Cardiovascular Flashcards by Ellen Thomas

Which valve is affected by rheumatic fever?

Mitral causing mitral stenosis

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Management of orthostatic hypotension?

Fludrocortisone
Midodrine

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ECG changes in aortic dissection?

Inferior lead ST elevation

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Aortic dissection investigation?

CT aortic angiogram

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Transfusion threshold in ACS?

Hb < 80

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Reversible causes of PEA?

Tension pneumothroax

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Management of acute limb ischaemia?

IV heparin and vascular review

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Management if GRACE score > 3%?

Coronary angiography within 72 hours of admission

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ECG changes in posterior MI?

Tall R waves in V1 and 2

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Management of MI secondary to cocaine use?

Benzos

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What valve is most commonly affected in IE in IVDU?

Tricuspid valve

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In previously normal valves which valve is the most commonly affected in IE?

Mitral

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When can flash pulmonary oedema occur?

Mitral regurgitation due to MI

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Management of broad complex tachycardia?

Amiodarone

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Indication for emergency valve replacement in IE?

IE plus CCF

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ECG changes in hypercalcaemia?

Short QT interval

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ECG changes in severe hyperkalaemia?

Sinusidal/ sine wave

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Where is claudication in iliac stenosis?

Buttock pain

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Where is claudication in femoral stenosis?

Calf pain

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First line imaging in PAD?

Duplex USS

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Quinke’s sign?

Aortic regurgitation (nail bed pulsation)

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Associated murmur with narrow pulse pressure ?

Aortic stenosis

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ECG changes in Wolf-Parkinson-White?

Short PR
Wide QRS
Delta wave

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In non-shockable rhythms, when should adrenaline be administered?

Immediately

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Management of stable, regular narrow complex tachycardia?

Vasovagal manoeuvres Adenosine (6mg IV, if unsuccessful give 12mg IV, if unsuccessful give 18mg IV) Stilll ineffective give verapamil or beta blocker

Management of stable, regular broad complex tachycardia?

Amiodarone 300mg IV over 10-60 minutes

Management of irregular narrow complex tachycardia?

Probable AF Rate control with a beta blocker Consider digoxin/amiodarone if evidence of HF Anticoagulate if duration > 48 hours

Management of irregular broad complex tachycardia?

AF with possible BBB: treat as narrow complex irregular tachycardia Polymorphic VT (TDS): Magnesium 2mg over 10 mins

Before administration of flecanide in AF?

Echo, check for evidence of structural heart disease

Which anti-hypertensive is required in controlling HTN in phaeochromacytoma?

Labetalol (require alpha and beta blockade)

Subclavian steal syndrome?

Stenosis of subclavian artery = arm symptoms when in high demand (cramping)

Most effective way of correcting hyperkalaemia?

Calcium resonium ennema (as K+ secreted by rectum)

Epsilon wave on ECG?

Small deflection buried at the end of the QRS complex Characteristic of ARVD - Arrhythmogenic Right Ventricular Dysplasia

PAD management?

Statin 80mg Clopidogrel Exercise training

Murmur in aortic regurgitation?

Early diastolic

Leriche syndrome?

Classically, it is described in male patients as a triad of symptoms: 1. Claudication of the buttocks and thighs 2. Atrophy of the musculature of the legs 3. Impotence (due to paralysis of the L1 nerve) Atherosclerotic occlusive disease involving the abdominal aorta and/or both of the iliac arteries

Most common causes of infective endocarditis?

Staphylococcus aureus Staphylococcus epidermidis if < 2 months post valve surgery

U waves?

Hypokalaemia

ECG in hypothermia?

J waves Long QT Bradycardia First degree heart block

Kussmaul’s sign

JVP that doesn't fall with inspiration (constrictive pericarditis)

Normal varient in athlete on ECG?

Mobitz type 1 (Wenckebach phenomenon)

When should nifedipine be avoided?

Drug contraindicated in VT?

Verapamil

Heart sound in pulmonary HTN?

Loud S2

When is pulmonary stenosis loudest?

Inspiration

Pulses paradoxus?

Abnormally large drop in BP during inspiration

How is the QT interval measured ?

Start of the Q wave to the end of the T wave

prolonged QTc interval values?

Men: >440 Women: >460

If fibrinolysis is given for an ACS, when should an ECG be repeated?

After 60-90 minutes

Most common cause of IE in IVDU?

Staph A

Most common cause of IE following surgery for prosthetic heart valve?

Strep epidermis (only until up to 2 months post surgery)

What can cause a falsely low BNP?

Aldosterone antagonists ACEi ARB Beta blockers Diuretics Obesity

IE cause in very poor dental hygiene?

Strep viridian's (strep sanguinus)

Pathophysiology of long QTc syndrome?

Loss of function/blockage of K+ channels

Persistent ST elevation in anterior leads following MI?

Left ventricular aneurysm

Mitral stenosis ECG?

Broad, notched (bifid) p waves Most prominent in lead II Due to atrial dilatation

Increased p wave amplitude on ECG?

Cor pulmonale

Normal PR interval?

3-5 small squares 0.12-0.2

Artery affected in inferior MI?

Right coronary artery

Artery affected in anterior MI?

Left anterior decending artery

Artery affected in anterolateral MI?

Left anterior descending artery or left circumflex artery

Artery affected in posterior MI?

Left circumflex, right coronary

Artery affected in lateral MI?

Left circumflex artery

Symptoms of carotid artery disection?

Localised headache Neck pain Neuro signs (e.g. Horner's syndrome)

Jerky pulse?

HOCM

Slow rising pulse?

Aortic stenosis

How long can CPR continue for if cardiac arrest is due to PE?

60-90 Minutes

When should betablockers Be stopped in HF patients?

Hr <50, 2nd or 3rd degree block or shock

Electrical alterans ECG?

Cardiac tamponade (Beat variation in QRS amplitude and morphology)

Packed RBC frransfusion in HF and furusemide?

If giving > 2 units Give after every other unit

Notching of inferior border of ribs ?

Present in 70% of those with co arctation of the aorta

Causes of 3rd heart sound?

Normal < 30 years LV failure (cardiomyopathy, constrictive pericarditis) Mitral regurgitation

Causes of 4th heart sound?

Aortic stenosis HOCM HTN

Inheritance of Marfan's?

Autosomal dominant

When should lvabradine be considered in HF?

Sinus rhythm Bpm >75 LVEF < 35% Haven’t responded to ACEi, beta blocker or aldosterone agonist

Investigation of superficial thrombophlebitis affecting proximal long saphenous vein?

USS to exclude DVT

Management of superficial thrombophlebitis?

Oral NSAIDs Compression stockings

Management of superficial thrombophlebitis affecting proximal long saphenous vein?

Prophylactic dose LMWH for 30 days or foniparinaux for 45 days Oral NSAIDs for 8 to 10 days info LMWH contraindicated

What can make AS murmur quieter?

LV systolic dysfunction

What drug can cause heart racing?

Nifedipine causes peripheral vasodilation which may result in reflex tachycardia

Cardiovascular Flashcards

(80 cards)