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RCE 2021 > Cardiology > Flashcards

Cardiology Flashcards

1
Q

S3 or S3/S4

A

CHF

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2
Q

S4 alone

A

HTN

HFPEF

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3
Q

Continuous murmur

A

Pulmonary AVM
PDA
Coarctation aorta

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4
Q

Loud S1

A 
Exercise
Short PR
MS/TS
ASD
PDA
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5
Q

Soft S1

A

LBBB
Long PR
Severe MS
MR/AR

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6
Q

Variable S1

A

AF
AV block
Tamponade

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7
Q

Wide split S1

A

RBBB
ASD
Ebstein’s

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8
Q

Loud S2

A

A2 - sev HTN, coarctation, aneurysm

P2 - pHTN, ASD

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9
Q

Soft S2

A

A2 - sev AS, AR

P2 - PS

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10
Q

Physiologic split S2

A

During inspiration

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11
Q

Paradoxical split S2

A 
Delayed closure of aortic valve
During expiration (not inspiration)
1. LBBB
2. WPW
3. AS
4. HOCM/LVOT
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12
Q

Fixed split S2

A

Heard EQUALLY in both inspiration and expiration

ASD

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13
Q

Persistent/wide split S2

A

Heard in inspiration and expiration but LOUDER in inspiration (inc venous return)
RBBB

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14
Q

Rhythm control AF - CHF

A 
EF>40% = amio or sotalol
EF<40% = amio
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15
Q

Rhythm control AF - CAD

A

Amio
Sotalol (need QTc <440, not in renal)
Dronedarone

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16
Q

Rhythm control AF - no CHF or CAD

A

Sotalol
Dronedarone (not perm AF or CHF, hepatotoxic)
Propafenone (not in CAD, CHF, liver, renal)
Flecainide (not in CAD, CHF, liver, renal)

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17
Q

When to do rhythm control

A
  1. Stable, <1 yr onset AF
  2. Symptomatic/QOL
  3. Paroxysmal recurrent episodes
  4. CMO
  5. Hard to rate control
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18
Q

NYHA IV/LVAD Driving

A

None

19
Q

Non reversible VT/VF driving

A

6 mos/none

20
Q

Unexplained syncope

A

3 mos/12 mos symptom free

21
Q

ICD insertion

A

Primary - 1 month
Secondary - 6 mos
Commercial - none

22
Q

Familial hypercholesterolemia dx

A

LDL >5 plus

  1. Tendon xanthoma
  2. Family member LDL>5
  3. Family early CVD M<55, F<65
23
Q

Familial DLD Tx

A
  1. Statin
  2. Ezetimibe
  3. PCSK9 inhibitor
    Target LDL <2.5 (2 if CAD) and 50%
24
Q

POTS Definition

A

Sustained HR inc >30 bpm 10 mins standing

With no drop in BP >20/10

25
Q

POTS Tx

A 
Na 10 g/d
Water 3-4 L
Compression stockings
Exercise
Midodrine, fludrocortisone
Other: methyldopa, ivabradine, clonidine
26
Q

PAD Screening

A 
Rule In
1. Femoral bruit
2. Pulse abnormality
Rule out
1. No pulse abnormality
27
Q

PAD Symptoms

A 
Rule In
1. Cool to touch
2. Bruit
3. Pulse abnormality
4. Discolouration
Rule Out
1. No pulse abnormality
28
Q

PAD Tx

A 
Stop smoking, exercise, foot care
Pharm
1. Statin in all
2. ACEi in all
3. ASA/Plavix - definitely in symptomatic. Consider ASA+riva 2.5
4. T2DM management
5. PDE5 inhibitor - not in chf
29
Q

Diffuse T wave inversion

A

Increased ICP

30
Q

RV strain pattern

A

STD/T wave inversion V1-V3, inferior leads

31
Q

LVH Criteria

A
  1. LV strain - STD, T wave inv V4-6

2. R I and S III >25 mm OR S V1 and tallest R V5/6 >35 mm

32
Q

Biphasic T waves V1/V2

A

Wellen’s

Critical pLAD stenosis

33
Q

Persistent STE post MI

A

LV aneurysm
Q waves
Small T waves

34
Q

Posterior MI

A

STD V1-V3
Tall broad R waves
Upright T
Dominant R in V2

35
Q

Canon a waves

A

AV dissociation - AV block, VT

36
Q

Notched P wave

A

P mitrale

Mitral stenosis

37
Q

Peaked T waves

A

Hyperkalemia

38
Q

Hypokalemia

A

T wave inversion
U wave
STD
Long PR

39
Q

Brugada

A

Type 1 - domed ST and negative T wave V1-3
Type 2 - saddle ST
High risk SCD

40
Q

J waves

A

Hypothermia
Deflection at J point (right after QRS)
Also get Brady, ventricular ectopy, VT/VF

41
Q

Digoxin use ECG

A

Fast atrial arrhythmia
AV block
ST scooping
Bidirectional VT

42
Q

LAFB

A

L axis deviation
qR I/AVL
rS II/III/AVF

43
Q

LPFB

A

R axis deviation
rS I/AVL
qR II/III/AVF

RCE 2021 (6 decks)

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