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  • Question 1 - A 50 yr. old male patient was started on amiodarone. Prior to commencement,...

    Correct

    • A 50 yr. old male patient was started on amiodarone. Prior to commencement, his blood urea and electrolytes were checked. What is the reason for doing this investigation before starting amiodarone?

      Your Answer: To detect hypokalaemia

      Explanation:

      Any antiarrhythmic drugs can potentially cause arrhythmias. Before starting amiodarone, any electrolyte imbalance including hypokalaemia, hypomagnesemia, or hypocalcaemia should be corrected to prevent any arrhythmias.

    • This question is part of the following fields:

      • Cardiology
      69.8
      Seconds

  • Question 2 - A 60 yr. old female presented after an acute overdose of amiodarone. Her...

    Incorrect

    • A 60 yr. old female presented after an acute overdose of amiodarone. Her blood pressure was 110/70 mmHg and pulse rate was 35 bpm. She was given 500mcg of atropine but there was no response. Which of the following is the most appropriate next step?

      Your Answer: Percussion pacing

      Correct Answer: Isoprenaline

      Explanation:

      Permanent pacing is not indicated as the bradycardia is reversible. Temporary pacing is the definite treatment. Isoprenaline can be used until temporary pacing is available.

    • This question is part of the following fields:

      • Cardiology
      38.6
      Seconds

  • Question 3 - A 80 yr. old male with hypertension presented with his second episode of...

    Incorrect

    • A 80 yr. old male with hypertension presented with his second episode of atrial fibrillation. He was warfarinised and discharged. Later he was reviewed and found to be in sinus rhythm. Which of the following is the most appropriate next step?

      Your Answer: Stop warfarin + start aspirin

      Correct Answer: Continue lifelong warfarin

      Explanation:

      CHAā‚‚DSā‚‚-VASc score is used for atrial fibrillation stroke risk calculation.
      Congestive heart failure – 1 point
      Hypertension – 1 point
      Age ā‰„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
      A score of 2 or more is considered as high risk and anticoagulation is indicated. This patient’s score is 3, so he needs life long warfarin to prevent stroke.

    • This question is part of the following fields:

      • Cardiology
      58.6
      Seconds

  • Question 4 - A 54 yr. old patient presented with a dry cough after starting treatment...

    Correct

    • A 54 yr. old patient presented with a dry cough after starting treatment for hypertension. He was prescribed ramipril 2.5mg and the dry cough started after that, which disturbed his sleep. His blood pressure was normal. Which of the following is the most appropriate management?

      Your Answer: Stop the ramipril and prescribe candesartan

      Explanation:

      ACE inhibitors are known to cause a dry cough and they should be stopped, to settle the cough. The next drug of choice is an angiotensin receptor blocker such as candesartan.

    • This question is part of the following fields:

      • Cardiology
      19.5
      Seconds

  • Question 5 - A 55 yr. old male with a history of myocardial infarction 4 years...

    Correct

    • A 55 yr. old male with a history of myocardial infarction 4 years ago, was admitted with a history of fever for the past 2 weeks. On investigation, his echocardiography revealed a small vegetation around the mitral valve. His blood culture was positive for Streptococcus viridans. Which of the following is the most appropriate antibiotic therapy?

      Your Answer: IV benzylpenicillin

      Explanation:

      According to the American Heart Association (AHA) penicillin-susceptible S viridans, S bovis, and other streptococci (MIC of penicillin of ā‰¤0.1 mcg/mL) should be treated with penicillin G or ceftriaxone or penicillin G + a gentamicin combination or vancomycin (if allergy to penicillin).

    • This question is part of the following fields:

      • Cardiology
      31.5
      Seconds

  • Question 6 - A 45 yr. old male was discharged recently after treatment of bleeding peptic...

    Correct

    • A 45 yr. old male was discharged recently after treatment of bleeding peptic ulcers. 3 days after discharge he was readmitted complaining of acute severe chest pain for the past 1 hour. His ECG showed an acute ST elevation myocardial infarction. His FBC, blood urea, serum electrolytes and serum creatinine were within normal ranges. Faecal occult blood was negative. Which of the following is the most appropriate management for this patient?

      Your Answer: Primary angioplasty

      Explanation:

      The patient has a recent history of bleeding peptic ulcer disease, which is an absolute contraindication for thrombolysis. So he should be offered primary angioplasty.

    • This question is part of the following fields:

      • Cardiology
      38.6
      Seconds

  • Question 7 - A 26 yr. old male was being investigated further following several hypertensive episodes....

    Correct

    • A 26 yr. old male was being investigated further following several hypertensive episodes. There was a marked difference in his systolic blood pressures between the right brachial and the right femoral arteries. Which of the following is most probable diagnosis?

      Your Answer: Coarctation of the aorta

      Explanation:

      From the given physical findings (the difference in BP between the radial and femoral arteries), the most probable diagnosis is coarctation of the aorta.

    • This question is part of the following fields:

      • Cardiology
      19.1
      Seconds

  • Question 8 - A 72 yr. old male presented to the Emergency Department with a broad...

    Correct

    • A 72 yr. old male presented to the Emergency Department with a broad complex tachycardia. Which of the following features is more suggestive that this has resulted because of a supraventricular tachycardia (SVT) rather than a ventricular tachycardia (VT)?

      Your Answer: Absence of QRS concordance in chest leads on ECG

      Explanation:

      To differentiate ventricular tachycardia (VT) from supraventricular tachycardia (SVT) with aberrant conduction the following electrocardiographic features should be looked for:

      Evidence of preceding atrial activity for SVT. Oesophageal leads are helpful if P waves are hidden in the QRS complex.
      QRS duration more than 140 ms for VT.
      QRS morphology: Features of QRS morphology that favour SVT are RBBB or triphasic patterns like rSR in V1 and qRS in V6. Monophasic pattern like R or qR in V1 and rS or QS in V6 or multiple morphology QRS complexes favour VT.
      AV dissociation for VT.

    • This question is part of the following fields:

      • Cardiology
      35.7
      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
      25.7
      Seconds

  • Question 10 - A 65 yr. old previously well man was referred due to an abnormal...

    Incorrect

    • A 65 yr. old previously well man was referred due to an abnormal heart sound which was detected during a medical check up. On examination he looked well. His blood pressure was 120/70 mmHg and pulse rate was 68 bpm which was regular. His jugular venous pressure was not elevated and he didn't have ankle oedema. He had an early diastolic murmur, best heard at the left sternal edge, which was more clear in expiration when the patient leant forward. His lungs were clear. His FBC, Urea and electrolytes, LFTs and lipid profile were normal. His ECG showed sinus rhythm. His chest X-ray was normal. Echocardiography showed mild to moderate aortic regurgitation with normal left ventricular size and normal function. Which of the following is the most appropriate way of managing this patient?

      Your Answer: Discharge him from the clinic

      Correct Answer: Start him on an angiotensin-converting enzyme (ACE) inhibitor

      Explanation:

      Although this patient’s left ventricular function is normal at the time of examination, there is chance of deterioration of it due to aortic regurgitation. It is found that ACE inhibitors slow the development of left ventricular dysfunction. So this patient should be started on an ACE inhibitor.

    • This question is part of the following fields:

      • Cardiology
      59.5
      Seconds

  • Question 11 - Which of the following indicates the opening of tricuspid valve in jugular venous...

    Correct

    • Which of the following indicates the opening of tricuspid valve in jugular venous waveform?

      Your Answer: y descent

      Explanation:

      The a wave indicates atrial contraction. The c wave indicates ventricular contraction and the resulting bulging of tricuspid valve into the right atrium during isovolumetric systole. The v wave indicates venous filling. The x descent indicates the atrium relaxation and the movement of the tricuspid valve downward. The y descent indicates the filling of the ventricle after tricuspid opening.

    • This question is part of the following fields:

      • Cardiology
      7
      Seconds

  • Question 12 - A 80 yr. old male was found on the floor. His blood pressure...

    Correct

    • A 80 yr. old male was found on the floor. His blood pressure was 100/60 mmHg. His core temperature was 31ĀŗC. His FBC and serum electrolytes were within normal limits. Which of the following would be found in his ECG?

      Your Answer: Long QT interval

      Explanation:

      Hypothermia is defined as a core body temperature of < 35 Ā°C.
      Hypothermia may produce the following ECG changes:
      -Bradyarrhythmia
      -Osborne Waves (= J waves)
      -Prolonged PR, QRS and QT intervals
      -Shivering artefact
      -Ventricular ectopics
      -Cardiac arrest due to VT, VF or asystole

    • This question is part of the following fields:

      • Cardiology
      7.4
      Seconds

  • Question 13 - A 25 yr. old previously well female, in her 10th week of pregnancy...

    Correct

    • A 25 yr. old previously well female, in her 10th week of pregnancy presented with a left sided painful calf swelling. An ultrasound scan revealed deep venous thrombosis (DVT) of her left leg. Which of the following is the most appropriate management of this patient?

      Your Answer: Initiate and then continue treatment with heparin until delivery

      Explanation:

      Warfarin is contraindicated during pregnancy due to its teratogenic effects. She should be given heparin throughout her pregnancy. It can be converted to warfarin if necessary after the delivery.

    • This question is part of the following fields:

      • Cardiology
      18.9
      Seconds

  • Question 14 - What is correct statement regarding pulsus alternans? ...

    Incorrect

    • What is correct statement regarding pulsus alternans?

      Your Answer: The pulse is irregular

      Correct Answer: It is found in association with a third heart sound

      Explanation:

      Pulsus alternans is the alternation of one strong and one weak beat without a change in the cycle length. It occurs most commonly in heart failure due to increased resistance to LV ejection, as occurs in hypertension, aortic stenosis, coronary atherosclerosis, and dilated cardiomyopathy. Pulsus alternans is usually associated with an S3 gallop, which is associated with a poor prognosis. It usually disappears with treatment of the heart failure.

    • This question is part of the following fields:

      • Cardiology
      29
      Seconds

  • Question 15 - A 70 yr. old male patient presented with chronic congestive heart failure. Which...

    Correct

    • A 70 yr. old male patient presented with chronic congestive heart failure. Which of the following is the most important factor to consider when prescribing drugs for this patient?

      Your Answer: Administration of a B-blocker reduces the time spent in hospital

      Explanation:

      It is proven that spironolactone has survival benefits and loop diuretics only give symptomatic relief. Beta blockers are however, known to improve exercise tolerance, left ventricular function and reduce symptoms. They also reduce the mortality associated with heart failure. So administration of beta blockers will reduce the time spent in hospital by improving symptoms.

    • This question is part of the following fields:

      • Cardiology
      32.1
      Seconds

  • Question 16 - A 42 yr. old previously well woman presented with acute severe central chest...

    Correct

    • A 42 yr. old previously well woman presented with acute severe central chest pain for the past 2 hours. She has a family history of premature coronary artery disease. Her husband passed away recently due to prostate cancer. On examination her blood pressure was 130/80 mmHg and pulse rate was 80 bpm. Her ECG showed ST segment elevation and her troponin was slightly elevated. Emergency angiogram revealed slight wall irregularities with no luminal obstruction. Cardiovascular MR showed an apical ballooning of the myocardium resembling an octopus pot. Which of the following is the most likely cause for the ST segment elevation?

      Your Answer: Takotsubo cardiomyopathy

      Explanation:

      Causes for ST segment elevation other than myocardial infarction
      Natural variants
      -Early repolarization
      -Left ventricular hypertrophy and hypertrophic cardiomyopathy
      -Left bundle branch block
      Artefacts
      -Leads mispositioning
      -Electrical cardioversion
      Cardiovascular diseases
      -Pericarditis/ Myocarditis
      -Aortic dissection
      -Prinzmetal’s angina
      -Takotsubo Cardiomyopathy
      -Brugada Syndrome and arrhythmogenic right ventricular cardiomyopathy/dysplasia
      Pulmonary diseases
      -Pulmonary thromboembolism
      -Pneumothorax
      -Atelectasis and pulmonary metastases
      Gastrointestinal diseases
      -Acute pancreatitis
      -Acute cholecystitis
      Other conditions
      -Hyperkalaemia
      -Drug induced ST segment elevation (e.g. – clozapine)
      -Haemorrhagic cerebrovascular disease

      Coronary artery disease and myocardial infarction can be excluded with a negative angiogram and a slightly elevated troponin. Hypertrophic cardiomyopathy can be excluded with cardiovascular MR findings. Left ventricular aneurysm usually occurs following a myocardial infarction, but there is no positive history for that. The characteristic findings on cardiovascular MR confirms the diagnosis of Takotsubo cardiomyopathy.

    • This question is part of the following fields:

      • Cardiology
      47.8
      Seconds

  • Question 17 - A 65 yr. old male with a history of smoking and alcohol was...

    Correct

    • A 65 yr. old male with a history of smoking and alcohol was admitted with an ST elevation myocardial infarction. He was obese and lives a sedentary lifestyle. What is the non-pharmacological intervention which will be most helpful to reduce future ischaemic events?

      Your Answer: Stopping smoking

      Explanation:

      Stopping smoking is the single most effective non-pharmacological intervention which will reduce future ischaemic events. But the rest of the responses are also important interventions with regards to reducing future ischaemic events.

    • This question is part of the following fields:

      • Cardiology
      11.1
      Seconds

  • Question 18 - A 68 yr. old male with history of poorly controlled hypertension was admitted...

    Correct

    • A 68 yr. old male with history of poorly controlled hypertension was admitted with shortness of breath on exertion, orthopnoea for three months. He was diagnosed with congestive cardiac failure and was started on digoxin 62.5 Ī¼g daily, furosemide 80mg daily and amiloride 10mg daily. On admission his lab results showed that his serum urea was 6 mmol/L and serum creatinine was 115 Ī¼mol/L. One month later he came for a follow up consultation. On examination he had bilateral ankle oedema. His blood pressure was 138/90 mmHg and pulse rate was 92 bpm. His JVP was not elevated. His apex beat was displaced laterally and he had a few bibasal crepitations on auscultation. There were no cardiac murmurs. His investigation results revealed the following: Serum sodium 143 mmol/L (137-144), Serum potassium 3.5 mmol/L (3.5-4.9), Serum urea 8 mmol/L (2.5-7.5), Serum creatinine 140 Ī¼mol/L (60-110), Serum digoxin 0.7 ng/mL (1.0-2.0). CXR showed cardiomegaly and a calcified aorta. ECG showed left ventricular hypertrophy. Which of the following is the most appropriate next step in the management of this patient?

      Your Answer: Add an ACE inhibitor to the current regimen

      Explanation:

      From the given history the patient has NYHA grade III heart failure. He can be safely started on an ACE inhibitor as his serum potassium was towards the lower limit. As there an impairment of renal function, his urea, creatinine and serum electrolytes should be closely monitored after commencing an ACE inhibitor. Adding atenolol will not have any clinical benefit. Increasing the digoxin dose is not needed as the patient is in sinus rhythm. Increasing furosemide will only have symptomatic relief.

    • This question is part of the following fields:

      • Cardiology
      92.2
      Seconds

  • Question 19 - Which of the following features of the jugular venous waveform indicates the closure...

    Correct

    • Which of the following features of the jugular venous waveform indicates the closure of the tricuspid valve?

      Your Answer: c wave

      Explanation:

      The a wave indicates atrial contraction. The c wave indicates ventricular contraction and resulting bulging of the tricuspid valve into the right atrium during isovolumetric systole. The v wave indicates venous filling. The x descent indicates the atrium relaxation and the movement of tricuspid valve downward. The y descent indicates the filling of the ventricle after the opening of the tricuspid valve.

    • This question is part of the following fields:

      • Cardiology
      7.5
      Seconds

  • Question 20 - A 24 yr. old male with a history of a cardiac murmur which...

    Correct

    • A 24 yr. old male with a history of a cardiac murmur which was not properly followed up, presented with right sided hemiparesis. His blood pressure was 120/70 mmHg. His ECG revealed right bundle branch block with right axis deviation. Which of the following is the most likely cause for this presentation?

      Your Answer: Ostium secundum atrial septal defect

      Explanation:

      Ostium secundum atrial septal defects are known to cause stroke due to the passage of emboli from the right sided circulation to the left sided circulation. ECG shows tall, peaked P waves (usually best seen in leads II and V2) and prolongation of the PR interval, rSR pattern in leads V3 R and V1 as well as right axis deviation.

    • This question is part of the following fields:

      • Cardiology
      41.8
      Seconds

  • Question 21 - A 60 yr. old patient with hypertension attended his regular clinic. His compliance...

    Correct

    • A 60 yr. old patient with hypertension attended his regular clinic. His compliance was poor. His blood pressure was 180/100 mmHg. His pulse rate was 85 bpm which was irregularly irregular. On examination there was bibasal crepitation. No murmurs were heard. What is the most likely cause for these findings?

      Your Answer: Left ventricular hypertrophy

      Explanation:

      Left ventricular hypertrophy due to long standing hypertension is the most probable cause. The irregularly irregular pulse was suggestive of atrial fibrillation, which is due to diastolic dysfunction. Poor ventricular filling causes pulmonary congestion which manifests as bibasal crepitations.

    • This question is part of the following fields:

      • Cardiology
      25.7
      Seconds

  • Question 22 - A 65 yr. old male patient presented with acute severe central chest pain...

    Correct

    • A 65 yr. old male patient presented with acute severe central chest pain for one hour. His ECG confirmed the diagnosis of acute ST elevation myocardial infarction and he was treated with thrombolysis. Two days later he developed sudden onset breathlessness and became unwell. On examination he had bibasal crepitation and a systolic murmur at the apex which radiated to the axilla. Which of the following is the most likely cause for this presentation?

      Your Answer: Ruptured papillary muscle

      Explanation:

      The most likely cause for acute breathlessness is due to papillary muscle rupture which causes mitral regurgitation.

    • This question is part of the following fields:

      • Cardiology
      29
      Seconds

  • Question 23 - A 70 yr. old female was brought in by the paramedics after she...

    Correct

    • A 70 yr. old female was brought in by the paramedics after she collapsed whilst shopping. She has a tachycardia of 150 bpm and her BP is 100/60 mmHg. Her ECG showed a broad complex tachycardia. Which of the following is more suggestive of a ventricular tachycardia (VT) over a supraventricular tachycardia (SVT) with aberrant conduction?

      Your Answer: Atrioventricular dissociation

      Explanation:

      To differentiate VT from SVT with aberrant conduction the following electrocardiographic features should be looked for:

      Evidence of preceding atrial activity for SVT. Oesophageal leads are helpful if P waves are hidden in the QRS complex.
      QRS duration more than 140 ms for VT.
      QRS morphology: Features of QRS morphology that favour SVT are RBBB or triphasic patterns like rSR in V1 and qRS in V6. Monophasic pattern like R or qR in V1 and rS or QS in V6 or multiple morphology QRS complexes favour VT.
      AV dissociation for VT.

    • This question is part of the following fields:

      • Cardiology
      14.9
      Seconds

  • Question 24 - A 28 yr. old male was screened for hypertrophic cardiomyopathy (HOCM). His father...

    Correct

    • A 28 yr. old male was screened for hypertrophic cardiomyopathy (HOCM). His father has passed away recently at the age of 48 and found to have HOCM during post mortem examination. On examination of this patient his BP was 142/84 mmHg and pulse rate was 68 bpm which was regular. There was a mid systolic murmur and a double apex beat. Echocardiography showed a septal wall thickness of 3.3 cm. What is the factor most closely linked to his 20 year risk of sudden cardiac death?

      Your Answer: Septal wall thickness of 3.3 cm

      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 ā‰„ 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
      71.8
      Seconds

  • Question 25 - A 32 yr. old male who was on methadone has suddenly collapsed while...

    Correct

    • A 32 yr. old male who was on methadone has suddenly collapsed while running and was found dead. What is the most likely cause for his death?

      Your Answer: Prolonged QT

      Explanation:

      Methadone and cocaine can cause QT prolongation through the direct effects on the resting membrane potential. Methadone can increase QT dispersion in addition to QT interval. Methadone inhibits the Human Ether-a-go-go Related Gene (hERG) and causes QTc prolongation and development of Torsades de point. Brugada-like syndrome is another condition found in methadone users which predisposes the users to life-threatening ventricular tachycardia and sudden cardiac death.

    • This question is part of the following fields:

      • Cardiology
      3.9
      Seconds

  • Question 26 - 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
      14.7
      Seconds

  • Question 27 - 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
      47.7
      Seconds

  • Question 28 - A 72 yr. old male with a history of type II diabetes mellitus...

    Correct

    • A 72 yr. old male with a history of type II diabetes mellitus and hypertension for 15 years, presented with gradual onset difficulty in breathing on exertion and bilateral ankle swelling for the past 3 months. On examination he had mild ankle oedema. His JVP was not elevated. His heart sounds were normal but he had bibasal crepitations on auscultation. Which of the following clinical signs has the greatest sensitivity in detecting heart failure in this patient?

      Your Answer: Third heart sound

      Explanation:

      The presence of a third heart sound is the most sensitive indicator of heart failure. AllĀ of the other signs can be found in heart failure with varying degrees.

    • This question is part of the following fields:

      • Cardiology
      49
      Seconds

  • Question 29 - A 30 yr. old primigravida in her 23rd week of pregnancy presented with...

    Correct

    • A 30 yr. old primigravida in her 23rd week of pregnancy presented with palpitations. Her ECG showed supraventricular tachycardia (SVT). 15 minutes after admission the SVT spontaneously reverted to sinus rhythm. She had two episodes of SVT later which were associated with palpitations. Which of the following is the most appropriate treatment for this presentation?

      Your Answer: Verapamil

      Explanation:

      Both long-acting calcium channel blockers and beta blockers improve symptoms of patients with SVT. Verapamil does not have adverse maternal or fetal side effects which would suggest that the use of verapamil in the treatment of supraventricular arrhythmias in pregnancy is safe and effective. Beta blockers are associated with intrauterine fetal growth restriction.

    • This question is part of the following fields:

      • Cardiology
      21.1
      Seconds

  • Question 30 - A 75 yr. old male with rheumatoid arthritis underwent a colectomy 2 days...

    Correct

    • A 75 yr. old male with rheumatoid arthritis underwent a colectomy 2 days ago for colon cancer. He was put on a prophylactic dose of low molecular weight heparin post operatively as well as prednisolone. Now he complains of central chest pain and his ECG revealed an acute ST elevation myocardial infarction. He was given aspirin and oxygen as the initial treatment. Which of the following is the most appropriate management for this patient?

      Your Answer: IV diamorphine + arrange percutaneous coronary intervention

      Explanation:

      There is a high risk of bleeding due to recent surgery and heparin. So thrombolysis is not an option. The most appropriate management is percutaneous coronary intervention.

    • This question is part of the following fields:

      • Cardiology
      28.8
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Cardiology (26/30) 87%
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