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Short Cases Q&A > Short Cases Q&A > Flashcards

Short Cases Q&A Flashcards

1
Q

Signs of Aortic Stenosis Severity

A
  • small vol, slow rising, plateau carotid pulse
  • aortic thrill
  • long late peaking ESM
  • S4 (reduced LV compliance)
  • paradoxical splitting of S2
  • presence of left ventricular failure
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2
Q

Signs of Aortic Regurgitation severity

A
  • wide pulse pressure + collapsing pulse.
  • long decrescendo diastolic murmur (in very severe AR + LV decompensation murmur may be soft/absent).
  • S3.
  • soft A2.
  • Austin-Flint murmur.
  • LV enlargement.
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3
Q

CXR features of left atrial enlargement

A
  • straightening/convexity of left heart border
  • double heart border
  • splaying of carina
  • posterior expansion of LA on lateral CXR
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4
Q

Causes of Mitral regurgitation

A

Secondary mitral regurgitation:
Left ventricular dilatation e.g. dilated cardiomyopathy.

Primary mitral valve disease:
Chronic
1, degenerative
2. mitral valve prolapse
3. Rheumatic
4. Papillary muscle dysfunction - LV failue, ischaemia
5. Connective tissue disease - RA, ank spon
6. Congenital

Acute

  1. IE
  2. MI
  3. trauma
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5
Q

Indicators of severity of mitral regurgitation

A 
Left ventricular dilatation.
A soft S1.
A split S2 (earlier A2)
The presence of an S3.
Complication of left ventricular failure.
Small pulse volume (very severe mitral regurgitation).
Early diastolic rumble
pulmonary hypertension
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6
Q

Signs of severity of mitral stenosis

A
  1. Small pulse pressure.
  2. A short distance between the opening snap and S2.
  3. A long diastolic murmur (present as long as there is a gradient between LA & LV).
  4. The presence of pulmonary hypertension.
  5. An apical diastolic thrill.
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7
Q

Causes of AS

A
  1. Degenerative (calcified valve)
  2. Calcific bicuspid valve
  3. Rheumatic
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8
Q

Evidence of critical stenosis in echocardiogram

A
  1. valve area <0.7cm2/m2

2. valve gradient >70mmHg

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9
Q

Indications for surgery for AS

A
  1. symptoms (exertional angina, dyspnoea, syncope)

2. Critical obstruction & severe LVH

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10
Q

Causes of mitral stenosis

A
  1. rheumatic
  2. severe calcification
  3. post mitral valve repair for MR
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11
Q

Causes of chronic AR

A 
Valvular
1. rheumatic
2. congenital
3. anks spon
Aortic root
1. Marfan's syndrome
2. Aortitis
3. Dissecting aneurysm
4. Old age
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12
Q

Causes of acute AR

A
  1. Infective endocarditis
  2. Marfan’s syndrome
  3. HTN, dissecting aneurysm
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13
Q

Indications for surgery for AR

A
  1. Symptoms - dyspnoea on exertion
  2. Worsening LV function
  3. LV end-systolic dimension >5.5cm -> LV dilatation
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14
Q

Causes of tricuspid regurgitation

A
  1. Functional
  2. Rheumatic
  3. IE
  4. Congenital - Ebstein’’s anomaly
  5. RV papillary muscle infarction
  6. Pacemaker/defib lead
  7. Trauma (steering wheel injury to sternum)
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15
Q

Causes of anaemia in chronic liver disease

A
  1. Blood loss from portal hypertensive gastropathy
  2. EtOH excess causing marrow suppression
  3. Poor nutrition
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16
Q

GI causes of clubbing

A
  1. liver cirrhosis
  2. IBD
  3. coeliac disease
  4. GI lymphoma
17
Q

Clinical manifestations of altered sex hormone metabolism in chronic liver disease

A
  1. spider naevi
  2. palmar erythema
  3. gynaecomastia
  4. loss of body hair
18
Q

Causes of tender hepatomegaly

A

Recent hepatic enlargement

  1. infective hepatitis
  2. alcoholic hepatitis
  3. malignancy
19
Q

Causes of cirrhosis

A
  1. Alcohol
  2. Hep B/C
    3, Metabolic - NASH, haemachromatosis, a1AT deficiency
  3. Autoimmune - AIH, PBC, PSC
  4. Drugs: MTX, isoniazid amiodarone, phenytoin
20
Q

Signs of EtOH misuse

A
  1. tremor
  2. cachexia
  3. parotid enlargement
  4. Dupuytren’s contracture
  5. cerebellar syndrome
  6. peripheral neuropathy
  7. myopathy
21
Q

Causes of decompensated cirrhosis

A
  1. Infection
  2. SBP
  3. hypoK
  4. GI bleeding
  5. Sedatives
  6. HCC

Short Cases Q&A (1 decks)

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