS: SOBOE, syncope, LV dysfunction,
SIGNS:
ejection systolic murmur, slow rising pulse, narrow pulse pressure, S4, split A2.
Tx: if symptomatic- surgery
59
Aortic regurgitation
causes
symptoms
signs
treatment
causes: post rheumatic fever, HTN, syphylis, Ank spon, infective endocarditis, AORTIC DISSECTIOn
symptoms
SOB, LV failure, infective endocarditis not responsive to treatment, enlarged heart
signs,
lengthening diastolic murmur, pistol shot femorals, de quinckes, de musset, collapsing radial pulse
tx= prompt surgery
60
eponymous signs assosciated with AR
see album on phone
61
cyanotic or acyanotic?
ASD
acyanotic
62
cyanotic or acyanotic?
ToF
cyanotic
63
cyanotic or acyanotic
VSD
acyanotic
64
cyanotic or acyanotic
CoA
acyanotic
65
cyanotic or acyanotic
PDA
acyanotic
66
cyanotic or acyanotic
ebstiens anomaly
- what type of murmur does ebsteins anomaly cause
causes TR
cyanotic
67
cyanotic or acyanotic
transposition of great vessels
cyanotic
68
cyanotic or acyanotic
hypoplastic left heart
cyanotic
69
acyanotic heart disease with shunt
ASD, VSD, PDA, CoA
70
cyanotic disease without shunt
congen AS, CoA
71
cyanotic disease with shunt
ToF, ebsteins anomaly, complete transposition of great vessels,
72
acyanotic disease without shunt
lefy hypoplastic heart, pulmonary antresia, pulmonary stensis, tricuspid atresia
73
ASD signs , what is shown on ecg
ASD- split HS2 , Left parasternal heave
74
types of ASD, which is more common, ECG findings for both
1. Secundem= most common , ECG shows RBBB, RAD, AFFETCS MITRAL VALVE
2. primium- affects AV valve, ecg shows RBBB
75
VSD- what type of shunt
Left- right shunt
76
what type of murmur VSD
pansystolic if a large VSD
Ejection systolic if small VSD
77
which congenital heart defect causes machinery murmur
PDA
78
PDA- signs
prem babies
wide pulse pressure
bounding pulse
left subclavicular thrill,
machinery murmur
79
when is prostaglandin given in congenital heart defects and WHY
prostaglandin prevents the natural closing of DA- to allow blood flow in TGA, hypoplastic left heart syndrome, CoA
80
ebsteins anomaly: causes, symptoms
Low insertion of the tricuspid valve resulting in a large atrium and small ventricle.
ass'd with:
patent foramen ovale/ ASD
White syndrome
lithium
signs:
prominent a wave
RBBB, WOLF parkinson white syndrome, cyanosis, pansystolic murmur, tricuspid regurg
Ebstein's anomaly → tricuspid regurgitation → pansystolic murmur, worse on inspiration
81
how soon can drive after permanent pacing
1 week
82
warfarin management of INR (when to stop, hold, give vit k)
see phone screenshot
83
intervention of choice for severe mitral stenosis
Percutaneous mitral commissurotomy
84
BNP - actions:
vasodilator: can decrease cardiac afterload
diuretic and natriuretic
suppresses both sympathetic tone and the RAAS
85
marker of severity in AS
S4
86
methadone commonly causes ?ECG change and causes death
long QTC
87
dilated cardiomyopathy can be caused by deficiency in what
selenium deficiency
88
how does hydralazine reduce bp
increases GMP= smooth muscle relaxation
89
which aa most likely affected following MI causing complete heart block
r coronary aa
90
which sided murmur best heard on inspiration
RIGHT sided murmur
Aortic ejection systolic
Tricuspid regurg
91
Dipyridamole MOA
phosphodiesterase inhibitor
92
first line HTN in pregnancy management
po labetalol
2nd lie (if CI or not tolerated)= nifedipine
93
when to thrombolyse in PE
hypotension + massiv ePE
94
how does complete heart block affect heart sounds
variable S1
95
ECG abnormalities in V1-3, typically T wave inversion. An epsilon wave - which condition?
Arrhythmogenic right ventricular cardiomyopathy
ECG abnormalities in V1-3, typically T wave inversion- EPSILON wave
96
A Swan-Ganz catheter is inserted to enable measurement of the pulmonary capillary wedge pressure in which chamber
left atrium
97
which type of antiHTN med impairs glucose tolerance
thiazide
98
wolf parkinson white drug treatment
Flecainide
99
prosthetic heart valves: anticoagulation
for mechanical VS bioprosthetic
bioprosthetic: aspirin
mechanical: warfarin + aspirin
100
ECG changes in ASD
RAD
RBBB
101
how does SVCO affect JVP
non pulsatile raised JVP
102
which type of murmur most associated with LBBB
AS
LBBB= MOST CONCERNING== == AS == WORST murmur
103
persistent ST elevation following recent MI, no chest pain
left ventricular aneurysm
104
o2 sats rising in the right ventricle, == what type of defect?
ventricular defect
105
right side of heart noral o2 sats
approx 70%
106
carcinoid syndrome
TIPS
Tricuspid Insufficiency
Pulmonary Stenosis
107
murmurs best heard on inspiration/ expiration
RILE
Right-sided murmur → heard best on Inspiration
Left-sided murmur → heard best on Expiration
BUT: AS = louder on expiration
108
AS MR ARMS PS TR
AS ej systolic
MR pansystolic
AR mid diastolic
MS late diastolic
PS ej systolic
TR pansystolic
109
ASD type of murmur
ej systolic, loudest on expiration (same as PS)
110
tetralogy of fallot
cyan or acyan
murmur
cause
shunting
4 features of ToF
4 features
-VSD
-RVHypertrophy
-RV outflow tract obstruction-pulmonary stenosis
-overriding aorta
boot shape heart
ej systolic murmur (Pulm stenosis)
R---L shunt!!
Mx
surgery in 2 stages
beta blockers may help cyanotic spells
ej systolic
111
VSD murmur
what conditions VSD associated with 4
pansystolic
Downs
Edwards
Pataut
cru di chat
post MI
112
Co A murmur
late systolic
113
S4== on ecg
p wave
114
S1 what valves close
atrial valves- tricuspid and mitral
115
S2 what valves close
Aortic and pulmonary
116
S3 causes
diastolic filling of the ventricle
- normal if < 30 years old
-LVF (e.g. dilated cardiomyopathy)
-constrictive pericarditis (PERICARDIAL KNOCK)
- mitral regurgitation
117
S4 causes
AS
HOCM
HTN
ECG IS P WAVE
118
obese people, inferior MI, hyperkalemia, LBBB, L ANTERIOR hemiblock ====ecg change, WPW RIGHT accessory pathwy
LAD
119
causes of RAD
RVH
left POSTERIOR hemiblock
lateral MI
cor pulmonale
PE
ostium secundum ASD
WPW* - LEFT-sided accessory pathway
normal in infant < 1 years old
minor RAD in tall people
120
ARB MOA
block effects of angiotensin II at the AT1 receptor
121
first line HTN treatment for diabetics
ACEi or ARB REGARDLESS of age
122
most common cardiac tumour
atrial myxoma
123
most common location atrial myxoma
left atrium
124
CFs atrial myxoma
- systemic: dyspnoea, fatigue, weight loss,
pyrexia of unknown origin, clubbing
-emboli
-atrial fibrillation
-mid-diastolic murmur, 'tumour plop'
-echo: pedunculated heterogeneous mass typically attached to the fossa ovalis region of the interatrial septum
125
LVEF <40% affects driving how?
cannot drive if <40%
126
amiodarone half life
20-100 days
127
Tendon xanthoma, tuberous xanthoma, xanthelsma & palmar xanthoma: most associated with what type of hyper lipidaemia
Eruptive xanthoma: E-FL(familial hypertriglyceridaemia)
remnant hyperlipidaemia & familial hypercholesterolemia
128
Eruptive xanthoma: associated with what type of hyperlipdaemia/hypertriglyceridaemia
E-FL(familial hypertriglyceridaemia)
129
what is brugada syndrome
inheritance
most common in ? population
inherited cardiac disease- can cause sudden death
inheritance- aut dominant
common in asians
130
ECG changes brugada syndrome
what can be given to diagnose/investigate if brugada syndrome
Tx
ST elevation followed by negatvie T wave
partial RBBB
administration of flecainide or ajmaline - will make ecg changes more visible
Tx= ICD
131
indication for temporary pacemaker
- symptomatic/haemodynamically unstable bradycardia, not responding to atropine
- post-ANTERIOR MI: type 2 or complete heart block
-trifascicular block prior to surgery
132
sacubitril MOA
prevents the degradation of natriuretic peptides such as BNP and ANP.
133
management pulmonary arterial hypoertension
1. test whether responsive to asodilators. If YES-- give calcium channel blocker eg nifedipine
2. no response (maj of pts)
prostacyclin analogue eg iloprost
or
endothelin receptor antagonist eg bosentan
134
mechanical valve replacement-- antithrombotic therapy?
warfarin (upside down M)
135
Takayasu's arteritis
large vessel vasculitis
occlusion of aorta
absent limb pulse
Systemic features of a vasculitis e.g. malaise, headache
unequal blood pressure in the upper limbs
carotid bruit and tenderness
absent or weak peripheral pulses
upper and lower limb claudication on exertion
aortic regurgitation (around 20%)
Mx= steroids
136
pan-systolic murmur
prominent/giant V waves in JVP
pulsatile hepatomegaly
left parasternal heave
signs ==?
tricuspid regurgitation
137
prolonged PR causes
MILD RASH
Myotica dystrophica
IHD
Lyme
Digoxin toxicity
Rheumatic fever
Aortic abscess
Sarcoidosis
Hypokalemia
138
Tx PDA
indomethacin as a neonate
or ibuprofen
GIVE IF ECHO SHOWS PDA one week after delivery- in neonatal period
139
STOP STATINS in which type of antibiotic?
what happens
clarIthromycin-- MACROLIDES
and pregnancy
statin+ clarithromycin = RHABDOMYOLISIS
140
gynacomastia common in hypo or hyperthyroid
Gynaecomastia is seen HYPERTHYROIDISM
141
WPW syndrome- what is it
- ECG changes
- associated conditions
- management
WPW= re entry tachycardia
ECG
short PR interval
wide QRS complexes with delta wave
LAD if right sided accessory pathway(more common)
RAD if left sided accessory pathway
LAD if right sided accessory pathway
Associations of WPW
HOCM
mitral valve prolapse
Ebstein's anomaly
thyrotoxicosis
secundum ASD
Mx:
radiofrequency ablation of accessory pathway
medical therapy: sotalol, fleicanide, amiodarone
142
causes pf psuedohyponatremia
high cholesterol
143
heart failure LVEF<35% start which medication/
SUBCUBITRIL VALSARTAN (if still symptomatic on beta blocker and ACE inhibitor
IVRABRADINE if >35%
144
Mitral stenosis severe- valve replacements
1st Balloon Percutaneous mitral commissurotomy
fails:
2nd surgical
fails:
3rd catheter replacement
145
egg on side appearance paeds cardiac condition
= TGA - CYANOTIC
146
HOCM what type of mm fibre affected
beta myosin HEAVY CHAIN
147
long qt syndrome: which electrolyte channel causes this
potassium channel- LOSS of function
Blocking of the K channels
148
ECG Changes in severe hypokalemia
: I know 'U' are 'depressed' because got no 'T' and 'Pot', but dont worry U got 'long QT' and 'long PR'.
u wave
ST depression
T wave inversion
low potassium
long qt
long PR
149
psudoxanthoma elasticum CFs
GI haemorrhage
incr risk IHD
retinal angyloid streaks
plucked chicken skin
mitral valve prolapse
150
Pulmonary arterial hypertension patients with positive response to vasodilator testing TX???
should be treated with calcium channel blockers
151
hocm treatment
ABCDE
Amiodarone
Betablocker or verapamil for symptoms
Cardiac defibrillator
Dual chamber pacemaker
Endocarditis prophylaxis
152
Associations of X condition???
Turner's syndrome
bicuspid aortic valve
berry aneurysms
neurofibromatosis
CoA
153
dilated cardiomyopathy affect on heart sounds
and causes of dilated cardio myopathy
causes 3rd heart sound
Causes of DCM - THIAMIN
Thiamine deficiency (wet beri-beri)
Hypertension
Ischaemic heart disease
Alcohol (and cocaine)
Myocarditis
Infiltrative (haemochromatosis and sarcoidosis)
No cause (idiopathic)
154
VT rather than SVT with aberrant conduction features
AV dissociation
fusion or capture beats
positive QRS concordance in chest leads
marked left axis deviation
history of IHD
lack of response to adenosine or carotid sinus massage
QRS > 160 ms
155
a paradoxical rise in the JVP during inspiration
constrictive pericarditis
156
157
post PCI- time frame for re-stenosis and thrombosis
stent thrombosis in first 4 weeks
re-stenosis-3-6 months
IF ASAP after pci--- then likely thrombosis
158
Cholesterol emboli CFs and mneumonic
and what can trigger it
PERL
Purpura
eosinophilia
renal failure
livedo reticularis
majority of cases are secondary to vascular surgery or angiography
159
clopidogrel MOA
antagonist of P2y ADP receptor= inhibits platelet action
need to stop 7 days before surgery
concurrent PPI use may make clopi less effective
160
Causes of:
eruptive xanthoma
Palmar xanthoma
Tendon xanthoma,tuberous xanthoma and xanthelasma
eruptive xanthoma=
familial hypertriglyceridaemia
lipoprotein lipase deficiency
(T in erupTive)
Palmar xanthoma= remnant hyperlipidaemia (familial hyperchol less)
palms remain sweaty
Tendon xanthoma,tuberous xanthoma and xanthelasma=
remnant hyperlipid AND familial hypercholesterolaemia
161
when to stop exercise tolerance test
and how to remember it
when to stop exercise tolerance test
The 23 rule!!
2 mm ST elevation, 3 mm ST depression , SBP> 230 mmHg , SBP falling more than 20mmHg , HR falling more than 20%.
162
takotsubo cardiomyopathy
ST elevation
balloon heart, octopus pot
163
cf
164
cf
165
CT angiography of the chest is organized, which demonstrates an intimal flap proximal to the brachiocephalic vessels==== is this TYPE A OR TYPE B aortic dissection
type A= needs surgery and iv labetalol
166
PCI - what type of antiplatelets do pts need to be on and for how long
aspirin for life
+/- clopidogrel pending type of stent
167
when should primary pci take timeframe
within 120 minutes
if not possible
thrombolysis within 12 hrs of onset with altepalse
168
stroke + leg DVT =?
likely cause
Ix
patent foramen ovale-- ASD OR VSD
Ix= echo
169
poor prognostic factors HOCM
Poor prognostic factors
-syncope
-family history of sudden death
-young age at presentation
-non-sustained VT on 24 or 48-hour Holter monitoring
- abnormal BP changes on exercise
-An increased septal wall thickness
170
conditions associated with CoA
acyanotic condition
Turners
biscusipid aortic valve
neurofibromatosis
berry aneurysms
171
complete heart block: 5 features
syncope
regular bradycardia
WIDE pulse pressure
JVP cannon waves
Variable intensity of S1
172
first line treatment of prinzmetal angina
dihydropyridine calcium channel blocker
FELODIPINE
173
which med used in angina medication can cause ulcers anywhere in the body
Nicorandil
174
troponin role
troponin = component of THIN filaments
troponIN = thIN
175
ticagrelor MOA
inhibits ADP binding to platelet receptors
176
rheumatic heart disease 4 features
The 4 As of rheumatic fever:
caused by group-A-strep
high ASO-titre
presence of Aschoff bodies and Anitschkow cells
177
what type of heart mumur can VSD go on to cause in addition to the existing pansystolic
AR
other complications o VSD:
Eisenmengers complex ( due to prolonged pulm HTN from L=r shunt
R heart failure
pulm HTN
178
which coronary aa supplies AVN and SAN
R coronary
179
MOA sacubitril/valsartan
prevents the degradation of natriuretic peptides such as BNP and ANP.
180
cholesterol embolism CFs
complication of coronary angiography
cholesterol emboli may break off and cause renal disease
CFs
eosinophilia
purpuric rash- renal
renal failure
livedo reticularis
181
for AF which type of med is ONLY used
DOAC
eg apixaban
dabigatran
edoxaban
rivaroxaban
182
whcih part of P QRS ST is used in DC cardioversion
Electrical cardioversion is synchronised to the R wave
183
how to remember risks for statin induced myopathy
thin old diabetic lady
184
tracer used in PET scan
Fluorodeoxyglucose
185
Furosemide MOA
inhibits Na K Cl co transporter at thick ascending loop of henle
186
bumetanide MOA and what type of diuretic is it
bumetanide= loop diuretic
MOA= inibits na k cl co transporter at thick ascending loop of henle
187
causes of restricted cardiomyopathy (5)
SLASH
SLASH: sarcoidosis lofflers amyloid scleroderma haemochromatosis
188
Causes of ST depression (5)
SIADH: mnemonic for ST depression causes
syndrome X
Ischemia
Abnormal qrs
Digoxin
Hypokalemia
189
how to treat uraemic pericarditis
haemdialysis
190
thiazide/thiazide like drugs MOA
inhibition of sodium reabsorption at start of DCT
191
Persistent ST elevation following recent MI, no chest pain = ???
left ventricular aneurysm
192
GTN moa
dilates systemic veins
193
What is lutembachers syndrome
AF and progressive RH Failure
L parasternal heave
mid diastolic murmur
L to R shunt
194
SVT prophylaxis in pregnancy
metoprolol
195
If high-risk of failure of cardioversion (previous failure), offer electrical cardioversion after at least 4 weeks treatment with ???????
If high-risk of failure of cardioversion (previous failure), offer electrical cardioversion after at least 4 weeks treatment with amiodarone
196
centrally acting antihypertensive (3)
CMM= central news cnn
Clonidine
Methyldopa
Moxonidine
197
pt unable to do stress echo due to eg pain, trauma reasons- what to do
dobutamine stress echo
198
how does valsava affect body
decrease venous return to heart
199
how does severe heart failure affect aldosterone
increases plasma aldosterone concentration
200
post inferior MI= what is most likely to happen
AV node block
201
multifocal tachycardia is mANAGEMENT
RATE LIMITING CA CHANNEL BLOCKER= VERAPAMIL
three different P wave morphologies are seen
202
L parasternal heave which type of heart murmur
TR
203
regulary vs irregular cannon a waves meaning
REGULAR cannon waves = atrioventricular nodal re entry
IRREG= complete heart block
204
post MI which antidepressant to start
sertraline
205
post MI complete heart block- which coronary aa most likely affected
right coronary artery
206
which antihytertensive can cause lithium toxicity
ramipril ACEi
207
when to use anti lipid meds in T2DM
NICE specifically state that we should not use QRISK2 for type 1 diabetics. Instead, the following criteria are used:
older than 40 years, or
have had diabetes for more than 10 years or
have established nephropathy or
have other CVD risk factors
208
EZETIMIBE moa
NPC1L1 inhibitor
209
Which type of anti htn med causes gum hypertrophy
amlodipine/ ca channel blockers
210
NSTElevation in V1-3 caused by? which aa
posterior descending artery
211
culture-negative endocarditis causative organism for a farmer
culture-negative endocarditis
coxiella
treat with doxy
coxy doxy
