Cardiovascular Flashcards
(95 cards)
1
Q
Cause dementia, prescribed beta blocker and bradycardia
A
Beta-blocker overdose
Treat w glucagon
2
Q
When is atropine required in bradycardia?
A
Adverse features
Risk factors for asystole
3
Q
First line for brady management
A
Thyroid function, electrolytes, observe
4
Q
Brady treatment after maximum atropine?
A
Isoprenaline 5mg/m, transuctaneous pacing, adrenaline 2-10mg/m
5
Q
ECG finding of A wave in complete heart block
A
Cannon A-waves
6
Q
Management of AF with heart failure
A
Digoxin
7
Q
ALS Algorithm in SVT
A
Vagal Manoeuvres
IV Adenosine
8
Q
Additional Adenosine Treatment
A
6mg
12mg
18mg
9
Q
Atrial flutter treatment
A
2.5mg bisoprolol, PO
Beta blocker
10
Q
Haemodynamically unstable BP?
A
Systolic <90mmHg
11
Q
AF treatment without HF
A
Beta blocker
if contraindicated, Diltiazem
12
Q
Contraindication for adenosine
A
Asthma
give verapamil instead
13
Q
Imaging for aortic dissection
A
CT
Trans-oeso echo (TOE)
14
Q
Stanford Type B management
A
(Desc aorta - Medical management)
Labetalol to control BP
15
Q
Type A dissection features
A
Asc aorta
Located anteriorly
Thicker than desc aorta
16
Q
Coronary artery dissection on ECG
A
ST elevation in inferior leads
17
Q
Mos common cause of aortic regurg
A
Rheumatic HD
18
Q
Best inv for aortic regurg
A
TTE
19
Q
Symptomatic AR treatment w HF symptoms
A
Surgical valve replacement
20
Q
Pulse pressure in AR?
A
Wide PP
21
Q
Pulse in aortic stenosis
A
Slow-rising
22
Q
Determining severity of aortic stenosis
A
Elevated pressure gradient >40mmHg across valve
23
Q
Does aortic sclerosis radiate to carotids?
A
No
24
Q
Surgery in symptomatic severe AS?
A
TAVI
25
AF treatment <48h onset
LMWH and DC cardioversion
26
What CHA2DS2-VASc score should AF patients have to be anticoagulated?
0
| All AF patients should be anticoagulated
27
First line rate control for fast AF in haem stable
Cardioselective blocker - bisoprolol
28
Anticoag drugs in AF
Apibaxin
Dabigatran
Rivaroxaban
29
Asymptomatic AF with score 0 - which anticoag?
None
30
Treatment of fast AF with failed rhythm control
Digoxin, carvdilol, warfarin
31
Drugs causing TdP
Antibiotics
| Antiarrhythmics
32
Rate of compressions in vent tachy
100-120 per min
| 30:2 breaths
33
First line for haemo stable vent tachy
Amiodarone
34
HF on auscultation
Bibasal crackles
35
Magnesium sulfate in vent tachy
TdP with no adverse features (If QRS is twisting around baseline)
36
Definitive management of Brugada
ICD
37
How long should a patient wait after angio to drive?
1 week
| 6 months if ICD is implanted
38
Chest pain <12h onset
Angio + PCI
39
Type of stroke risk after angio
Embolic
40
Haem unstable and failure to respond to med therapy... type of pacing?
Trans-cutaneous/venous pacing
41
Dual chamber pace rhythm
2 spikes
| 1 before P, 1 before QRS - means there's 2 leads pacing the rhythm
42
Pacing for sinus arrest >3s
Permanent pacemaker
43
Amyloidosis
Amyloid protein depos in body tissues e.g. kidneys, heart
| Leads to restrictive cardiomyopathy (sparkling on echo)
44
How does heart compensate during HF?
Elevated right atrial pressure
45
What vessels control blood flow through capillaries?
Arterio-venous anastomoses
46
Changes in arteries w sympathetic stimulation
Vasoconstriction
Incr systemic vasc resistance
Reduced distal blood flow
47
Dextrocardia
Heart points to RHS
48
Function of autoregulation
Maintaining constant blood flow in organs such as the kidney and brain
49
MAP=
COxTPR
| e.g. 6.3 x 20 = 126
50
Isovolumetric Contraction
AV valves closed
| Semilunar valves closed
51
Sudden decr in blood pressure causes increases in...
Vasoconstriction
HR
Force of myocardial contraction
52
Indication for IE valve surgery
HF symptoms (bilateral crackles, elev JVP, SOB)
53
If strep. bovis is found in IE what investigation must be performed?
Colonoscopy
54
Common acute murmur seen 2-10 days post-MI
Mitral regurgitation
55
Management of asympto mitral stenosis w no HF symptoms
6 month follow-up
56
Features of cornary artery vasospasm
Central chest pain on exertion
| Strongly assoc w cocaine
57
GRACE score
Estimates in-hosp mortality and 6-month post-discharge mortality
58
What anti-coag should be given w dual anti-platelet in acute MI?
LMWH
59
Left bundle branch block on ECG
Broad QRS
Dominant S wave in V1
Notched R waves (M shaped QRS)
**Treat same as STEMI
60
What ECG do you need for a posterior infarct?
15-lead ECG
| 3 extra leads (V7, 8, 9
61
What clotting factors does warfarin act on?
1972
| 10, 9, 7, 2
62
Brown deposition in legs?
Haemosiderin deposition
63
Left renal artery origin?
L1
64
5 Features of HF on CXR
```
Alveolar oedema
B lines
Cardiomegaly
Diversion of vessels
Effusion
```
65
LV ejection fraction =
(stroke vol/end diastolic LV vol) x 100
66
What vessel is beside the inferior parathyroid gland?
Common carotid
67
Reduced ejection fraction in HF?
Less than 40%
68
Where is great saphenous vein?
Anterior to medial malleolus
69
JVP waveform features
Upward deflections
a wave = atrial contraction
c wave = ventricular contraction
v wave = atrial venous filling
Downward deflections
x wave = atrium relaxes and tricuspid valve moves down
y wave = ventricular filling
70
Jones Criteria for RF
Major - arthritis, pancarditis, Sydenham's chorea, erythema marginatum, subcutaneous nodules
Minor - fever, athralgia, raised acute phase protein (ERS and CRP), prolonged PR interval
71
Diag of RF
Evidence of recent strep infection
PLUS
2 majors OR 1 major, 2 minor
72
Treatment of RF
Benzylpenicillin
73
LBBB vs RBBB pneumonic
V1 QRS looks like W and V6 QRS looks like M - WiLLaM
| V1 looks like M and V6 looks normal (sometimes slurred S) - MaRRoW
74
Sick sinus on ECG
Sinus bradycardia
Sinoatrial block
Periods of sinus arrest
Abnormally long pauses after a premature beat
75
1st line inv after ECG for angina
CT coronary angio
Indicated for atypical/atypical angina pain
OR
ECG ischaemic changes in chest pain w <2 angina features
76
Angina treatment if BBs and Ca blockers are contraindicated
Long-acting nitrate e.g. Isosorbide Mononitrate
Ivabradine
Nicorandil
Ranolazine
77
Contraindication to CTCA
Renal impairment which risks contrast induced nephropathy
| Instead use myocardial perfusion imaging
78
Tricuspid regurg on JVP waveform
Prominent V wave
79
WPW on ECG
Delta waves (slurred upstroke in the QRS)
Short PR interval (<120ms)
Broad QRS
If a re-entrant circuit has developed the ECG will show a narrow complex tachycardia
80
First line treatment for WPW
Catheter ablation of the accessory conduction pathway
81
Why do ACE inhibitors cause a dry cough?
Increased bradykinin
82
Side effects of thiazide diuretics
Hypokalaemic metabolic alkalosis, impaired glucose tolerance, impotence
83
First line for suspected STEMI secondary to pericarditis if NSAIDs are contraindicated
Colchicine or steroids
84
ECG changes characteristic of digoxin treatment
Down-slopping ST segments seen in leads V4-V6, I and aVL
(ST segment = hockey stick)
85
What type of cardioversion of haem unstable patient with AF?
Synchronised DC cardioversion under sedation
86
Recent viral illness and sudden onset chest pain with no ECG changes
Myocarditis
87
Indications for permanent pacing
Severe HF (unresponsive to meds)
Complete Av block
Mobits 2
Sympomatic bradycardia
Symptomatic sick sinus
Drug-resistant tacharrythmias
88
Most common type of VSD?
Type 2 - membranous
89
Most common cause of myocarditis
Coxsackievirus B
90
Initial management of SVT
Vagal manoeuvres e.g. blow into empty syringe
91
Murmur assoc with SLE
Mitral stenosis
92
What are the components of Tetralogy of Fallot?
VSD
Pulmonary stenosis
Right ventricular hypertrophy
Overriding aorta
93
Is R common carotid a direct branch of aorta?
No (only the left)
94
ID vessels of heart on CT from left right
SVC, asc aorta, pulm artery, pulm vein
95
Which leads would show ST elevation in anterolateral STEMI?
V1-V4
