Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MRCP Part 1 > Cardiology > Flashcards

Cardiology Flashcards

(51 cards)

Start Studying
1
Q

Risk score to assess when patients should be started on anticoagulation if they have had a history of AF

A

CHA2DS2VASc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the points in the CHA2DS2VaSc Score

A

C - Congestive Heart failure - 1
H - Hypertension - 1
A - Age >75 - 2
Age 64-74 - 1
D - Diabetes - 1
S - Stroke, VTE, Thromboembolic - 2
Vas - Vascular disease - PAD - 1
S - Sex - F - 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What indication is there to start Anticoagulation in AF patients

A

1) CHADSVASC Score of >2 in anyone or Male >1
2) Echo - Mitral stenosis/metallic heart valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What bleeding score is used to deliniate risk/benefit ratio

A

ORBIT score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What parameters are in the Orbit score

A

Hb - <130 M, <120 F - 1
eGFR <60 - 1
Previous Bleeds - 2
Age >74 - 1
Treatment with antiplateles - 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Orbit score to risk equivalent

A

0-2 - Low
3 - Medium
4-7 - High risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

1st line management for AF to prevent the risk of stroke

A

DOAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Holiday Heart syndrome

A

Paroxysmal AF due to Heavy alcohol consumption acutely which should self resolve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a J point on ECG

A

It is the point where the QRS complex meets the ST segment and signifies the end of depolarisation and start of repolarisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why does a J-wave form in hypothermia

A

Due to delayed repolarisation of the myocardium secondary to hypothermia

  • Therefore you would see a J-wave which is an UPWARD deflection (In the true limb leads) between the point where the QRS complex meets the ST segment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does Hypothermia present on a ECG

A

Bradycardia
Heart block - 1st degree or higher depending on severity of hypothermia
J waves
QT prolongation

Severe hypothermia - Torsades de points secondary to QT prolongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to classify a SVT

A

Origin - Atria/AV node
Regularity - Regular vs Irregular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Classification of SVT’s

A

Regular Atria:
- Atrial flutter
- Sinus Tachycardia
Irregular Atria:
- AF
- Atrial flutter + Hear block
Regular AV node:
- AVNRT
- AVRT - WPW
- Junctional tachycardias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cause of WPW

A

Accessory pathway - Bundle of Kent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ECG findings of WPW

A

PR <120ms
Delta wave - Sloping of the R wave
Broad QRS complex >120ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Management of SVT

A

1ST LINE:
- Vagal manouvres
Valsalva –> Expiration with a closed glottis
carotid artery massage

2ND LINE:
Adenosine 6mg –> 12mg –> 18mg

3rd LINE:
Ectrical cardioversion (1st line in case of Haemodynamic compromise)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

C/I of adenosine

A

Asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management of known SVT to prevent further episodes

A

B-blockers -1st line
Radio-frequency ablation - 2nd line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Medication to prevent SVT in pregnancy

A

Metoprolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When should Synchronised DC cardioversion be used in the management of AF (Rhythm control)

A

If haemodynamically unstable (Hypotensive, Chest pain)
If definitely <48 hours in AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why use synchronised DC cardioversion for rhythm control

Study These Flashcards
A

SYnchronise to the R wave to prevent VF if unsynchronsied shock delivered

22
Q

Management of AF <48 hours (Rhythm control)

Study These Flashcards
A

Heparinise and cardiovert.
1) Electical - Synchronsied DC cardioversion
2) Chemical - Amiodarone if structural heart issues or Flecanide/amiodarone if no structural heart issues

23
Q

Management of AF >48 hours

Study These Flashcards
A

Anticoagulate for 3 weeks
DC Cardiovert
Anticoagulate for 4 weeks after

24
Q

Name of the classification system used to classify anti-arrhythmics

Study These Flashcards
A

Vaughan Williams classification

25
Class 1 Anti-arrhythmics as per Vaughan Williams classification
Double Quarter Pounder, with Lettuce and Mayo and Fries Please Class 1a - Disopyramide, Quinidine, Procainamide Class 1b - Lidocaine, Mexiletine Class 1c - Felcainide, Propafenone
26
Mechanism of action of class 1 anti-arrhythmic drugs
Na+ Channel blockers Class 1a - Increase AP time Class 1b - Recued AP time Class 1c - No effect on AP
27
Mechanism of action of Class II Anti-arrhythmic drugs
B-adrenergic receptor blockers
28
Exampels of Class II Anti-arrhythmic drugs
MBAPe Metoprolol Bisoprolol Atenolol Propranolol
29
Mechanism of action of Class III Anti-arrhythmic drugs
K+ Channel blockers
30
Examples of class III Anti-arrhythmic drugs
AIDS A - Amiodarone I - Ibutilide D - Dofetilide S - Sotalol
31
Mechanism of action of Class IV anti-arrhythmic drug
Calcium channel blocker
32
Examples of Class IV Anti-arrhythmic drugs
Verapamil - Rate limiting Diltiazem - Non -rate limitin, Non-dihydropyridine
33
Context in which digoxin is used for the treatment of AF
In the context of heart failure - +VE Inotrope --> Also diuretic effects due to increased renal perfusion - -ve chronotrope
34
Mechanism of action of digoxin
Na+/K+ ATPase inhibitor - Increase Ca2+ accumulation in the sarcoplasmic reticulum --> +ve inotropic effect -ve chronotropic effect: - Stimulates vagun nerve - Slows AP conduction via AVN
35
Signs of digoxin toxicity
Lethargy Anorexia Green-Yellow vision Confusion Gynaecomastia Bradycardia AV Block
36
ECG signs of Digoxin toxicity
Reverse tick sign Short QT interval
37
Precipitants of Digoxin toxicity
Hypokalaemia - Main Iatrogenic interaction
38
Management of dig toxicity
Digibind Monitor K+ levels
39
What type of murmur can you hear with AVR
Early diastolic murmur best heard on the left sternal edge
40
Signs of Aortic valve regurgication
Orthopnoe Dyspnoea Reduced exerise tolerance Angina like pain
41
Signs of Aortic valve regurgitation (7)
1) Early diastolic murmur 2) Severe AR - Mid diastolic (Austin flint murmur) 3) Wide pulse pressure 4) Collapsing (Water hammer pulse) 5) Quinke sign - Nail bed thrombbng 6) De Musset's sign - Head bobbing
42
Diagnosis of Aortic regurg
Echo
43
Causes of aortic regurg - Acute vs chronic and also valvular vs aortic root
Acute: - Valve - Infective endocarditis - Root - Aortic dissection Chronic: 1)Valve: - Bicuspid aortic valve - Rheumatic fever (MOST COMMON IN THE DEVELOPING WORLD) -Connective tissue disorders: Rheumatoid arthritis SLE 2) Root: - Bicuspid aortic valve - Hypertension -Syphyllis - Marfans - Spondyloathropathies - Psoriatic
44
Most common cause of aortic regurgitation in the developing world
Rheumatic fever
45
How would you classify Stage 1 hypertension
Clinic BP >140/90 ABPM >135/85
46
How would you classify Stage 2 HTN
Clinic BP > 160/100 ABPM > 150/95
47
Severe HTN
Clinic BP Sys >180 Diastolic >120
48
When should you initiate treatment
Any patient with a BP of >140/90 sould be offered ABPM Based on that treatment should be started
49
Based on the ABPM When should you start treatment
ABPM <135/85 -No treatment ABPM>135/85: <80 + RF - Start Rx >80 - Start Rx ABPM > 150/95 - Strart treatment
50
1st line treatment for HTN
<55 Or T2DM - ACEi or ARB >55 or afrocarribean - CCB
51

MRCP Part 1 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions