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Flashcards in Clinical very good :) :) Deck (34):
1

Harsh pan-systolic murmur, loudest at the lower left sternal edge and inaudible at the apex. The apex is not displaced. It does not intensify on inspiration

Ventricular septal defect

2

Soft late systolic murmur at the apex, radiating to the axilla

Mitral valve prolapse

(late systolic murmurs resemble mitral incompetence)

There may also be a systolic click

3

Possible reason for systolic click?

Mitral incompetence

4

Slow-rising pulse and heaving apex (apex not displaced)
Ejection systolic murmur best hears at the right second interspace that does not radiate

Aortic stenosis

5

The pulse is regular and jerky in character. The cardiac impulse is hyperdynamic and not displaced.
There is a mid-systolic murmur with no ejection click, loudest at the left sternal edge

Hypertrophic cardiomyopathy

6

Constant "machinery-like" murmur throughout systole and diastole

Patent ductus arteriosus

7

Tented T waves on ECG?

Hyperkaelemia

(hyperkaelemia impairs cardiac conduction)

8

You can investigate arrhythmias with an electrophysiological study, what is this?

This is when you induce a clinical arrhythmia to study mechanism and map pathway

-Also gives the opportunity to treat the arrhythmia by radiofrequency ablation

9

Why would you carry out an exercise ECG?

To assess for ischemia
Exercise induced arrhythmia

10

How would you check for paroxysmal arrhythmia?

To assess for paroxysmal arrhythmia

11

Side effects of statins?

Myalgias, myositis and deranged liver function tests

12

Side effects of amiodarone?

Hepatic/pulmonary fibrosis
Hypo/hyperthyroidism
Blue-grey photosensitivity rash

13

Side effects of GTN?

Headaches and hypotension

14

Loud S1 with opening snap
Palpable S1
Rumbling low pitched diastolic murmur

Mitral stenosis

15

A 72 year old woman with an acute ischaemic stroke has ST elevation on her electrocardiogram. There is a past medical history of MI

Left ventricular aneurysm

16

Retinal haemorrhages that are usually caused by an immune complex vasculitis and are most commonly seen in bacterial endocarditis

Roth's spots

17

ECG yellow electrode

Left arm

18

Which ECG electrode should be put on bony prominence on left side of abdomen or left leg?

Green

19

Which ECG electrode should be placed on bony prominence on the right arm/shoulder?

Red

20

Risks of RIPE aneurysm

Rupture
Infection (of thrombus)
Pressure effects on neighbouring structures
Emboli of thrombi to lower limb

21

Cardiac abnormalities
Thymoma
Cleft palate
Hypocalcemia/hypoparathyroidism
22nd chromosome

DiGeorge syndrome

22

Raised J waves

Hypothermia

23

Loud P2

Pulmonary hypertension

24

Congenital rubella syndrome is associated with

PDA
Atrial septal defect
Pulmonary stenosis

25

Marfan syndrome is associated with

Aortic root dilaration (causing aortic regurgitation)
Mitral valve proplapse
Mitral regurgitation

26

Turner syndrome is associated with

Coarction of the aorta

27

When and how does Tetralogy of Fallot usually present?

Prevents with cyanotic episodes usually at 1-2 months

28

Why should you not use rate-limiting Ca channel blockers and beta blockers together?

May cause severe AV block and hypotension

29

Opens into the left posterior aortic sinus

Left coronary artery

30

Opens into the right atrium

Coronary sinus

31

Commonly associated with the atrioventricular groove

Right coronary artery

32

Supplies the AV node

Posterior interventricular artery

33

Supplies the apex of the heart

Anterior interventricular artery

34

Most common cause of aortic stenosis

Calcification of congenital bicuspid valve