Cardiology Flashcards

1
Q

Causes of Peripheral Cyanosis

A
  1. Peripheral vascular disease
  2. Raynaud’s syndrome
  3. Heart failure
  4. Shock
  5. Central cyanosis (when severe)
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2
Q

Causes of irregular irregular pulse

A
  1. AF
  2. Ventricular ectopic beats (VEB)
    Differentiate between 1 and 2 by exercising patient (VEB will be abolished)
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3
Q

Causes of AF

A
  1. Ischaemic heart disease
  2. Rheumatic heart disease
  3. Thyrotoxicosis
  4. Pneumonia / PE / Alcohol
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4
Q

Causes of an absent radial pulse

A
  1. Congenital (usually bilateral)
  2. Previous arterial line
  3. Previous cardiac catheterisation
  4. Atheromatous disease (usually subclavian)
  5. Arterial embolism (e.g. AF)
  6. Surgical ligation
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5
Q

Increased JVP

A
  1. RHF
  2. Volume overload
  3. PE
  4. SVC obstruction (raised and fixed)
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6
Q

Large a-wave

A
  1. Pulmonary HTN

2. Pulmonary stenosis

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7
Q

Giant v-wave

A
  1. Tricuspid regurgitation
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8
Q

Causes of non-palpable apex beat

A
  1. Adipose tissue (obese patient)
  2. Air (pneumothorax, COPD)
  3. Fluid (pleural effusion, haemothorax, pericardial effusion)
  4. Apex displaced (usually LVH)
  5. Dextrocardia
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9
Q

Causes of LVH

A
  1. Aortic stenosis
  2. Hypertension
  3. HOCM
  4. Coarctation of the aorta
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10
Q

Causes of third heart sound

A
(Volume overload)
Normal if <30 years old
1. CHF/MI/cardiomyopathy
2. HTN
3. MR
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11
Q

Causes of fourth heart sound

A

(Stiffening of ventricle walls) - always abnormal, cannot be Dx in the context of AF

  1. CHF/MI/cardiomyopathy
  2. HTN
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12
Q

Causes of cardiac failure

A
  1. Pump failure
  2. Excessive preload
  3. Excessive after load
  4. Isolated RHF
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13
Q

Cardiac failure - pump failure Ddx

A
  1. IHD
  2. Cardiomyopathy
  3. Constrictive pericarditis
  4. Arrhythmias
  5. Negative ino/chronotropes
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14
Q

Cardiac failure - excessive preload Ddx

A
  1. AR/MR

2. Fluid excess (renal failure, Iv fluids)

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15
Q

Cardiac failure - excessive after load Ddx

A
  1. AS

2. HTN

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16
Q

Cardiac Failure - isolated RHF

A
  1. Cor pulmonale

2. Pulmonary HTN

17
Q

CXR features of LVF

A

ABCDE

  1. Alveolar oedema
  2. Kerley B lines
  3. Cardiomegaly
  4. Upper lobe venous diversion
  5. Pleural effusion
18
Q

Causes of pericarditis

A
  1. Viral (coxsackie)
  2. Bacterial / fungal infection
  3. Immediately post-MI
  4. Dressler’s syndrome
  5. SLE / RA / Scleroderma
  6. Uraemia
  7. Malignancy
19
Q

Indication for pacemakers

A
  1. Sick sinus syndrome (symptomatic bradycardia with frequent sinus pauses)
  2. Second degree AV Block
  3. Third degree AV Block
  4. Tachyarrhythmia - PSVT
20
Q

Pacemaker complications

A

Infection - erythema, swelling, purulent discharge

Risk factors - DM, defibrillator placement

21
Q

Tachyarrhythmia Ddx

A
  1. Sinus tachycardia
  2. SVT (paroxysmal, with aberrancy)
  3. AF/Flutter
  4. Torsades de pointes
22
Q

Most common marfans murmur

A

Aortic regurgitation

23
Q

Rheumatic fever Dx

A

JONES

  1. Joints - migrating polyarthritis (tends to be large joints)
  2. Heart - carditis (endocarditis causing rheumatic heart disease, mostly mitral stenosis), may also have pericarditis
  3. Nodules - subcutaneous nodules on extensor surfaces
  4. Erythema marginatum - non-itchy red rings on trunk
  5. Sydenham’s chorea - late finding
24
Q

Rheumatic fever Ddx (migratory polyarthritis with rash)

A
  1. Myocarditis
  2. Lyme’s disease
  3. SLE
  4. Bacterial endocarditis
  5. Juvenile idiopathic arthritis
25
Q

Rheumatic fever investigations

A
  1. FBC
  2. ESR and CRP (raised due to inflammation)
  3. Antistreptolysin O titre + throat culture (test for group A strep)
  4. ECG - AV Block
  5. CXR - signs of CHF
  6. ECHO - check valves, MR,MS,AR
26
Q

Rheumatic fever management

A
  1. NSAIDS - polyarthritis
  2. Corticosteroids - carditis
  3. Management of CHF
  4. prophylactic penicillin
27
Q

Strepococcal pharyngitis Tx

A

10 days penicillin

Or 5 days erythromycin

28
Q

Causes of Central Cyanosis

A
  1. Hypoxic Lung Disease
  2. Right to Left shunt
    - cyanotic congenital heart disease
    - eisenmenger’s syndrome
  3. Methaemoglobinaemia (drug or toxin-induced)