Cardiology Notes

Question 1

chest pain relieved by sitting up and leaning forward?

Answer 1

pericarditis

Question 2

what sort of symptoms would you get in pericarditis?

Answer 2

non productive cough, dyspnoea, flu like symptoms

Question 3

pericarditis on ECG?

Answer 3

saddle shaped ST elevation, PR depression

Question 4

when would a patient typically get pericarditis?

Answer 4

2-10 weeks post MI

Question 5

what is the triad of symptoms in Dresslers syndrome

Answer 5

triad of fever, pleuritic chest pain and pericardial effusion

Question 6

which valve is affected in IV drug users in endocarditis?

Answer 6

tricuspid

Question 7

what is the criteria for classification of endocarditis

Answer 7

Duke

Question 8

signs and symptoms (from jane)

Answer 8

fever 
roth spots 
oslers nodes 
murmur 
janeway lesions 
anaemia 
nails (splinter haemorrhages) 
emboli

Question 9

Investigations (BBUCE)

Answer 9

Blood cultures (3 separate cultures from 3 peripheral sites 
Bloods for anaemia 
Urinalysis (macroscopic haematuria) 
CXR 
Echo

Question 10

native valve tx

Answer 10

amox and gent

Question 11

native valve severe sepsis

Answer 11

flucloxacillin

Question 12

prosthetic valve (or suspected MRSA)?

Answer 12

Vancomycin + Rifampicin + Gent

Question 13

Native valve severe sepsis and risk factors for resistant pathogens

Answer 13

Vancomycin IV + Meropenem IV

Question 14

complications of endocarditis?

Answer 14

HAAES 
Heart failure 
Arrythmia 
Abcess formation in cardiac muscle 
embolic formation

Question 15

what do you give to someone with a heart rate of less than 40 or symptomatic bradycardia?

Answer 15

IV atropine

Question 16

what is definition of SVT?

Answer 16

narrow complex tachycardia (>100bpm, qrs <0.12s)

Question 17

what manouvre can you do in SVT?

Answer 17

valsalva manouvre

Question 18

what do you give in SVT after the valsalva manoeuvre?

Answer 18

IV adenosine or verapamil

Question 19

what maintenance therapy do you give?

Answer 19

bbs or verapamil

Question 20

AF, what wave missing on ECG?

Answer 20

P wave

Question 21

saw tooth baseline at 150bpm?

Answer 21

atrial flutter

Question 22

treatment for pre excited AF

Answer 22

flecainide

Question 23

the two shockable rhythms ?

Answer 23

VF and pulseless VT

Question 24

broad complex tachycardia?

Answer 24

vt

Question 25

acute management of vt?

Answer 25

iv amiodarone

Question 26

o Congenital accessory conduction pathway between atria and ventricles

Answer 26

wpw

Question 27

what wave do you see on ECG?

Answer 27

delta wave

Question 28

what is the treatment of WFW?

Answer 28

requires ablation

Question 29

what is holiday heart syndrome?

Answer 29

binge drinking in person without any clinical evidence of heart disease

Question 30

slow rising pulse

Answer 30

aortic stenosis

Question 31

collapsing pulse?

Answer 31

aortic regurg

Question 32

bounding pulse?

Answer 32

acute CO2 retention

Question 33

radiofemoral delay

Answer 33

coarctation of aorta

Question 34

jerky pulse?

Answer 34

hypertrophic obstructive cardiomyopahty

Question 35

pulsus paradoxus

Answer 35

contrictive pericarditis, cardiac tamponade

Question 36

systolic pressure drops > 10 Hg with inspiration ?

Answer 36

pulsus paradoxus

Question 37

how does conns cause hypertension ?

Answer 37

Increased aldosterone, causing increased salt and water retention. Potassium goes down

Question 38

what is the effect of aldosterone on sodium and potassium ?

Answer 38

causes increased (retention) of sodium and decreased potassium

Question 39

normal and abnormal Bps?

Answer 39

``` ♣ Normal <120 / <80 ♣ Pre-hypertension 120-139 / 80 – 89 ♣ Stage 1 140-159 / 90 – 99 ♣ Stage 2 160-179 / 100-109 ♣ Severe ≥180 / ≥110 ```

Question 40

ECG change in hypertension ?

Answer 40

LVH

Question 41

how do you treat resistant hypetension ?

Answer 41

higher doses of thiazide or spironolactone

Question 42

what can you add if diuretic is insufficient in treating hypertension ?

Answer 42

alpha or beta blocker

Question 43

rib notchin in babies on CXR?

Answer 43

coarctation of aorta

Question 44

tetrallogy of fallot?

Answer 44

``` PROVe pulmonary stenosis ventr septal defect over riding aorta RV hypertrophy ```

Question 45

cyanosis on first day of life? boot shaped heart?

Answer 45

tetralogy of fallot

Question 46

Wide, fixed split S2, ejection systolic murmur 2nd/3rd IC space

Answer 46

atrial septal defect

Question 47

harsh pansystolic murmur left sternal edge ?

Answer 47

ventricular septal defect

Question 48

continuous machinery murmur below left clavicle

Answer 48

persistent ductus arteriosus

Question 49

Cyanosis first day of life, egg-shaped ventricles

Answer 49

- Transposition of the great vessels

Question 50

when do fallots present?

Answer 50

2 months

Question 51

which murmur would you get a large systolic JVP?

Answer 51

triscupid regurg

Question 52

raised fixed JVP?

Answer 52

superior vena cava obstruction

Question 53

JVP rising on inspiration ?

Answer 53

cardiac tamponade, constrictive pericarditis

Question 54

large V waves?

Answer 54

triscupid regurg

Question 55

cannon a waves?

Answer 55

complete heart block

Question 56

drug that causes blurred yellow vision headache?

Answer 56

digoxin toxicity

Question 57

s2 splitting during inspiration ?

Answer 57

normal

Question 58

when is S3 heard?

Answer 58

LVF, constrictive pericarditis

Question 59

s4 heard in ?

Answer 59

HOCM 1,2,3,4

Question 60

why is aspirin not given to children ?

Answer 60

due to risk of reyes syndrome

Question 61

tall tented t waves?

Answer 61

hyperkalaemia

Question 62

S1, Q3, T3 pattern ?

Answer 62

pulmonary embolism