Flashcards in Cardiovascular and Respiratory Deck (33)
1
Give 7 modifiable risk factors for cvs disease.
Hypertension - over 140/90
Hyperlipidaemia - total cholesterol/HDL over 4.5 and triglycerides over 1.5
Diabetes
Smoking
Alcohol
Low exercise
Stress
2
Give 5 complications of hypertension
Stroke
MI
Heart failure
Kidney failure
Retinopathy
3
Give as many causes of secondary hypertension as you can.
High renin due to:
High sympathetic - Phaechromocytoma
Low renal perfusion - renal artery stenosis
Low GFR - renal failure
High aldosterone effect - Cushing's and Conn's
Preeclampsia
4
How would you treat hypertension?
Young, diabetes, ckd
1. Ace
2. Add Ca channel or diuretic
Or if older or black
1. Ca channel
2. Add diuretic
5
What would a pacemaker look like on inspection?
Lump around second intercostal space mid clavicular line
6
What is the name of a scar which runs down the middle of the chest? What might cause it?
Median sternotomy scar
CABG (especially if leg scar)
Valve repair or replacement
Congenital defect
7
How would you listen for aortic stenosis? What would it sound like?
Late systolic murmur
Crescendo
Radiates to carotid.
8
How would you listen for mitral stenosis? What would it sound like?
Mid diastolic
Apex with the bell and lean
9
How would you listen for mitral regurgitation? What would it sound like?
Pan systolic
Axilla
10
How would you listen for aortic regurgitation? What would it sound like?
Diastolic
Left sternal edge lean forwards and expire
11
Give 6 important causes of AF.
Ischaemic heart (post MI)
Hypertension
Mitral regurgitation
Pneumonia
Thyrotoxicosis
Alcohol
12
Give two causes of an irregularly irregular pulse and how to differentiate them.
AF
Ventricular ectopic beats
Ventricular ectopic beats will disappear in exercise
13
Give 3 causes of peripheral cyanosis
Reynauds
Peripheral vascular disease
Heart failure
14
Give 2 causes of central cyanosis.
Right to left cardiac shunt
Hypoxic lung disease
15
What might cause an elevated JVP?
Right heart failure
PE
Cardiac tamponade
Tension pneumothorax
16
What are the waves of the JVP? What does it mean if they are large?
A - atria contracting. If large complete heart block
V - tricuspid regurgitation
17
Give four important causes of heart failure.
Pump failure: MI, arrhythmia
High preload: valve regurgitation
High after load: hypertension, valve stenosis
Cor pulmonale
18
Give some of the stigmata of infective endocarditis.
Clubbing
Splinter haemorrhages
Splenomegaly
Osler nodes
Janeway lesions
19
Give some complications that occur with prosthetic valves.
Infective endocarditis
Thrombosis
Warfarin related problems
20
Give 4 unmodifiable risk factors for cvs disease?
Age
Sex
Ethnicity - South Asian
Family history
21
What are the principal cardio-respiratory causes of clubbing?
Lung Cancer
Interstitial lung disease (inc TB, sarcoidosis)
Bronchiectasis
Infective endocarditis
22
What does a flapping tremor indicate?
Hypercapnia
Could be type 2 respiratory failure, renal failure, or hepatic failure
23
What are the signs of anaemia?
Conjunctival pallor
Peripheral cyanosis
Cold hands
Bounding pulse
Large smooth tongue - glossitis
24
What might cause a bounding pulse?
Aortic regurgitation
Hypercapnia
Anaemia
Septic shock
Anaphylactic shock
25
What might cause hyperinflation of the chest?
COPD
Asthma
26
What might cause a mediastinal shift?
Tension Pneumothorax
Complete lung collapse (atelectasis)
Big pleural effusion
27
What might sound dull to percussion? What might sound hyper resonant?
Dull - fibrosis/consolidation
Stony dull - fluid
Hyper resonant - air
28
What causes consolidation in the lung?
Transudate
Exudate
Blood
Inflammation and fibrosis
29
What are the signs of hyperinflation of the chest?
Barrel appearance
Reduced cricosternal distance
Increased AP diameter
Hyper resonant to percussion
30
Give 3 causes of bilateral crackles.
Heart failure - pulmonary oedema
ILD
Cystic fibrosis
31
Give 5 causes of ILD
Idiopathic
Sarcoidosis
SLE
Asbestos
Drug induced - methotrexate, Amiodarone, nitrofurantoin, cisplatin
32
Give 3 causes of a transudative pleural effusion.
Heart failure
Cirrhosis
Hypo albumen
33