Week 6

Question 1

What does the presence of a parasternal heave indicate?

Answer 1

Right ventricular overload

Question 2

During the first heart sound, what valves close?

Answer 2

Mitral and tricuspid

Question 3

What does the 2nd heart sound indicate?

Answer 3

Aortic and pulmonary valves closing

Question 4

A patient’s murmur radiates to the carotids. What type of valvular issue do they have?

Answer 4

Aortic stenosis

Question 5

A patient’s murmur radiates to the axilla. What type of valvular disease do they have?

Answer 5

Mitral regurgitation

Question 6

What is the congenital cause of aortic stenosis?

Answer 6

Bicuspid valve

Question 7

What type of pulse would you find on a patient with aortic stenosis?

Answer 7

Low volume

Question 8

What is a TAVI?

Answer 8

Transcatheter Aortic Valve Implantation

Question 9

What is the pharmalogical treatment for a person with mitral regurgitation?

Answer 9

Diuretics and heart failure medication

Question 10

What are some of the signs of mitral stenosis?

Answer 10

Malar flush

Tapping apex

Mid diastolic rumbling

Diastolic murmur localised to apex

Question 11

What could you see on the X-ray of a patient with mitral stenosis?

Answer 11

Straight left heart border

Question 12

If a patient has a collapsing pulse, what heart murmur does this indicate that they have?

Answer 12

Aortic regurgitation

Question 13

An early diastolic murmur found on the left sternal edge is a sign of what murmur?

Answer 13

Aortic regurgitation

Question 14

What medication should be given to a patient with aortic regurgitation?

Answer 14

ACE-i

Question 15

What antibody is transported across the placenta to the foetus?

Answer 15

IgG

Question 16

What are the 3 shunts found in a foetus?

Answer 16

Ductus venosus

Foramen ovale

Ductus arteriosus

Question 17

What does the Ductus venosus do?

Answer 17

Connects the umbilical vein to the inferior vena cava

Question 18

What does the Ductus arteriosus do?

Answer 18

Connects pulmonary bifurcation to the descending aorta

Question 19

What is the treatment for patent ductus arteriosus?

Answer 19

Waiting

NSAIDS

Surgery

Question 20

What drug can be used to keep the ductus arteriosus open until an alternative shunt can be established or surgery?

Answer 20

IV prostalandin E2

Question 21

What colour is the bottom of a positive blood culture bottle?

Answer 21

yellow/brown

Question 22

What colour is the bottom of a negative culture bottle?

Answer 22

Purple

Question 23

What is infective endocarditis an infection of?

Answer 23

The endothelium of the heart valves

Question 24

Dental treatment increases the risk of what infection?

Answer 24

Infective endocarditis

Question 25

What is the most common bacteria causing endocarditis?

Answer 25

Staphylococcus aureus

Question 26

What are rose spots a sign of?

Answer 26

Typhoid

Question 27

What are roth spots a sign of?

Answer 27

Endocarditis

Question 28

What are Janeway lesions and Olser nodes a sign of?

Answer 28

Endocarditis

Question 29

How many sets of bloods should be taken when diagnosing endocarditis?

Answer 29

3

Question 30

What type of bacteria are associated with prosthetic valve endocarditis?

Answer 30

Staphylococcus epidermidis Staphylococcus aureus

Question 31

What is the treatment for a patient who has prosthetic valve endocarditis?

Answer 31

Vancomycin Gentamicin Rifampicin

Question 32

What bacteria usually causes right sided endocarditis?

Answer 32

Staphylococcus aureus

Question 33

What is the empirical treatment for native valve bacterial endocarditis?

Answer 33

Amoxicillin and gentamicin

Question 34

What is the empirical treatment for prosthetic valve endocarditis?

Answer 34

Vancomycin Gentamicin at 3-5 days add in oral rifampicin

Question 35

What is the treatment for drug user endocarditis?

Answer 35

Flucloxacillin

Question 36

What is the treatment for staphylococcus aureus endocarditis?

Answer 36

FLUCLOXACILLIN

Question 37

What is the treatment for Viridans streptococci?

Answer 37

Benzylpenicillin and gentamicin

Question 38

What is the treatment for enterococcus endocarditis?

Answer 38

Amoxicillin/vancomycin and gentamicin

Question 39

What is the treatment for staphylococcus epidermidis?

Answer 39

Vancomycin IV Gentamicin IV Rifampicin (oral)

Question 40

How is endocarditis treatment monitored?

Answer 40

Cardiac function Temp CRP

Question 41

What infection of the heart is more common in younger people and a cause of sudden death?

Answer 41

Myocarditis

Question 42

What usually causes myocarditis?

Answer 42

Enteroviruses e.g. coxsackie A and B, echovirus etc

Question 43

How is myocarditis usually diagnosed?

Answer 43

Viral PCR Throat swab and stool swab

Question 44

What does pericarditis often occur with?

Answer 44

Myocarditis

Question 45

What is the most common cause of pericarditis? Viral or bacterial?

Answer 45

Viral

Question 46

What is Brugada syndrome?

Answer 46

Affects the way that electrical signals pass through the heart ST elevation and AF common ST elevation and RBBB in V1-V3 VF triggers at rest, fever, excess alcohol