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Disorders Flashcards

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1
Q

Mc known cause of acute pericarditis

A

Coxackie

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2
Q

Kussmaul absent in CP or CT

A

CT Strength-(fluid

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3
Q

Y descent in CP and CT

A

Rapid Absent

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4
Q

Earliest ECHO sign of ct

A

E RV D C

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5
Q

Becks triad (CT)

A

Shock

Engorged neck veins

Muffled heart sounds

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6
Q

Earliest symptoms of CT CP

A

Dyspnoea. Swelling.

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7
Q

Broadbent sign

A

CP fibrous pericardium pulls AB downwards

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8
Q

Normal pericardial fluid

A

15-20

pEff- >200

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9
Q

Is E:A (early:atrial kick) normal in CP

A

Yes

Normal = >1

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10
Q

Relief of Acute pericarditis pain

Aggravation?

A

Leaning forwards
(Heart away from mediastinal pleura)

Supine
(Inc VR—- heart engorges—— pain)

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11
Q

Cp heart sound

A

Pericardial Knock

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12
Q

AP heart sound

A

Pericardial rub

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13
Q

Most specific ecg sign of AP

A

Downsloping of TP segment

SPODICK SIGN

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14
Q

Mcc MS

A

Rhd

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15
Q

Mcc MS (non rheumatic)

A

Lutembacher

ASD primum + MS

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16
Q

D/D MS

A

Atrial clot

Atrial myxoma

Cor triatum

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17
Q

LAE seen in

A

MS — Double density sign

VSD

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18
Q

Hoarseness of voice d/t LRLN compression d/t LAE

A

ORTNERS SYNDROME

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19
Q

Mc vein to rupture in Ms

A

Bronchial vein (not pulmonary vein)

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20
Q

Murmurs of MS (all)

A

1° = MDM

2° = TR (High pulmonary pressures cause destruction of pulmonary valve)

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21
Q

ECG MS

A

P mitrale (bifid)—- due to LAE

RAD— due to RVH

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22
Q

Rx Uncomplicated MS

A

Diuretics

ACE (prevent remodelling of heart)

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23
Q

Rx Complicated MS

A

Balloon Mitral valvotomy OR replacement

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24
Q

Severity of Ms criteria

A

S2-OS gap

Pulsatile Liver

Afib

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25
Type of LVH in AR
Eccentric
26
Classic symptom of AR
Palpitation | Increased FOC
27
Pulses in AR
Bisferiens Water Hammer Bounding Dancing carotids
28
Murmurs in AR
1° Early Diastolic 2° Austin Flint (MDM) - due to blood in LA ESM- due to inc blood in LV DUROZIEZ SIGN : Continuous murmur over FEMORAL ARTERY
29
Causes of AR
Valvular. Aortic root : marfan/syp RHD (mc) IE Congenital
30
Type of LVH in AS
Concentric
31
Mcc of AS
Degeneration (mc) Biscuspid valve Rhd (rare)
32
Cardinal symptoms of AS (SAD)
Syncope (earliest) Angina (lvh = inc demand) Dyspnea (most dreaded)
33
Murmurs in AS
ESM with radiation to carotids + With GALLAVERDIN PHENOMENON (Radiation to apex)
34
Drugs C/I AS
Nitrates (dec afterload) - diastolic hypot Diuretics (dec preload) - systolic hypot
35
Most common valvular HD a/w SCD
AS
36
Regurgitant blood volume for severe AR and MR
>60ml
37
Competence of Mitral valve | Derive pathogenesis
Healthy leaflets (RHd=mcc) Normal position (iatrogenic/dehiscence) Papillary muscles (necrosed in MI) Chordae tendinae (trauma/cpr/marfan)
38
Murmurs in MR
1° Early Systolic (Acute) Pan systolic chronic (as atria enlarged) 2° MDM (dt more blood in left atrium) LVS3 (same reason)
39
Rx Acute and Chronic MR
Emergency MR Rep. MV Repair>rep
40
MS criteria in pregnancy
URGENT valvotomy/replacement (mortality high)
41
Barlow’s Syndrome?
MVP
42
Early sign of MR
Palpitations
43
Late MR c/f
Hypotension and hf
44
Mc CHD with MVp
ASD secundum
45
MVP syndrome?
Click Murmur Syndrome (Non ejection click + MR) NEC always in late systole
46
Most common symptom of MvP
Palpitations | Chordae stretch—ventricle fibre stretch—ventricle ectopics —palpitations
47
Complications of MvP
TIA Arrythmia Sudden death
48
Mcc chd IE
VSD
49
Mc valvular cause IE
MR
50
Lowest risk of IE
Small ASD >>> MVP+MR
51
Community acquired IE organisms
Strep viridans (mc) H A C E K (hemophilus aggragatobacter cardiobacterium eikenella kingella)
52
Hospita acquired IE mcc
MSSA >> enterococci
53
Prosthetic valve IE mcc
Within 1 yr = CONS > S. Epidermidis After 1 year ~ Normal valve
54
Mc organism in IVDA
S. Aureus | @ tricuspid valve
55
Bacteremia mc in IE dt which procedure
Dental surgery
56
Complications of IE vegetations
Direct spread : valve damage/paraval abs Vascu embo : janeway/infarcts/cer hge Im cx rxn : Roth/osler/GN/arthritis
57
Fastidious organism for IE
Coxiella
58
Major Duke criteria
Blood culture evidence Echo evidence
59
Minor duke criteria
1) Fever 2) Vascular Phenomenon 3) Immunological phenomenon (RROG) 4) Blood culture positive 5) Pre disposing condition
60
Blood culture evidence criteria (duke)
>2 blood cultures positive 24 hr typical 2 blood culture positive persistently 12 hr atypical >1 positive for fastidious organisms > 1:800 titre for coxiella
61
Echo evidences (duke)
Osclillating mass Paravalvular abscess Partial dehiscence of prosthesis New onset regurgitant lesion
62
Vascular involvement (minor dukes)
Major Arterial emboli (mcs brain>>spleen) Septic pulmonary infarct Mycotic aneurysm Hge stroke
63
Immunological involvement dukes | RROG
Roth spots Rheumatoid factor + Osler nodes (palms soles) GN
64
Rx IE Native
Iv penicillin/ 3g ceph
65
Rx IE healthcare exposed
Iv nafacillin/gentamicin
66
Prophylactic abx in IE for which condition?
Co arctation of aorta
67
Elective sx IE conditions
>10mm vegetation Mycotic vegetation (mcc candida— lifelong rx—poor px)
68
Emergency surgery in IE?
MR/AR Intracardiac fistula Unstable prosthesis
69
Vegetations in SLE
Liebman sacks
70
Dcmp causes
``` Alcohol Myocarditis Beri beri Peripartum Untreated psvt ```
71
Rcmp causes | Diastolic fn disturbed
Amyloidosis Sarcoidosis hemochromatosis
72
Doc for hcm
Beta blockers
73
Greatest risk of hocm
SCD (~AS) AS murmur radiates to carotids***
74
Best rx for SCD
ICD intracardia defibrillator >> AMIODARONE
75
ECG dcmp rcmp hocm
V.ectopics. AV blocks. Giant T in (V5-v6)
76
Murmurs in dcmp rcmp hocm
MR. MR/TR. ESM(~AS)
77
Heart sounds in cmp
S3 (dcmp) S4 (rcmp hocm)
78
Pointed finger pulse
HOCM
79
BERNHEIMS EFFECT
Compression of RV in HCM | Leads to increased JVP
80
Drugs not allowed in hocm
Contractility increasers (digoxin) Hypotensives( nitrates diuretics)
81
ARVD genetics and ecg
PKP2 gene Epsilon wave Mc arrythmia is PSVT most dreaded Vtach
82
Takutsubo(DCMP) pathology
Apical akinesia (octopus heart)
83
Yamaguchi (HOCM) pathology
Apical Septal hypertrophy SPADE SHAPED HEART Both yama and takut are d/d coronary syndromes
84
Symptoms of HF | FED-PP-CT
``` Fatigue Edema Dyspnoea on exertion PND Palpitations Cheyne stokes Trepopnea ```
85
Signs of Hf | HIP-SEC
``` Hypotension Insp crepts Pedal Edema S3-S4 Elevated JVP Congestive hepatomegaly (ascites) ```
86
Cardiomarkers of Hf
BNp Soluble ST2 Galectin
87
Mc secondary cause of htn
Reno Parenchymal (ckd gn)
88
Mcc renal artery stenosis
<30 FMD | >50 atherosclerosis
89
Renal causes of htn
Reno parenchymal RAStenosis Gordon syndrome (gof nacl ch in dct) Liddle syndrome (gof enac ch in CD) ``` Gordon = M acidosis Liddle = M alkalosis ```
90
Endocrine causes of HTN
Hypothyroidism (DBP) Hyperthyroidism (SBP) CONS Syndrome (DBP)—aldo=BV fibrosis Phaeochromocytoma (TBP)
91
Miscellaneous causes of HtN
Co arctation of aorta (mcc congenital) | Obstructive sleep apnoea (OSA)- hypoxia—pulm vasoconstriction—symp+ due to repeated awakening
92
Doc angina + htn
Beta blockers
93
Doc Htn with RENAL ARTERY STENOSIS
``` UL = ACE BL= CCB ```
94
Doc elderly c htn
Diuretics | If BPH then alpha blockers
95
MI with bradycardia-suspect?
Inferior wall MI | RCA = SAN+ inferior wall
96
MI with tachycardia-suspect?
Anterior wall MI | Thoracic nerve is sympathetic and gets stimulated
97
Dressler syndrome in CP | 4p
Pericarditis Pneumonitis Pleuritis Pyrexia
98
ECG changes in MI sequence
1) T wave inversion / TALL T WAVE (Dt k+ release from infarcted myocyte) 2) Tombstone (ST elevation) (Infarcted myocytes repolarise early) 3) Pardees sign- STE + T inv (S/o evolving MI) 4) Pathological Q wave (S/o evolved MI)
99
Ixoc to detect REVERSIBLE MI
Thallium scan
100
Localization of MI
``` Anterior wall/septum : v2- v3 (LAD) Posterior wall : v7-v8-v9 (LCX) Inferior wall : (II) (RCA) Lateral wall : v4-v5-v6 (LCX) High lateral : avL (I) Right wall : Rv4- (III) (RMA) ```
101
Cardiac biomarkers and time
HTFAB- 30-24h Ckmb- 5hrs-72hrs Troponin I&T- 5hrs-14d
102
DOC NSTEMI and UNSTABLE ANGINA | Aanb
Antiplatelet (asp+clop) Antithrombotics (enoxaparin). (NOT THROMBOLYTICS) Nitrates Beta blockers
103
DOC STEMI | MOdAC NBS
``` Morphine O2 ACE Aspirin Clopidogrel Nitrates Beta blockers Statins high dose ``` C/I = CCB (hypotension)
104
DOC Prinzmetal Angina
``` Nitrates (acute) Alpha blockers (maintainence) Ccb (maintainence) ``` C/I = Beta blockers (unapposed alpha) Aspirin (xPG—> vasoconstriction)

Cardiology (3 decks)

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