cardiovascular

Question 1

what are the 3 main symptoms of aortic stenosis?

Answer 1

SOB, chest pain, syncope
on exertion

Question 2

what can happen to heart rate post MI?

Answer 2

bradycardia

Question 3

how do you measure central cap refill?

Answer 3

press on sternum for 5s, should reperfuse <2s.

Question 4

what does left axis deviation in an ecg usually mean?

Answer 4

LVH

Question 5

what does right axis deviation in an ecg usually mean?

Answer 5

RVH

Question 6

what are some examples of blood tests that go in the gold bottle?

Answer 6

U and Es
CRP
troponin
LFTs
bone profile
thyroid function

Question 7

what is shock?

Answer 7

state of cellular and tissue hypoxia due to mismatch between o2 supply and demand.

Question 8

how do you treat hyperkalaemia?

Answer 8

calcium glucanate-stabilises myocardium
insulin and dextrose
salbutamol nebs

Question 9

what does the chadsvasc score do?

Answer 9

stroke risk in AF

Question 10

what does the hasbled score do?

Answer 10

bleeding risk in AF

Question 11

what are the 2 important causes of irregularly irregular rhythm?

Answer 11

atrial flutter with variable block
AF

Question 12

what are 2 things you can temporarily do to slow someone’s heart rate?

Answer 12

give drug called adenosine (reduces conduction time in the atrioventricular node of the heart)
carotid massage

Question 13

what is Beck’s triad?

Answer 13

cardiac tamponade:
low BP
muffled heart sounds
raised JVP

Question 14

how can you treat hyperkalaemia?

Answer 14

calcium gucanate-stabilises myocardium
insulin and dextrose
salbutamol nebs

Question 15

why does long lie cause hyperkalaemia?

Answer 15

rhabdomyolysis-muscles release potassium.

Question 16

what is the significance of Marfan’s in chest pain?

Answer 16

it affects big vessels and valves. can cause aortic aneurysms and aortic dissections.

Question 17

what is cardiac tamponade?

Answer 17

blood or fluid fills the sac around the heart, compressing the heart.

Question 18

what is a potential complication of myocarditis?

Answer 18

arrythmias like VF, VT

Question 19

what is the affect of oestrogen on the cardiovascular system?

Answer 19

it decreases plaque formation bc it stops LDL deposition in tunica intima.
however it increases production of coagulation factors in liver so makes your blood more prone to clot .

Question 20

what big change should happen to someone’s bloods post infusion?

Answer 20

increased haemoglobin

Question 21

what is a boot shaped heart classically associated with?

Answer 21

tetralogy of fallot

Question 22

what additional blood tests should look at/do if patient has a low Hb?

Answer 22

MCV
B12
folate
ferritin

Question 23

what is the difference between pericardial effusion and cardiac tamponade?

Answer 23

pericardial effusion can cause cardiac tamponade. becomes cardiac tamponade when heart stops being able to expand properly due to blood present in the sac.

Question 24

what blood vessel supplies the AVN and the effect of this?

Answer 24

right coronary artery
means if you see heart block it can be due to a RCA infarct

Question 25

what is prinzmetal angina?

Answer 25

just another word for unstable angina

Question 26

what leads are supplied by the right coronary artery?

Answer 26

inferior -II, III, aVF

Question 27

what is first line treatment for bradycardia with adverse outcomes like syncope and shock?

Answer 27

IV atropine

Question 28

what does widespread saddle shaped ST elevation suggest?

Answer 28

acute pericarditis

Question 29

what is the preferred first line treatment for acute pericarditis?

Answer 29

naproxen, colchine has also been used in some cases, can also use other NSAIDs

Question 29

what is the preferred first line treatment for acute pericarditis?

Answer 29

naproxen, colchine has also been used in some cases, can also use other NSAIDs

Question 30

what cardiac issue is adenosine used for?

Answer 30

narrow complex tachycardias

Question 31

what is dressler's syndrome and why does it happen?

Answer 31

pericarditis post MI-can be with or without pericardial effusion antibodies from damaged heart tissue trigger immune response

Question 32

what are the classic findings of pericarditis?

Answer 32

chest pain, fever raised ESR ECG findings: widespread concave st-elevation, pr depression, reciprocal st depression and pr elevation in avr

Question 33

what is the nice guideline target for BP control in diabetes?

Answer 33

target <130/80

Question 34

what is the treatment for torsades de pointes?

Answer 34

IV magnesium sulfate

Question 35

what are the causes of raised BNP?

Answer 35

heart failure age over 70 LVH renal dysfunction (egfr<60) ischaemia hypoxia (eg PE) sepsis COPD diabetes liver cirrhosis

Question 36

what are the rules post MI and driving?

Answer 36

driving may resume 1 week after ACS if successful PCI and EF>40% if not treated successfully driving may resume after 4 weeks provided no other disqualifying condition

Question 37

what are the ECG changes that are considered normal variants in athletes?

Answer 37

sinus bradycardia junctional rhythm first degree heart block Mobitz type 1 (Wenckebach phenomenon)

Question 38

what would haemolytic anaemia look like on bloods?

Answer 38

normocytic anaemia high reticulocyte count

Question 39

what happens in DIC?

Answer 39

a disease process messes up your clotting pathways so you get a tendency to both bleed and clot at the same time.

Question 40

which arteritis causes an absent limb pulse and unequal BP in upper limbs due to aortic occlusion?`

Answer 40

takayasu's arteritis

Question 41

what are the symptoms of pericarditis?

Answer 41

chest pain -may be pleuritic or relieved sitting forwards nonproductive cough, dyspnoea, flu-like symptoms, tachycardia, tachypnoea

Question 42

what are some important things that increase the QT interval?

Answer 42

hypokalaemia hypomagnesaemia lithium TCAs citalopram+escitalopram antipsychotics

Question 43

what is the most appropriate initial management of intermittent claudication?

Answer 43

supervised exercise and cardiovascular risk management

Question 44

what is an ecg finding sensitive to cardiac tamponade?

Answer 44

electrical alternans -beat to beat variation of QRS this is due to heart 'swinging' in pericardial fluid.

Question 45

how does antiphospholipid syndrome present?

Answer 45

venous +arterial thromboses recurrent foetal loss thrombocytopaenia paradoxical rise in APTT

Question 46

what is fat embolism syndrome?

Answer 46

trauma leads to release of fat emboli causes cascade leading to sx of: resp -high RR, low 02, high temp, high HR derm -non blanching petechial rash CNS -confusion, agitation

Question 47

if a patient is allergic to aspirin which medication may they also react to?

Answer 47

sulfasalazine