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CARDIOLOGY - RIA > Cardio > Flashcards

Cardio Flashcards

1
Q

what is an Aortic dissection?

A

Tear in the intima (innermost layer of the abdominal aorta); causing blood to bulge and continuously fill between the intima and media layers, creating a false lumen & reduction of blood supply to rest of body

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2
Q

name of Aortic dissection classification

A

stanford type A & B

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3
Q

Type A aortic dissection location

& management

A

ascending aorta/arise anywhere before the origin of the left subclavian artery

surgery

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4
Q

Type B aortic dissection location

& management

A

distal to the origin of the left subclavian

BP control

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5
Q

3 possible pathophysiology of blood entering media

A

1) Atherosclerotic ulcer leading to intimal tear
2) Disruption of vasa vasorum causing intramural haemorrhage
3) de novo intimal tear

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6
Q

Symptomatic presentation of aortic dissection

A

Sudden onset tearing chest pain, radiating to back.

sweating, nausea, SoB, weakness, syncope

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7
Q

symptoms other than chest pain

A
  • syncope
  • seizure
  • limb paraesthesia
  • pain/weakness
  • SoB
  • haemoptysis
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8
Q

3 inherited risk factors for aortic dissection

A
  • Marfans syndrome
  • ehlers-danlos syndrome type IV
  • turner syndome
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9
Q

risk factors for aortic wall stress

A
  • HTN
  • Previous cardiovascular surgery
  • infection
  • cocaine
  • smoking
  • high cholesterol
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10
Q

investigations for aortic dissection

A
  • ECG

- Bloods: troponin, FBC, CRP, U&E, cross match/group&save, WCC

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11
Q

imaging for investigating aortic dissection, and findings

A

CXR: widening mediastinum, abnormal aortic contour

ECHO: either transthoracic or transoesophageal

CT/MRI

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12
Q

Emergency A-E management of aortic dissection

A
  • High flow 15Loxygen via non-rebreath mask
  • insert 2 large bore cannula into each ACF
  • Invasive monitoring
  • Group & save/crpss match blood, warn blood bank

IV Beta blocker: propranolol/labetalol & Vasodilator: GTN/labetalol

Call senior & cardiothoracic surgeon

(beta blockers avoids reflex tachycardia which would increase aortic wall stress)

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13
Q

indications for surgery for an aortic dissection (4)

A
  • Type A
  • Persistent pain
  • Branch occlusion
  • Leaking
  • Continued extension despite optimal med management
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14
Q

name 5 congenital heart defects

A
  • Atrial septal defects
  • Bicuspid aortic valve
  • Ventricular septal defects
  • Coarctation of the aorta
  • Pulmonary stenosis
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15
Q

symptoms of ASD

A
  • pulmonary HTN
  • cyanosis
  • haemoptysis
  • chest pain
  • arrhythmia
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16
Q

complication of Atrial septal defect

A

the initial left to right shunt causes pulmonary hypertension that then causes reversal to a right to left shunt causing cyanosis, HF & chest infections

17
Q

presentation of VSD in infants

A

severe heart failure

18
Q

classical auscultation in VSD

A

harsh pan systolic murmur in left sternal edge w/ systolic thrill

19
Q

2 associations with coarctation of aorta

A
  • turner syndrome

- bicuspid aortic valve

20
Q

signs of coarctation of aorta

A
  • radiofemoral delay
  • weak femoral pulses
  • raised BP
21
Q

4 features of Fallot’s tetralogy

A

1) Ventricular septal defect
2) Pulmonary stenosis
3) Right ventricular hypertrophy
4) Aorta overriding the VSD

22
Q

most common cyanotic congenital heart defect?

A

Fallots tetrology

23
Q

name 3 cyanotic heart diseases

A
  • Fallots tetrology
  • Tricuspid atresia
  • Transposition of great arteries
24
Q

name 3 acyanotic heart diseases

A
  • ASD
  • VSD
  • PDA
25
Q

thoracic aorta extends between what part of spine

A

T4 to T12

26
Q

abdominal aorta extends between what part of spine

A

T12 to L4

27
Q

3 branches of the coeliac trunk (L1)

A

left gastric artery

splenic artery

common hepatic artery

28
Q

branches of the left gastric artery

A
  • gastric branches

- oesophageal branched

29
Q

branches of the splenic artery

A
  • branches to spleen
  • branches to body and tail of pancreas
  • short gastric branch
  • left gastro-omental artery
30
Q

branches of common hepatic artery

A
  • proper hepatic artery –> left branch of proper hepatic, right gastric & right branch of hepatic
  • gastro-duodenal artery–> right gastroduodenal artery & superior anterior pancreaticoduodenal artery
31
Q

what causes an Abdominal aortic aneurysm?

A

weakness in the wall of the aorta due to reduced collagen

32
Q

where are 95% of AAA’s found?

A

below renal arteries & above bifurcation of aorta

33
Q

width of AAA for poss elective surgical repair?

A

> 5.5 cm (male)

> 5 cm (female)

34
Q

5 complications of massive blood transfusion

A

1) Dilutional coagulopathy
2) hypothermia
3) Hypocalcaemia
4) transfusion related acute lung injury
5) haemolytic anaemia

CARDIOLOGY - RIA (8 decks)

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