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Flashcards in General Cardiology Deck (74)
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31

What is the sensitivity and specificity of pulsus paradoxus >10 for cardiac tamponade?

98% sens
70% spec

32

What are the causes of pulsus paradoxus?

CARDIAC
Cardiac tamponade
Constructive pericarditis
RV infarction
Restrictive Cardiomyopathy
RESPIRATORY
COPD
asthma
Large pleural effusion
Tension pneumothorax
Pulmonary embolism
OTHER
Obesity

33

What is the spec of rv collapse for cardiac tamponade?

90%

34

What are the causes of secondary hypertension?

Renal
- Renal artery stenosis
- Chronic Kidney Disease
Endocrine
- cushings syndrome
- primary hyperaldosteronism
- Phaeochromocytoma
- Hypothyroidism
- Hyperparathyroidism
Structural
- coarctation of the aorta
- OSA
Medications
- NSAIDs
- OCP
- Steroids
- Calcineurin inhibitors

35

What are the indications for revascularisation of unilateral renal artery stenosis?

Short duration of hypertension
Failure of OMT to manage BP
Intolerance to medical therapy
Recurrent flash APO
Refractory heart failure

36

What are the indications for revascularisation of bilateral renal artery stenosis?

Short duration of hypertension
Failure of OMT to manage BP
Intolerance to medical therapy
Recurrent flash APO
Refractory heart failure
Unexplained progressive renal insufficiency

37

What is the mortality rate of those with myocardial injury?

70% 5 year mortality

38

What is the urine sodium in SIADH?

>40

39

What is the urine osmolality in SIADH?

>100

40

What is the latent period between rheumatic fever and symptomatic mitral stenosis?

16 years

41

What is the negative predictive value of reproducible chest wall tenderness for ACS?

98%

42

What is the 30 day mortality of patients with unstable angina?

1.6%

43

What is the 30 day mortality of patients with NSTEMI?

7%

44

What is the difference in 1 year mortality between patients with NSTEMI and STEMI?

No difference

45

In which patients with ACS should beta blockers be avoided in the acute setting?

Cardiogenic shock
Risk for cardiogenic shock
Coronary vasospasm
Cocaine use

46

If an LDL target is not achieved as secondary prevention (<1.8), what additional agent should be considered?

Ezetimibe

47

If an Triglyceride target is not achieved as secondary prevention, what additional agent should be considered?

Fenofibrate

Though ACCORD showed no benefit when added to statins in T2DM

48

What are the side effects of ezetimibe?

Gastrointestinal intolerance
Hepatitis
Rhabdo


Avoid in liver cirrhosis Child Pugh B and C
Avoid in renal impairment GFR <30

49

What are the adverse events with fenofibrate?

Hepatitis
Rhabdo
Pancreatitis
Photosensitivity
Kidney injury
Decrease HDL

Avoid in liver disease
Avoid in significant renal disease

50

What is the annual reduction in mortality associated with a decrease in LDL by 1?

10%

51

What are the benefits of beta blockers in AMI?

Less repeat MI
Less angina
?8-13% mortality benefit in hospital

52

What are the negatives of beta blockers in acute MI?

Heart failure
Cardiogenic shock

53

What is the blood supply to the posteromedial papillary muscles?

PDA

54

What supply’s the Anteolateral papillary muscle?

Diagonals
OM

55

What are the negative prognostic features post cardiac arrest requiring intubation?

Clinical - no pupillary response, no corneal reflex, motor response 1/2, status myoclonus <48hours
Laboratory - Neuron specific enolase
Imaging - HBI on brain imaging
Electrophysiology - absent N2O SSEP, EEG

56

Formula for pulmonary vascular resistance?

PVR (wood) = (mean PAP - Cap wedge) / pulmonary flow (or CO if no shunt)

57

What is the interpretation of wood units for pulm vascular resistance?

Less than 3-5 wood units is normal pulmonary vascular resistance

If more than 5 indicates high PVR and may require lung transplant as well (in appropriate clinical context)

58

What are the features that warrant digibind in the setting of digitalis toxicity?

Life threatening arrhythmia
End organ dysfunction
Hyperkalaemia >5.5

59

When is charcoal considered in digitalis overdose?

Acute overdose within 2 hours of presentation
Alert patient protecting airway

60

What is sensitivity and specificity of ctca for significant stenosis?

Sensitivity 90-95%
Specificity 65-85%