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MRCP 1 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What should the height of the JVP be?

A

3cm vertical height above sternal angle

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2
Q

Draw the JVP waves

A
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3
Q

What is the a wave in jvp

A

Atrial contraction

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4
Q

What is the x descent of JVP

A

Atrial relaxation

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5
Q

What is the c wave in the JVP

A

Closure of the tricuspid, ventricular systole

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6
Q

What is the c wave in JVP

A

Passing filling of RA against closed tricuspid

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7
Q

What is y descent of JVP

A

Opening of tricuspid with passive movement of blood from RA to RV

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8
Q

Causes of absent a wave on JVP

A

AF

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9
Q

Causes of large a waves on JVP

A

Contracting against high pressure– Pulmonary HTN, tricuspid stenosis, right HF, pulmonary stenosis

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10
Q

Cause of cannon a waves in JVP

A

Av dissociation:
Complete HB , ventricular arrhythmias/ectopics , AF, atrial tachy

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11
Q

Causes of steep x descent in JVP

A

Cardiac constriction, tamponade

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12
Q

Causes of giant v waves in JVP

A

Tricuspid regurg

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13
Q

Causes of slow y descent in JVP

A

Tricuspid stenosis

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14
Q

Causes of slow y descent in JVP

A

Cardiac constriction

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15
Q

What is kassmauls signs , what does it mean

A

JVP rises on inspiration and drops on expiration
That R heart is unable to increase in size and accommodated venous return
Pericardial disease- constriction /effusion

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16
Q

What does raised JVP with loss of normal pulses mean

A

SVCO

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17
Q

Causes of raised jvp

A

Biventricular or R HF
Severe Brady
Fluid overload

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18
Q

Causes of absent radial pulse

A

Post catheterisation/arterial line
Blalock-taussig shunt with congenital heart disease eg tetralogy of Fallot
Aortic dissection with subclavian involvement
Trauma
Takayasus arteritis
Peripheral arterial embolus

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19
Q

Causes of collapsing radial pulse

A

Aortic regurg
AV fistula
PDA

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20
Q

Causes of slow rising oulse

A

AS

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21
Q

What is the name of a double shudder of radial pulse

A

Bisferiens

22
Q

Cause of bisferiens pulse

A

Mixed aortic valve disease and significant regurg

23
Q

Cause of jerky radial pulse

A

Hypertrophic obstructive cardiomyopathy

24
Q

What is alternans pulse

A

Alternate between strong and weak pulse

25
Q

Cause of alternans radial pulse

A

Severe LV dysfunction
EF reduced meaning end diastolic volume is elevated, stretching myocytes to improve EF on the next heart beat

26
Q

What is pulsus paradoxus

A

Reduction in pulse on inspiration

Occurs with LV compression, due to venous return being compromised&- R chambers not accommodating for increased intrathoracic pressure

27
Q

Cause of pulsus paradoxus

A

Tamponade , constrictive pericarditis, severe asthma

(venous return comprised)

28
Q

Causes of absent apex beat

A

Obesity
Emphysema
r pneumonectomy with displacement
Pericardial effusion ir construction
Dextrocardia

29
Q

Causes of heaving apex beat

A

LVH- causes of this
- HTN
- hypertrophic cardiomyopathy
- AS

May be assoc with s4

30
Q

Causes of thirsting/hyperdynamic apex

A

High LV volume:
- mitral regurg
- aortic regurg
- PDA
-VSD

31
Q

Causes of tapping apex beat

A

Palpable s1, mitral stenosis

32
Q

Causes of displaced and diffuse/dyskinetic apex

A

LV impairment and dilatation:
- dilated cardiomyopathy
- MI

33
Q

Cause of double impulse apex

A

With dyskineaia- LV aneurysm
Without dyskinesia- HCM

34
Q

Cause of pericardial knock apex

A

Constrictive pericarditis

35
Q

Causes of parasternal heave

A

RV hypertrophy:
- ASD
- pulm HTN
- COPD
- pulmonary stenosis

36
Q

Causes of palpable s3 on aoex

A

HF
Severe mitral regurg

37
Q

What is S1

A

Closure of mitral and tricuspid valves before systole

38
Q

What is s2

A

Closure of aortic and pulmonary valves at end of systole

39
Q

Causes of loud S1

A

Mobile mitral stenosis
Hyperdynamic states- eg exercise, anxiety
Tachycardia
L to R shunts
Short PR interval

40
Q

Causes of soft S1

A

Immobile mitral stenosis
Hypodynamic states
Mitral regurg
Poor LV function
Long PR interval

41
Q

Causes of split S1

A

R/L BBB
VT
Inspiration
Ebsteins anomalt

42
Q

Causes of variable S1

A

AF
Completed HB

43
Q

Causes of loud S2

A

Systemic HTN
Pulmonary HTN
Tachycardia
ASD

44
Q

Causes of soft/absent s2

A

Severe AS

45
Q

Causes of split s2

A

FIXED– ASD

WIDELY split:
RBB
Pulmonary stenosis
Deep insp
MR

SINGLE:
severe pulm/aortic stenosis
HTN
Large VSD
Tetralogy of Fallot
Eisenmengers
Pulmonary atresia
Elderly

REVERSED:
LBBB
RV pacing
PDA
AS

46
Q

What is the third heart sound

A

Passive filling of ventricles in opening of the atrioventricular valves

47
Q

Causes of S3

A

Children
Young adults

Rapid ventricular filling:
Mitral regurg
VSD
CHF
Constrictive pericarditis

48
Q

What is s4

A

Atrial contraction filling a stiff LV

49
Q

Causes of S4

A

LVH-
Amyloid
HCM
Left ventricular ischaemia

50
Q

Causes of valvular clicks

A

Aortic ejection- AS, bicuspid
Pulmonary ejection- stenosis
Mid systolic- mitral valve prolapse

51
Q

When is opening snap? Cause?

A

After S2 in early diastole
Mitral stenosis

52
Q

What indicates severity of the pathology causing opening snap?

A

Closer opening snap is to s2 , but absent in very severe MS (when it becomes completely immobile)

MRCP 1 (1 decks)

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