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Symptom Words, Abbreviations, Good Random Questions > Random Ass Facts For Cardio > Flashcards

Random Ass Facts For Cardio Flashcards

1
Q

What is Cushings triad

A

A triad of symptoms due to increased intracranial pressure. It is normally seen in the terminal stages of acute head injury and consists of hypertension, bradycardia and irregular breathing.

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2
Q

Which part of the heart conducts the fastest?

A

Purkinje fibres

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3
Q

What would be seen on a persons chest x-ray if they had an aortic dissection?

A

A widened mediastinum - occurs due to a tear in the tunica intima of the wall of the aorta, creating a false lumen which fills with large volumes of blood

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4
Q

What might a patient present with if they had an aortic dissection?

A

Tearing chest pain which radiates to the back, hypertension and aortic regurgitation

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5
Q

How might a Hypertrophic obstructive cardiomyopathy present?

A
  • ejection systolic murmur, louder on performing Valsalva and quieter on squatting
  • exertional dyspnoea, chest pain, and syncope
  • an ECG with sinus rhythm, with generalised deep Q waves and widespread T waves, atrial fibrillation may occasionally be seen
    • evidence of Left ventricular hypertrophy
  • characterised by myofibrillar hypertrophy with chaotic and disorganised fashion myocytes (‘disarray’) and fibrosis on biopsy. - typically associated with asymmetric septal hypertrophy and impaired diastolic function, which can cause symptoms such as palpitations and shortness of breath

NOTE: Valsalva could be fatal in a patient with Brugada syndrome as it may precipitate life-threatening arrhythmias such as ventricular fibrillation.

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6
Q

What is the leading cause of cardiac sudden death in the young?

A

HOCM

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7
Q

How is Arrhythmogenic right ventricular dysplasia characterised in a biopsy?

A

fibrofatty infiltration of the right ventricle

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8
Q

How Is Dilated cardiomyopathy characterised in a biopsy?

A

dilation of the ventricular chambers and impaired systolic function,

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9
Q

What is cardiomyopathy?

A

a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body

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10
Q

What is Takotsubo cardiomyopathy character reprised by?

A

transient left ventricular dysfunction following emotional or physical stress

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11
Q

What are the characteristics of resistant cardiomyopathy?

A

impaired diastolic function and restrictive filling of the ventricles

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12
Q

Echo findings in individuals with HOCM

A
  • mitral regurgitation (MR)
  • systolic anterior motion (SAM) of the anterior mitral valve leaflet
  • asymmetric hypertrophy (ASH)

mnemonic - MR SAM ASH

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13
Q

Which artery is the dorsalis pedis artery a continuation of?

A

Anterior tibial artery

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14
Q

What is the external iliac artery formed from?

A

from the common iliac artery at the level of the pelvis.

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15
Q

What supplies the lateral compartment of the leg?

A

The peroneal artery (also known as the fibular artery).

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16
Q

What is the tibioperoneal trunk a branch of?

A

Is a branch of the popliteal artery.

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17
Q

What does the popliteal artery form?

A

The anterior tibial artery.

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18
Q

What is the first line antihypertensive in white males under the age of 55-years-old?

A

ACE inhibitor

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19
Q

What is the 1st line treatment for black patients or those aged >55 years of age with hypertension?

A

Calcium channel blockers

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20
Q

Following an MI, the tissue undergoes extensive coagulative necrosis and inflammation is caused by neutrophil infiltration what can this lead to?

A

Fibrinous pericarditis, causing pain with inspiration, a low-grade fever and audible pericardial friction rub.

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21
Q

Abrupt withdrawal from what medication can cause ‘rebound tachycardia’?

A

Beta-blockers

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22
Q

How does beta-blockers increase the symptoms of peripheral vascular disease?

A

By inhibition of beta-adrenoreceptors in skeletal muscle it can restrict blood flow by preventing vasodilation, and hence exacerbate symptoms of peripheral vascular disease

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23
Q

Where do Vertebral arteries enter the cranial cavity?

A

Via the foramen magnum

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24
Q

How do thiazides and thiazide-like drugs work?

A

inhibits sodium reabsorption by blocking the Na+-Cl− symporter at the beginning of the distal convoluted tubule

Examples: bendroflumethiazide and indapamide

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25
Q

How does hypokalaemia present itself on an ECG?

A

ECG features of hypokalaemia

  • U waves
  • small or absent T waves (occasionally inversion)
  • prolong PR interval
  • ST depression
  • long QT

Prolongation of the PR interval may be found in either hypokalaemia or hyperkalaemia. A short PR interval suggests pre-excitation or an AV nodal rhythm.

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26
Q

Symptoms of hyperkalaemia

A

Fatigue, muscle weakness, myalgia, muscle cramps, constipation, hyporeflexia and rarely paralysis

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27
Q

What causes a S4 heart sound?

A

Forceful atrial contraction due to an effort to overcome an abnormally stiff ventricle - can be a sign of heart failure

28
Q

What causes a S3 sound?

A

rapid movement of blood into the ventricle

29
Q

Examples of Glycoprotein IIb/IIIa receptor antagonists

A
  • abciximab
  • eptifibatide
  • tirofiban
30
Q

In a great saphenous vein cutdown. Where do you make the incision?

A

An incision Anterior to the medial malleolus
- The long saphenous vein passes anterior to the medial malleolus and is commonly used for venous cutdown

31
Q

What is the remnant of the ductus arteriosus

A

Ligamentum arteriosum

32
Q

What is the mechanism of ticagralol

A

similar mechanism of action to clopidogrel - inhibits ADP binding to platelet receptors

33
Q

Which arterial vessel usually supplies both the sinoatrial (SA) node and the atrioventricular (AV) node?

A

The right coronary artery

34
Q

What does the right coronary artery supply?

A
  • right atrium and ventricle
  • interatrial septum and the posterior inferior third of the interventricular septum
  • supplies the sinoatrial (SA) node in 60% of cases
  • supplies the atrioventricular (AV) node in 80% of cases
35
Q

On what Leeds in an ECG does changes occur when the RCA is occluded? What type of MI is this?

A
  • leads II, III and aVF
  • this is an inferior MI (also can be assoc. with arrhythmias)
36
Q

If the left anterior descending is occluded, what leads have ECG changes and what type of MI is this?

A
  • leads V1-V4 have changes
  • this results in an anteroseptal MI
37
Q

If the left circumflex artery is occluded, what type of MI occurs?

A

A lateral MI

38
Q

What is the most common primary cardiac tumour?

A

atrial myxoma
- showing a pedunculated mass

39
Q

What is the mechanism of action of dipyridamole?

A

non-specific phosphodiesterase inhibitor and decreases cellular uptake of adenosine

40
Q

What is the most common congenital heart disease in Down syndrome (which also causes a pan-systolic murmur)?

A

Ventricular septal defect

41
Q

What artery does the ophthalmic artery arise from?

A

The internal carotid artery (from the circle of willis)

42
Q

What is the Circle of Willis and what does it consist of?

A

The two internal carotid arteries and two vertebral arteries form an anastomosis known as the Circle of Willis on the inferior surface of the brain. Each half of the circle is formed by:
1. Anterior communicating artery
2. Anterior cerebral artery
3. Internal carotid artery
4. Posterior communicating artery
5. Posterior cerebral arteries and the termination of the basilar artery

The circle and its branches supply; the corpus striatum, internal capsule, diencephalon and midbrain.

43
Q

Amiodarone decreases Warfarins metabolism, what does this increase the risk of and is a concern?

A

Increases risk of bleeding

44
Q

What type of drug is Amiodarone?

A
  • class III antiarrhythmic agent used in the treatment of atrial, nodal and ventricular tachycardias
  • main mechanism of action: blocking potassium channels -> inhibits repolarisation and hence prolongs the action potential
  • Amiodarone also has other actions such as blocking sodium channels (a class I effect)
45
Q

Clopidogrels mechanism?

A
  • inhibiting ADP from binding to platelet receptors
  • This means that platelets cannot be activated, and so prevents clots from forming.
46
Q

What is the mechanisms that allows the ductus arteriosum to close during first breaths?

A

increased pulmonary flow enhances prostaglandins clearance
- decreased prostaglandin conc. closes the ductus arteriosum

47
Q

Aortic regurgitation due to aortic root dilation can be associated with what diseases/syndromes?

A
  • ankylosing spondylitis
  • Marfan syndrome
  • aortic dissection
48
Q

What is ankylosing spondylitis?

A

long-term condition in which the spine and other areas of the body become inflamed.

49
Q

What causes aortic valve leaflet disease (which causes aortic regurgitation)?

A
  • calcific degeneration
  • congenital bicuspid aortic valve
  • rheumatic heart disease
  • infective endocarditis
50
Q

When is B-type natriuretic peptide released?

A

In response to ventricular strain e.g. increased ventricular filling pressure (mainly left ventricular myocardium)

51
Q

What clotting factors does warfarin effect?

A

X, IX, VII, II
Think :1972 (10,9,7,2)

52
Q

What beta-blockers is least lipid soluble so least likely to cause side effects like sleep disturbance?

A

Propranolol

53
Q

What would a histology of the myocardium show 0-24hrs post MI?

A
  • early coagulative necrosis
  • neutrophils
  • wavy fibres
  • hypercontraction of myofibrils

High risk of ventricular arrhythmia, HF and cardiogenic shock

54
Q

What tend to accumulate 3-14 days post-MI?

A
  • granulation tissue - eventually form scar tissue in the myocardium.
  • macrophages - helps clear away dead tissue in order for granulation tissue to form as the heart begins to heal
55
Q

What are the 3 branches of the Coeliac trunk?

A
  • left gastric
  • hepatic
  • splenic

LHS

56
Q

What is Torsades de pointes?

A

(‘twisting of the points’) is a form of polymorphic ventricular tachycardia associated with a long QT interval. It may deteriorate into ventricular fibrillation and hence lead to sudden death

Management
- IV magnesium sulphate

57
Q

What should you consider is someone in acute heart failure is not responding to treatment?

A

Continuous positive airway pressure CPAP

58
Q

What is the mechanism of Furosemide (loop diuretic)?

A

inhibits the Na-K-Cl cotransporter in the thick ascending limb of the loop of Henle

59
Q

What congenital heart disease is trisomy 13 (Patau’s syndrome) highly associated with?

A

Ventricular septal defect - causes a pan-systolic murmur on auscultation

60
Q

What reduces the absorption of ACE inhibitors and should stop being used if on?

A

Antacids

61
Q

What is the last step in the formation of an atheroma?

A

Smooth muscle proliferation and migration from the tunica media into the intima

62
Q

What cranial nerve is at risk of damage during a carotid endarterectomy

A

The hypoglossal nerve CN XII

63
Q

How is torsades de pointes characterised?

A

rapid, irregular QRS complexes, which appear to be ‘twisting’ around the baseline shown on the ECG. This condition is associated with a prolonged QT interval

macrolides can cause torsades de pointes

64
Q

What is adenosines mechanism of action?

A

Agonist of the A1 receptor acting in the AV node
- This inhibits adenylyl cyclase, resulting in reduced cAMP and hyperpolarisation (by increasing potassium outflow). This should prevent the supraventricular tachycardia from continuing.

65
Q

How does Hydralazine cause fluid retention?

A
  • cause fluid retention, and it does this by increasing plasma concentration of renin
  • antihypertensive not commonly used anymore
  • mechanism of action: increases cGMP leading to smooth muscle relaxation
66
Q

What is Dressler syndrome

A

An autoimmune mediated pericarditis occurring 2-6 weeks after a MI

Symptom Words, Abbreviations, Good Random Questions (5 decks)

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