Flashcards in General Clinical Deck (45):
These are non-ferrous fibres but they are surrounded by macrophages. Take up iron so best visualised with iron stain
How can malignancy cause pleural effusion?
By blocking the lymphatic drainage from the pleura, but then also causes increased secretion of fluid
What is the most common cause of death in pregnancy?
What are you thinking of with unilateral calf swelling with pain and haemoptysus?
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
What is the immediate treatment for PE?
Heparin to anti-coagulate and ventilation to improve oxygen and CO.
What causes sudden cardiac death following MI?
Cardiac arrhythmias leading to ventricular tachycardia
How do you differentiate ICDs from pacemakers in CXR?
ICDs have a wire coming from it, pacemakers do not
Which x-ray technique is used to visualise the coronary arteries?
Which murmurs are the manoeuvres in precordial examination for?
Diastolic (mitral stenosis and aortic regurgitation)
When does S3 occur?
Immediately after S2
When does S4 occur?
Immediately before S1
What does distended veins in the neck indicate?
What are the causes of raised JVP?
Right heart failure and tricuspid regurgitation
What are the causes of lowered JVP?
Haemorrhage, or anything that reduces blood volume
How do you find the brachial pulse?
Tense biceps and find tendon, then feel under tendon when relaxed
True or False: Everyones pulse is always regular
False, it changes on breathing
What are some of the causes of a bounding pulse?
hypertrophy or CO2 retention (or can be normal)
What are some causes of a weak pulse?
Shock or aortic stenosis
What does collapsing pulse indicate?
Which groups of people is aortic regurgitation common in?
Marfan's, IVDU or ancholysing spondylitis
What classes ventricular ectopic beats as ventricular tachycardia?
> 7 in a row
How do you recognise AF on ECG?
No p waves and narrow QRS, and irregular
What does tall tented T waves indicate?
Where would the MI be located if pathology in leads II, III and aVF?
Inferior (right coronary a.)
Where would the MI be located if pathology in leads II, III, aVF, V5 and V6?
Where would the MI be located if pathology in leads I, III and aVL?
What causes the heaves on examination?
Right ventricular hypertrophy
Where is the apex beat found?
Left 5th intercostal space midclavicular line
Which intercostal space is at the level of the clavicle and sternal angle?
Clavicle - 1st intercostal
Sternal angle - 2nd intercostal
What tests should you do with an MI?
- Cardio exam
What are causes of AF?
Hypertension (most common)
What is a side effect of lisinopril?
What is a normal ankle brachial pressure index?
What investigations would you do for peripheral vascular disease?
When is splitting of S2 normal and why?
On inspiration in the pulmonary area due to change in intrathoracic pressure
When is splitting of S2 not normal?
If it doesnt change on breathing and is in the mitral area - S3
What causes S4?
Occurs during atrial contraction (active filling) due to stiff or less compliant ventricles. Heard in the mitral area - like S3
What signals the start of systole and diastole?
S1 signals systole and S2 signals diastole
What causes S1?
Closure of the atrioventricular valves (mitral and tricuspid)
What causes S2?
Closure of the semilunar valves (aortic and pulmonary)
Which murmurs are felt in time with the carotid pulse?
What are the 5 red flags of cardio?
Chest pain, SOB, palpitations, dizziness or ankle swelling
Which part of the stethoscope do you use for mitral stenosis manoeuvre?