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Cardiology Flashcards

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1
Q

What does ST elevation in II, III & aVF signify?

A

Inferior STEMI - RCA

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2
Q

What does ST elevation in V1-4 signify?

A

Anteroseptal STEMI - LAD

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3
Q

What does ST elevation in V4,5 & aVL signify?

A

Anterolateral STEMI - LAD or circumflex

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4
Q

What does ST elevation in I & aVL signify?

A

Lateral STEMI - circumflex

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5
Q

What does ST elevation in V7-9 signify?

A

Posterior STEMI - circumflex

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6
Q

What are some causes of a prolonged QT?

A

Congential, anti-psychotics, amiodarone, hypokalaemia, erythromycin

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7
Q

What are the ECG signs of hyperkalaemia?

A

Low flat P waves, broad QRS, slurs into ST, tall tented T waves

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8
Q

What is angina and what are the symptoms?

A

Symptomatic, reversible myocardial ischaemia

  1. Constricting/heavy discomfort to chest/arms/jaw
  2. Brought on by exertion
  3. Relieved within 5 mins by rest or GTN
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9
Q

What is decubitus angina?

A

Precipitated by lying flat

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10
Q

What is prinzmetal angina?

A

Caused by coronary artery spasm

Amphetamines, cocaine, hypomagnesia

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11
Q

What tests should be done for angina?

A

ECG
FBC, U&Es, TFTs, lipids, HbA1c
Exercise tolerance test

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12
Q

What is the management of angina?

A

Stop smoking, diet, exercise, HTN & lipid control
75mg aspirin daily
GTN
B blocker

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13
Q

What is the acute treatment for STEMI?

A 
O2 if needed 
300mg aspirin 
180mg ticagrelor 
Morphine + anti-emetic 
PCI
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14
Q

What is the chronic treatment following a STEMI?

A 
75mg aspirin + clopidogrel + PPI for 12 months
Anticoagulation till discharge 
B blocker 
High dose statin 
ACEi
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15
Q

What are the rules for driving following an MI?

A

1 week after successful angioplasty

4 weeks after ACS without angioplasty

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16
Q

What are some complications of MI?

A

Cardiac arrest, cardiogenic shock, left ventricular failure, arrhythmias, pericarditis, tamponade, mitral regurgitation, Dressler’s syndrome, left ventricular aneurysm

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17
Q

What are the signs of cardiac tamponade?

A

Decreased cardiac output - pulsus paradoxes, muffled heart sounds
Kussmaul’s sign - JVP rises during inspiration

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18
Q

What is Dressler’s syndrome?

A

Recurrent pericarditis, pleural effusion, fever, anaemia, raised ESR

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19
Q

What are the signs of a left ventricular aneurysm?

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A

LVF, angina, recurrent VT, persistent ST elevation

20
Q

What tests should be done for an arrhythmia?

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A

FBC, U&E, glucose, calcium, magnesium, TFTs
ECG
Echo

21
Q

What are the indications for D/C cardioversion rhythm control in arrhythmias?

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A

Shock, chest pain, heart failure, syncope

22
Q

What are some causes of atrial fibrillation?

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A

Heart failure, HTN, IHD, PE, mitral valve disease, hyperthyroidism, alcohol, electrolyte imbalances

23
Q

What is WPW syndrome and what are the ECG findings?

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A

Congenital accessory conduction pathway between atria and ventricles
Short PR, wide QRS, ST changes

24
Q

What is heart failure?

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A

Cardiac output is inadequate for the body’s requirements

25
What are some causes of systolic heart failure?
IHD, MI, cardiomyopathy
26
What are some causes of diastolic heart failure?
Ventricular hypertrophy, constrictive pericarditis, tamponade, restrictive cardiomyopathy, obesity
27
What is the classification of heart failure?
I - no dyspnoea from ordinary activity II - comfortable at rest III - less than ordinary activity causes dyspnoea IV - dyspnoea at rest
28
What are the CXR features of heart failure?
Alveolar oedema, Kerley B lines, cardiomegaly, dilated upper lobe veins, pleural effusions
29
What is malignant hypertension?
Rapid rise in BP leading to vascular damage | Severe HTN + bilateral retinal haemorrhages + exudates
30
What are some causes of secondary hypertension?
Renal disease e.g. glomerulonephritis Endocrine - Cushing's, Conn's, acromegaly Pregnancy, COCP, cocaine
31
What are the stages of hypertensive retinopathy?
1. Tortuous arteries, thick shiny walls 2. AV nipping 3. Flame haemorrhages & cotton wool spots 4. Papilloedema
32
What is the treatment for hypertension?
Over 55 or black - Ca channel blocker | Under 55 - ACEi
33
What are some causes of mitral regurgitation?
Calcification, rheumatic fever, IE, CTD, mitral valve proplapse
34
What are the signs and symptoms of mitral regurgitation?
Dyspnoea, fatigue, palpitations AF, hyperdynamic apex, displaced apex Pansystolic murmur at apex, radiates to axilla
35
What are the signs and symptoms of mitral stenosis?
Dyspnoea, haemoptysis, chronic bronchitis Fatigue, palpitations, chest pain Malar flush, low volume pulse, tapping apex, RV heave Mid-diastolic murmur
36
What are the causes of aortic stenosis?
Senile calcification, bicuspid valve, rheumatic fever
37
What are the symptoms of aortic stenosis?
1. Angina 2. Syncope 3. Heart failure
38
What are the signs of aortic stenosis?
Slow rising pulse, narrow pulse pressure LV heave, aortic thrill Ejection systolic murmur - left sternal edge to carotids
39
What are the symptoms and signs of aortic regurgitation?
Dyspnoea, orthopnoea, PND, syncope Collapsing pulse, wide pulse pressure, hyperdynamic apex De-musset's, Corrigan's, Quincke's Early diastolic murmur
40
What are the causes of pulmonary stenosis?
Usually congenital - Tuner's, Noonan's, William's, TOF, rubella
41
What are the risk factors for infective endocarditis?
Skin breaches, renal failure, immunosuppression, DM, IVDU
42
What are the signs and symptoms of IE?
Fever, rigors, night sweats, malaise New/changing murmur, vegetations Vasculitis, microscopic haematuria, Roth spots Osler nodes, Janeway lesions, splinter haemorrhages
43
What are the Duke's major criteria for IE?
Blood culture - 2x typical organism, persistently positive | Echo - vegetation, abscess
44
What are the causes of pericarditis?
Bacteria - TB, lyme disease Viruses - EBV, CMV Autoimmune - SLE, RA, vasculitis Drugs - chemo
45
What are the symptoms and ECG signs of pericarditis?
Central chest pain worst on inspiration and lying flat Relieved by sitting forwards Saddle shaped ST elevation, PR depression
46
How is cardiac tamponade diagnosed?
``` Beck's triad: 1. Falling BP 2. Rising JVP 3. Muffled heart sounds Echo diagnostic ```

FINALS (19 decks)

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