random Flashcards

1
Q

if someone has an NSTEMI and <3% GRACE score what medications should they receive? what if they have bleeding risk

A

ASPIRIN 300mg +Ticagrelor

Clopidogrel if bleeding risk

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2
Q

ECG findings in posterior MI

A

horizontal ST depression
tall, broad R waves
upright T waves
dominant R wave in V1/2

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3
Q

how does a left ventriuclar aneurysm presetn post MI and ehat are ECG findings

A

NO PAIN
signs of HF eg dyspnoea, bibasal crackles rasied JVP
ECG - persistent ST elevation

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4
Q

treatment of neurogenic shock

A

vasoconstrictors - spinal cord transection casues peripheral vasodilaion

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5
Q

prophylaxis of variceal rebleed

A

propanolol

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6
Q

what drug is used in hypercholesterolaemia in people who dont tolerate statins

A

ezetimibe

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7
Q

features of takayasu arteritis

A

headache malaise, unequal BP in arms, aortic regurgitation, claudication on exertion

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8
Q

what is pulsus paradoxus and when is it seen

A

decrease in pulse pressure during insp
asthmas

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9
Q

what is romano ward syndrome ?

A

auto dom congenital long QT syndrome

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10
Q

Pericarditis ECG findings

A

st elevation and pr depression

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11
Q

what antibiotic can prolong the QT

A

tetrayclines

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12
Q

does warfarin affect the PT or APTT

A

PT

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13
Q

ank spond x-ray findings

A

subchondral erosions, sclerosis
and squaring of lumbar vertebrae

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14
Q

maagement ofpancreatic pseudo cyst

A

conservatively - 50% reslove in 3 months

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15
Q

what type of colostomy is placed in an emergency sigmoid persoration

A

end colostomy - hartmanns procedure

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16
Q

treatment of intrapartum GABHS

A

IV benpen

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17
Q

what is osteomalacia

A

softening of the bones secondary to low vitamin D levels

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18
Q

MI of what region causes AV nodal block

A

inferior

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19
Q

biochemical findings in osteomalacia

A

low calcium
low phosphate
high ALP
high PTH

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20
Q

what is th emost reliable test to confirm ovulation

A

day 21 progesterone

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21
Q

treatmet of pneumothorax< 2cm

A

if SOB > need asp
if aymp - discahrge

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22
Q

biochemistry in oesteogenesis imperfecta

A

normal CA, P04, ALP and PTH

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23
Q

what medication is used for people wiht systemic scleorsis with renal crisis

A

ACEI

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24
Q

tx of torsades

A

iv magnesium sulphate

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25
what size of aorta is classed an aneurysmal
>3cm
26
management of AAA depending on size
3cm- 4.5 = rescan every 12 month 4.5-5.5cm - -rescan every 3month .5.5cm or rapidly enlarging eg> 1cm/ yr- refer urgent 2 week referral
27
diagnosis of AAA rupture
theatre straight away if unstable CTA if stable
28
types of arotic dissection
type A -ascending `type b - descending
29
investigations in arotci dissection and when used
CXR - widened mediastinum CT -stable TOE - unstable
30
mangemenet of differeretn arotic dissections
type A Ascending - emergecny Surgical (TEVAR) TyPE B - Iv labetalol and conservative
31
STEMI ECG changes
increase in 1mm on limb leads increase of 2mm on chest new LBBB
32
what classically precipitates digoxin toxicity
hypokalaemia
33
classical causes fo SVT
AVNRT - most common AVRT eg WPW
34
what to give in SVT if allergic to adenosine
verapamil
35
what is PR prolongation classed as
>0.2
36
mobitzII
P's not always followed by QRS
37
after TIA or Stroke folllowign AF when should anticoagulation begine
TIA - immediately Stroke - 2 weeks
38
options for chemical cardioversion
flecanide and amiodarone (if structural heart disease)
39
what should be given alongside cardioversion if presenting <48 hours
heparin
40
how long shoud a patient be anticoaged for prior to cardioversion
3weeks
41
how long shoudl a patient be anticoaged for prior to ablation
4 weeks
42
what electrolyte disturbances cause long QT
hypokalaemia hypocalcaemia hypomagnesium
43
difference between paroxysmal and persistent AF
paroxsymal <48 hours peristenet >48hrs and can be cardioverted
44
what must be done in AF if CHADVASC says no anticoag
must do echo to exclude valvular disease
45
when is S3 heard
left ventricular failure (e.g. dilated cardiomyopathy, HF), constrictive pericarditis mitral regurg
46
are innocent murmurs sys or diastolic
always systolic
47
regurgitation murmurs tend to have what sound
blowing
48
management of mitral stenosis
aymp - monitor symp -perc balloom valvotomy
49
management of mitra regurg
medical - nitrates diuretics Hf meds severe - pig/artificial valve replacement
50
management of aaortic stenosis
aymp - monitor if >40mmhg then replace symp - AVR
51
aortic regurg mangeemnt
medical aymp with LV dys or symp = AVR
52
most common endocarditis organism forllowin gsurgery/indwellign lines
staph epidermidis
53
enodcarditis organims assoc with colorectal cancer
strep bovis
54
how far apart do cultures need to be in infective endocarditis and how many
2 >12 hrs apart 3 cultures fi less specific organism eg staph aureus/epidermidis
55
how to diagnse brugada syndrome
give flecanide if ECG gets worse then brugada (ST elevation in leads V1-3 and t wave inversion )
56
treatment of brugadas
ICD
57
ECG changes seen in brugada
TS elevation and RBBB in V1,2,3
58
mutation in HOCM
β-myosin heavy chain protein or myosin-binding protein C
59
characteristic biopsy findings in HOCM
myofibrillar hypertrophy with chaotic and disorganized fashion myocytes ('disarray') and fibrosis on biopsy
60
what movements alter murmur in HOCM
decrease with squatting increase with valsalva
61
echo findings in HOCM
MR SAM ASH mitral regurg sys anterior mitral valve leaflet asyym hypertrophy
62
cancer assoc with Acanthosis nigricans
gastrointestinal cancer
63
what overdose causes tinnitus
aspirin
64
mist common casue of neutropenic sepsis
staph epidermidis
65
what size of DCIS warrants mastectoym
>4cm
66
symptoms of myocarditis
chest pain , SOB, arrhythmia
67
what test must all pericarditis patients have
TTE
68
what test is used to monitor LMWH
anti-Xa activity