Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardio > Passmedicine > Flashcards

Passmedicine Flashcards

1
Q

U waves seen on ECG

A

Hypokalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

J waves on ECG

A

Hypothermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In hypokalaemia, you have no T, but a long PR and a long QT

And you are depressed

A

Hypokalaemia - small or absent T waves,
Long PR interval
Long QT
ST depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Who should you avoid giving adenosine to?

A

Don’t give to asthmatics - could cause bronchospasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which drugs interact with adenosine?

A

DEAR
Dipyridamoles - Enhance effect
Aminophylline - Reduces effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Adenosine adverse effects

A

Bronchospasm
Chest pain
Can enhance conduction down accessory pathways, resulting in increased ventricular rate (e.g. wolff parkinson white)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most common cause of aortic stenosis in younger patients (<65)

A

Bicuspid aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most common cause of aortic stenosis in older patients (>65)

A

Calcification of the aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does a narrow pulse pressure indicate?

A

Decreased cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which syndromes are associated with VSD?

A

Down’s syndrome
Patau syndrome
Edward’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Fragile X is associated with, which heart problem?

A

Mitral valve prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

William’s syndrome is associated with which heart problem?

A

Supravavlular aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

First line treatment for hypertension in a diabetic

A

ACE inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Investigation if you suspect a patient has aortic stenosis

A

Transthoracic echocardiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which common drug, may cause skin necrosis (rare)

A

Warfarin
Patients are particularly at risk if they are given warfarin without LMWH, and it is most likely to occur in the first 3-5 days of treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

1972 and protein C

A

Warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Chest pain relieved when sitting forward

A

Pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ECG changes in pericarditis

A

Saddle shaped ST elevation

PR depression - most specific ECG marker for pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Acute management of SVT

A

Vagal manoeuvres
Adenosine 6mg-12mg-12mg (UNLESS ASTHMATIC - give verapamil instead)
Electrical cardioversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Xanthomata are seen in what

A

Hyperlipidaemia

eruptive xanthomata - due to high triglyceride levels and present as multiple red/yellow vesicles on extensor surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Does of adrenaline for baby - 6 years

A

150 micrograms, 0.15ml 1 in 1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Does of adrenaline for 6 years to 12 years

A

300 micrograms, 0.3ml in 1 in 1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Dose of adrenaline for adult and child >12 years

A

500 micrograms, 0.5ml 1 in 1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Adverse effects of statins

A

Myopathy: includes myalgia, myositis, rhabdomyolysis and asymptomatic raised CK.

Risk factors for myopathy include advanced age, female sex, low BMI, presence of multisystem disease (e.g. diabetes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ECG findings of Wolff parkinson white

A

Delta waves, short PR interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which drug are the most common cause of drug-induced angioedema

A

ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

ACE inhibitor mechanism of action

A

Inhibit conversion of angiotensin I to angiotensin II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Side effects of ACEis

A

Cough
Angioedema (may occur up to a year after starting treatment)
Hyperkalaemia
First-dose hypotension: more common in patients taking diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Antagonists of the P2Y12 adenosine disphosphate receptor

A

Clopidogrel

Prasugrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Statins interact with which drugs

A

Clarithromycin/erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

The only shockable rhythms

A

Ventricular fibrillation and ventricular tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Where do thiazide diuretics work

A

Work at the beginning of the distal convoluted tubule (inhibit sodium reabsorption)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How long do thiazide diuretics take to work? And how long do they work for?

A

Begin to work after 1-2 hours, duration of action is 12-24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Common adverse effects of thiazide diuretics

A 
Dehydration
Postural hypotension
Hyponatremia, hypokalaemia, hypercalcemia
Gout
Impaired glucose tolerance
Impotence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What QRISK should you offer statins for?

A

Offer if QRISK>10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Side effects of GTN

A

Hypotension
Tachycardia
Headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How does GTN work?

A

Causes release of nitric oxide in smooth muscle, increasing cGMP, which leads to a fall in intracellular calcium levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Management of aortic stenosis

A

Valve replacement if the patient is symptomatic

If not, then only replace when aortic valve gradient >36mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

When might you want to measure BNP levels in patients?

A

Measure in patients who you think have heart failure, but no history of myocardial infarction

> 400 = poor prognosis

(If they have previous MI then they require urgent referral, echo and specialist assessment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Describe BNP levels and heart failure

A

High levels = don’t confirm heart failure, but likely

Low levels = rule out heart failure

(Highly sensitive but varying specificity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When might BNP levels be elevated?

A

In heart failure
But also LVH, myocardial ischaemia, atrial fibrillation, pulmonary hypertension, hypoxia, pulmonary embolism, right ventricular strain, COPD, liver failure, sepsis, diabetes and renal impairment,

May also be high in women, and particularly in people older than 70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is BNP?

A

A hormone produced by left ventricular myocardium in response to strain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Antiplatelet regimen following stroke?

A

check ct first lol

300mg aspirin for 2 weeks then 75mg clopidogrel for life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Adrenaline dose for cardiac arrest

A

1mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

When do you give adrenaline in cardiac arrest?

A

Give after third shock, and then every 3-5 minutes (during alternate cycles of CPR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Non-shockable rhythms

A

Pulseless electrical activity

Asystole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Initial treatment of PEA and asystole

A

Patients should immediately receive 1mg IV adrenaline and high quality CPR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Pericardial knock - loud S3

A

Constrictive pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Kussmauls sign

A

JVP increases during inspiration

50
Q

What is pulsus paradoxus?

A

When stroke volume and systolic BP decrease during inspiration

51
Q

When might you see pulsus paradoxus?

A

Cardiac tamponade

52
Q

Becks triad

A

Associated with cardiac tamponade - muffled heart sounds, distended veins, low arterial blood pressure

53
Q

Causes long QT and deafness

A

Jervell-Lange-Nielsen syndrome

54
Q

Causes long QT but no deafness

A

Romano-Ward syndrome

55
Q

Which electrolyte abnormalities can cause long QT?

A

Hypocalcaemia
Hypokalaemia
Hypomagnesaemia

56
Q

Dietary advice for prevention of MI

A

Eat a mediterranean style diet - switch butter and cheese for plant based oils

57
Q

Exercise advice for prevention of MI

A

20-30 minutes of exercise per day until patients are slightly breathless

58
Q

When can you have sex after a heart attack?

A

Can have sex 4 weeks after an uncomplicated MI

59
Q

A patient should avoid sildenafil if they are on which medications?

A

Avoid sildenafil if a patient is on nitrates or nicorandil

60
Q

What is sildenafil used for?

A

Used to treat erectile dysfunction

61
Q

If a patient has had an acute MI and has symptoms or signs of heart failure, which drug might you consider initiating?

A

An aldosteone antagonist (e.g. eplerenone)

Try to start 3-14 days after MI and after the ACE inhibitor

62
Q

Best site for adrenaline injection?

A

Anterolateral aspect of middle third of thigh

63
Q

The most important cause of ventricular tachycardia

A

Hypokalaemia (followed by hypomagnesaemia)

64
Q

What precipitates Torsades de pointes?

A

Torsades de pointes is precipitate by elongation of the QT interval

65
Q

Most common cause of monomorphic VT

A

Myocardial infarction

66
Q

Which condition may be worsened by bendroflumethazide?

A

Gout

67
Q

Name 2 rate controlling drugs

A

Atenolol and diltiazem

68
Q

Drugs used in pharmacological cardioversion of atrial fibrillation?

A

If no structural/ischaemic heart disease - flecainide/amiodarone

Structural/ischaemic heart disease - amiodarone

69
Q

ECG shows elevation in leads V1-V4, with reciprocal changes in the inferior leads, which vessel has been occluded?

A

100% occlusion of the left anterior descending artery

70
Q

What does an aortic regurgitation murmur sound like?

A

Early diastolic, heard best in the aortic area on end expiration, radiates to the 4th intercostal space

71
Q

Investigation for aortic stenosis

A

Echocardiogram

72
Q

What is Wenckebach phenomenon?

A

2nd degree atrioventricular block mobitz type 1 - seen in athletic individuals

73
Q

Treatment of Dressler’s syndrome

A 
NSAIDs preferably
(or a prolonged course of colchicine or steroids)
74
Q

What is Dressler’s syndrome?

A

Pericarditis that occurs a couple of weeks after MI

75
Q

Most common cause of death following MI?

A

Ventricular fibrillation

76
Q

Which beta blockers specifically reduce mortality in heart failure?

A

Carvedilol and bisoprolol

77
Q

Which drugs improve mortality following heart failure?

A

Ace inhibitors
Spironolactone
Beta-blockers
Hydralazine with nitrates

78
Q

Name 2 aldosterone antagonists

A

Spironolactone

Eplerenone

79
Q

Which patients need a pneumococcal booster vaccine every five years?

A

Patients with asplenia, splenic dysfunction or chronic kidney disease

80
Q

How do thrombolytic drugs work?

A

Activate plasminogen to form plasmin

81
Q

Examples of drugs used in thrombolysis?

A

Alteplase
Tenecteplase
Streptokinase

82
Q

Side effects of thrombolysis?

A

Haemorrhage
Hypotension - more common with streptokinase
Allergic reactions - may occur with streptokinase

83
Q

Why would you use a 24 hour holter ECG

A

To look for paroxysmal arrhythmia

84
Q

Why would you use an electrophysiological study?

A

To trigger an arrhythmia so you can study it - also gives you the opportunity to treat the arrhythmia by delivering radiofrequency ablation to the extra pathway

85
Q

Lenegres disease

A

Genetic idiopathic heart block, due to fibrosis and calcification of conduction system of heart

86
Q

Investigation for cardiac tamponade

A

Echocardiogram

87
Q

What is coarctation of the aorta associated with?

A

Associated with Turner’s syndrome

Also associated with biscupid valve

88
Q

Infection with what causes rheumatic disease?

A

Strep. pyogenes

89
Q

Most common cause of infective endocarditis?

A

Staph aureus

90
Q

Strongest risk factor for developing endocarditis?

A

Previous endocarditis

91
Q

Used to determine the need to anticoagulate a patient in AF

A

CHA2DS2-VASc

92
Q

DAS28

A

Measure of disease activity in rheumatoid arthritis

93
Q

Used in the assessment of suspected obstructive sleep apneoa

A

Epworth scale

94
Q

ABCD2

A

Prognostic score risk stratifying patients who’ve had a suspected TIA

95
Q

NYHA

A

Heart failure severity scale

96
Q

Child-Pugh classification

A

A scoring system used to assess the severity of liver cirrhosis

97
Q

What is pulsus paradoxus?

A

When there is a greater than normal fall in systolic BP during inspiration (means faint or absent pulse in inspiration)

Seen in severe asthma and cardiac tamponade

98
Q

What is pulsus alterans and when is it seen?

A

Weak arterial pulse and then strong arterial pulse

- seen in severe left ventricular failure

99
Q

If someone has complete heartblock following an MI, which vessel is likely to be affected?

A

Right coronary artery

100
Q

Persistent ST elevation after MI, what is this most likely to be?

A

Left ventricular thromboembolism

101
Q

Treatment of Dresslers syndrome

A

NSAIDs

102
Q

What is indapemide?

A

A thiazide-like diuretic

103
Q

Why can you get hypertension in aortic dissection?

A

Because there is a catecholamine surge

104
Q

Most common CXR finding of pulmonary embolism

A

Pulmonary embolism - normal CXR

105
Q

Hypertrophic cadiomyopathy inheritance

A

Autosomal dominant

106
Q

Management of Torsades de Pointes

A

IV magnesium sulphate

107
Q

When should you take a statin?

A

Last thing in the evening

108
Q

What does the PHQ-9 score assess?

A

Depressive symptoms

109
Q

Can be used to evaluate the anxiety level of a patient?

A

HAD

110
Q

Saddle shaped ST elevation

A

Pericarditis

111
Q

Foods high in vitamin K

A

Broccoli, spinach, kale and sprouts (so avoid if you’re on warfarin)

112
Q

Foods which might trigger migraines

A

Caffeine, cured meats, dark chocolate

113
Q

Foods high in potassium

A

Dried apricots, banana, butternut squash, avacado

114
Q

How are proximal aortic dissections managed?

A

Aortic root replacement

115
Q

A 35-year-old Singaporean female attends a varicose vein pre operative clinic. On auscultation a mid diastolic murmur is noted at the apex. The murmur is enhanced when the patient lies in the left lateral position

A

Mitral stenosis

116
Q

Used in the assessment of suspected obstructive sleep apnoea

A

Epworth scale

117
Q

Pulsus paradoxus

A

greater than the normal (10 mmHg) fall in systolic blood pressure during inspiration → faint or absent pulse in inspiration
severe asthma, cardiac tamponade

118
Q

If you have complete heart block following an MI, which vessel has been occluded?

A

Right coronary artery

119
Q

How does amiodarone work?

A

Blocks potassium channels, which inhibits repolarisation and prolongs the action potential (also blocks sodium channels)

120
Q

Wedge shaped opacification on CXR

A

Pulmonary embolism

121
Q

What could cause torsades de pointes

A 
Hypokalaemia
Hypomagnesaemia
Hypocalcemia
Hypothermia
MI
Post cardiac arrest
Raised ICP (subarachnoid haemorrhage)
Hypothyroidism
122
Q

Contraindication to statin therapy

A

Pregnancy

Cardio (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions