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Flashcards in General Clinical Deck (45):
1

Asbestos body

These are non-ferrous fibres but they are surrounded by macrophages. Take up iron so best visualised with iron stain

2

How can malignancy cause pleural effusion?

By blocking the lymphatic drainage from the pleura, but then also causes increased secretion of fluid

3

What is the most common cause of death in pregnancy?

Pulmonary embolism

4

What are you thinking of with unilateral calf swelling with pain and haemoptysus?

PE

5

Why do you get haemorrhage with PE?

Lungs have a dual blood supply, so that if you occlude the pulmonary system you still get circulation. However, bronchial doesn’t penetrate the parenchyme of the lung, so if pulmonary circulation is blocked then you still get blood supply to the lung but it is going to tissue that is dying so causes excessive bleeding instesad

6

What is the immediate treatment for PE?

Heparin to anti-coagulate and ventilation to improve oxygen and CO.

7

What causes sudden cardiac death following MI?

Cardiac arrhythmias leading to ventricular tachycardia

8

How do you differentiate ICDs from pacemakers in CXR?

ICDs have a wire coming from it, pacemakers do not

9

Which x-ray technique is used to visualise the coronary arteries?

Coronary angiogram

10

Which murmurs are the manoeuvres in precordial examination for?

Diastolic (mitral stenosis and aortic regurgitation)

11

When does S3 occur?

Immediately after S2

12

When does S4 occur?

Immediately before S1

13

What does distended veins in the neck indicate?

SVC obstruction

14

What are the causes of raised JVP?

Right heart failure and tricuspid regurgitation

15

What are the causes of lowered JVP?

Haemorrhage, or anything that reduces blood volume

16

How do you find the brachial pulse?

Tense biceps and find tendon, then feel under tendon when relaxed

17

True or False: Everyones pulse is always regular

False, it changes on breathing

18

What are some of the causes of a bounding pulse?

hypertrophy or CO2 retention (or can be normal)

19

What are some causes of a weak pulse?

Shock or aortic stenosis

20

What does collapsing pulse indicate?

Aortic regurg

21

Which groups of people is aortic regurgitation common in?

Marfan's, IVDU or ancholysing spondylitis

22

What classes ventricular ectopic beats as ventricular tachycardia?

> 7 in a row

23

How do you recognise AF on ECG?

No p waves and narrow QRS, and irregular

24

What does tall tented T waves indicate?

Hyperkalaemia

25

Where would the MI be located if pathology in leads II, III and aVF?

Inferior (right coronary a.)

26

Where would the MI be located if pathology in leads II, III, aVF, V5 and V6?

Inferolateral

27

Where would the MI be located if pathology in leads I, III and aVL?

Anterolateral (Circumflex)

28

What causes the heaves on examination?

Right ventricular hypertrophy

29

Where is the apex beat found?

Left 5th intercostal space midclavicular line

30

Which intercostal space is at the level of the clavicle and sternal angle?

Clavicle - 1st intercostal
Sternal angle - 2nd intercostal

31

What tests should you do with an MI?

- Cardio exam
- ECG
- Troponins

32

What are causes of AF?

Hypertension (most common)
Hyperkalaemia
Ischaemia

33

What is a side effect of lisinopril?

Hyperkalaemia

34

What is a normal ankle brachial pressure index?

0.9

35

What investigations would you do for peripheral vascular disease?

Ankle/brachial pressure
Doppler ultrasound
Peripheral angiogram

36

When is splitting of S2 normal and why?

On inspiration in the pulmonary area due to change in intrathoracic pressure

37

When is splitting of S2 not normal?

If it doesnt change on breathing and is in the mitral area - S3

38

What causes S4?

Occurs during atrial contraction (active filling) due to stiff or less compliant ventricles. Heard in the mitral area - like S3

39

What signals the start of systole and diastole?

S1 signals systole and S2 signals diastole

40

What causes S1?

Closure of the atrioventricular valves (mitral and tricuspid)

41

What causes S2?

Closure of the semilunar valves (aortic and pulmonary)

42

Which murmurs are felt in time with the carotid pulse?

Systolic

43

What are the 5 red flags of cardio?

Chest pain, SOB, palpitations, dizziness or ankle swelling

44

Which part of the stethoscope do you use for mitral stenosis manoeuvre?

Bell

45

Which part of the stethoscope do you use for aortic regurgitation manoeuvre?

Diaphragm