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Flashcards in PM - 2 Deck (50):
1

Ejection systolic murmur (5)

aortic stenosis, pulmonary stenosis, HOCM (hypertrophic obstructive cardio myopathy), ASD (atrial septal defect), Fallot's

2

pan systolic murmur

mitral/tricuspid regurgitation (high-pitched and 'blowing' in character)
VSD ('harsh' in character)

3

late systolic murmur

mitral valve prolapse
coarctation of aorta

4

early diastolic murmur

aortic regurgitation (high-pitched and 'blowing' in character)
Graham-Steel murmur (pulmonary regurgitation, again high-pitched and 'blowing' in character)

5

Mid-late diastolic

mitral stenosis ('rumbling' in character)
Austin-Flint murmur (severe aortic regurgitation, again is 'rumbling' in character)

6

Continuous machine-like mumur

patent ductus arteriosus

7

slow rising pulse

aortic stenosis

8

sinus bradycardia treatment

IV atropine (500 micrograms) ** think poked with 'at yo pin' will get heart rate up**

9

ECG changes for thrombolysis or percutaneous intervention:

ST elevation of > 2mm (2 small squares) in 2 or more consecutive anterior leads (V1-V6) OR

ST elevation of greater than 1mm (1 small square) in greater than 2 consecutive inferior leads (II, III, avF, avL) OR

New Left bundle branch block

10

how does thrombolysis work

ctivate plasminogen to form plasmin. This in turn degrades fibrin

11

examples of thrombolysis drugs

alteplase
tenecteplase
streptokinase

12

which thrombolystic drug can cause hypotension

streptokinase

13

type of diuretic given in heart failure

loop - furosemide

14

Hypertension management - step 4

K+ < 4.5 then spironolactone
K+ > 4.5 then higher-dose thiazide-like diuretic

15

ECG changes seen in tricyclic OD

QRS widening

16

ST depression is associated with

severe ischeamia (usually LAD)

17

non shockable rythmes

pulses electrical activity and asystole

18

treatment for non shockable

IV adrenaline (given every 3-5 mins/2 cycles of CPR) + CPR

19

PR depression indicates

pericarditis (also get saddle shared ST elevation)

20

U wave seen in

hypokalaemia (looks like big broad T wave)

21

MI secondary prevention drugs

dual antiplatelet therapy (aspirin plus a second antiplatelet agent)
ACE inhibitor
beta-blocker
statin

22

HOCM inheritance

autosomal dom

23

1st degree heart block features

PR >0.2 (one big block)

24

2nd degree mobitz 1 features

PR prolongation then a dropped QRS

25

2nd degree mobitz II features

PR interval is constant but the P wave is often not followed by a QRS complex

26

ST elevation in leads II, III, aVF

inferior MI - right coronary artery

27

nifedipine is hat and used when

long acting calcium channel blocker - angina

28

supraventricular tachycardia (SVT) QRS appearance

narrow QRS

29

what is conns syndrome

type of primary hyperaldosteronism due to adrenal adenoma

30

why low potassium in conns syndrome

excess production of the hormone aldosterone by the adrenal glands resulting in low renin levels. retention of sodium and water and loss of potassium

31

Atrial fibrillation: pharmacological cardioversion

amiodarone
flecainide (if no structural heart disease)

32

antithrombin given in MI

Fondaparinux

33

narrow pulse pressure

aortic stenosis

34

4th heart sound indicates what

left ventricular hypertrophy

35

which drugs must be avoided in WPW

digoxin and verapamil

36

when do you give digoxin in heart failure

only if they have pre-existing heart failure

37

which antibiotic can't you give in long QT syndrome

erythromycin

38

atrial fibrillation: what QRS

narrow

39

regular narrow complex tachy treatment

valsalva/carotid massage, IV adenosine

40

polymorphic VT (different heights) think

Torsade de pointes

41

Torsade de points treatment

IV magnesium

42

regular broad complex tachy treatment

assume VT - give amiodarone

43

flu like symptoms + chest pain + wide spread ST elevation

pericarditis

44

Investigation: patients with suspected heart failure who have not had a previous myocardial infarction

BNP (B-type natriuretic peptide) - released from left ventricle in heart failure

45

common side effect of calcium channel blockers

oedema - particularly verapamil

46

blood pressure medication in diabetics regardless of age

ACE (unless afro caribbean then calcium)

47

antibiotic that can cause QT interval prolongation

clarthromycin

48

most common cause of cyanotic heart disease in infants is

Fallot's tetralogy

49

The commonest heart defect in Down's syndrome is

endocardial cushion defect.

50

congenital rubella, can lead to which heart defects (3)

Patent ductus arterioles, pulmonary stenotic lesions and atrial septal defect