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What is the key pathological feature of acute rheumatic heart disease?
Aschoff body (focal inflammatory lesions, small sterile vegetations)
What is the skin rash in rheumatic fever?
Erythema marginatum and skin nodules
What does acute rheumatic fever follow?
Sore throat: group A strep – antibody cross-reactivity
After an MI and low BP, what is most common cause of acute renal failure?
Acute tubular necrosis
Which conditions is rosiglitazone CI in?
CCF (fluid retention), hepatic dysfunction
Which conditions can you not use sulphonylurea in?
When should metformin be stopped?
In organ FAILURES eg heart, liver, kidney, resp
What are the ECG signs of hypercalcaemia?
QT interval shortening
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
What are the signs, symptoms and ECG signs of digoxin toxicity?
- ECG: reverse tick sign on ST segment, Heart block
Which congenital heart disease is associated with wide fixed split second heart sound?
Which type of murmur is assciated with ASD?
- Pulmonary ejection systolic murmur
- Also PR or TR due to pulmonary hypertension
What are the 2 complications of ASD?
- Eisenmenger’s syndrome (L to R then pulm HTN then R to L – cyanosis!)
- Paradoxical embolism
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
When does fallots tetralogy present?
- After 3 months of life
- It is the most common congenital cyanotic heart disease
when do you get reverse splitting of 2nd HS and what does this mean?
- P2 before A2
- aortic stenosis
when do you get wide fixed splitting of 2nd HS?
when do you get wide splitting of 2nd HS?
- pulmonary stenosis
- mitral regurg
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)
what causes a 4th HS?
atrial contraction against a stiff ventricle due to aortic stenosis or hypertensive heart disease
what is it called when there is an ESM over aortic area but not radiation to carotids?
when do you get gallop rhythms?
3rd or 4th HS occuring in sinus tachycardia