1. What is the key pathological feature of acute rheumatic heart disease?
    Aschoff body (focal inflammatory lesions, small sterile vegetations)
  2. What is the skin rash in rheumatic fever?
    Erythema marginatum and skin nodules
  3. What does acute rheumatic fever follow?
    Sore throat: group A strep – antibody cross-reactivity
  4. After an MI and low BP, what is most common cause of acute renal failure?
    Acute tubular necrosis
  5. Which conditions is rosiglitazone CI in?
    CCF (fluid retention), hepatic dysfunction
  6. Which conditions can you not use sulphonylurea in?
    Renal failure
  7. When should metformin be stopped?
    In organ FAILURES eg heart, liver, kidney, resp
  8. What are the ECG signs of hypercalcaemia?
    QT interval shortening
  9. What happens to the intensity and the length of the murmur in AS with time?
    • Intensity decreases as less CO with disease
    • Length increases: as disease becomes more severe, longer ejection time is needed
  10. What are the signs, symptoms and ECG signs of digoxin toxicity?
    • Nausea
    • Fatigue
    • ECG: reverse tick sign on ST segment, Heart block
  11. Which congenital heart disease is associated with wide fixed split second heart sound?
  12. Which type of murmur is assciated with ASD?
    • Pulmonary ejection systolic murmur
    • Also PR or TR due to pulmonary hypertension
  13. What are the 2 complications of ASD?
    • Eisenmenger’s syndrome (L to R then pulm HTN then R to L – cyanosis!)
    • Paradoxical embolism
  14. Which type of MI will furosemide make the situation worse in? and what is the ideal treatment? And monitor?
    • Right ventricular MI
    • Treat: give fluid to increase the LVEDP
    • Monitor: PCWP
  15. When does fallots tetralogy present?
    • After 3 months of life
    • It is the most common congenital cyanotic heart disease
  16. when do you get reverse splitting of 2nd HS and what does this mean?
    • P2 before A2
    • LBBB
    • aortic stenosis
    • PDA
  17. when do you get wide fixed splitting of 2nd HS?
  18. when do you get wide splitting of 2nd HS?
    • RBBB
    • pulmonary stenosis
    • mitral regurg
    • VSD
  19. what is the cause of 3rd HS and what age is it pathological?
    • pathological over 30
    • cause: dilated LV with rapid ventricular filling (mitral regurg, VSD)
    • or poor LV function (post MI, DCM)
  20. what causes a 4th HS?
    atrial contraction against a stiff ventricle due to aortic stenosis or hypertensive heart disease
  21. what is it called when there is an ESM over aortic area but not radiation to carotids?
    aortic sclerosis
  22. when do you get gallop rhythms?
    3rd or 4th HS occuring in sinus tachycardia
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