| A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Front | Back | Note | |||||||||||||||||
2 | 11 P's of ACS | Pain relief, Paralyse the platelets, Pacify the plaque, Perfuse the myocardium, Prevent adverse remodelling, Predict risk of sudden death, Protect from sudden death, Promote exercise, Prevent smoking, Praise health, Permit sex after 2 weeks | Cardiology | |||||||||||||||||
3 | 3 criteria for angina pain | Constriction/discomfort in chest (+/- radiation), Brought on by exercise or emotion, Relieved by rest or GTN | Cardiology | |||||||||||||||||
4 | ABCDE of CXR in heart failure | Alveolar oedema, B lines, Cardiomegaly, Diversion, Efffusion | Cardiology | |||||||||||||||||
5 | AF begets AF | Bigger heart => Predisposition to AF. AF => Bigger heart | Cardiology | |||||||||||||||||
6 | Ajmaline | Class Ia antiarrhythmic agent, used to bring out typical findings of ST elevations in patients suspected of having Brugada syndrome | Cardiology | |||||||||||||||||
7 | Anticoalgulation for drug-eluting stents | Both paclitaxal and sirolimus raise risk of thrombosis => Triple therapy (aspirin, clopidogrel, warfarin) for at least 3 months | Cardiology | |||||||||||||||||
8 | Apex displacement in LVH | Late sign - Intial growth is inwards | Cardiology | |||||||||||||||||
9 | Arrhythmogenic right ventricular dysplasia | Genetic defect in desmosomes => Hypokinetic RV + Arrhythmias. Presents with syncope or sudden cardiac death. Epsilon waves on ECG | Cardiology | |||||||||||||||||
10 | Austin Flint murmur | Low-pitched mid-diastolic/presystolic rumbling murmur, best heard at the apex. Associated with severe aortic regurgitation | Cardiology | |||||||||||||||||
11 | Beck's triad | Hypotension, Distended neck veins, Distant/muffled heart sounds => Acute cardiac tamponade | Cardiology | |||||||||||||||||
12 | Behaviour of mumurs with squatting | Most are exagerated, except HOCM | Cardiology | |||||||||||||||||
13 | Behaviour of mumurs with Valsava manoeuvre | Most get softer. Exceptions are HOCM (gets louder) and Mitral valve prolapse (gets longer) | Cardiology | |||||||||||||||||
14 | Best drugs for off-loading heart in heart failure | Morphine + GTN. Much better than furosemide | Cardiology | |||||||||||||||||
15 | Beta-carotene post-MI | Less likely to have another MI (NNT = 24 at 6 years) but Increased risk of dying (NNH = 14 at 6 years) | Cardiology | . | ||||||||||||||||
16 | Bloods in ACS | Cardiac enzymes (CK for early changes, Trop for specificity), Renal function (cf Trop, LMW heparin), Lipid profile, Glucose, TFTs | Cardiology | |||||||||||||||||
17 | BNP false positives | Old, female, AF, LVH, renal or resp failure, PE... | Cardiology | |||||||||||||||||
18 | Cannon A waves | Due to atrial contraction against a closed AV valve, in complete heart block. Will be intermittent, as the valve is not always closed | Cardiology | |||||||||||||||||
19 | Cardiac biomarker to look for a second MI | Trop T remains raised for 10 days so is no good. Use CK-MB instead, which should be back to normal within 2-3 days | Cardiology | |||||||||||||||||
20 | Cardiac cause of malar flush | Mitral stenosis => Back-pressure to lungs => CO2 buildup => Malar flush | Cardiology | |||||||||||||||||
21 | Cardiac involvement in carcinoid syndrome | 5-HT release from liver => Right heart fibrosis. May necessitate tricuspid valve replacement | Cardiology | |||||||||||||||||
22 | Cardiology drugs associated with photosensitivity | Amiodarone, Thiazide diuretics. ACEi's and ARBs may cause rashes but they are not photosensitive | Cardiology | |||||||||||||||||
23 | Causes of tricuspid incompetence | Rheumatic fever, Pulmonary hypertension, Infective endocarditis | Cardiology | |||||||||||||||||
24 | Chest pain in pericarditis | Sudden sharp retrosternal pain. May radiate to shoulder or neck. Worse when coughing, eating, lying down. Relieved by sitting up or leaning forward | Cardiology | |||||||||||||||||
25 | Cutoff CT calcium scores for CT coronary angiography | 0 => Consider other causes. 1-400 => 64-slice CT coronary angiography. >400 => Invasive angiography as you won't see anything on a CT angiogram | Cardiology | |||||||||||||||||
26 | Danger time post-MI | 2-3 days. Myocytes are broken down but scar has not yet formed => VSD/Aneurysm | Cardiology | |||||||||||||||||
27 | Distinguishing high takeoff from STEMI | T wave maintains independent wave form, "Smily face" shape, No reciprocal ST segment depression, Non-anatomical distribution. If in doubt, compare with earlier ECGs | Cardiology | |||||||||||||||||
28 | Distinguishing SA exit block from sinus arrest | Pause in SA exit block is a multiple of the P-P interval that preceded the pause (i.e. just skips a beat) | Cardiology | |||||||||||||||||
29 | Drug-eluting stents | Paclitaxel (mitotic inhibitor) or sirolimus (antiproliferative) | Cardiology | |||||||||||||||||
30 | Drugs with survival benefit in chronic heart failure | ACEi, Beta blocker, Spironolactone | Cardiology | |||||||||||||||||
31 | Earliest biomarkers in ACS | Myoglobin rises within 2 hrs but is non-specific. CK-MB rises over 10-24 hrs and is relatively specific when there's no skeletal muscle damage | Cardiology | |||||||||||||||||
32 | Earliest cardiac enzyme | CK | Cardiology | |||||||||||||||||
33 | ECG changes in hypercalcaemia | QT shortening most common. Higher levels => PR prolongation, Broad QRS, Flat/Inverted T waves, Heart block | Cardiology | |||||||||||||||||
34 | ECG in Brugada syndrome | Persistent ST elevations in V1-V3 plus RBBB. Predisposes to VF | Cardiology | |||||||||||||||||
35 | ECG in junctional rhythm | Narrow QRS complex (normal conduction pathway). Inverted P waves from retrograde conduction +/- normal P waves | Cardiology | |||||||||||||||||
36 | ECG in pericarditis | Diffuse saddle-shaped ST elevation that doesn't correspond to vascular territory. PR depression | Cardiology | |||||||||||||||||
37 | ECG indications for thrombolysis | ST elevation >1 mm in limb leads or contiguous chest leads. New LBBB | Cardiology | |||||||||||||||||
38 | Effect of exercise on ventricular ectopics | Disappear | Cardiology | |||||||||||||||||
39 | Effect of inspiration on left heart | Decrease in intrathoracic pressure=> Expanded pulmonary vasculature => Bloods pooling in lungs => Reduced pulmonary venous return => Reduced LVEDP | Cardiology | |||||||||||||||||
40 | Effect of inspiration on right heart | Decrease in intrathoracic pressure => Increased systemic venous return => Raised RVEDP | Cardiology | |||||||||||||||||
41 | Electrical alternans | Tamponade/Severe pericardial effusion => Heart wobbles => Beat-to-beat alteration in electrical axis => Alternation of QRS complex amplitude or axis between beats, with possible wandering base-line | Cardiology | |||||||||||||||||
42 | Epsilon wave | Small positive deflection (‘blip’) buried in the end of the QRS complex. Characteristic finding in arrhythmogenic right ventricular dysplasia (ARVD) | Cardiology | |||||||||||||||||
43 | Feature of Viridans Streptococcus that allows invasion of heart | Synthesize dextrans from glucose, which allows them to adhere to fibrin-platelet aggregates at damaged heart valves | Cardiology | |||||||||||||||||
44 | Femoral bruits in aortic regurgitation | Traube's sign ('pistol shot' systolic sound), Duroziez's sign (systolic and diastolic murmurs on compression with stethoscope) | Cardiology | |||||||||||||||||
45 | Glycoprotein IIb/IIIa inhibitors in ACS | Useful if clopidogrel is contraindicated | Cardiology | |||||||||||||||||
46 | Heart failure definition | Inability of the heart to provide oxygen requirements of tissue, Or only at the expense of raised LV filling pressure | Cardiology | |||||||||||||||||
47 | Leads picking up a circumflex occlusion | Lateral - V5, V6, I, AVL | Cardiology | |||||||||||||||||
48 | Leads picking up an RCA occlusion | Inferior - II, III, AVF | Cardiology | |||||||||||||||||
49 | Managment of anginal pain due to AS | Don't give nitrates as they reduce output and worsen the problem. Give beta blockers instead, to lower oxygen demand | Cardiology | |||||||||||||||||
50 | Mechanism of pulsus paradoxus in asthma | Sudden negative intrathoracic pressure on inspiration => Raised LV transmural pressure => Resists contraction => Raised afterload => Reduced output | Cardiology | |||||||||||||||||
51 | Mechanism of pulsus paradoxus in tamponade | Tamponade => Pressure equalisation between R and L heart => Bulging of septum into LV as a result of increased right heart filling during inspiration => Exagerated reduction in LVEDV | Cardiology | |||||||||||||||||
52 | Most common cause of 1st degree block | Medication (e.g. Beta blockers, CCBs) | Cardiology | |||||||||||||||||
53 | Most common cause of pericardial tamponade | Malignant infiltration => Effusion | Cardiology | |||||||||||||||||
54 | Most common congenital heart defects in Down's | AVSD > VSD > PDA > TOF > ASD | Cardiology | |||||||||||||||||
55 | Murmus in tricuspid incompetence | LLSB, Radiates to liver, Loudest on inspiration | Cardiology | |||||||||||||||||
56 | P pulmonale vs P mitrale | P pulmonale is tall, P mitrale is wide (and notched) | Cardiology | |||||||||||||||||
57 | Pathological Q wave | > 2 mm | Cardiology | |||||||||||||||||
58 | Pemberton's sign | For SVC syndrome (e.g. substernal goiter). Raise both arms above head => Facial flushing, Inspiratory stridor, Raised JVP. | Cardiology | |||||||||||||||||
59 | Pericarditis cause | Previous viral infection, Uremic pericarditis, Bacterial (e.g.,TB), Post-infarct pericarditis (Dressler's) | Cardiology | |||||||||||||||||
60 | Progression of endocarditis | Rheumatic heart disease/Congenital heart disease/Valve damage/Hyperdynamic circulation => TURBULANCE => Non-bacterial thrombotic endocarditis (VWF/Platelets/Fibrin) => Invasion | Cardiology | |||||||||||||||||
61 | Risk scores in ACS | GRACE (recommended by NICE), TIMI | Cardiology | |||||||||||||||||
62 | Secondary prevention in angina | BASIC: Beta blockers, Aspirin, Statin, ACEi, Control risk factors | Cardiology | |||||||||||||||||
63 | Sinus node disease - subtypes | Slow rate, Occasional failure, Exit failure, Tachy-Brady syndrome | Cardiology | |||||||||||||||||
64 | Subtypes of AVRT | Orthodromic (Impulse retrogradely re-enters the atrium via the accessory pathway). Antidromic (Impulse re-enters the atrium retrogradely via the AV node) | Cardiology | |||||||||||||||||
65 | Symptomatic AF | CHF, Syncope, Angina. Mortality rates from the onset of symptoms: 25% at 1 year and 50% at 2 years | Cardiology | |||||||||||||||||
66 | Thrombolysis in pericarditis | Heavens no - They'll tamponade. Don't confuse with MI! | Cardiology | |||||||||||||||||
67 | Treatment ladder for angina | Beta blocker => Non-dihydropyridine CCB => Ranolazine. Plus PRN GTN | Cardiology | |||||||||||||||||
68 | Where do you place LV pacing leads? | NOT in the LV (risk of thrombosis). Thread it round the veins, on the outside | Cardiology | |||||||||||||||||
69 | Why is it so hard to see prosthetic valve endocarditis on echo? | Tends to affect the ring of scar tissue, not the valve itself => Don't rely on echo for diagnosis | Cardiology | |||||||||||||||||
70 | Classification of clavicle fracture | Group I (Middle third - 75%), Group II (Lateral third - 25%), Group III (Medial third - 2%) | General | |||||||||||||||||
71 | 2 problems with using bicarbonate to correct acidosis | Generates CO2, which crosses into cells and causes cellular acidosis (which wasn't a problem before). And normally can't be blown off, as patient is already breathing maximally. | General | |||||||||||||||||
72 | 3 key features of Gardner's syndrome | Multiple osteomas, Cutaneous + soft tissue tumours, Polyposis coli | General | |||||||||||||||||
73 | 6 killers in thoracic trauma | Laryngeotracheal injury, Tension pneumothorax, Open pneumothorax, Flail chest/Pulmonary contusion, Massive haemothorax, Cardiac tamponade | General | |||||||||||||||||
74 | ACEi effect on creatinine | Usually cause a rise of 10-20%. Don't worry unless >25% | General | |||||||||||||||||
75 | ACEi in diabetes | YES. Reduces proteinuria + preserves function. (Unless renovascular disease) | General | |||||||||||||||||
76 | Acetyl cycteine second use | Prevents contrast nephropathy | General | |||||||||||||||||
77 | Achondroplasia | Rhizomelic dwarfism, Macrocephaly, Frontal bossing, Flat nasal bridge, Trident hand | General | |||||||||||||||||
78 | Acute rheumatic fever | Group A Strep (Strep. pyogenes) => Autoimmune inflammatory reaction => Fever, Migratory polyarthritis, Carditis, Subcutaneous nodules, Erythema marginatum, Sydenham's chorea | General | |||||||||||||||||
79 | Aetiological organism in Kaposi's sarcoma | Kaposi's sarcoma-associated herpesvirus (KSHV), AKA Human herpes virus 8 (HHV-8) | General | |||||||||||||||||
80 | Allergic bronchopulmonary aspergillosis | Usually in patients with asthma or CF. Looks like poorly controlled asthma: Wheezing, cough, shortness of breath, exercise intolerance, recurrent pneumonia. Treat with high-dose prednisolone | General | |||||||||||||||||
81 | Alport syndrome | Impaired type IV collagen synthesis => Defective basement membranes in kidney, inner ear, eye => Glomerulonephritis => End-stage renal failure | General | |||||||||||||||||
82 | Amiodarone and sun exposure | Can predispose to phototoxic reactions => Shield and use high-factor sunscreen for several months following treatment (very long half-life) | General | |||||||||||||||||
83 | AMPLE | Alergies, Meds, PMH, Last meal, Event/Environment | General | |||||||||||||||||
84 | Angiodysplasia | Small vascular malformation of the gut (caecum/proximal ascending colon). Common cause of otherwise unexplained gastrointestinal bleeding and anemia. | General | |||||||||||||||||
85 | Anti-inflammatory to avoid in gout | Aspirin may precipitate gout | General | |||||||||||||||||
86 | Anti-smoking drugs | Bupropion (dopamine, serotonin, norepinephrine reuptake inhibitor), Clonidine (a2-noradrenergic agonist), Nortriptyline (tricyclic antidepressant), Varenicline (partial alpha4beta2 nicotinic agonist) | General | |||||||||||||||||
87 | Antibiotic treatment of Bacteroides fragilis | Requires penicillin plus aminoglycoside (gentamicin) | General | |||||||||||||||||
88 | Antibiotics and the COCP | Fine, as long as: <3 weeks, No D+V, Not enzyme-inducing (e.g. rifampicin, rifabutin) | General | |||||||||||||||||
89 | Antiemetic choice in Parkinson's | Domperidone - doesn't cross BBB | General | |||||||||||||||||
90 | Associations of acanthosis nigricans | Endocrine (acromegaly, Cushing's, type II diabetes), PCOS, Paraneoplastic (GI tumours, esp. adenocarcinoma of stomach) | General | |||||||||||||||||
91 | Asterixis | Flapping tremor | General | |||||||||||||||||
92 | Atheroma outcomes | Occlusion/stenosis, Rupture, Aneurysm | General | |||||||||||||||||
93 | Autoimmune polyglandular syndrome type 1 | Defect in the AIRE gene that normally confers immune tolerance. Adrenal, thyroid, parathyroid, gonadal failure. Plus malabsorption. Plus mucocutaneous candidiasis from immune deficiency | General | |||||||||||||||||
94 | Benazthine penicillin | For prophylaxis of rheumatic fever and treatment of syphilis. IM injection => Slowly absorbed into the circulation and hydrolysed to benzylpenicillin => Prolonged low concentrations of benzylpenicillin => Prolonged antibiotic action over 2–4 weeks after a single IM dose | General | |||||||||||||||||
95 | Bennet's fracture | Intra-articular fracture of base of first metacarpal | General | |||||||||||||||||
96 | Blood chemistry in Cushing's | Hypokalaemic metabolic alkalosis. High glucose. Hypertension | General | |||||||||||||||||
97 | Blood gas effects of aspirin | Initially causes hyperventilation (resp. alkalosis). Then metabolic acidosis if big dose | General | |||||||||||||||||
98 | Blood gas effects of ethylene glycol | Metabolic acidosis | General | |||||||||||||||||
99 | Blood loss is like tennis | 15% => No effect. 30% => Tachy but normotensive. 40% => Hypotensive. Game (>40%) => Bradycardia, Catastrophic hypotension | General | |||||||||||||||||
100 | Brown-Séquard syndrome | Ipsilateral paralysis and loss of discriminatory and joint sensation, and contralateral loss of pain and temperature sensation; due to damage to one half of the spinal cord | General |