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#passmed 2023 > CardioResp > Flashcards

CardioResp Flashcards

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1
Q

What is Long QT syndrome caused by?

A

Loss-of-function / blockage of K+ channels

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2
Q

What can Long QT syndrome lead to? (2 things)

A
  1. VT (Torsades de Pointes)
  2. (–> death)
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3
Q

What condition can cause Postural Hypotension?

A

T2DM

(secondary to autonomic dysfunction)

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4
Q

What are the CF of Autonomic dysfunction, caused by T2DM? (3 things)

A
  1. Postural hypotension
  2. Loss of resp arrhythmia (aka HR doesn’t change w deep breathing)
  3. Erectyle dysf
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5
Q

What are the causes of Autonomic vs Sensory Neuropathy?

A
  • Autonomic: DM
  • Sensory: Vit B12 def / Alcohol
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6
Q

What are the causes of Autonomic vs Sensory Neuropathy?

A
  • Autonomic: DM
  • Sensory: Vit B12 def / Alcohol
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7
Q

What is the FIRST line investigation for Angina?

A

Contrast-enhanced CT Coronary Angiogram (cCTA)

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8
Q

What is Bumetanide?

A

Loop diuretic

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9
Q

What elec abn can Loop diuretics cause?

A

HypOkalaemia

l - OO - P , like the O is a loop shape lol

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10
Q

What CF’s mean asthma attack is LIFE threatening? (6 things)

A
  1. Confusion
  2. PEFR < 33%
  3. Sats < 92%
  4. Normal pCO2
  5. Silent chest
  6. Bradycardia / Hypotension
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11
Q

What CF’s mean asthma attack is SEVERE? (4 things)

A
  1. Inability to complete sentences
  2. PEFR 33-50%
  3. RR 25+
  4. Pulse 110+
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12
Q

What is the most common cause of Aortic Stenosis in YOUNG ppl (under 65)?

A

Bicuspid aortic valve

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13
Q

What is the most common cause of Aortic Stenosis in OLD ppl (over 65)?

A

Calcification of the aortic valve

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14
Q

What should you do before you Cardiovert a stable pt w AF, presenting 48+ hrs since onset? (2 things)

A
  1. Anticoag at least 3 wks prior to Cardioversion
  2. Transoesophageal Echo (TOE)
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15
Q

What is the point of Transoesophageal Echo (TOE) before Cardioverting a AF pt?

A

To exclude Left Atrial Appendage (LAA) thrombus

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16
Q

What meds should you give for secondary prevention after MI? (4 things)

A

He had an MI, now he dabs…

  1. Dual anti-platelet
  2. ACE inhibitor
  3. Beta blocker
  4. Statin
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17
Q

For Dual Antiplatelet therapy, after PCI for NSTEMI what are the options?

A

Aspirin + one of:
* Prasugrel / Ticagrelor (if not taking oral anticoag)
* Clopidogrel (if taking oral anticoag)

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18
Q

For Dual Antiplatelet therapy, after PCI for NSTEMI what are the options?

A

Aspirin + one of:
* Prasugrel / Ticagrelor (if not taking oral anticoag)
* Clopidogrel (if taking oral anticoag)

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19
Q

What Anticoag should you use in pt w Mechanical heart valves?

A

Warfarin (not a DOAC)

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20
Q

What are the features of Mitral Stenosis? (3 things)

A
  1. Mid-diastolic murmur
  2. Louder on EXpiration
  3. Loud S1
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21
Q

What is the Tx option for severe Mitral Stenosis?

A

Percutaneous mitral commissurotomy

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22
Q

What things in the bloods will suggest a persons COPD will respond to steroids?

A

High blood eosinophils

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23
Q

What things suggest a pt COPD will respond to steroids? (4 things)

A
  1. Previous Dx of Asthma
  2. High eosinophils
  3. Big variation in FEV1 over time (400+ ml)
  4. Big diurnal variation in Peak Flow (20% +)
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24
Q

If someone has Fever + Heart murmur what should you consider?

A

Inf Endocarditis

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25
How do you Dx Inf Endocarditis?
3x blood cultures
26
What type of bacteria usually causes Inf Endocarditis?
Gram positive cocc
27
What does the ECG show below?
* Big T wave in V1, V2 * Often first sign of Myocardial ischaemia --> admit dem to hosp
28
What antiHTN meds is CI in pt w Renal artery stenosis?
ACEi (so give ARBS instead) | i already knew this n got q right lol
29
What ECG changes will a Lung cancer pt most likely have?
Short QT interval (bc hypercalcaemia)
30
What are the CF of hypercalcaemia? (4 things)
1. Bones 1. Stones 1. Groans (abd) 1. Psychiatric Moans
31
What are the ECG changes of Pericarditis? (2 things)
1. Widespread ST elevation 2. PR depression
32
What are the CF of Pericarditis?
1. Pleuritic CP (relieved @ leaning forward) 1. Dry cough 1. Pericardial rub 1. Tachypnoea 1. Tachycardia
33
What investigation should you do if you sus Pericarditis?
Transthoracic **Echo**-cardiography
34
What are the Mx options for Pericarditis? (2 things)
1. TUC 2. NSAIDs + Colchicine
35
Which Ca channel blockers are CI with Beta blockers? (2 things)
1. Verapamil 2. Diltiazem
36
What should you give if Beta Blocker / Nifedipine (Ca channel blocker) is not working for Angina CF?
Ivabradine (HCN channel blocker)
37
What is the time window for PCI for a MI?
12 hours (not 2 hours like I previously thought)
38
What elec abn can Thiazide diuretics cause? (2 things)
1. Hypercalcaemia 2. Hypocalciuria
39
What Smoking cessation things are CI in pregnancy? (2 things)
1. Varenicline 1. Bupropion
40
What Smoking cessation thing is fine to have during pregnancy?
Nicotine replacement therapy
41
What is a visible side fx of Amiodarone?
Grey skin
42
What is the FIRST line tx for COPD?
SABA / SAMA (aka Salbutamol / Ipratropium)
43
What is the FIRST line tx for COPD?
SABA / SAMA (aka Salbutamol / Ipratropium)
44
What does persistent ST elevation (in V1-V6) after an MI, w/o chest pain mean?
Left ventricular aneurysm (MI complication)
45
What should you give to a VF / pulseless VT after 3 shocks have been given? (2 things)
1. IV Adrenaline 1 mg 1. IV Amiodarone 300 mg
46
What is the Dx test for Obstructive Sleep Apnoea?
Polysomnography
47
What is important about Diabetics having an MI?
Can present WITHOUT chest pain (bc neuropathy)
48
What is HOCM associated with?
S4
49
What are the CF of LV free wall rupture (MI complication)? (4 things)
1. Sudden HF 2. Raised JVP 3. Pulsus paradoxus (BP drop @ inspiration) 4. Recent MI (obv)
50
What is important about taking Erythromycin / clarithromycin?
Need to stop Statins (bc interactions)
51
When should you stop Beta blockers used for HF? (3 things)
1. Bradycardia (HR 50-) 2. 2nd / 3rd Degree HB 3. Shock (hypotension)
52
What can be used to reduce risk of death in HOCM?
ICD
53
What should you give a pt w COPD when they get pneumonia, apart from abx?
Prednisolone (even if COPD not exacerbated)
54
What does a decreased pO2/FiO2 suggest?
Acute Resp Distress Syndrome (ARDS)
55
How can an MI give you bilat crackles in entire lung fields? (7 steps)
1. MI 2. Papillary muscle rupture 3. Mitral Regurg 4. Backflow from LV --> LA 5. Increased pressure in L heart 6. Pulm vessels can't drain into L heart 7. Pulm oedema
56
What should you do w NSTEMI pt w GRACE score of 3+ %?
Coronary angiography within 72 hours of admission
57
What are signs specific to RIGHT sided HF? (3 things)
1. Raised JVP 2. Ankle oedema 3. Hepatomegaly
58
How do you remember Resp vs Met Acidosis / Alkalosis?
ROME Resp = Opposite Metabolic = Equal
59
How do you work out Resp Acidosis / Alkalosis?
RO = Opposite * Low pH + High pCO2 = Acidosis * High pH + Low pCO2 = Alkalosis
60
How do you work out Met Acidosis / Alkalosis?
ME = Equal * Low pH + Low Bicarbs = Acidosis * High pH + High Bicarbs = Alkalosis
61
How do you interpret Resp component of ABG according to Resus Council UK?
Resp component = PaCO2 * If 6.0+ = Resp acidosis (or resp compensation for met alkalosis) * If 4.7- = Resp alkalosis (or resp compensation for met acidosis)
62
How do you interpret Met component of ABG according to Resus Council UK?
Met component = Bicarbs * If 22- = Met acidosis (or renal compensation for resp alkalosis) * If 26+ = Met alkalosis (or renal compensation for resp acidosis)
63
What should be offered annually for all HF pts?
Influenza vaccine
64
What is the FIRST line Tx for LV impairment?
ACEi + Beta blocker
65
What are the ECG signs of Dextrocardia? (2 things)
1. Inverted P wave in lead 1 1. Right axis deviation
66
What do you see on a CXR of HF?
1. **A**lveolar oedema (bat’s wings) 1. Kerley **B** lines (interstitial oedema) 1. **C**ardiomegaly 1. **D**ilated prominent upper lobe vessels 1. Pleural **E**ffusion
67
What do you hear in the heart w Pulm HTN?
Loud S2
68
What are the CF of Dresslers Syndrome (MI complication)? (4 things)
1. Fever 2. Pleuritic CP 3. ESR raised 4. 4 weeks after MI
69
What is the Tx for asymptomatic Sarcoidosis?
No Tx
70
What is the FIRST line tx for Sarcoidosis?
Prednisolone
71
What is the IMMEDIATE Mx of NSTEMI?
1. Aspirin 2. Nitrate 3. Morphine (Oxygen only if sats under 94)
72
What will you see on a Echo of HOCM? (2 things)
1. Asymmetric Septal Hypertrophy 1. Systolic Anterior Movement (SAM) of Anterior leaflet of Mitral Valve
73
What should you consider for Acute HF not responding to Tx?
CPAP
74
What are the Mx options for Sleep Apnoea? (2 things)
1. WL (first line) 2. CPAP (if moderate – severe)
75
What is Brugada Syndrome?
Heart condition characterized by (Brugada sign): 1. ST elevation (V1-V3) 2. T wave inversion
76
What will you see in Hx of Brugada Syndrome?
FHx of sudden death before 45
77
What is the Mx of Brugada syndrome?
ICD
78
What are the characteristics of the murmur in HOCM? (3 things)
1. Ejection systolic 2. Louder @ Valsalva manoeuvre 3. Quieter on squatting
79
What are the ECG changes in HOCM? (3 things)
1. Big R waves (ventricular hypertrophy) 2. T wave inversion (looks biphasic in V3) 3. Deep Q waves (leads II and III)
80
What med is CI in VT?
Verapamil (will cause severe hypotension / VF / cardiac arrest)
81
What is the FIRST line meds for HTN in diabetics?
ACEi / ARB (regardless of age)
82
What are the Mx options for Aortic dissection?
Type A = IV labetalol (for BP) + Surgery Tybe B = IV labetalol (for BP)
83
What are some obvious CF of Sarcoidosis? (2 things)
1. Erythema nodosum (raised red shins) 2. Hypercalcaemia
84
What should you give a COPD pt who has 4+ exacerbations in a year and doesn’t smoke?
Azithromycin prophylaxis
85
What is the first line meds for Broad complex Tachycardia with NO adverse features (aka pt feeling well)?
Amiodarone (IV)
86
What should you give for pt w Hx of DVT / PE when travelling as prophylaxis?
Anti-embolism stockings
87
What is Coarctation of Aorta?
Congenital narrowing of descending aorta
88
What are the CF of Coarctation of Aorta? (3 things)
1. HF (in infants) 2. Systolic murmur 3. Weakened femoral pulses
89
What is the Mx of Major Bleeding? (3 things)
1. Stop warfarin 2. IV vit K 5mg 3. Prothrombin complex concentrate
90
What is the Mx of Minor Bleeding w INR over 8? (3 things)
1. Stop warfarin 2. IV vit K 1-3mg (repeat PRN after 24 hrs) 3. Restart warfarin @ INR 5
91
What is the Mx of NO Bleeding w INR over 8? (3 things)
1. Stop warfarin 2. PO vit K 1-5mg (repeat PRN after 24 hrs) 3. Restart warfarin @ INR 5
92
What is the Mx of Minor Bleeding w INR 5 - 8? (3 things)
1. Stop warfarin 2. IV vit K 1-3mg 3. Restart warfarin @ INR 5
93
What is the Mx of NO Bleeding w INR 5 - 8? (2 things)
1. Withhold 1 or 2 doses of Warfarin 2. Reduce subsequent maintenance dose
94
What type of lung cancer is Hypertrophic Pulmonary Osteoarthropathy (HPOA) most common in?
Squamous cell carcinoma
95
What are the ECG signs of Posterior MI? (2 things)
1. ST depression (V1-V3) 2. Tall R waves (V1-V2) aka depression in anterior leads (so da opposite of a anterior MI)
96
What is the most common causative organism of Infective endocarditis?
Staph aureus
97
What can you give (after ABS) for HF if 75+ bpm and LVEF is less than 35%?
Ivabradine
98
What GRACE score means a NTESMI pt needs a PCI within 72 hours?
More than 3%
99
What are the Mx options for Symptomatic Aortic Stenosis pts?
Low / Medium risk pt: Surgical AVR High risk pt: Transcatheter AVR
100
What are the CF of Acute Pericarditis? (4 things)
1. SOB 2. Non-prod cough 3. Pleuritic chest pain (relieved by leaning forward) 4. Pericaridal rub (scratchy rubbing sound, best heard @ systole)
101
What ECG change is most common in Acute Pericarditis?
PT depression (PeRicari-die-tis)
102
What are the target sats for COPD pt if CO2 is NORMAL on ABG?
94-98%
103
What should you do with the anticoagulant of AF pt who has Catheter ablation?
Carry on anticoagulant (if chadvasc says so) (ablation doesn’t change anything)
104
What murmur do you hear in VSD?
Pansystolic murmur (ASD n VSD r part of ASMR innit)
105
What meds do you need to stop when starting Macrolide abx (e.g clarithromycin)?
Statins (risk of rhabdomyolysis)
106
What is the Step wise approach for COPD? (3 steps)
* Step 1: SABA / SAMA * Step 2 NO Asthma CF: LABA + LAMA * Step 2 Asthma CF: LABA + ICS * Step 3: LABA + LAMA + ICS (so add missing one n obv SABA)
107
What is the difference in Adrenaline (dose + route) in Anaphylaxis vs Cardiac arrest?
* Anaphylaxis: IM 500 mcg * Cardiac arrest: IV 1 mg
108
What is the Dx when CXR shows upper lung fibrosis, presents like interstitial fibrosis but isn’t?
Radiation pneumonitis (caused by radiotherapy for previous lung cancer)
109
What lung cancer is assoc w Gynaecomastia?
Adenocarcinoma (obv coz enzymes n stuff)
110
What are the most common pathogens causing Inf Endocarditis? (2 things)
1. Staph aureus 2. Staph epidermis (if less than 2 months after valve surgery)
111
When can Mobitz 1 Wenceback be normal?
Athletes
112
What are the Antiplatelet rules in NSTEMI?
Aspirin + either: 1. Ticagrelor (if not high bleeding risk) (give tiger if safe) 2. Clopidogrel (if high bleeding risk)
113
What are some urgent referral things for Lung cancer? (2 things)
1. Hyponatraemia 2. Raised platelets 3. WL
114
What might you see on CXR for PE? (2 things)
1. Normal XR (most of the time) 2. Wedge-shaped opacification (20%)
115
What should you start AF pt on after a stroke to prevent another stroke?
Warfarin
116
Which type of lung cancer has Cavitating lesions?
Squamous cell cancer
117
What meds is the most common cause of Drug induced angioedema?
ACEi
118
What are the criteria for LTOT?
PaO2 less than 7.3 // OR // PaO2 less than 7.3 with: 1. Peripheral oedema 2. Pulm HTN 3. Polycthaemia
119
What are the criteria for LTOT?
PaO2 less than 7.3 // OR // PaO2 less than 8 with: 1. Peripheral oedema 2. Pulm HTN 3. Polycthaemia

#passmed 2023 (39 decks)

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