DPD Amir Sam 1 Flashcards Preview

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Flashcards in DPD Amir Sam 1 Deck (50)
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1

60M
Tight chest pain 2hrs
Nausea and sweating
Hx HTN, on amlodipene

What are your cardio differentials?

Ischaemic heart disease
Aortic dissection
Pericarditis

2

60M
Tight chest pain 2hrs
Nausea and sweating
Hx HTN, on amlodipene

What is the most appropriate investigation?

ECG

3

What are you looking for in an ECG of a Pt with chest pain?

STEMI/NSTEMI

4

What investigation would you do after the ECG of a Pt with chest pain?

Troponin levels

5

What investigation would you do if the troponin levels were positive?

Angiography

6

What investigation would you do if the troponin levels were negative?

ETT

7

What investigation would you do after the troponins of a Pt with chest pain?

Echocardiogram

8

What would the echo show in a Pt with an MI?

Regional wall motion abnormality (RWMA)

9

What would you do in a Pt with a STEMI?

Percutaneous coronary intervention

10

What would you do in a Pt with a NSTEMI?

Aspirin, clopidogrel, LMWH etc

11

How would a Pt present with aortic dissection?

Tearing pain, radiating to the back

12

What would you note on examination of a Pt with aortic dissection?

Aortic regurgitation
Radio-radial relay
Difference in BP in right and left upper limbs

13

How would a Pt present with pericarditis?

Pleuritic pain
Worse on inspiration
Relieved when leaning forwards
Flu-like symptoms

14

How would you treat a Pt with pericarditis?

Give NSAIDs

15

Why could a Pt w/ a brain tumour on high dose dexamethasone to reduce inflammation around the lesion present with chest pain?

Dexamethasone- steroid
Steroid- immunosuppressant
Immunosuppressed- susceptible to candidiasis

16

An occlusion of the LAD coronary artery would lead to what type of MI?

Anterior MI

17

An occlusion of the circumflex coronary artery would lead to what type of MI?

Lateral MI

18

An occlusion of the right coronary artery would lead to what type of MI?

Inferior MI

19

Where would you expect to see ST elevation in an anterior MI?

V1-V4

20

Where would you expect to see ST elevation in a lateral MI?

V5-6, I, aVL

21

Where would you expect to see ST elevation in an inferior MI?

II, III, aVF

22

What do you ask a Pt/witness seeing someone collapse?

What happened before?
What happened during?
What happened after?

23

What can happen before the collapse and what does it signify?

Aura- likely seizure
Nothing- likely cardiovascular involvement

24

What can happen during the collapse and what does it signify?

Tongue biting/incontinence- likely seizure

25

What are the causes of collapse?

Hypoglycaemia
Vasovagal syncope
Outflow obstruction
Arrhythmia
Postural hypotension
Seizure

26

What are the types of left/right sided outflow obstructions?

L- aortic stenosis, HOCM
R- pulmonary embolus

27

What would you request for in a Pt suspected of postural hypotension?

Standing and lying BP

28

What would you request for in a Pt suspected of an arrhythmia?

ECG
Cardiac monitor bed
24hr tape

29

What are the causes of a long QT?

Congenital- K+ channel mutation
[Pts may recall a FHx of sudden death]
Acquired- low K+/Mg++; drugs

30

45M fever and malaise
Known IVDU
Raised JVP to ear
Pan-systolic murmur
Louder on inspiration
Hepatomegaly
Diagnosis?

Tricuspid regurgitation

IVDU- infective endocarditis
V raised JVP
PSM -> RILE
Louder on inspiration therefore right-sided