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  • Question 1 - Which of the following describes the reason for the decline of the use...

    Correct

    • Which of the following describes the reason for the decline of the use of betablockers as antihypertensives in last few years?

      Your Answer: Less likely to prevent stroke + potential impairment of glucose tolerance

      Explanation:

      According to the latest research, beta blockers are associated with higher incidence of fatal and non-fatal strokes, all cardiovascular events, and cardiovascular mortality. New-onset diabetes also associates with beta blockers.

    • This question is part of the following fields:

      • Cardiology
      33.5
      Seconds

  • Question 2 - A 60 yr. old female presented with difficulty in breathing. What is the...

    Correct

    • A 60 yr. old female presented with difficulty in breathing. What is the clinical sign that will indicate the presence of established pulmonary hypertension?

      Your Answer: Raised jugular venous pressure

      Explanation:

      A prominent A wave is observed in the jugular venous pulse and this indicates the presence of established pulmonary hypertension. In addition the pulmonic component of the second heart sound (P2) may be increased and the P2 may demonstrate fixed or paradoxical splitting. The signs of right ventricular failure include a high-pitched systolic murmur of tricuspid regurgitation, hepatomegaly, a pulsatile liver, ascites, and peripheral oedema.

    • This question is part of the following fields:

      • Cardiology
      16
      Seconds

  • Question 3 - A 62 yr. old male presented with worsening breathlessness and fatiguability. On examination...

    Incorrect

    • A 62 yr. old male presented with worsening breathlessness and fatiguability. On examination there was bilateral ankle swelling and pulsatile liver. Auscultation revealed a pansystolic murmur best heard at the lower left sternal border. Which of the following is the most probable diagnosis?

      Your Answer: Pulmonary stenosis

      Correct Answer: Tricuspid regurgitation

      Explanation:

      All the clinical features are suggestive of tricuspid regurgitation. The pansystolic murmur of mitral regurgitation is best heard at the apex.

    • This question is part of the following fields:

      • Cardiology
      23.7
      Seconds

  • Question 4 - A 18 yr. old male was screened for hypertrophic cardiomyopathy (HOCM) as his...

    Correct

    • A 18 yr. old male was screened for hypertrophic cardiomyopathy (HOCM) as his brother had the same condition. What is the echocardiographic finding that is related to the highest risk of sudden cardiac death?

      Your Answer: Significant thickening of the interventricular septum

      Explanation:

      There are five prognostic factors which indicate poor prognosis in HOCM:
      -family history of HOCM-related sudden cardiac death
      -unexplained recent syncope
      -large left ventricular wall thickness (MLVWT ≥ 30 mm)
      -multiple bursts of nsVT on ambulatory electrocardiography
      -hypotensive or attenuated blood pressure response to exercise

    • This question is part of the following fields:

      • Cardiology
      99.4
      Seconds

  • Question 5 - A 65 yr. old man with hypertension presented with sudden onset right arm...

    Correct

    • A 65 yr. old man with hypertension presented with sudden onset right arm weakness which resolved after 10 hrs. He has had 2 similar episodes during the last 6 weeks. On examination his blood pressure was 140/80 mmHg and pulse rate was 88 bpm. His ECG showed atrial fibrillation and the CT scan of his brain was normal. Which of the following is the most appropriate management for this patient?

      Your Answer: Warfarin

      Explanation:

      CHA₂DS₂-VASc score is used for atrial fibrillation stroke risk calculation.
      Congestive heart failure – 1 point
      Hypertension – 1 point
      Age ≥75 years – 2 points
      Diabetes mellitus – 1 point
      Stroke/Transient Ischemic Attack/Thromboembolic event – 2 points
      Vascular disease (prior MI, PAD, or aortic plaque) – 1 point
      Age 65 to 74 years – 1 point
      Sex category (i.e., female sex) – 1 point
      Score of 2 or more is considered as high risk and anticoagulation is indicated. This patient’s score is 4, so he needs life-long warfarin to prevent a stroke.

    • This question is part of the following fields:

      • Cardiology
      20.9
      Seconds

  • Question 6 - Which of the following is not associated with right axis deviation? ...

    Correct

    • Which of the following is not associated with right axis deviation?

      Your Answer: Wolf-Parkinson-White syndrome with right-sided accessory pathway

      Explanation:

      Causes for right axis deviation:
      -Right ventricular hypertrophy and Left posterior fascicular block
      -Lateral myocardial infarction.
      -Acute or chronic lung diseases: Pulmonary embolism, pulmonary hypertension, chronic obstructive pulmonary disease (COPD), cor pulmonale.
      -Congenital heart disease (e.g., dextrocardia, secundum atrial septal defect).
      -Wolff-Parkinson-White syndrome.
      -Ventricular ectopic rhythms (e.g., ventricular tachycardia).

    • This question is part of the following fields:

      • Cardiology
      19.9
      Seconds

  • Question 7 - Which one of the following responses is the least likely to be associated...

    Incorrect

    • Which one of the following responses is the least likely to be associated with primary pulmonary hypertension?

      Your Answer: Fenfluramine

      Correct Answer: Recurrent pulmonary embolism

      Explanation:

      Connective-tissue diseases, liver cirrhosis, exposure to anorexigens and likely other alpha-adrenergic stimulants [e.g., cocaine, amphetamines] and HIV infection are associated with primary pulmonary hypertension. Recurrent pulmonary emboli, chronic lung diseases, left heart diseases are causes for secondary pulmonary hypertension. Pulmonary vascular hypertension after use of fenfluramine is rarely reported.

    • This question is part of the following fields:

      • Cardiology
      14.6
      Seconds

  • Question 8 - A 65 yr. old heavy smoker presented with acute central chest pain for...

    Correct

    • A 65 yr. old heavy smoker presented with acute central chest pain for 2 hours. Which of the following ECG findings is an indication for thrombolysis in this patient?

      Your Answer: 1 mm ST elevation in 2 limb leads

      Explanation:

      Thrombolytic therapy is indicated in patients with evidence of ST-segment elevation MI (STEMI) or presumably new left bundle-branch block (LBBB) presenting within 12 hours of the onset of symptoms if there are no contraindications to fibrinolysis. STEMI is defined as new ST elevation at the J point in at least two contiguous leads of 2 mm (0.2 mV) or more in men or 1.5 mm (0.15 mV) in women in leads V2-V3 and/or 1 mm (0.1 mV) or more in other contiguous limb leads.

    • This question is part of the following fields:

      • Cardiology
      9.1
      Seconds

  • Question 9 - A 28 yr. old male was admitted with palpitations and chest discomfort for...

    Correct

    • A 28 yr. old male was admitted with palpitations and chest discomfort for the past 1 hour. On examination his pulse rate was 200 bpm and blood pressure was 80/50 mmHg. His ECG revealed narrow complex tachycardia with a heart rate of 200 bpm. Which of the following is the most appropriate management of this patient?

      Your Answer: Synchronised DC synchronised cardioversion

      Explanation:

      Narrow complex tachycardia with hypotension is a medical emergency. Immediate synchronized cardioversion is the ideal management.

    • This question is part of the following fields:

      • Cardiology
      16.5
      Seconds

  • Question 10 - A 72 yr. old female patient with a history of atrial fibrillation was...

    Correct

    • A 72 yr. old female patient with a history of atrial fibrillation was admitted with recurrent episodes of syncopal attacks. Her ECG showed torsade de pointes. What is the drug which does not cause the above presentation?

      Your Answer: Omeprazole

      Explanation:

      Drugs causing torsades de pointes are Amiodarone, Chlorpromazine, Clarithromycin, Disopyramide, Dofetilide, Erythromycin, Haloperidol, Methadone, Procainamide, Quinidine, Sotalol, Levofloxacin, Moxifloxacin, Nilotinib, Ondansetron, Ranolazine, Sunitinib, Ziprasidone, Amitriptyline, Ciprofloxacin, Imipramine, Chlorthalidone, Dasatinib, Hydrochlorothiazide, Furosemide.

    • This question is part of the following fields:

      • Cardiology
      22.9
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiology (8/10) 80%
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