CVS OnelinerS by Swammy – Mock for PLAB
CVS_SWAMMY
- sudden onset back pain>>>leading to severe abdominal pain>>> o/e pale , sweaty ,restless>>> pulse high, bp low>>>> pulsatile abdominal mass= RUPTURED ABDOMINAL AORTA
- oral penicillin>>> perioral itching, thirst, skin rash >>>collapses = ANAPHYLAXIS
- tampons>>> offensive vaginal discharge >>>pallor , sweating, pulse 130, bp80/40 =STAPHYLOCOCCAL SEPSIS
- 16year old boy>>>fall from a horse>>> upper left abdominal pain, left shoulder tip pain, pale, sweaty>>>pulse 110=SPLENIC RUPTURE
- middle aged female>>> surgery >>> chronic asthmatic on oral prednisolone>>> 4hours post op circulatory collapse>>> normal ecg , cxr>>>no intraabdominal bleed >>>no drug allergy, DVT prophylaxis given =ADRENAL INSUFFICIENCY
- .M.C.C of cardiovascular cause of death in the UK= ISCHAEMIC HEART DISEASE
- treatment with warfarin in atrial fibrillation reduces the risk of stroke
- autosomal dominant with skeletal manifestations=MARFANS SYNDROME
- light to moderate consumption of alcohol is protective in ischaemic heart disease
- ACEinh following MI improves morbidity in LVF
- shortness of breathness + angioedema=ANAPHYLAXIS
- fracture of femur and pelvis >>> circulatory collapse= HYPOVOLEMIC SHOCK
- post MI shock=CARDIOGENIC SHOCK
- perforated gall bladder>>>circulatory collapse>>>drowsy and warm peripheries= SEPTIC GRAM NEGATIVE SEPTICAEMIA
- Pulse increased, jvp raised>>>ecg:T wave inversion in V1-V3 = PULMONARY EMBOLISM
- pulse increased >>>cxr-absent vascular markings on the right side>>>remaining investigations normal=PNEUMOTHORAX
- Old MI>>>increased pulse , jvp normal= AORTIC STENOSIS
- pulse increased and irregular >>> cxr-absent vascular markings on the left side>>>jvp raised =PNEUMOTHORAX
- pulse and temperature increased >>> lower lobe consolidation =PNEUMONIA
- Pregnant female>>>tachycardia 160bpm>>>no response to adenosine grin emoticon.C. CARDIOVERSION (?SVT)
- refractory pulmonary edema and cardiac failure >>>already on furosemide>>>continues to deteriorate =PRESCRIBE THIAZIDES
- diabetes + hypertension=ACEinh (captopril)
- family h/o sudden death>>> s/o HOCM= BETA BLOCKER
- 30 year old (<55years)>>> BP 160/100>>>BMI 27 =ACEinh
- 35 year old (<55 year) >>>BP 160/100 >>> BMI 33 =ACEinh
- 50year old, hypertensive = ACEinh
- Usg shows dissecting aortic aneurysm >>>next best step=IMMEDIATE SURGERY
- mitral stenosis>>> o/e finger clubbing and splinter haemorrhage =INFECTIVE ENDOCARDITIS
- AUTOIMMUNE THYROIDITIS = enlarged heart+ hypothyroidism >>> mechanism :autoimmune
- homeless man>>>cardiac failure >>>o/e spider naevi and cxr-enlarged heart, bp normal = CAUSE:NUTRITIONAL (ALCOHOL)
- bicuspid aortic valve>>> fainting episode = CONGENITAL (turners)
- mitral valve prosthesis inserted>>> high fever+new murmur=INFECTIVE ENDOCARDITIS
- central chest pain ×2hours , continued >>>sweating, anxious>>>smoker =MYOCARDIAL INFARCTION
- 12 days post partum>>>left sided chest pain and SOB =PULMONARY EMBOLISM
- young tall thin man>>> sudden SOB and left chest pain =PNEUMOTHORAX (MARFANS)
- old man >>>epigastric discomfort on exertion>>>2 hours =MYOCARDIAL INFARCTION
- post viral illness>>>left sided chest pain >>> worse on inspiration =PLEURISY (?pneumonia )
- fever+murmur >>>scientific basis=INFECTIVE
- breathlessness + bicuspid aortic valve>>>scientific basis= CONGENITAL
- alcoholic + enlarged heart>>> scientific basis= NUTRITIONAL
- prosthetic heart valve +INR 3.7 >>>scientific basis= WARFARIN OVERDOSAGE (INR 2-3)
- swelling in leg+ hoarseness of voice >>> scientific basis=HORMONAL ???
- post anteriorMI + thrombolysis >>> presents after 2 hours with pulse 140 and bp 90/40 >>>ecg-long run of VT = treatment = D.C. CARDIOVERSION (unstable)
- chronic renal failure on dialysis>>>low grade fever +abdominal pain >>>develops broad complex tachycardia (broad QRS) >>>BP 80/50 >>> treatment =CALCIUM GLUCONATE (HYPERKALAEMIA)
- BPH + high BP >>>treatment =TERAZOSIN
- .diabetic+ rental failure + hypertensive >>> treatment =ACEinh ( lisinopril)
- old lady+ glaucoma + hypertension >>>treatment = BETA BLOCKER (BETAXOLOL)
- paroxysmal atrial fibrillation >>>most appropriate treatment = SOTALOL
- Pregnancy induced hypertension >>> bp control = METHYL DOPA (first line-labetalol)
- PHEOCHROMOCYTOMA =hypertension + glycosuria + sweating , flushing, diarrhoea >>>treatment =PHENOXYBENZAMINE F/B PROPRANOLOL
- Diverticulitis > Intestinal perforation>>> rigid abdomen>> Gas under the diaphragm
- Trauma>> Central chest pain >>> Pulses and bp different in each arm>>> Aotic dissection>>> chest X- ray >>> Widening of the mediatinum
- H/O angina>>> now severe crushing left sided chest pain>>> radiating to BACK and NECK>>> ECG: post MI >>>> X-ray will be NORMAL
- Stabbed on the right side of the chest >>> Breathless and distressed >> RR= 32 bpm>>> So2 = 85%>>> right side of the chest not moving well>>> LUNG COLLAPSE >>> CXR= Right sided absent vascular marking
- Oesophageal rupture >>>> Free mediastinal gas
- Malaise + fever + cough + dullness in the left lower lobe === Streptococcus pneumonia >>> Inv of choice CXR
- Long distance air travel >> sharp chest pain >> breathlessness >>> CXR and ECG normal >>> Next most appropriate investigation = V/Q scan but Most APPROPIATE is CTPA
- Tall young man >>> sudden chest pain+ breathlessness >>> on cycling >>> Dx= Pneumothorax >>> Inv : CXR
- Chest pain radiating to left arm >>> ECG : normal >> next MOST APPROPIATE test = Cardiac enzymes >>> Dx : MI ????
- Obese ,man >>> episodic anterior chest pain >> particularly at night X 3days >>> ??? GERD >>> Inv of Oesophageo gastroduodenoscopy
- Wt loss + diarrhea + palpitations >>>> ECG : simus rhythm >>> Dx : Thyrotoxicosis
- Missed beats at rest >> Aggravated by coughing , tiredness , stress >>> Disappears during exercise >>> Dx: VENTRICULAR ECTOPICS
- 63 year+ IHD+ fast irregular pulse + intermittent palpitations for few months ( H/o ischaemic heart disease) >>>> Dx: Atrial fibrillation
- ANXIETY= chest tightness + heart racing + episodes lasts for few minutes to hours + Sinus rhythm + ECG: normal
- ATRIAL FIBRILLATION = h/o rheumatic fever + intermittent fast irregular palpitations+ systolic murmur radiating to the axilla+ soft diastolic murmur at the apex
- COMPLETE HEART BLOCK= recurrent chest pain + dypsnea 12 hours post acute MI+ pulse rate 40 bpm .
- ACUTE PERICARDITIS= recurrent left sided chest pain+ worse on inspiration+ 4days after acute MI+ ECG : wide spread ST elevation
- Rupture Mitral valve chordate= acute breathlessness 5 days post MI+ new loud pan systolic murmur in the apex
- Acute LVF = Pul oedema + irregular pulse 140bpm+ 24 hours after MI
- Pulmonary embolum= acute MI+ post ot + breathlessness and right sided expiratory pain after 5
- Complete heart block >> site – Bundle of his
- Reflux of blood into left atrium>> Mitral valve dysfunction
- Failure of closure of foramen ovale >>> Interatrial septum
- Left ventricle >>> most common site of Cardiac aneyrysm
- Endocarditis in IV drug abusers>>> Tricuspid valve
- Rapid pounding = VT
Slow pounding – Heart block
