Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EMQ > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

65 year old woman being treated with large doses of loop diuretics requires add on for oedema refractory to treatment

A

Metolazone which is a thiazide diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A 70 year old woman with a history of chronic heart failure presents with severe pulmonary oedema, what treatment?

A

100% O2, IV diamorphine, IV frusemide, sublingual GTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment of mild symptoms of shortness of breath and ankle oedema in a 65 year old man with left ventricular dysfunction caused by ischaemia heart disease, he is already taking an ACEi. What next?

A

Loop diuretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment of a 65 year old man with AF of longer than 48hrs before DC cardioversion

A

Digoxin and Warfarin for a month. Patient with AF of longer than 48hrs after cardioversion is at risk of thromboembolism after cardioversion. Ventricular rate should be controlled with digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Initial therapy in a 60 year old woman presently severely compromised with acute persistent AF

A

Direct DC cardioversion and heparin because patient is severely immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A 55 year old man admitted with acute MI develops a short run of VT. He requires treatment for prophylaxis against recurrent VT

A 
IV Amiodarone
-Amidarone works through class II action to prolong the plateau phase of cardiac action potential and prolongs the QT interval. Side effects in long term.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Drugs to aid diagnosis in a 50 year old man presenting with an unidentifiable, regular, narrow complex tachycardia

A

IV Adenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Prophylaxis of ventricular tachycardia in a patient with varying QRS axis and prolonged QT interval

A

IV Magnesium and ventricular pacing

-This is Torsades de Pointes which will often degenerate to ventricular fibrillation to cardiac arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

63 year old man with a history of high blood pressure presents in A&E with sudden onset tearing chest pain radiating to the back

A

Aortic dissection
-The dissection can interrupt flow to the coronary arteries, resulting in myocardial ischaemia.

Type A involves the ascending aorta but type B does not.

Type A involves surgery whereas B aggressive reduction in blood pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

40 year old woman develops sudden onset dyspnoea at rest following hip replacement surgery. On examination she is tachycardic and her ECG shows right axis deviation

A

PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

60 year old businessman complains of central crushing chest pain radiating to both arms after running to catch a bus. Pain was relived by rest and his ECG recording 1hr later was unremarkable

A

Angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

21 year old high jumper presents with acute onset dyspnoea and right sided pleuritic chest pain. Examination reveals increased resonance and reduced expansion on right side

A

Tension pnuemothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

23 year old woman presents with localised left sided chest pain that is exacerbated by coughing and is particularly painful on light pressure to that area. Pain is relived by aspirin. ECG unremarkarble

A

Costochondritis

-2nd rib frequently affected in this condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Slow rising pulse, narrow pulse pressure, heaving apex beat and fourth heart sound.

A

Aortic Stenosis

-Angina, SOB and syncope and common presenting symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Collapsing pulse, wide pulse pressure, ‘pistol-shot’ sound heard over femoral arteries.

A

Aortic Regurgitation

-Other signs include Corrigan’s sign, de Musset’s sign and Quincke’s sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Radiofemoral delay in a patient with hypertension.

A

Coarctation of aorta

  • Involves narrowing of the aorta and is twice as common in men
  • Assoc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pulsus paradoxus, jugular venous pressure (JVP) rises on inspiration, heart sounds
muffled

A

Mixed aortic valve disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Bounding pulse in a patient who is short of breath

A

acute CO2 retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Radiofemoral delay in a patient with hypertension.

A

Coarctation of aorta

  • Involves narrowing of the aorta and is twice as common in men
  • Associated with Turner’s syndrome
  • Can maybe see rib notching on CXR die to formation of collateral arterial circulation which can erode the undersurface of ribs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Bounding pulse in a patient who is short of breath

A

acute CO2 retention

-Can be felt in a patient with sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Falling blood pressure, rising JVP on inspiration and muffled heart sounds

A

Beck’s Triad which is an indication of cardiac tamponade/constrictive pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tapping apex beat, loud S1, mid diastolic murmur loudest at apex in expiration lying on the left side

A

Mitral Stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Heaving undisplaced apex beat, absent A2 with ejection systolic murmur radiating to the carotids

A

Aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pansystolic murmur heard best at lower left sternal edge during inspiration in a patient with pulsatile hepatomegaly

A

Tricuspid regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Displaced, volume-overloaded apex. Soft S1, pansystolic murmur at apex radiating to axilla

A

Mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Left parasternal heave and harsh pansystolic murmur at lower left sternal edge that is also audible at apex

A

Ventricular septal defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Elevated JVP with absent pulsation

A

Superior IVC obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Giant systolic ‘v’ waves

A

Tricuspid regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Elevated JVP with absent pulsation

A

Superior IVC obstruction

-Due to Bronchial Carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Giant systolic ‘v’ waves

A

Tricuspid regurgitation

-Represents regurgitant blood ejected from the right ventricle at systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Large ‘a’ waves and slow ‘y’ descent in JVP. Patient has ascites

A

Tricuspid Stenosis
-Rhematic fever is most common
cause
-Fatigue is most common symptom

32
Q

Cannon ‘a’ waves

A

Complete heart block

-Atrioventricular dissociation

33
Q

Raised JVP that rises on inspiration

A

Constrictive pericarditis

-Can also be seen in cardiac tamponade

34
Q

A 26-year-old woman presents acutely unwell with shortness of breath. Her ECG shows sinus tachycardia, deep S waves in I, inverted T waves in III and Q waves in III

A

Pulmonary embolus

35
Q

Prolonged P–R interval, depressed ST, flattened T waves, prominent U waves

A

Hypokalaemia

-Look for loop/thiazide diuretics as cause

36
Q

Sinus rhythm, bifid ‘p’ waves best seen in II, V3 and V4

A

Mitral stenosis

-Suggest Left Atrial Hypertrophy

37
Q

A 65-year-old man presents with chest pain radiating to the jaw. The ECG shows ST segment elevation in II, III and aVF, with T-wave inversion in V5 and V6

A

inferior myocardial infarction

38
Q

Dominant “M” in V1, inverted T waves in V1–V3, deep wide “W” waves in V6.

A

RBBB

-Causes include VSD and PE

39
Q

ECG of a 55 year old being treated for hypertension shows tall tented T waves

A

Hyperkalaemia

40
Q

A 34-year-old man presents to A&E after a road traffic accident. The ECG shows
pulseless electrical activity

A

Cardiac tamponade

41
Q

An 85-year-old man with pneumonia complains of palpitations. ECG shows absent P waves

A

Atrial fibrillation

42
Q

ECG of a 45-year-old man with sarcoidosis shows an ‘M’ pattern V5 and inverted T waves in I, aVL and V5–V6

A

Left bundle-branch block

43
Q

ECG of an 8-year-old girl shows normal P waves and QRS complexes but shows T-wave inversion in V1

A

Normal ECG

44
Q

ECG of a 55 year old being treated for hypertension shows tall tented T waves

A

Hyperkalaemia

-Look out for potassium sparing diuretics and ACEi. Other causes: renal failure and metabolic acidosis

45
Q

An 85-year-old man with pneumonia complains of palpitations. ECG shows absent P waves

A

Atrial fibrillation

  • AF is associated with a significantly high risk of embolic events e.g. stroke
  • Hyperthyroidism is also a cause of AF
46
Q

ECG of a 45-year-old man with sarcoidosis shows an ‘M’ pattern V5 and inverted T waves in I, aVL and V5–V6

A

Left bundle-branch block

-Delayed left ventricular depolarisation is responsible for this

47
Q

ECG of an 8-year-old girl shows normal P waves and QRS complexes but shows T-wave inversion in V1

A

Normal ECG

-Normal in V1-3 in children

48
Q

A 30-year-old woman presenting with hypertension is found to have hypokalaemia and a mild metabolic alkalosis

A

Conn’s syndrome

49
Q

An anxious 26-year-old woman presents with episodes of chest pain and palpitations precipitated by stress and smoking. Her 24-hour urine shows elevated catecholamines

A

Phaeochromocytoma

50
Q

A 45-year-old woman presents with weight gain, muscle weakness and hirsutism. On examination she is hypertensive and has pedal oedema.

A

Cushing’s syndrome

51
Q

A 40-year-old man is brought to A&E with severe headache. On examination he has papilloedema and fundal haemorrhages. His BP is 220/145 mmHg.

A

Malignant hypertension

52
Q

Hypertension in a 75 year old who is a heavy smoker with widespread peripheral vascular disease.

A

Renal artery stenosis

53
Q

A 30-year-old woman presenting with hypertension is found to have hypokalaemia and a mild metabolic alkalosis

A

Conn’s syndrome

  • Hypertension, Hypokalaemia and Metabolic Alkalosis is suggestive of primary hyperaldosteronism
  • More common in young people with hypertension
54
Q

An anxious 26-year-old woman presents with episodes of chest pain and palpitations precipitated by stress and smoking. Her 24-hour urine shows elevated catecholamines

A

Phaeochromocytoma

-Rare catecholamine-secreting tumour

55
Q

A 45-year-old woman presents with weight gain, muscle weakness and hirsutism. On examination she is hypertensive and has pedal oedema.

A

Cushing’s syndrome

  • These are symptoms of chronic glucocorticoid excess
  • Other symptoms, menstrual irregularities and mood disturbance
56
Q

A 40-year-old man is brought to A&E with severe headache. On examination he has papilloedema and fundal haemorrhages. His BP is 220/145 mmHg.

A

Malignant hypertension

  • Severe hypertension with acute end organ failure
  • Treatment involves careful reduction in BP over several days, usually with oral therapy
57
Q

Hypertension in a 75 year old who is a heavy smoker with widespread peripheral vascular disease.

A

Renal artery stenosis

  • Renal disease is the most common cause of secondary hypertension
  • Treatment is to reduce BP and preserve renal function
58
Q

A 65-year-old man with heart failure requires rate control to treat coexisting atrial fibrillation.

A

Digoxin

-Signs of digoxin toxicity include confusion, nausea, arrythmias and visual disturbance

59
Q

A 65-year-old woman being treated with large doses of loop diuretic requires add-on therapy for oedema refractory to treatment.

A

Metolazone

  • Thiazide diuretics added to loop due to synergistic effects
  • Metolazone is drug of choice as it remains effective even in the presence of significant renal impairment
60
Q

A 69-year-old woman with asthma being treated with a loop diuretic, ACE inhibitor and long-acting nitrate is prescribed a drug to reduce long-term mortality.

A

Spironolactone

61
Q

A 70-year-old woman with a history of chronic heart failure presents with severe pulmonary oedema.

A

100 per cent O2, intravenous
diamorphine, intravenous furosemide (frusemide), sublin- gual glyceryl trinitrate (GTN)

-Patients with COPD/asthma or have coexisting chest infection should be given antibiotic and nebulised bronchodilators as required

62
Q

Treatment of mild symptoms of shortness of breath and ankle oedema in a 65-year-old man with left ventricular dysfunction caused by ischaemic heart disease. He is already taking an ACE inhibitor.

A

Oral furosemide

63
Q

Treatment of a 65-year-old man with atrial fibrillation (AF) of longer than 48 h before DC cardioversion.

A

Digoxin and warfarin for a month

64
Q

Initial therapy in a 60-year-old woman presenting severely compromised with acute persistent AF.

A

Direct current (DC) shock heparin

65
Q

A 55-year-old man admitted with an acute myocardial infarction develops a short run of ventricular tachycardia (VT). He requires treatment for prophylaxis against recurrent VT.

A

Intravenous amiodarone

-Amidarone works through class II action to prolong the plateau phase of cardiac action potential and prolongs the QT interval. Side effects in long term.

66
Q

Drug to aid diagnosis in a 50-year-old man presenting with an unidentifiable, regular, narrow-complex tachycardia.

A

-IV Adenosine

67
Q

Prophylaxis of ventricular tachycardia in a patient with varying QRS axis and prolonged Q–T interval.

A

IV Magnesium and Ventricular pacing

-This is Torsades de Pointes which will often degenerate to ventricular fibrillation to cardiac arrest

68
Q

Treatment of a 65-year-old man with atrial fibrillation (AF) of longer than 48 h before DC cardioversion.

A

Digoxin and warfarin for a month

-A patient with AF of longer than 48 h duration is at risk of thromboembolism after cardioversion. Unless the patient is severely compromised, it is standard practice to anticoagulate the patient with warfarin for a month before attempting elective cardioversion. During that time the ventricular rate is controlled by prescribing digoxin.

69
Q

Initial therapy in a 60-year-old woman presenting severely compromised with acute persistent AF.

A

Direct current (DC) shock heparin

-DC shock indicated in severely compromised

70
Q

A 55-year-old man admitted with an acute myocardial infarction develops a short run of ventricular tachycardia (VT). He requires treatment for prophylaxis against recurrent VT.

A

Intravenous amiodarone

  • Amidarone works through class III action to prolong the plateau phase of cardiac action potential and prolongs the QT interval. Side effects in long term.
  • Drug of choice to treat VT
71
Q

A 57-year-old businessman presents with a 4-h history of crushing chest pain. The ECG changes include ST elevation in II, III and aVF.

A

Aspirin, Streptokinase

72
Q

A 65-year-old man presenting with chest pain becomes unresponsive. His ECG shows ventricular fibrillation.

A

DC shock and adrenaline

73
Q

A 40-year-old woman collapses after a flight with breathlessness and right- sided pleuritic chest pain.

A

100 per cent O2, subcutaneous
LMW heparin, intravenous
fluids

74
Q

A 45-year-old man with chronic glomerulonephritis presents with a severe headache. On examination he has papilloedema and bilateral retinal haemor- rhages. His BP is 240/132 mmHg.

A

Labetalol

75
Q

A 55-year-old man requires immediate pharmacological management for severe symptomatic sinus bradycardia.

A

Atropine

76
Q

A 45-year-old man with chronic glomerulonephritis presents with a severe headache. On examination he has papilloedema and bilateral retinal haemor- rhages. His BP is 240/132 mmHg.

A

Labetalol

-Malignant hypertension

77
Q

A 55-year-old man requires immediate pharmacological management for severe symptomatic sinus bradycardia.

A

Atropine

-Increases HR by inhibiting vagal tone

EMQ (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions